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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

Comparison of Water Potential Parameters in Aster scaber and Synurus deltoides Leaves Obtained from P-V Curves (P-V 곡선법에 의한 참취와 수리취의 수분포텐셜 비교)

  • Lee, Kyeong-Cheol;Jeon, Seong-Ryeol;Han, Sang-Sup
    • Korean Journal of Plant Resources
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    • v.24 no.4
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    • pp.413-418
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    • 2011
  • This study was carried out to establish a proper cultivation site and diagnose the drought-tolerance of Aster scaber and Synurus deltoides leaves by using Pressure-volume curves. In order to measure pressure-volume (P-V) curves, Aster scaber and Synurus deltoides were cut off above ground part and the tip of the cutting were placed in water, which was covered with a plastic bag. Samples were kept overnight (about 12 hours) in darkness at room temperature (20~25$^{\circ}C$) to achieve maximal turgor (full saturation). The pressure in the chamber was gradually increased from 0.3MPa to 1.8MPa by nitrogen gas. After measured, leaf samples were dried at 80$^{\circ}C$ for 48 hours and dry weight of each samples were determined. The result of the original bulk osmotic potential at maximum turgor ${\Psi}^{sat}_o$ sat was lower -0.8 MPa in Aster scaber leaves than -0.7 MPa Synurus deltoides leaves. Also the osmotic potential at incipient plasmolysis ${\Psi}^{tlp}_o$ in Aster scaber leave was -0.9 MPa. In contrast, the value of maximum bulk modulus of elasticity $E_{max}$ of Aster scaber leaves were approximately two folds higher than that of Synurus deltoides leaves. The values of the relative water content at incipient plasmolysis $RWC^{tlp}$ are all above 90% showing that the function of osmoregulation is somewhat better, and Vo/DW, Vt/DW, Ns/DW of Synurus deltoides leaves were approximately 1~2 times higher than that of Aster scaber leaves. Thus, responses to water relations of Aster scaber and Synurus deltoides such as ${\Psi}^{sat}_o$, ${\Psi}^{tlp}_o$, $E_{max}$, ${\Psi}_{P,max}$, $RWC^{tl}$ were shown that the Aster scaber leaves was slightly higher drought-tolerance than Synurus deltoides leaves. However, in both of Aster scaber and Synurus deltoides, occurring incipient plasmolysis at the high water content, have a relatively lower drought-tolerance property indicating that growth of these plants are cultivated appropriate in high moisture soil sites.

Clinicopathologic Features and Prognostic Factors for Patients with Large Gastric Tumors (대형 위암의 임상병리학적 분석 및 예후)

  • Jang, You-Jin;Park, Jung-Min;Kim, Jong-Han;Park, Sung-Soo;Kim, Chong-Suk;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.244-249
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    • 2006
  • Purpose: Tumor size has been reported to be one of the prognostic factors in the preoperative setting and 8 cm has been confirmed as a cut-off value for large gastric tumors with respect to postoperative complications. The aim of this study was to investigate the clinicopathologic features and the prognosis in patients with tumors larger than 8 cm in diameter. Materials and Methods: We retrospectively studied 2,260 patients with gastric cancer who underwent a gastrectomy from 1983 to 2001 at the Department of Surgery, Korea University College of Medicine. For a comparative analysis we divided the cases into the large and the small groups according to tumor size. The clinicopathological factors associated with large gastric tumors were analyzed by using univariate and multivariate analyses. To determine which variables were independent prognostic factors for overall survival, we applied the Cox proportional hazards model and we used P<0.05 as the cutoff value for statistical significance. Results: Univariate and multivariate analyses disclosed that tumor location (P<0.001), resection type (P<0.001), curability (P<0.001), depth of invasion (P<0.001), number of metastatic lymph nodes (P<0.001), differentiation (P<0.001) and combined resection (P<0.001) were significantly different between the two groups. The independent factors for survival identified by using the Cox proportional hazards model for large gastric tumors were nodal status (P<0.001), curative resection (P<0.001), depth of invasion (P=0.010), type of resection (P=0.018) and age (P=0.033). Conclusion: Large gastric tumors showed more aggressive local findings than their smaller counterparts. In patients with large gastric tumors, a curative resection was the most important factor for the prognosis. Therefore, we suggest that every effort should be made to do a curative gastrectomy and an accurate preoperative examination. (J Korean Gastric Cancer Assoc 2006;6:244-249)

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A Comparative Considerations of the Moat at the East and West (동.서양 해자(垓字)의 비교 고찰)

  • Jung, Yong-Jo;Park, Joo-Sung;Sim, Woo-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.3
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    • pp.29-38
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    • 2010
  • A moat is a pond or waterway paved on the outside of a fortress that is one of the facilities to prevent enemy from approaching the fortress wall or classify it as the boundary space, and this study was undertaken to find out the characteristics of the moat that was existed in the East and the West from ancient time to medieval time with the following result. First, the moat in the East was installed of natural moat and artificial moat at the same time while the moat in the West had the fortress built in naturally advantageous site to use natural most substantially more. Second, the moats of Korea were smaller in scale compared to other countries (Japan, China and the Western countries). Third, the fortresses in the East were built to protect towns or royal palace while the West had the fortress to protect the residence of kings, lords, great wealthy persons and the like, and they were used jointly with the natural moat and artificial moat to defend against the infiltration of enemy. Fourth, the Pungsujiri in the Orient is one of the numerous ideologies forming the supplementary ideologic system of Korean people that could not be denied as the perception that influences on Korean people after the Silla Dynasty, and this Pungsujiri was considered when determining the location of the castle. The moat surrounding the castle had the role to keep the good energy in the castle from escaping away. Fifth, the Ha-Ha technique in the west was designed to prevent the external power from infiltration by digging the ditch on the place applicable to the boundary of the garden site, rather than the fence. While walking around along the water-side path without knowing the existence of this ditch, when the road is discovered with the cut off in the ditch, people had the exclamation without actually recognizing such astonishment. It was originally the dike for military purpose during the medieval time that was designed to look into the garden without physical boundary surrounded with the vertical fence in the garden that by having the deep ditch like shape on the boundary line of the garden which was designed to form the farm by preventing various types of cattle from coming inside the garden and bring in the garden element for farms, forestry, agricultural land and the like.

An Experimental Study on Evaluation of Axially Compressive Buckling Strength of Corroded Temporary Steel (부식 손상된 가시설 강재의 축압축 좌굴강도 추정에 관한 실험적 연구)

  • Kim, In Tae;Lee, Myoung Jin;Shin, Chang Hee
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.15 no.6
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    • pp.135-146
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    • 2011
  • Steel structures have been generally painted to prevent corrosion damage. However, the painted film is deteriorated with increase in service life, and then corrosion damage resulting in cross sectional area occurs on steel surface. As a result, the buckling strength of steel structures can be decreased due to the corrosion damages. The evaluation method of the axial buckling strength of columns about a variety of section shapes and supporting conditions have been presented, but evaluation method of buckling strength about irregular nonprismatic columns is not established. In this study, the axial buckling strength of corroded steels was evaluated based on the buckling test results of corroded steel specimens that were cut off at a temporary steel structure. The corroded specimens were picked up total 10 specimens according to various slenderness ratio from the web of a temporary structure's main beam. The length of specimens is 200, 300, 400, 500 and 600mm respectively. The rust productions were removed by the chemical treatment. Then, the surface geometry was measured at intervals of $1{\times}1mm$ by using the optical 3D digitizing system, and the residual thickness of the specimens was calculated. The axial buckling test was performed on 10 corroded specimens and 12 non-corroded specimens under the fixed-fixed support condition. From the test results, the effect of corrosion damages on axial buckling load was investigated. Regardless of corrosion damage degree, the axial buckling strength of corroded specimens and non-corroded specimens was evaluated identically by using minimum average residual thickness or average residual thickness to minus its standard deviation. Reasonable measuring intervals of residual thickness was proposed by using the results to apply for practical works.

Examination of Urban Gardening as an Everydayness in Urban Residential Area, Haebangchon (도심주거지에 나타나는 일상문화로서의 도시정원가꾸기에 대한 고찰 - 용산구 용산동2가 해방촌을 중심으로 -)

  • Sim, Joo-Young;Zoh, Kyung-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.2
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    • pp.1-12
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    • 2015
  • This study explores urban gardening and garden culture in residential area as an everydayness that has been overlooked during the modern period urbanization and investigates the meaning and value of urban gardening from the perspective of urban formations and growth in spontaneous urban residential area, Haebangchon. The result identified that urban gardening as a meaning of contemporary culture is a new clue to improving the urban physical environment and changing the lives and community network of residents. Haebangchon is one of the few remaining spontaneous habitations in Seoul, and was created as a temporary unlicensed shantytown in 1940s. It became the representative habitation for common people in downtown Seoul through the revitalization of the 60s and the local reform through self-sustaining redevelopment projects during the 70s through the 90s. This area still contains the image of times during the 50s to the 60s, the 70s to the 80s and present, with the percentage of long-term stay residents high. Within this context, the site is divided into third quarters, and the research undertaken by observation and investigation to determine characteristics of urban gardening as an everydayness. It can be said that urban gardening and garden culture in Haebangchon is a unique location culture that has accumulated in the crevices of the physical condition and culture of life. These places are an expression of resident's desires that seeking out nature and gardening as revealed in densely-populated areas and the grounds of practical acting and participating in care and cultivation. It forms a unique, indigenous local landscape as an accumulation of everyday life of residents. Urban gardens in detached home has retained the original function of the dwelling and the garden, or 'madang', and takes on the characteristic of public space through the sharing of a public nature as well as semi-private spatial characteristic. Also, urban gardens including small kitchen garden and flowerpots that appear in the narrow streets provide pleasure as a part of nature that blossoms in narrow alley and functions as a public garden for exchanging with neighbors by sharing produce. This paper provides the concept of redefining the relationship between the private-public area that occurs between outside spaces that are cut off in a modern city.

Impact of Postoperative Oral Administration of UFT for Completely Resected pT2N0 Non-Small Cell Lung Cancer (완전 절제된 비소세포폐암 병기 IB (pT2N0) 환자에서 수술 후 UFT의 효과)

  • Lee, Jin-Gu;Park, In-Kyu;Kim, Dae-Joon;Kim, Kil-Dong;Cho, Sang-Ho;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.428-434
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    • 2007
  • Background: Recent studies have suggested that UFT may be an effective adjuvant therapy for completely resected IB (pT2N0) non-small cell lung cancer (NSCLC). We designed this study to clarify the feasibility of performing adjuvant chemotherapy with UFT for completely resected IB nor-small cell lung cancer, Material and Method: We randomly assigned patients suffering with completely resected IB non-small cell lung cancer to receive either UFT 3g for 2 year or they received no treatment. All patients had to be followed until death or the cut-off date (December 31 2006). Result: From June 2002 through December 2004, 64 patients were enrolled. Thirty five patients were assigned to receive UFT (the UFT group) and 29 patients were assigned to observation (the control group). A follow-up surrey on the 3 year survival rate was successfully completed for all the patients. The median follow-up time for all the patients was 32.8 months. In the UFT group, the median time of administration was 98 weeks (range: $2{\sim}129$ weeks). The rate of compliance was 88.2% at 6 months, 87.5% at 12 months, 80.6% at 18 month and 66.7% at 24 months. Seven recurrences (24.1%) occurred in the control group and six (17.1%) occurred in the UFT group (p=0,489). The three-year disease free survival rate was 71.3% for the control group and 82.0% for the UFT group (p=0.331). On the subgroup analysis, the three-year disease free survival rate for the patients with adenocacinoma was 45.0% for the control group and 75.2% for the UFT group (p=0.121). The three-year disease free survival rate for the patients with non-adenocarcinoma was 88.1% for the control group and 88.9% for the UFT group (p=0.964), Conclusion: Postoperative oral administration of UFT was well-tolerated. Adjuvant chemotherapy with UFT for completely resected pT2N0 adenocarcinoma of the lung could be expected to improve the disease free survival, but this failed to achieve statistical significance. A prospective randomized study for a large number of patients will be necessary.

INFLUENCE OF THE COLOR OF COMPOSITE RESINS APPLIED TO LINGUAL SURFACE ON THE LABIAL TOOTH COLOR (설측 복합레진 색상이 치아 순측 색상에 미치는 영향)

  • Mun, Seung-Hui;Park, Su-Jung;Cho, Hyun-Gu;Hwang, Yun-Chan;Oh, Won-Mann;Hwang, In-Nam
    • Restorative Dentistry and Endodontics
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    • v.34 no.4
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    • pp.309-323
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    • 2009
  • In this study we evaluated the influence of both the thickness of residual enamel and the color of the composite resins applied to lingual surface on the labial surface color. Background plates were made by randomly (A1, A2, A6D, B1, B2, B3, C1, C2, C6D) selected colors of Filtek Supreme (3M ESPE, St. Paul, U.S.A.) composite resin. Crown portion of 9 maxillary central incisors were cut off and embedded with acrylic resin except labial surface. Samples of average thickness of 2.2 mm were obtained after cutting it in a thickness of 2.5 mm from the labial surface and sandpaper polish. The shade of composite resin background was measured using Spectrophotometer ($Spectrolino^{(R)}$, GretagMacbeth, Regensdorf, Switzerland). And CIE $L^{\ast}a^{\ast}b^{\ast}$value of 2.2 mm thickness tooth samples were measured on the 9 composite resin backgrounds. And then, the cutting side of tooth samples was ground to the extent of 1.9 mm, 1.6 mm, 1.3 mm, 1.0 mm and placed on composite resin backgrounds and measured $L^{\ast}a^{\ast}b^{\ast}$values with the same method. In all samples, $L^{\ast}$value and $b^{\ast}$value seemed to have a tendency of decreasing as thickness of tooth sample becomes thinner regardless of background colors (p < 0.05). But, $a^{\ast}$value didn't show the significant differences depending on the thickness.

Utilization of Ascidian, Halocynthia roretzi -4. Browning of Ascidian meat, Halocynthia roretzi and Its Prevention- (우렁쉥이 이용에 관한 연구 -4. 우렁쉥이 육의 갈변 및 그 방지-)

  • LEE Kang-Ho;CHO Ho-Sung;KIM Dong-Soo;HONG Byeong-Il;PARK Cheon-Soo;KIM Min-Gi
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.26 no.3
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    • pp.214-220
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    • 1993
  • Browning of ascidian, Halocynthia roretzi, meat occurres very rapidly when skinned off or cut during processing and it resulted the quality loss of fresh frozen, dehydrated or fermented products. In this study, the causes of color development and prevention of browning were experimented. The browning of ascidian meat may be occurred enzymatically by a tyrosinase contained in meat and viscera which acted specifically on L-tyrosine as a substrate rather than on catechol. Activity of the enzyme in viscera was three times higher than in meat. The optimum pH and temperature on the tyrosinase activity of crude enzyme obtained from ascidian was 6.0 and $30{\sim}35^{\circ}C$, respectively. The enzyme was inactivated heating at $80^{\circ}C$ for 3 minutes or $90{\sim}100^{\circ}C$ for 1 minute and it was inhibited by $0.1{\sim}0.5mM$ solutions at ascorbic acid, sodium hydrogen sulfite, cystein, citric acid, cyanide but only sodium hydrogen sulfite treatment was effective to retard such a high content of enzyme as in case of viscera. In practical use for processing of ascidian meat browning was retarded by dipping the viscera removed ascidian meat in 0.2M citric acid for 5 minutes or $0.2\%$ sodium hydrogen sulfite solution for 1 minute resulting in sulfur dioxide residue less than 100 ppm.

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An Elementary School Children Screen Test for Attention Deficit Hyperactivity Disorder in Taegu City (대구지역 국민학교 어린이의 주의력 결핍 과잉 운동 장애 경향에 대한 선별 검사)

  • Park, Hyung-Bae;Kim, Jin-Sung;Jang, Sang-Ruyl;Park, Sung-Chan;Suh, Hye-Sao;Lee, Kwang-Hun;Kim, Young-Uck;Kim, Chang-Su
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.56-74
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    • 1995
  • The authors applied ADDES-HV parent evaluation scale for the purpose of screening test to 538 2nd grade elementary school students from March 1994 to May. The results were as follows: There was no differences in scores of ADHD between schools. In comparing the male and female between three school students, male students showed signifieant high scores (p<0.05) than female students in the score of ADDES-HV subscale and total. There was no significant differences in ADDES-HV scale between male students and female students in both ADHD patients and normal controls. In reliability test for test and retest, the reliability coefficient was higher satisfatorily and that of inattention was 0.80, inpulsivity was 0.69, hyperactivity was 0.63 and the total score was 0.82. In reliability test by internal consistancy, the Cronbach ${\alpha}$ coefficient of patient group was 0.85(p<0.05) and that of normal control was 0.84(p<0.05). The Concurrent validity between ADDES-HV scale and DSM-III-R scale was 0.57(p<0.05) in ADHD patient group and 0.84(p<0.05) in normal control group. In discriminant validity test between ADHD patient group and normal control, the ADHD patient group showed higher score(p<0.05). The total disciminant capacity of the patient group in ADDES-HV scale was 94.44%. When we regard the cut off point as standard deviation 1.5, the male student was 80 score and the female student was 69 score. In this point of view, ADDES-HV scale was proved to be the useful screening test tool for ADHD research and showed higher reliability and validity in applying to Korean subjects.

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