• Title/Summary/Keyword: Rate function

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Clinical Observations of the Drug Induced Hepatitis during Antituberculosis Medication (항결핵제 투여 중 나타난 간기능 장애의 임상적 고찰)

  • Park, Moon-Hwan;Yun, Sang-Won;Kim, Kung-Ho;Lee, Mung-Sun;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.405-412
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    • 1994
  • Background: In Korea, the prevalence of tuberculosis and hepatitis is high, and combined therapy with rifampicin and pyrazinamide is used in tuberculosis, so drug induced hepatitis is not only problem of tuberculosis therapy but also cause of treatment failure. However most of recent reports on drug induced hepatitis during antituberculosis medication have dealt with its pathogenesis and have stressed the biochemical, and histopathological aspects of the disorder, whereas this study was designed primarily to provide information on the clinical features. Method: The subjects of study were 1414 patients treated with antituberculosis drugs on the department of chest medicine at National Medical Center during the 5-year 6-month period from January 1, 1988, to June 30, 1993. Retrospective analysis of clinical features for the 29 patients who developed drug induced hepatitis was done. Results: 1) The incidence of antituberculosis drug induced hepatitis was 2.1%. 2) Male to fema1e ratio of antituberculosis drug induced hepatitis was 2:1, but case rates among males and females were not significantly different. 3) Rates of drug induced hepatitis according to age distribution shows the most common incidence between 35 to 49 year old age group, but rates among groups of age were not significant1y different. 4) Drug induced hepatitis was most common in the case of moderate advanced pulmonary tuberculosis(rate is 2.78%), but rates among types of tuberculosis were not significant1y different. 5) 18 cases(62%) of antituberculosis drug induced hepatitis patients had no signs or symptoms. In remaining cases, they were nausea, vomiting, jaundice, hepatomegaly, icteric sclera, right upper quadrant tenderness in order. 6) 22 cases(76%) of antituberculosis drug induced hepatitis cases had occured within the first month. 7) The duration of abnormal liver function was $28{\pm}5$(Mean${\pm}$SD), ranged from 5 days to 180 days. 8) One case of antituberculosis drug induced hepatitis died. 9) The levels of abnormal GOT ranged from 64 to 1055U/L and GPT from 68 to 931U/L. Conclusion: There are no dicided predisposing factors of antituberculosis drug induced hepatitis, so it should be done biochemical monitoring as well as close monitoring for overt signs or symptoms of hepatitis to avoid the development of irreversible hepatic reaction, especially at the treatment of the first month.

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Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis (과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증)

  • Chung, Jae-Kyung;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.40-44
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    • 2011
  • Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

Characteristics of Percutaneous Absorption of Glycol ethers (Glycol ethers에 대한 피부 투과 특성)

  • Lee, Han-Seob;Choi, Sung-Boo;Kim, Nac-Joo;Keun, Jang-Hyoun;Hwang, Hyun-Suk;Baek, Jung-Hun;Choi, Jin-Ho;Lee, Ho-Joon
    • Journal of the Korean Applied Science and Technology
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    • v.30 no.1
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    • pp.116-126
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    • 2013
  • Glycol ethers are a group of solvents based on alkyl ethers of ethylene glycol commonly used in paints. These solvents typically have a higher boiling point, together with the favorable solvent properties of lower-molecular weight ethers and alcohols. The word "Glycol ethers" was registered as a United States trademark by Union Carbide Corp. Typically, glycol ethers are found in pharmaceuticals, sunscreens, cosmetics, inks, dyes and water based paints. On the other hand, glycol ethers are used in degreasers, cleaners, aerosol paints and adhesives. Most glycol ethers are relatively water soluble, biodegradable and only a few are considered toxic. Therefore, they are unlikely to pose an adverse risk to the environment. Recent study suggests that occupational exposure to glycol ethers is related to low motile sperm count in men, but the finding has been disputed by others. In this study, skin permeation of 3 types glycol ethers were studied in vitro using matrix such as solvent and detergent. The absorption of glycol ethers[methyl glycol ethers(MC), ethyl glycol ethers(EC) and butyl glycol ethers(BC)] has been measured in vitro through rat skin. Epidermal membranes were set up in Franz diffusion cells and their permeability to PBS measured to establish the integrity of the skin before the glycol ethers were applied to the epidermal surface. Absorption rates for each glycol ethers were determined and permeability assessment made to quantify any irreversible alterations in barrier function due to contact with the esters. Types of glycol ethers in vitro experimental results on MC> EC> BC quickly appeared in the following order: skin permeation was beneficial to the skin permeation small molecular weight, the difference in chemical structure, such as hydrophilic, because with the partition coefficient and solubility mechanisms and passive diffusion to increase the speed at which transmission is considered.

Development of Automated Region of Interest for the Evaluation of Renal Scintigraphy : Study on the Inter-operator Variability (신장 핵의학 영상의 정량적 분석을 위한 관심영역 자동설정 기능 개발 및 사용자별 분석결과의 변화도 감소효과 분석)

  • 이형구;송주영;서태석;최보영;신경섭
    • Progress in Medical Physics
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    • v.12 no.1
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    • pp.41-50
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    • 2001
  • The quantification analysis of renal scintigraphy is strongly affected by the location, shape and size of region of interest(ROI). When ROIs are drawn manually, these ROIs are not reproducible due to the operators' subjective point of view, and may lead to inconsistent results even if the same data were analyzed. In this study, the effect of the ROI variation on the analysis of renal scintigraphy when the ROIs are drawn manually was investigated, and in order to obtain more consistent results, methods for automated ROI definition were developed and the results from the application of the developed methods were analyzed. Relative renal function, glomerular filtration rate and mean transit time were selected as clinical parameters for the analysis of the effect of ROI and the analysis tools were designed with the programming language of IDL5.2. To obtain renal scintigraphy, $^{99m}$Tc-DTPA was injected to the 11 adults of normal condition and to study the inter-operator variability, 9 researchers executed the analyses. The calculation of threshold using the gradient value of pixels and border tracing technique were used to define renal ROI and then the background ROI and aorta ROI were defined automatically considering anatomical information and pixel value. The automatic methods to define renal ROI were classified to 4 groups according to the exclusion of operator's subjectiveness. These automatic methods reduced the inter-operator variability remarkably in comparison with manual method and proved the effective tool to obtain reasonable and consistent results in analyzing the renal scintigraphy quantitatively.

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A Study on Shape Optimization of Plane Truss Structures (평면(平面) 트러스 구조물(構造物)의 형상최적화(形狀最適化)에 관한 구연(究研))

  • Lee, Gyu won;Byun, Keun Joo;Hwang, Hak Joo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.5 no.3
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    • pp.49-59
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    • 1985
  • Formulation of the geometric optimization for truss structures based on the elasticity theory turn out to be the nonlinear programming problem which has to deal with the Cross sectional area of the member and the coordinates of its nodes simultaneously. A few techniques have been proposed and adopted for the analysis of this nonlinear programming problem for the time being. These techniques, however, bear some limitations on truss shapes loading conditions and design criteria for the practical application to real structures. A generalized algorithm for the geometric optimization of the truss structures which can eliminate the above mentioned limitations, is developed in this study. The algorithm developed utilizes the two-phases technique. In the first phase, the cross sectional area of the truss member is optimized by transforming the nonlinear problem into SUMT, and solving SUMT utilizing the modified Newton-Raphson method. In the second phase, the geometric shape is optimized utilizing the unidirctional search technique of the Rosenbrock method which make it possible to minimize only the objective function. The algorithm developed in this study is numerically tested for several truss structures with various shapes, loading conditions and design criteria, and compared with the results of the other algorithms to examme its applicability and stability. The numerical comparisons show that the two-phases algorithm developed in this study is safely applicable to any design criteria, and the convergency rate is very fast and stable compared with other iteration methods for the geometric optimization of truss structures.

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Follow-up of Children with Chronic Hepatitis B Virus Infection (B형 간염 바이러스 만성 감염 소아의 추적 관찰)

  • Hwang, Sung Hyun;Kim, Jong-Hyun;Kang, Jin-Han;Hur, Jae Kyun;Lee, Kyung Il;Oh, Jin Hee;Lee, Seung Hee;Kyun, Dae
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.73-80
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    • 2004
  • Purpose : The serial clinical findings, biochemical results, and serological hepatitis B virus(HBV) markers in Korean children with chronic HBV infection were analyzed to determine the relationships among these factors. Methods : Ninety children have been chosen from those who have visited to the Department of Pediatrics at St. Vincent's Hospital in The Catholic University of Korea from July 1st, 1995 to June 30th, 2000. The sample patients were followed up for over six months. HBV markers and liver function tests were all performed. Results : All children were asymptomatic at presentation. Eighty-three percent of the children had a history of chronic HBV infection in their families. Eighty-one percent were HBeAg positive, 16% were anti-HBe positive, while 3% were all HBeAg and anti-HBe negative. The prevalence of HBeAg among three age groups : 0~5; 6~10; and 11~15 year-old was 90%, 96% and 61% respectively. The prevalence of HBeAg in less than 10 year-old group was significantly higher than 11~15 year-old group(P=0.001). Serum ALT levels were within 40 IU/L in 64% children, 41~80 IU/L in 17%, 81~200 IU/L in 10%, and beyond 201 IU/L in 9%. The percentage of abnormality of ALT levels in HBeAg positive patients was significantly higher than that of HBeAg negative(P=0.036). Eleven of the 73 HBeAg positive children lost their HBeAg and seroconverted to anti-HBe. In these cases, all had transient elevations in ALT levels before HBeAg seroconversions. The annual rates of spontaneous seroconversion of HBeAg and HBsAg were 9.7% and 0.6%, respectively. Conclusion : Recognition of the dynamics of these changes in viral markers and biochemical findings is needed in the selection and evaluation of therapeutic regimens, establishment of treatment, and calling for controlled trials with adequate follow-up. The hepatitis B carrier state may be asymptomatic in children however, continued surveillance of carriers is important to determine the individual adverse prognostic factors of chronic HBV infections.

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An Exploratory Study on the Project Performance by PMO Capability (PMO 역량에 따른 프로젝트 성과에 관한 연구)

  • Bae, Jae-Kwon;Kim, Jin-Hwa;Kim, Sang-Yeoul
    • Asia pacific journal of information systems
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    • v.18 no.1
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    • pp.53-77
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    • 2008
  • In recent years, although numbers of corporations are bringing in PMO, they seem to be indifferent to PMO performance measurement. This demonstrates that there are also other reasons beside performance measurement of information systems (IS) project being ambiguous by introducing PMO; the lack of acknowledging the concrete function of PMO, and the scarcity of empirical study about the effect of PMO on the project members and project performance. In this sense, this study is aimed at proposing a new research model in which project success factors (i.e., standardization, management advocacy, and staff expertise) affect PMO capability (i.e., knowledge management, resources management, and problem solving competency) positively, leading to project performance (i.e., task outcomes, psychological outcomes, and organizational outcomes) eventually. To empirically test the research model, data are surveyed from PMO department and IS department. To prove the validity of the proposed research model, PLS analysis is applied with valid 132 questionnaires. By employing PLS technique, the measurement reliability and validity of research variables are tested and the path analysis is conducted to do the hypothesis testing. The path analysis results can be organized into 7 ways in large scale. First, standardization of project success factors has a positive association with knowledge management, resources management, and problem solving competency of PMO capabilities. The findings of this result indicate that the multiple or single project management should satisfy standardization in order to operate an effective PMO. Second, management advocacy of project success factors has a positive association with knowledge management, resources management, and problem solving competency. Management advocacy refers to the willingness of management to provide the required resources and authority for project success. There is agreement among researchers regarding the importance of management advocacy for favorable PMO capability. Third, staff expertise of project success factors has a positive association with knowledge management, resources management, and problem solving competency. The findings of this result indicate that the formation of an exceptional consultant or members with a proficient knowledge for staff expertise of project member is the key factor to elevate the PMO capability. Past research suggests that experience and knowledge and the resultant familiarity with the problem faced can be an important determinant of PMO capability. A capable project with appropriate staff expertise means that it enjoys a diversity of abilities and experiences. Fourth, knowledge management competency of PMO capabilities has a positive impact on psychological outcomes but has no direct effect on task outcomes and organizational outcomes. In domestic case of S. Korea, PMO was finally introduced to many other corporations in 2005 though it started bringing in 2000. Therefore, it had neither a significant impact on the task outcomes nor organizational outcomes by lacking the contents and the infrastructure of the knowledge management because the knowledge consolidation and management period of PMO is comparatively shorter by terms than other foreign nations. Fifth, resources management competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. In addition, problem solving competency of PMO capabilities has a positive association with task outcomes, psychological outcomes, and organizational outcomes. Therefore, the findings of this results stress that PMO capabilities has a positive impact on project performance. Sixth, according to the path analysis of the hypothesis, which suggested in this research, problem solving competency is the PMO capability which is the key success factor for task, psychological, and organizational outcomes as an integrated performance model. Further, the analysis reveals that problem solving competency is an important factor for integrated performance model. The finding is in line with past IS research, which affirms that the work of IS projects is essentially a problem solving endeavor. Seventh, in the path analysis of the hypothesis in this research, the path of the management advocacy $\rightarrow$ problem solving competency $\rightarrow$ organizational outcomes appears to be the most important and strongest path. In brief, the finding of this study suggests that project success factors influence PMO capability positively, and project performance as well. From the results, it can be concluded that PMO helped great improve the project success rate and project performance. This study advances research on PMO capability in three important aspects. First, the findings of our study have implications for IS theory and future research. Our study contributes to IS theory by synthesizing concepts from PMO research and project management research with those in IS research. We proposed and tested PMO capability of IS projects and the findings of our investigation provided some preliminary answers to some of the questions raised. Secondly, this thesis does not only help depicting the concept of IT governance but also approaches empirically. It makes a gradual approach to the main content, step by step, in contrary of simple standard, scholastic way of thinking. Finally, we argued that this task-oriented(technical) view is not sufficient to adequately conceptualize IS project performance. Hence, we applied that the research on organization teams, which provides a flip viewpoint to that of project management research in that it gives more weight for psychological outcomes of organizational work groups, can be very helpful in reconceptualizing the IS project performance construct. The limitations of this study are also discussed to provide research directions for future research.

Pulmonary Complications after Surgery for Esophageal Cancer (식도암 수술 후 발생한 호흡기 합병증)

  • Lee, Jang-Hoon;Lee, Jung-Cheul
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.134-139
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    • 2006
  • Background: Complications after surgery for esophageal cancer are various and not rare. Among them, pulmonary complication is well known as one of the most important insults which has negative influence on the postoperative course and results in mortality. So we attempted to analyze the factors which may have relation to postoperative pulmonary complication. Material and Method: The retrospective study was undertaken in 87 patients who underwent curative surgery for esophageal cancer from Jan. 1996 to Aug. 2005. We divided them into two groups, patients with pulmonary complication (group A, n=28), without pulmonary complication (group B, n=59). Statistical analysis was performed with Fisher's exact test. Result: The postoperative pulmonary complication developed in 28 patients ($32\%$). There was no difference between two groups in past medical history, preoperative pulmonary function, surgery time, anastomosis method, pathologic stage, and trial of neoadjuvant therapy. Age and incidence of cervical anastomosis were significantly higher in group A (p=0.001, p=0.023). The rate of routine postoperative ventilator care was significantly higher in group S (p=0.007). Chest tube indwelling time and hospital stay were significantly longer in group A (p=0.011, p=0.001). There were 6 postoperative deaths ($6.8\%$) and 5 deaths were related to pulmonary complication. Pneumonia was the most common cause of death and MRSA (methicillin resistant staphylococcus aureus) was the most common organism in sputum culture. Conclusion: Pulmonary complication after esophageal cancer surgery was the most important cause of death. Pulmonary complication was closely related to patient's age and cervical anastomosis. We think postoperative routine ventilator care is helpful for prevention of pulmonary complications, especially MRSA pneumonia, and reducing mortality.

Establishment of Featal Heart Surgery with an Improvement of the Placental Blood Flow in Cardiopulmonary Bypass Using Fetal Lamb Model (양태아를 이용한 심폐우회술에서의 태반혈류개선을 통한 태아심장수술의 기반기술 확립)

  • 이정렬;박천수;임홍국;배은정;안규리
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.11-18
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    • 2004
  • Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

Early Results of Coronary Bypass Surgery in Patients with Severe Left Ventricular Dysfunction (심한 좌심실 기능저하를 동반한 환자에서의 관상동맥 우회로 조성수술의 조기성적)

  • 정윤섭;김욱성
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.383-389
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    • 1997
  • From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

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