• Korean Journal of Psychosomatic Medicine
• /
• v.27 no.2
• /
• pp.101-110
• /
• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

• Journal of Trauma and Injury
• /
• v.18 no.2
• /
• pp.161-171
• /
• 2005

Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

• Journal of Chest Surgery
• /
• v.24 no.9
• /
• pp.843-852
• /
• 1991

We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

• Korean Journal of Environmental Agriculture
• /
• v.38 no.4
• /
• pp.338-351
• /
• 2019

BACKGROUND: To investigate distribution and seasonal variation of concentration and flux of pesticides in Han river basin, water samples were examined at 24 sites in 2012 and 2014. METHODS AND RESULTS: Water samples were collected four times per year and subjected to liquid-liquid partition extraction followed by GC-ECD/NPD analysis. Of fifteen pesticides detected, iprobenfos, diazinon, isoprothiolane, endosulfan sulfate and oxadiazon were detected in a higher frequency, while fenoxanil, carbofuran, fenitrothion, butachlor and metolachlor were only detected in a sample. Pesticides with high occurrences, iprobenfos, diazinon, isoprothiolane, endosulfan sulfate and oxadiazon were detected in residue level of 0.01-0.46, 0.01-0.24, 0.03-0.85, 0.02-0.06 and 0.05-0.24 ㎍/L, respectively. Carbofuran and acetanilide herbicides were found at lower frequencies, but their concentrations were one order of magnitude higher than those of the others. CONCLUSION: Discharge of pesticides in downstream area were mainly contributed from rice farming and suburban horticulture, while pesticide occurrences in upstream area, such as Donggang river basin were caused by highland agriculture for cabbage and potato production. Despite the influx of pesticides from tributaries through intensive agriculture areas, pesticide concentration in the main stream water was low due to the dilution effect from the upstream. Therefore, the water quality was considered to be good at the most downstream, the effluent of Paldang dam.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.1
• /
• pp.26-31
• /
• 2007

Background and Objectives：Microvascular free flap reconstruction has been revolutionized in last two decades, and became a standard option in the reconstruction of head and neck defects. We intended to review our experiences of 51 microvascular free flap for head and neck defects during 5-year period and to analyze the types of flaps according to primary sites, success and complication rates. Subjects and Methods：From Oct. 2001 through Dec. 2005, fifty one free flap reconstructions were performed in forty nine patients at ENT department of Soonchunhyang university bucheon hospital. Primary sites, pathology, T-stage, operative time, time interval of oral feeding, and various reconstructive factors such as recipient and donor vessels, free flap related complications, failure rates and salvage rates were retrospectively analyzed. The relation between complication rates and preoperative risk factors were statistically analyzed. Results：Methods of reconstruction were radial forearm free flap(RFFF)(n=28, 54.9%), anterolateral thigh free flaps(n=9, ALTFF)(17.6%), rectus abdominis free flap(n=7, RAFF)(13.7%), jejunal free flap(n=5, JFF)(9.8%), and miscellanous(n=2, 4.0%) in order. In free flap related complications, failure of free flap occurred in seven cases(13.7%) and pharyngocutaneous fistula occurred in five cases(9.8%) among fifty one free flaps. The overall success rate of free flaps was 86.3%. Salvage of free flaps was possible only one among eight cases(12.5%). In positive preoperative risk factor groups, failure of free flap was higher than in negative risk factor group. However, it was not statistically significant. Conclusion：We confirmed that free flap reconstructions are highly versatile and reliable options for use in the reconstruction of various soft tissue defects of the head and neck. Free flaps have gained great popularity given its versatility, ability for a two-team approach, and minimal donor site morbidity. However, complications related to microvascular surgery may be overcome by increased surgical experience and by intensive flap monitoring in early postoperative period.

• Journal of the Korean Society of Hazard Mitigation
• /
• v.8 no.5
• /
• pp.59-64
• /
• 2008

The urban is possessing of various landuses such as commercial, industrial, residential and official areas. All of these landuses is including the paved areas that are roads and parking lots. The NPS (nonpoint sources) pollutants are generally originated from pavement areas in urban by human activities. Especially the roads are stormwater intensive landuses because of high vehicle activities and high imperviousness. The main NPS pollutants from roads are particulates and metals from vehicles and pavements. The Korea MOE (Ministry of Environment) is developing the NPS control program to reduce the NPS pollutants from the basins. However, it is not easy to control the NPS because it has high uncertainty by characteristics of rainfalls and watersheds. Therefore, this research was conducted on characterizing the runoff and providing mean EMC from roads. The monitoring were performed for total 16 rainfall events from a road in Youngin City since 2006. The results show that the TSS is highly correlated with other pollutant parameters. The statistical regression models using TSS EMC have been developed to easily determine the EMC of other pollutant parameters.

• Journal of Internet Computing and Services
• /
• v.13 no.1
• /
• pp.37-44
• /
• 2012

Numerous scientists who are engaged in compute-intensive researches require more computing facilities than before, while the computing resource and techniques are increasingly becoming more advanced. For this reason, many works for e-Science environment have been actively invested and established around the world, but still the scientists look for an intuitive experimental environment, which is guaranteed the improved environmental facilities without additional configurations or installations. In this paper, we present an integrated scientific workflow execution environment for Scientific applications supporting workflow design with high performance computing infrastructure and accessibility for web browser. This portal supports automated consecutive execution of computation jobs in order of the form defined by workflow design tool and execution service concerning characteristics of each job to batch over distributed grid resources. Workflow editor of the portal presents a high-level frontend and easy-to-use interface with monitoring service, which shows the status of workflow execution in real time so that user can check the intermediate data during experiments. Therefore, the scientists can take advantages of the environment to improve the productivity of study based on HTC.

• Journal of Veterinary Clinics
• /
• v.31 no.2
• /
• pp.102-107
• /
• 2014

This study was conducted to analyze the results of inhalation anesthesia performed at the equine hospital of Korea Racing Authority (KRA) and to find out the influencing factors on mortality during and/or after inhalation anesthesia. Among 585 cases of anesthesia, orthopedic surgery (410) was performed the most frequently, followed by colic surgery (85) and upper airway surgery (45). Twenty out of 585 horses were either euthanized or died during and/or after anesthesia. Among those twenty horses, fourteen horses received colic surgery, three received orthopedic surgery, and three others received upper airway surgery. The major causes of mortality were rupture of intestine in colic surgery and airway obstruction during recovery in upper airway surgery. Myopathy, refracture, laminitis were the causes of mortality in orthopedic surgery. Consequently, the horses that received colic and upper airway surgeries showed significantly high mortality rate rather than horses that received orthopedic surgery (p < 0.01). According to the results, horses that received colic surgery showed the highest mortality rate from euthanasia due to poor and grave prognosis. To reduce the perioperative mortality of horses, it is recommended to perform perioperative intensive care for colic surgery and careful monitoring for upper airway surgery during recovery.

• International Journal of Highway Engineering
• /
• v.8 no.1 s.27
• /
• pp.99-106
• /
• 2006

During the dry periods, many types of pollutant are accumulating on the paved surface by vehicle activities. Particularly, the highways are stormwater intensive landuses because of high imperviousness and high pollutant mass emissions from vehicles. The accumulated pollutants in highways are washed-off during a rainfall event and are highly contributing on water quality of receiving water bodies. The stormwater runoff from the highways are containing various pollutants such as metals, oil & grease and toxic chemicals originated from vehicles. Therefore, this research is performed to find pollutant characteristics in the magnitude of statistical pollutant concentrations during storm periods. During the monitoring periods, the first-flush phenomenon is visibly occurred on most storm events, which is confirmed from hydro- and pollute-graphs. The 95% confidence intervals of washed-off pollutant concentration are ranged to 154.7-257.1 mg/L for 755,138.9-197.6 mg/L for COD, 3.5-6.4 mg/L for oil & grease, 6.3-9.2 mg/L for TN and 2.3-3.31 mg/L for TP. The first flush effect is mostly occurred within initial 30 min of storm duration.

• Archives of Plastic Surgery
• /
• v.32 no.4
• /
• pp.503-510
• /
• 2005

If we could predict the necrosis of the flap caused by reperfusion injury, we can minimize the necrosis of the flap by taking appropriate action before necrosis begins. In this study, we examined whether we can predict the survival of flap under reperfusion injury or not, by measuring laser doppler flow meter values. We divided the group into the control and experimental groups corresponding to 6, 8, 9, 10, and 12hours after reperfusion(hours after ligation of auricular central artery). In each group, we examined necrotic change, perfusion unit (PU), serum superoxide dismutase (SOD), glutathione peroxidase, angiography and pathologic findings. No necrosis was observed in the 6 and 8 hours group but 8, 18, 20 hours after ligation, necrosis was observed, Also in each of 9, 10 and 12 hours group (each group consisted of 20 flaps), necrosis were noted. According to the above data, the critical time of necrosis in the auricular skin flap model lies between about 8 to 9 hours. Comparing the PU between the necrosis and non-necrosis groups, the former group showed a mean 39.57 PU increase after 60 min of reperfusion, and the latter group showed a mean increase of 21.21 PU. We can conclude that better flow can dilute oxygen free radical into systemic circulation, and this means less injuries are caused on vessels. Our study implies that if blood flow increase is less than 30 PU, intensive care is needed to save the flap. Additionally, we found significant decrease of serum SOD and glutathione peroxidase in the necrotic group. Therefore, monitoring these serum markers will be helpful in predicting reperfusion injury and supplementing these enzymes could be helpful to save the flap. The laser doppler flow meter is thought to be helpful in clinical circumstances for evaluating the circulation of the flap after the operation. However, more accumulation of clinical studies should be necessary establishing useful clinical data.