• Title/Summary/Keyword: cut-off ratio

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Tensile Behavior of Hybrid Fiber Reinforced Cement Composite According to the Hooked Steel Fiber and Polyvinyl Alcohol Fiber Blending Ratio and Strain Rate (후크형 강섬유와 폴리비닐알코올 섬유의 혼합 비율과 변형속도에 따른 하이브리드 섬유보강 시멘트복합체의 인장거동)

  • Son, Min-Jae;Kim, Gyu-Yong;Lee, Sang-Kyu;Kim, Hong-Seop;Nam, Jeong-Soo
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.21 no.6
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    • pp.98-105
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    • 2017
  • In this study, the fiber blending ratio and strain rate effect on the tensile behavior of hybrid fiber reinforced cement composite was evaluated. Hooked steel fiber and polyvinyl alcohol fiber were used for reinforcing fiber. The fiber blending ratio of HSF+PVA were 1.5+0.5, 1.0+1.0 and 0.5+1.5vol.%. As a results, the tensile strength, strain capacity and fracture toughness of the hooked steel fiber reinforced cement composites were improved by the increase of the bond strength of the fiber and the matrix according to increase of strain rate. However, the tensile stress sharply decreased after the peak stress because of the decrease in the number of straightened pull-out fibers by micro cracks in the matrix around hooked steel fiber. On the other hand, PVA fiber showed cut-off fracture at strain rate $10^{-6}/s$ with multiple cracks. However, at the strain rate $10^1/s$, the multiple cracks and strain capacity were decreased because of the pull-out fracture of PVA fiber. The HSF1.5PVA0.5 shown the highest tensile strength because the PVA fiber suppressed the micro cracks in the matrix around the hooked steel fiber and improved the pull-out resistance of hooked steel fiber. Thus, DIF of strain capacity and fracture toughness of HSF1.5PVA were greatly improved. In addition, the synergistic response of fracture toughness was positive because the tensile stress was slowly decreased after the peak stress by improvement of the pull-out resistance of hooked steel fiber at strain rate $10^1/s$.

Diagnostic Value of ADA Multiplied by Lymphocyte to Neutrophil Ratio in Tuberculous Pleurisy (결핵성 흉막염에서 ADA 활성도와 림프구/중성구 비의 곱의 진단적 유용성)

  • Jeon, Eun Ju;Kwak, Hee Won;Song, Ju Han;Lee, Young Woo;Jeong, Jae Woo;Choi, Jae Cheol;Shin, Jong Wook;Kim, Jae Yeol;Park, In Won;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.17-23
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    • 2007
  • Background: Many diagnostic approaches for defining the definitive cause of pleurisy should be included due to the large variety of diseases resulting in pleural effusion. Although ADA is a useful diagnostic tool for making a differential diagnosis of pleural effusion, particularly for tuberculous pleural effusion, a definitive diagnostic cut-off value remains problematic in Korea. It was hypothesized that ADA multiplied by the Lymphocyte/Neutrophil ratio(L/N ratio) might be more powerful for making a differential diagnosis of pleural effusion. Methods: One hundred and ninety patients, who underwent thoracentesis and treatment in Chung-Ang University Hospital from January, 2005 through to February 2006, were evaluated. The clinical characteristics, radiologic data and the examination of the pleural effusion were analyzed retrospectively. Results: 1. Among the 190 patients, 59 patients (31.1%) were diagnosed with tuberculous pleurisy, 45 patients(23.7%) with parapneumonic effusion, 42 patients(22.1%) with malignant effusions, 36 patients(18.9%) with transudate, and 8 patients(4.2%) with empyema. One hundred and twenty one patients were found to have an ADA activity of 1 to 39 IU/L(63.7%). Twenty-nine were found to have an ADA activity of 40 to 75 IU/L(15.3%) and 40 were found to have an ADA activity of 75 IU/L or greater(21.0%). 2. Among the patients with tuberculous pleurisy, 5(8%), 18(30%) and 36 patients(60%) had an ADA activity ranging from 1 to 39 IU/L, 40 to 75 IU/L, and 75 IU/L or greater, respectively. In those with an ADA activitiy 40 to 75 IU/L, 18 patients(62%) had tuberculous pleurisy, 9(31%) had parapneumonic effusion and empyema, and 1(3.4%) had a malignant effusion. 3. In those with an ADA activity of 40 to 75 IU/L, there was no significant difference between tuberculous pleurisy and non-tuberculous pleural effusion(tuberculous pleurisy : 61.3 ${\pm}$ 9.2 IU/L, non-tuberculous pleural effusion : 53.3${\pm}$10.5 IU/L). 4. The mean L/N ratio of those with tuberculous pleurisy was 39.1 ${\pm}$ 44.6, which was significantly higher than nontuberculous pleural effusion patients (p<0.05). The mean ADA x L/N ratio of the tuberculous pleurisy patients was 2,445.7 ${\pm}$ 2,818.5, which was significantly higher than the non-tuberculous pleural effusion patients (level p<0.05). 5. ROC analysis showed that the ADA x L/N ratio had a higher diagnostic value than the ADA alone in the group with an ADA between 40-75 IU/L. Conclusion: The ADA multiplied by the lymphocyte-to-neutrophil ratio might provide a more definitive diagnosis of tuberculous pleurisy.

Studies on the Drying Mechanism of Stratified Soil-Comparison between Bare Surface and Grass plot- (성층토양의 건조기구에 관한 연구)

  • 김철기
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.15 no.1
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    • pp.2913-2924
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    • 1973
  • This study was to investigate the drying mechanism of stratified soil by investigating 'effects of the upper soil on moisture loss of the lower soil and vice versa' and at the same time by examining how the drying progressed in the stratified soils with bare surface and with vegetated surface respectively. There were six plots of the stratified soils with bare surface($A_1- A_6$ plot) and the same other six plots($B_1- B_5$ plot), with vegetated surface(white clover). These six plots were made by permutating two kinds of soils from three kinds of soils; clay loam(CL). Sandy loam(SL). Sand(s). Each layer was leveled by saturating sufficient water. Depth of each plot was 40cm by making each layer 20cm deep and its area. $90{\times}90(cm^2)$. The cell was put at the point of the central and mid-depth of the each layer in the each plot in order to measure the soil moisture by using OHMMETER. soil moisture tester, and movement of soil water from out sides was cut off by putting the vinyl on the four sides. The results obtained were as follow; 1. Drying progressed from the surface layer to the lower layer regardless of plots. There was a tendency thet drying of the upper soil was faster than that of the lower soil and drying of the plot with vegetated surface was also faster than that of the plot with bare surface. 2. Soil moisture was recovered at approximately the field capacity or moisture equivalent by infiltration in the course of drying, when there was a rainfall. 3. Effects of soil texture of the lower soil on dryness of the upper soil in the stratified soil were explained as follows; a) When the lower soil was S and the upper, CL or SL, dryness of the upper soils overlying the lower soil of S was much faster than that overlying the lower soil of SL or CL, because sandy soil, having the small field capacity value and playing a part of the layer cutting off to some extent capillary water supply. Drying of SL was remarkably faster than that of CL in the upper soil. b) When the lower soil was SL and the upper S or CL, drying of the upper soil was the slowest because of the lower SL, having a comparatively large field capacity value. Drying of CL tended to be faster than that of S in the upper soil. c) When the lower soil was CL and the upper S or SL, drying of the upper soil was relatively fast because of the lower CL, having the largest field capacity value but the slowest capillary conductivity. Drying of SL tended to be faster than that of S in the upper soil. 4. According to a change in soil moisture content of the upper soil and the lower soil during a day there was a tendency that soil moisture contents of CL and SL in the upper soil were decreased to its minimum value but that of S increased to its maximum value, during 3 hours between 12.00 and 15.00. There was another tendency that soil moisture contents of CL, SL and S in the lower soil were all slightly decreased by temperature rising and those in a cloudy day were smaller than those in a clear day. 5. The ratio of the accumulated soil moisture consumption to the accumulated guage evaporation in the plot with vegetated surface was generally larger than that in the plot with bare surface. The ratio tended to decrease in the course of time, and also there was a tendency that it mainly depended on the texture of the upper soil at the first period and the texture of the lower soil at the last period. 6. A change in the ratio of the accumulated soil moisture consumption was larger in the lower soil of SL than in the lower soil of S. when the upper soil was CL and the lower, SL and S. The ratio showed the biggest figure among any other plots, and the ratio in the lower soil plot of CL indicated sligtly bigger than that in the lower soil plot of S, when the upper soil was SL and the lower, CL and S. The ratio showed less figure than that of two cases above mentioned, when the upper soil was S and the lower CL and SL and that in the lower soil plot of CL indicated a less ratio than that in the lower soil plot of SL. As a result of this experiments, the various soil layers wero arranged in the following order with regard to the ratio of the accumulated soil moisture consumption: SL/CL>SL/S>CL/SL>CL/S$\fallingdotseq$S/SL>S/CL.

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Differentiation of Recurrent Rectal Cancer and Postoperative Fibrosis: Preliminary Report by Proton MR Spectroscopy (재발성 직장암과 수술 후 섬유화의 감별 진단: 수소 MRS에 의한 예비보고)

  • Jeon Yong Sun;Cho Soon Gu;Choi Sun Keun;Kim Won Hong;Kim Mi Young;Suh Chang Hae
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.1
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    • pp.24-31
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    • 2004
  • Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

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The Distribution Pattern of Lymphocyte Subsets according to the Level of Serum Albumin in Preoperative Patients with Gastric Cancer (위암 환자에서 수술 전 혈청 알부민수치에 따른 림프구아형의 분포양상)

  • Choi, Sang-Kyung;Son, Sun-Hyang;Lee, Sung-Hyen;Park, Soon-Tae;Ha, Woo-Song;Hong, Soon-Chan;Lee, Young-Joon;Jung, Eun-Jung;Jeong, Chi-Young;Joo, Young-Tae;Sung, Jung-Youp
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.106-112
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    • 2005
  • Purpose: Considering that nutritional state correlates to immunity, we performed this study to evaluate the correlation by assessing the numerical changes of the levels of serum albumin and lymphocyte subsets. Materials and Methods: The study was performed on patients who were diagnosed as having gastric cancer and who underwent curative surgery from August 1998 to August 2004 in the Gyeongsang National University Hospital and whose peripheral blood lymphocyte subsets were tested prior to surgery. The study population was a total of 150 cases. Results: The change in the lymphocyte subsets in relation to the change in the level of serum albumin in all patients with gastric cancer was determined, and was compared to disease stages. When patients were classified by using the level of serum albumin with 3.2 mg/dl as the cut-off point (low group: serum albumin <3.2 mg/dl, normal group = serum albumin $\geq$ 3.2 mg/dl), the number of peripheral blood lymphocytes, CD3+ cells, CD4+ cells, CD8+ cells, and CD16+ 56 cells were, significantly lower in the group with the level of serum albumin below 3.2 mg/dl (low group) than it was in the group with a serum albumin level above 3.2 mg/dl (normal group) (P<0.05). In stage I (n=59), CD16+56 cells were significantly lower in the low group. In stage II (n=29), the number of CD16+56 cells was lower and the ratio of CD4+/CD8+ was higher in the low group than in the normal group significantly. In stage IV (n=33), except for CD19+ cells, the number of all lymphocyte subsets was significantly lower and the ratio of CD4+/CD8+ was significantly higher in the low group. Conclusion: The group with a low level of serum albumin had a low absolute number of lymphocyte subsets. Based on this, we reconfirmed that the nutritional state is closely related with the immune state in patients with gastric cancer.

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A Validation Study for the Practical Use of Screening Scale for Potential Drug-use Adolescents(SPDA) (청소년 약물사용 잠재군 선별척도(SPDA) 활용을 위한 타당화 연구)

  • Lee, Ki-Young;Kim, Young-Mi;Im, Hyuk;Park, Mi-Jin;Park, Sun-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.305-335
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    • 2005
  • This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.

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Performance evaluation of hyperspectral bathymetry method for morphological mapping in a large river confluence (초분광수심법 기반 대하천 합류부 하상측정 성능 평가)

  • Kim, Dongsu;Seo, Youngcheol;You, Hojun;Gwon, Yeonghwa
    • Journal of Korea Water Resources Association
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    • v.56 no.3
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    • pp.195-210
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    • 2023
  • Additional deposition and erosion in large rivers in South Korea have continued to occur toward morphological stabilization after massive dredging through the four major river restoration project, subsequently requiring precise bathymetry monitoring. Hyperspectral bathymetry method has increasingly been highlighted as an alternative way to estimate bathymetry with high spatial resolution in shallow depth for replacing classical intrusive direct measurement techniques. This study introduced the conventional Optimal Band Ratio Analysis (OBRA) of hyperspectral bathymetry method, and evaluated the performance in a domestic large river in normal turbid and flow condition. Maximum measurable depth was estimated by applying correlation coefficient and root mean square error (RMSE) produced during OBRA with cascadedly applying cut-off depth, where the consequent hyperspectral bathymetry map excluded the region over the derived maximum measurable depth. Also non-linearity was considered in building relation between optimal band and depth. We applied the method to the Nakdong and Hwang River confluence as a large river case and obtained the following features. First, the hyperspectal method showed acceptable performance in morphological mapping for shallow regions, where the maximum measurable depth was 2.5 m and 1.25 m in the Nakdong and Hwang river, respectively. Second, RMSE was more feasible to derive the maximum measurable depth rather than the conventional correlation coefficient whereby considering various scenario of excluding range of in situ depths for OBRA. Third, highly turbid region in Hwang River did not allow hyperspectral bathymetry mapping compared with the case of adjacent Nakdong River, where maximum measurable depth was down to half in Hwang River.

Differential Diagnosis By Analysis of Pleural Effusion (흉수분석에 의한 질병의 감별진단)

  • Ko, Won-Ki;Lee, Jun-Gu;Jung, Jae-Ho;Park, Mu-Suk;Jeong, Nak-Yeong;Kim, Young-Sam;Yang, Dong-Gyoo;Yoo, Nae-Choon;Ahn, Chul-Min;Kim, Sung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.559-569
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    • 2001
  • Background : Pleural effusion is one of the most common clinical manifestations associated with a variety of pulmonary diseases such as malignancy, tuberculosis, and pneumonia. However, there are no useful laboratory tests to determine the specific cause of pleural effusion. Therefore, an attempt was made to analyze the various types of pleural effusion and search for useful laboratory tests for pleural effusion in order to differentiate between the diseases, especially between a malignant pleural effusion and a non-malignant pleural effusion. Methods : 93 patients with a pleural effusion, who visited the Severance hospital from January 1998 to August 1999, were enrolled in this study. Ultrasound-guided thoracentesis was done and a confirmational diagnosis was made by a gram stain, bacterial culture, Ziehl-Neelsen stain, a mycobacterial culture, a pleural biopsy and cytology. Results : The male to female ratio was 56 : 37 and the average age was $47.1{\pm}21.8$ years. There were 16 cases with a malignant effusion, 12 cases with a para-malignant effusion, 36 cases with tuberculosis, 22 cases with a para-pneumonic effusion, and 7 cases with transudate. The LDH2 fraction was significantly higher in the para-malignant effusion group compared to the para-pneumonic effusion group [$30.6{\pm}6.4%$ and $20.2{\pm}7.5%$, respectively (p<0.05)] and both the LDH1 and LDH2 fraction was significantly in the para-malignant effusion group compared to those with tuberculosis [$16.4{\pm}7.2%$ vs. $7.6{\pm}4.7%$, and $30.6{\pm}6.4%$ vs.$17.6{\pm}6.3%$, respectively (p<0.05)]. The pleural effusion/serum LDH4 fraction ratio was significantly lower in the malignant effusion group compared to those with tuberculosis [$1.5{\pm}0.8$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. The LDH4 fraction and the pleural effusion/serum LDH4 fraction ratio was significantly lower in the para-malignant effusion group compared to those with tuberculosis [$17.0{\pm}5.8%$ vs. $23.5{\pm}4.6%$ and $1.3{\pm}0.4$ vs. $2.1{\pm}0.6$, respectively (p<0.05)]. Conclusion : These results suggest that the LDH isoenzyme was the only useful biochemical test for a differential diagnosis of the various diseases. In particular, the most useful test was the pleural effusion/serum LDH4 fraction ratio to distinguish between a para-malignant effusion and a tuberculous effusion.

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APICAL FITNESS OF NON-STANDARDIZED GUTTA-PERCHA CONES IN SIMULATED ROOT CANALS PREPARED WITH ROTARY ROOT CANAL INSTRUMENTS (전동화일로 형성된 근관에서 비표준화 Gutta-percha Cone의 적합성)

  • Kwon, O-Sang;Kim, Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.25 no.3
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    • pp.390-398
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    • 2000
  • The purpose of this study was to evaluate the apical fitness of non-standardized gutta-percha cones in root canals prepared with rotary Ni-Ti root canal instruments of various tapers and apical tip sizes. Simulated sixty curved root canals of plastic blocks were prepared with crown-down technique using rotary root canal instruments of Maillefer ProFile$^{(R)}$ .04 and .06 taper (Maillefer Instrument SA, Switzerland). Specimens were divided into six groups and prepared as follows: Group 1, prepared up to size 25 of .04 taper ; Group 2, prepared up to size 30 of .04 taper ; Group 3, prepared up to size 35 of .04 taper ; Group 4, prepared up to size 25 of .06 taper ; Group 5, prepared up to size 30 of .06 taper ; Group 6 ; prepared up to size 35 of .06 taper. After cutting off the coronal portion of plastic, blocks perpendicular to the long axis of the canal with the use of a diamond saw, apical 5mm of canal space was analyzed. Prepared apical canal spaces were duplicated using rubber base impression material to evaluate two dimensional total area of apical canal space. Various sized gutta-percha cones were applied in the 5mm-apical canal space, which were size 25, size 30 and size 35 standardized gutta-percha cone, Diadent Dia-Pro ISO-.04$^{TM}$ and .06$^{TM}$(Diadent, Korea), and medium-fine (MF), fine (F), fine-medium (FM) and medium (M) sized non-standardized gutta-percha cones (Diadent, Korea). Coronal excess gutta-percha were cut off with a sharp blade. Photographs of impressed apical canal spaces and gutta-percha cones were taken with a CCD camera under a stereomicroscope and stored in a computer. Areas of the total canal space and gutta-percha cones were calculated using a digitalized image analysing program, CompuScope (Sungjin Multimedia Co., Korea). Ratio of apical fitness was obtained by calculating the area of gutta-percha cone to the total area of the canal space. The data were analysed statistically using One-way Analysis of Variance and Duncan's Multiple Range Test. The results were as follows: 1. In canals prepared up to size 25 ProFile$^{(R)}$ of .04 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 25 standardized ones (p<0.05). 2. In canals prepared up to size 30 ProFile$^{(R)}$ of .04 taper, non-standardized F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized MF cones occupied more canal space than size 30 standardized ones (p<0.05). 3. In canals prepared up to size 35 ProFile$^{(R)}$ of .04 taper, there was no significant difference in canal space occupation among non-standardized MF and F, size 35 standardized, and Dia-Pro ISO-.04$^{TM}$ cones (p>0.05). 4. In canals prepared up to size 25 ProFile$^{(R)}$ of .06 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$, or size 25 standardized ones (p<0.05), and Dia-Pro ISO-.06$^{TM}$, cones occupied significantly more space than size 25 standardized ones (p<0.05). 5. In canals prepared up to size 30 ProFile$^{(R)}$ of .06 taper, non-standardized FM cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized F cones occupied significantly more canal space than size 30 standardized ones (p<0.05). 6. In canals prepared up to size 35 ProFile$^{(R)}$ of .06 taper, non-standardized M and FM, Dia-Pro ISO-.06$^{TM}$ occupied significantly more canal space than size 35 standardized ones (p<0.05). In summary, in both canals prepared with .04 or .06 taper ProFile$^{(R)}$, non-standardized cones showed better fitness than Dia-Pro ISO$^{TM}$ or standardized ones, which was more characteristic in smaller canals.

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The Prognostic Role of B-type Natriuretic Peptide in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환의 급성 악화시 예후 인자로서의 혈중 B-type Natriuretic Peptide의 역할)

  • Lee, Ji Hyun;Oh, So Yeon;Hwang, Iljun;Kim, Okjun;Kim, Hyun Kuk;Kim, Eun Kyung;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.6
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    • pp.600-610
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    • 2004
  • Background : The plasma B-type natriuretic peptide(BNP) concentration increases with the degree of pulmonary hypertension in patients with chronic respiratory disease. The aim of this study was to examine the prognostic role of BNP in the acute exacerbation of chronic obstructive lung disease (COPD). Method : We selected 67 patients who were admitted our hospital because of an acute exacerbation of COPD. Their BNP levels were checked on admission at the Emergency Department. Their medical records were analyzed retrospectively. The patients were divided into two groups according to their in-hospital mortality. The patients' medical history, comobidity, exacerbation type, blood gas analysis, pulmonary function, APACHE II severity score and plasma BNP level were compared. Results : Multiple logistic regression analysis identified three independent predictors of mortality: $FEV_1$, APACHE II score and plasma BNP level. The decedents group showed a lower $FEV_1$($28{\pm}7$ vs. $37{\pm}15%$, p=0.005), a higher APACHE II score($22.4{\pm}6.1$ vs. $15.8{\pm}4.7$, p=0.000) and a higher BNP level ($201{\pm}116$ vs. $77{\pm}80pg/mL$, p=0.000) than the sSurvivors group. When the BNP cut-off level was set to 88pg/mL using the receiver operating characteristic curve, the sensitivity was 90% and the specificity was 75% in differentiating between the survivors and decedents. On Fisher's exact test, the odds ratio for mortality was 21.2 (95% CI 2.49 to 180.4) in the patients with a BNP level > 88pg/mL. Conclusion : The plasma BNP level might be a predictor of mortality in an acute exacerbation of COPD as well as the $FEV_1$ and APACHE II score.