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Development of Simple Prediction Method for Injury Severity and Amount of Traumatic Hemorrhage via Analysis of the Correlation between Site of Pelvic Bone Fracture and Amount of Transfusion: Pelvic Bleeding Score (골반골절 환자의 골절위치와 출혈량간의 상관관계 분석을 통한 대량수혈 필요에 대한 간단한 예측도구 개발: 골반골 출혈 지수)

  • Lee, Sang Sik;Bae, Byung Kwan;Han, Sang Kyoon;Park, Sung Wook;Ryu, Ji Ho;Jeong, Jin Woo;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.139-144
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    • 2012
  • Purpose: Hypovolemic shock is the leading cause of death in multiple trauma patients with pelvic bone fracures. The purpose of this study was to develop a simple prediction method for injury severity and amount of hemorrhage via an analysis of the correlation between the site of pelvic bone fracture and the amount of transfusion and to verify the usefulness of the such a simple scoring system. Methods: We analyzed retrospectively the medical records and radiologic examination of 102 patients who had been diagnosed as having a pelvic bone fracture and who had visited the Emergency Department between January 2007 and December 2011. Fracture sites in the pelvis were confirmed and re-classified anatomically as pubis, ilium or sacrum. A multiple linear regression analysis was performed on the amount of transfusion, and a simplified scoring system was developed. The predictive value of the amount of transfusion for the scoring system as verified by using the receiver operating characteristics (ROC). The area under the curve of the ROC was compared with the injury severity score (ISS). Results: From among the 102 patients, 97 patients (M:F=68:29, mean $age=46.7{\pm}16.6years$) were enrolled for analysis. The average ISS of the patients was $16.2{\pm}7.9$, and the average amount of packed RBC transfusion for 24 hr was $3.9{\pm}4.6units$. The regression equation resulting from the multiple linear regression analysis was 'packed RBC units=1.40${\times}$(sacrum fracture)+1.72${\times}$(pubis fracture)+1.67${\times}$(ilium fracture)+0.36' and was found to be suitable (p=0.005). We simplified the regression equation to 'Pelvic Bleeding Score=sacrum+pubis+ilium.' Each fractured site was scored as 0(no fracture) point, 1(right or left) point, or 2(both) points. Sacrum had only 0 or 1 point. The score ranged from 0 to 5. The area under the curve (AUC) of the ROC was 0.718 (95% CI: 0.588-0.848, p=0.009). For an upper Pelvis Bleeding Score of 3 points, the sensitivity of the prediction for a massive transfusion was 71.4%, and the specificity was 69.9%. Conclusion: We developed a simplified scoring system for the anatomical fracture sites in the pelvis to predict the requirement for a transfusion (Pelvis Bleeding Score (PBS)). The PBS, compared with the ISS, is considered a useful predictor of the need for a transfusion during initial management.

Predictors and Frailty Level in the Frail Elderly Receiving Home Visiting Health Care Services (방문건강관리사업 대상 재가노인의 허약정도와 예측요인)

  • Park, Jeong Sook;Oh, Yun Jung
    • Journal of agricultural medicine and community health
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    • v.41 no.3
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    • pp.129-139
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    • 2016
  • Objective: The purpose of this study was to identify the predictors and frailty level in the frail elderly receiving home visiting health care services. Methods: The subjects were 177 frail elders aged over 65 registered in the home visiting health care services of three public health centers in Daegu. The data collection was performed from June 9 to June 24, 2015. This study used descriptive statistics, t-test, ANOVA, scheffe test and stepwise multiple regression by SPSS Win 18.0 program. Results: The mean of the frailty score was 10.05 (${\pm}4.52$). Age and life satisfaction were the significant factors related to the frailty score in frail elderly. Health promotion behavior, empowerment, social participation and perceived health status had a negative correlation with the frailty score. Thirty seven point four percent of the variance in the frailty score can be explained by perceived health status (${\beta}=-0.398$, p<0.001), health promotion behavior (${\beta}=-0.251$, p<0.001) and age (${\beta}=0.232$, p<0.001)(Cum $R^2=0.374$, F=25.744, p<0.001). Perceived health status was the most important factor related to the frailty score in our study. Conclusions: An integrative care program which includes these significant variables of subjects is essential to prevent the deterioration of frailty in frail elderly.

Feeding Characteristics of Chub Mackerel Scomber japonicus in the Yellow Sea of Korea in Autumn (가을철 서해에 출현하는 고등어(Scomber japonicus)의 섭식특성)

  • Hyun-Sol Park;Changsin Kim;Jae Hyeong Yang;Se Hyun Song
    • Korean Journal of Ichthyology
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    • v.35 no.4
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    • pp.278-284
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    • 2023
  • The feeding characteristics of chub mackerel, Scomber japonicus was studied using 827 specimens caught in the Yellow Sea of Korea during Autumn season from October to December 2021 and September to November 2022. The size of the specimens ranged from 21.1 to 45.1 cm in total length. S. japonicus was a carnivore that consumed mainly on fishes, such as Engraulis japonicus (%IRI=67.9). Its diet also includes small quantities of copepods, amphipods, euphausiids, cephalopods, mysids, shrimps, and crabs, etc. The estimated trophic level of S. japonicus was 3.84. The proportion of fish had increased as the body size of S. japonicus increased, whereas those of euphausiids, copepods and amphipods decreased gradually. As the body size of S. japonicus increased, the mean weight of prey per the stomach (mW/ST) tended to increase (One-way ANOVA, F=2.382, P<0.05).

Evaluation of Standardized Uptake Value applying EQ PET across different PET/CT scanners and reconstruction (PET/CT 장비와 영상 재구성 차이에 따른 EQ PET을 이용한 표준섭취계수의 평가)

  • Yoon, Seok Hwan;Kim, Byung Jin;Moon, Il Sang;Lee, Hong Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.35-42
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    • 2018
  • Purpose Standardized uptake value(SUV) has been widely used as a quantitative metric of uptake in PET/CT for diagnosis of malignant tumors and evaluation of tumor therapy response. However, the SUV depends on various factor including PET/CT scanner specifications and reconstruction parameter. The purpose of this study is to validate a EQ PET to evaluate SUV across different PET/CT systems. Materials and Methods First, NEMA IEC body phantom data were used to calculate the EQ filter for OSEM3D with PSF and TOF reconstruction from three different PET/CT systems in order to obtain EARL compliant recovery coefficients of each spheres. The Biograph true point 40 PET/CT images were reconstructed with a OSEM3D+PSF reconstruction, images of the Biograph mCT 40 and Biograph mCT 64 PET/CT scanners were reconstructed with a OSEM3D+PSF, OSEM3D+TOF, OSEM3D+PSF+TOF. Post reconstructions, the proprietary EQ filter was applied to the reconstruction data. Recovery coefficient can be estimated by ratio of measured to true activity concentration for spheres of different volume and coefficient variability(CV) value of RC for each sphere was compared. For clinical study, we compared SUVmax applying different reconstruction algorithms in FDG PET images of 61 patients with lung cancer using Biograph mCT 40 PET/CT scanner. Results For the phantom studied, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.05, 0.04, 0.04 and 0.03 respectively for RC. Application of the proprietary EQ filter, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.04, 0.03, 0.03 and 0.02 respectively for RC. Clinical study, there were no statistical significance of the difference applying EQ PET on SUVmax of 61 patients FDG PET image. (p=1.000) Conclusion This study indicates that CV values of RC in phantom were decreased after applying EQ PET for different PET/CT system and The EQ PET reduced reconstruction dependent variation in SUVs for 61 lung cancer patients, Therefore, EQ PET will be expected to provide accurate quantification when the patient is scanned on different PET/CT system.

MICROLEAKAGE AND WATER STABILITY OF RESIN CEMENTS

  • Choi Sun-Young;Lee Sun-Hyung;Yang Jae-Ho;Han Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.3
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    • pp.369-378
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    • 2003
  • Statement of Problem: Recently, resin cements have become more widely used and have been accepted as prominent luting cements. Current resin cements exhibit less microleakage than conventional luting cements. However, the constant contact with water and exposure to occlusal forces increase microleakage even in resin cements inevitably. Most bonding resins have been modified to contain a hydrophilic resin such as 2-hydroxyethylmethacrylate (HEMA) to overcome some of the problems associated with the hydrophobic nature of bonding resins. By virtue of these modifications, bonding resins absorb a significant amount of water, and there may also be significant stresses at bonding interfaces, which may adversely affect the longevity of restorations. Therefore the reinforcement of water stability of resin cement is indispensable in future study. Purpose: This study was conducted to examine the influence of water retention on microleakage of two resin cements over the period of 6 months. Materials and Methods: 32 extracted human teeth were used to test the microleakage of a single full veneer crown. Two resin cements with different components and adhesive properties - Panavia F (Kuraray Co., Osaka, Japan) and Super-Bond C&B (Sun Medical Co., Kyoto, Japan)- were investigated. The storage medium was the physiological saline solution changed every week for 1 month, 3 months, and 6 months. One group was tested after storage for 1 day. At the end of the each storage period, all specimens were exposed to thermocycling from $5^{\circ}C$ to $55^{\circ}C$ of 500 cycles and chewing simulation of 50,000 cycles, and then stained with 50% silver nitrate solution. The linear penetration of microleakage was measured using a stereoscopic microscope at ${\times}40$ magnification and a digital traveling micrometer with an accuracy of ${\pm}3{\mu}m$. Values were analyzed using two-way ANOVA test, Duncan's multiple range tests (DMRT). Results : Statistically significant difference of microleakage was shown in the 3-month group compared with the1-day or 1-month group in both systems (p<0.05) and there were statistically significant differences in microleakage between the 3-month group and the 6-month group in both systems (p<0.05). The two systems showed different tendency in the course of increased microleakage during 3 months. In Panavia F, microleakage increased slowly throughout the periods. In Super-Bond C&B, there was no significant increase of microleakage for 1 month, but there was statistically significant increase of microleakage for the next 2 months. For the mean microleakage for each period, in the 3-month group, microleakage of Super-Bond C&B was significantly greater than that of Panavia F. On the other hand, in the 6-month group, microleakage of Panavia F was significantly greater than that of Super-Bond C&B (p<0.05). Conclusion: Within the limitation of this study, water retention of two different bonding systems influence microleakage of resin cements. Further studies with the longer observation periods in viro are required in order to investigate water stability and the bonding durability of the resin cement. CLINICAL IMPLICATIONS Microleakage at the Cement-tooth interfaces did not necessarily result in the failure of the crowns. But it is considered to be a major factor influening the longerity of restorations. Further clinical approaches for decreasing the amount of microleakage are required.

Anemia and Serum Iron Status in Adolescent Female (청소년기 여학생에서 빈혈 및 철분 영양 상태)

  • Cho, Ju Rae;Kim, Soon Ki;Park, Sang Kyu;Hah, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.362-369
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    • 2002
  • Background : Anemia is still the most common nutrient deficiency worldwide, especially in adolescence because of an insufficient supply of iron, an increased iron requirement due to accelerated physical growth and blood loss due to menstruation in girls. This study was designed to assess the anemia and serum iron status of middle school girls. Methods : Hematologic examinations, physical examinations and questionnaires were performed for middle school girls in 1990, 1997, 1999 and 2000. Anemia was defined as a serum hemoglobin level of less than 11.5 g/dL. Iron deficiency was defined as a serum ferritin level of less than 10 ng/mL. Iron deficiency anemia was defined as anemia plus one of the following; MCV less than 78 fL, Ferritin level less than 10 ng/mL or Transferrin saturation rate less than 10%. Results : There was no significant difference in mean Hb between urban and rural areas and decreases in mean Hb as with age. The prevalence of anemia decreased by year; 13.5% in 1990, 6.9 % in 1997, 6.0% in 1999, and 5.7% in 2000. It was high in high school girls(10.1% in 1997 and 12.6% in 2000). The prevalence of iron deficiency decreased by year; 36.1% in 1990, 13.9% in 1997, 13.3% in 1999, and 23.2% in 2000. It was 21.3% in 1997 high school girls and 37.8% in 2000. The prevalence of iron deficiency anemia(IDA) decreased by year; 10.0% in 1990, 4.6% in 1997, 8.3% in 1999, and 6.1% in 2000. It was 11.6% in 1997 high school girls and 18.6% in 2000. Conclusion : Although the prevalence of iron deficiency decreased during this period, the prevalence of anemia in the elder adolescence girls was high. Two things are recommended; first, it is necessary to screen for anemia in middle school girls and high risk groups, second, it is important to evaluate the knowledge of nutrition and to enforce effective nutritional education, leading to subjects receiving adequate nutrition.

The changes of electrocardiography and signal-averaged electrocardiography after surgical repair of Tetralogy of Fallot (활로씨 4징의 교정 수술 후 심전도와 신호 평준화 심전도의 변화)

  • Seo, Hye-Eun;Lim, Hae-Ri;Kim, Yeo-Hyang;Hyun, Myung-Chul;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.462-468
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    • 2007
  • Purpose : The purpose of this study was to analyze the changes of the late potential of Signal- averaged electrocardiography (SAECG) and Electrocardiography (ECG) parameters during follow up of those who had taken surgical repair of Tetralogy of Fallot (TOF). Methods : Nine patients who had taken surgical repair of TOF since 1985 checked SAECG and standard 12 leads ECG twice in 1999 and 2005 in Kyungpook national university hospital. We evaluated changes of QRS duration, QT interval and JT interval, QRS dispersion, QT dispersion and JT dispersion of standard 12 leads ECG and Filtered QRS (f-QRS), High frequency low amplitude potential (HFLA), Root mean square in terminal 40 ms (RMS) and Mean voltage in terminal 40 ms (MV) of SAECG between in 1999 and 2005. Results : There were significant decrease of JT dispersion ($101.11{\pm}50.11$ vs $71.11{\pm}22.61ms$, P< 0.05) and significant increase of HFLA ($24.67{\pm}13.19$ vs $32.89{\pm}14.21ms$, P<0.05). But there were no significant changes in other parameters. Conclusion : In repaired TOF patients, we evaluated ECG and SAECG to detect possible late complications such as tricuspid regurgitation, right ventricular enlargement, ventricualar arrythmia and sudden death. And there were significant changes of ECG and SAECG in some parameters (JT dispersion, HFLA). But to see the relationships between the changes of these parameters and the long term prognosis, we need to check more patients and longer follow-up.

Comparison Study between Myocardial Velocity obtained from Gated Myocardial SPECT and Myocardial Functional indices with a Focus on Myocardial Perfusion (게이트 심근 관류 SPECT에서 구한 심근 속도와 심근 관류를 중심으로 한 심근 기능 지표와의 비교연구)

  • Ha, Jung-Min;Jeong, Shin-Young;Bom, Hee-Seung;Lee, Byeong-Il
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.386-394
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    • 2009
  • Purpose: We aimed to assess the myocardial velocity on gated myocardial perfusion SPECT (gated MPS), to compare myocardial velocity between patients without coronary artery disease (CAD) and CAD patients and to assess the correlation of myocardial velocity and perfusion and wall thickening on CAD group. Materials and Methods: Seventeen patients without CAD (M:F=9:8, mean age $61.8{\pm}11.1$ yrs: group A) and thirty-nine patients with CAD (M:F=18:21, mean age $66.9{\pm}8.1$ yrs : group B) had undergone one-day adenosine stress gated MPS. In twenty segment model, 12 segments (except apical and basal segments) of each patient were included. We obtained systolic and diastolic gate ratio in left ventricular volume curve by eight frames per cardiac cycle on gated MPS. Using the systolic and diastolic gate ratio and R-R time of each patient, we obtained systolic and diastolic time ratio. The myocardial velocity was defined as wall thickening over systolic or diastolic time. Results: We presented normal range of myocardial velocities according segments and territories of coronary artery. The myocardial velocity of group B was significantly lower than group A (p=0.00). There was no significant difference between the myocardial velocity of group B with preserved EF and group A. The stress systolic velocity significantly correlated with regional myocardial perfusion in group B with preserved EF (p=0.00) as well as decreased EF (p=0.01). In group B, stress perfusion of segments which had decreased wall thickening and decreased myocardial velocity was significantly lower than segments which had decreased wall thickening and preserved myocardial velocity (p=0.01). Conclusion: The new functional index of velocity will be used as an useful of gated MPS.

Incidence of Fusarium Wilt of Sesame (Sesamum indicum L.) in Relation to Air Temperature (참깨 시들음병(病) 발병(發病)과 재배기간중(栽培期間中) 온도(溫度)와의 관계(關係))

  • KANG, S.W.;CHO, D.J.;Lee, Y.S.
    • Korean journal of applied entomology
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    • v.24 no.3 s.64
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    • pp.123-127
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    • 1985
  • Incidence of the Fusarium wilt caused by F. oxysporum f. sp. vasinfectum of sesame (var. Kwangsan) was remarkably influenced by seeding date and mean air temperature in the field of two or three year's continuous cropping with sesame in 1983 and 1985. Sesame were seeded on six different dates from April 20 to July 5. Air temperature was checked daily at the meteorological station near the experimental field. Low($16{\sim}20^{\circ}C$) and high temperature($20{\sim}25^{\circ}C$) periods were provisionally devided, based on every ten-day mean daily temperature during field experiment for last ten years, which corresponded to before and after June 15 in Jinju, Gyeong-nam. Infection rates were 83.7%, 68.2% and 59.4% in the plants grown for 55 days (seeding date: April 20), 40 days(May 5) and 25 days(May 20) under low temperature. On the other hand, infection rates were below 3% in those plots seeded during high temperature period. The longer the growth period exposed to low temperature, the higher was infection rates. It is interesting to note that 40 days old seedling or older are prone to severe infection compared to the younger ones, in higher temperature of $20{\sim}25^{\circ}C$. Therefore, seedlings in vegetative growth stage are less prone to infection than these in reproductive growth stage. The result showed that air temperature during sesame growth was one of the most important factor affecting the incidence of Fusarium wilt. This suggested that sesame crop, which is of tropical origin, has been predisposed to Fusarium wilt, when the plants were exposed to low temperature of $16{\sim}20^{\circ}C$.

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Association between Critical Thinking Disposition and Grade Point Average Score in Dental Hygiene Students (치위생(학)과 학생의 학업성적에 따른 비판적 사고 성향)

  • Hwang, Hye-Rim;Kim, Eung-Kwon;Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.12 no.1
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    • pp.7-13
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    • 2012
  • Critical thinking is a essential competency for dental hygiene education and practice. The purpose of this study was to examine critical thinking disposition between groups classified by GPA score in two dental hygiene educational program. A total 252 dental hygiene students responded. The study extracted six dimensions(intellectual eagerness/curiosity, prudence, healthy skepticism, intellectual integrity, objectivity, self-confidence) derived from 27 items with the exception of systematicity using factor analysis. The mean score for critical thinking disposition was 3.47 on a 5 point scale. The result showed a statistically significant correlation critical thinking disposition and age. Multivariate analysis of covariance(MANCOVA) was used to compare six subscales between the three groups. MANCOVA results revealed that intellectual eagerness/curiosity for three groups were significantly different(Wilks's lamda=0.914, F(6, 24)=1.869), p=0.01, partial eta square=0.044). Multiple comparison for intellectual eagerness/curiosity by Scheffe's method showed differences between high score group and mid score group(p=0.027), high score group and low score group(p=0.002). In this study, academic achievement and critical thinking tends to show significant correlations is known. Critical thinking skills by examining the actual grade compares the difference in propensity scores according to a case study in intellectual curiosity, passion, and could tell the difference to appear.