• Journal of Medicine and Life Science
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• v.17 no.3
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• pp.80-85
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• 2020

Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.

• Genomics & Informatics
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• v.19 no.3
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• pp.31.1-31.9
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• 2021

Leptospirosis is a zoonotic disease caused by spirochetes from the genus Leptospira. In Thailand, Leptospira interrogans is a major cause of leptospirosis. Leptospirosis patients present with a wide range of clinical manifestations from asymptomatic, mild infections to severe illness involving organ failure. For better understanding the difference between Leptospira isolates causing mild and severe leptospirosis, illumina sequencing was used to sequence genomic DNA in both serotypes. DNA of Leptospira isolated from two patients, one with mild and another with severe symptoms, were included in this study. The paired-end reads were removed adapters and trimmed with Q30 score using Trimmomatic. Trimmed reads were constructed to contigs and scaffolds using SPAdes. Cross-contamination of scaffolds was evaluated by ContEst16s. Prokka tool for bacterial annotation was used to annotate sequences from both Leptospira isolates. Predicted amino acid sequences from Prokka were searched in EggNOG and David gene ontology database to characterize gene ontology. In addition, Leptospira from mild and severe patients, that passed the criteria e-value < 10e^-5 from blastP against virulence factor database, were used to analyze with Venn diagram. From this study, we found 13 and 12 genes that were unique in the isolates from mild and severe patients, respectively. The 12 genes in the severe isolate might be virulence factor genes that affect disease severity. However, these genes should be validated in further study.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.377-387
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• 1996

Background : In 1980, WHO made a definition in which the term "impairment" as applied to the respiratory system is used to describe loss of lung function, "disability" the resulting diminution in exercise capacity. The measurement of pulmonary function during exercise would give us information about overall functional capacity and respiratory performance that would be lacking in tests performed at rest. We conducted this study to investigate the role of resting pulmonary function test and exercise test for assessing impairment/disability in patients with chronic airflow obstruction(CAO). Method : We studied 19 patients with CAO. The spirometry and body plethysmograph were performed in stable condition. And then patients performed a progressive incremental exercise test to a symptom-limited maximum using cycle ergometer. Patients were divided in two groups, severe and non-severe impairment, according to the resting PFTs and compaired each other. A patient was considered to be severely impaired if FVC < 50 %, FEV1 < 40 % or FEV1/FVC < 40 %. Results : 1) The airway obstruction and hypoxemia of severe impairment group were more severe and exercise performance was markedly reduced compairing to non-severe impairment group. 2) The severe impairment group showed ventilatory limitation during exercise test and the limiting symptomes ware dyspnea in 9/10 patients. 3) The impairment and disability of the patients with tuberculous destructed lung were most marked in patients with CAO. 4) The FEV1 was the most prevalent criterion for the determination of severe impairment based on resting PFTs and was the valuable best correlated to V02max(r=0.81, p < 0.001). 5) The sensitivity of exercise limits for predicting severe disability according to resting PFTs was 80 % and specificity 89 %. Conclusion : In patients with severe CAO, FEV1 is a good predictive of exercise performance and impairment measured by resting PFTs can predict a disability by exercise test.

• Journal of the Korean Society of Safety
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• v.29 no.6
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• pp.172-178
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• 2014

In terms of an accident management, the cases causing severe core damage need to be analyzed and arranged systematically for an easy access to the results since the Three Mile Island (TMI) accident. The objectives of this paper are to explain how to identify the plant response and cope with its vulnerabilities using the probabilistic safety assessment (PSA) quantified results and severe accident database SARDB(Severe Accident Risk Data Bank) based on sequences analysis results. Although PSA has been performed for the Korean Standard Power Plants (KSNPs), and that it considered the necessary sequences for an assessment of the containment integrity. The developed Database (DB) system includes a graphical display for a plant and equipment status, previous research results by a knowledge-based technique, and the expected plant behaviour. The plant model used in this paper is oriented to the cases of loss of coolant accident (LOCA) is be used as a training simulator for a severe accident management.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.361-367
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• 2004

The following case study suggests strongly the efficacy of Danggwisusan and acupuncture therapy in the treatment of patients with severe contusion and tissue injury of the liver and kidney. The chief symptoms of this case were severe pain in the right side, purpura hemorrhagica, insomnia and third degree bums at the shoulder and face. Analysis of blood chemistry indicated high AST, high ALT, high BUN, high creatine, high creatine kinase and high LDH. Fallowing medication of the patient with Danggwisusan, the symptoms and indexes for tissue injury decreased rapidily within the first week. This results support a potential role for Danggwisusan in the treatment of severe contusion with tissue injury of the liver and kidney.

• Journal of Pharmaceutical Investigation
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• v.31 no.3
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• pp.161-165
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• 2001

Acebutolol (ABT) is almost absorbed after oral administration, but its bioavailability is reduced because of considerable first-pass metabolism in the gastrointestine and liver. The purpose of this study was to report the pharmacokinetic changes of ABT and its metabolite, diacetolol (DAT) after oral administration of acebutolol to control rabbits and rabbits with mild and severe folate-induced renal failure (FIRRs). Both of the area under the plasma concentration-time curve $(AUC^0_{\infty})$ of ABT and DAT were significantly increased in mild (p<0.05) and severe FIRRs (p<0.01), but the $AUC^0_{\infty}$ of DAT was more influenced than that of ABT in severe rabbits. There was a good correlation between serum creatinine and both of $AUC^0_{\infty}$ of ABT and DAT. The elimination half-life of ABT and DAT was significantly prolonged in mild (p<0.05) and severe (p<0.01) FIRRs, but the half-life of DAT was more influenced than that of ABT in severe FIRRs. The results suggest that the dosage of acebutolol should be adjusted according to the degree of renal disorder on the base of the serum creatinine concentration.

• Journal of muscle and joint health
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• v.11 no.2
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• pp.119-126
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• 2004

Purpose: The purpose of this study was to identify health problem and joint bleeding, disability according to severity in patients with hemophilia. Method: The research design was survey study for conformed severity in patients with hemophilia, health problem and bleeding of joint and degree of limitation. The subjects were 186 men in patients with hemophilia by convenience sampling. These results were analyzed statistically by frequency, percentage, t-test, chi-square. Result: 1. Health problem of severe hemophilia patients were significantly higher than moderate group(t=3.17, p=.002). A severe hemophilia patients were significantly higher than moderate group in health problem of socio-psychological, emotional, physical, interpersonal. 2. There was relation between severity and the frequency of bleeding($X^{2}=7.642$, p=.054). 3. A severe hemophilia patients were more than moderate group in disability of ankle joint(t=2.52, p=.013). Conclusion: A severe hemophilia patients has more severe problems than moderate patient in case of health problem, joint bleeding and degree of disability.

• Transactions of the KSME C: Technology and Education
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• v.3 no.3
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• pp.209-215
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• 2015

The effects of the mounting location of ICI cables on severe accident mitigation systems, specially IVR-ERVC (In-Vessel Retention by External Reactor Vessel Cooling) and core catcher (Ex-vessel corium retention and cooling system), are investigated. The effects of bottom-mounted ICI strategy on severe accident mitigation are summarized and advantages of top-mounted ICI to improve severe accident mitigation are also highlighted.

• Nuclear Engineering and Technology
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• v.48 no.3
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• pp.702-710
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• 2016

Global concern and interest in the safety of nuclear power plants have increased considerably since the Fukushima accident. In the event of a severe accident, the reactor vessel water level cannot be measured. The reactor vessel water level has a direct impact on confirming the safety of reactor core cooling. However, in the event of a severe accident, it may be possible to estimate the reactor vessel water level by employing other information. The cascaded fuzzy neural network (CFNN) model can be used to estimate the reactor vessel water level through the process of repeatedly adding fuzzy neural networks. The developed CFNN model was found to be sufficiently accurate for estimating the reactor vessel water level when the sensor performance had deteriorated. Therefore, the developed CFNN model can help provide effective information to operators in the event of a severe accident.

• Nuclear Engineering and Technology
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• v.49 no.2
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• pp.434-441
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• 2017

Containment venting is one of several essential measures to protect the integrity of the final barrier of a nuclear reactor during severe accidents, by which the uncontrollable release of fission products can be avoided. The authors seek to develop an optimization approach to venting operations, from a simulation-based perspective, using an integrated severe accident code, THALES2/KICHE. The effectiveness of the containment-venting strategies needs to be verified via numerical simulations based on various settings of the venting conditions. The number of iterations, however, needs to be controlled to avoid cumbersome computational burden of integrated codes. Bayesian optimization is an efficient global optimization approach. By using a Gaussian process regression, a surrogate model of the "black-box" code is constructed. It can be updated simultaneously whenever new simulation results are acquired. With predictions via the surrogate model, upcoming locations of the most probable optimum can be revealed. The sampling procedure is adaptive. Compared with the case of pure random searches, the number of code queries is largely reduced for the optimum finding. One typical severe accident scenario of a boiling water reactor is chosen as an example. The research demonstrates the applicability of the Bayesian optimization approach to the design and establishment of containment-venting strategies during severe accidents.