Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.
We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.
The Keum River Estuary was investigated two times in April and July, 1986, to study process controlling chlorophyll distribution in estuarine waters. During the surveys, distribution patterns were studied for chlorophyll-a, nutrients, ph, SPM (Suspended Particulate Matter), DO (Dissolved Oxygen), temperature, salinity, etc. During April survey(low-discharge period), sea water penetrated to Kangkyung, about 35km upstream from the constructing weir, while in July (high-discharge period) only to 3 km upstream from the weir,In April SPM showed very high concentrations (500mg/l)on the average. But very low concentrations(about10mg/l)were observed in July due to high discharge of fresh water.Chlorophyll-a concentrations showed large variations both in time and space :much higher concentraations in July than in April and sharp decrease in concentrations at the fresh water-sea water interface (April:$6.5\mu\textrm{g}/{\ell}$ for fresh waters and 41.4\mu\textrm{g}/{\ell}$ forestuarine waters). Differebce ub chlorophyll-a concentrations for these two surveys appear to be caused mainly by the difference in effectiveness of penetrating lights controlled by SPM in the waters. Sharp decrease in chlorophll-a at the fresh water-sea water interface is believed to be resulted from mass mortality of fresh water phytoplankton caused by changes in osmotic pressure in the region. Observations in the same regions such as increase in AOU(Apparent Oxygen Utilization)and ammonia, decrease in PH,probably resulted through decomposition processes of dead planktons,furtuer support the idea.
A physical model experiment was conducted using a sand and gravel-filled tank model, to investigate the influence on the GPR response of LNAPL vapor phase effects in the unsaturated zone and of residual phase of LNAPL trapped in the saturated zone. Background measurements of GPR were made with only water in the tank using a fluctuating water table model. Gasoline was, then, injected into the bottom of the model tank to simulate a subsurface discharge from a leaking pipe or tank at depth, obtaining GPR data with rising and lowering of water table. Results from the experiment show the GPR sensitivity to the changes in the moisture content in the vadose zone and its effectiveness for monitoring minor fluctuation of the water table. The results also demonstrate a potential of GPR for monitoring possible vapor phase effects of volatile hydrocarbons in the vadose zone as a function of time, and for detecting the effects of residual phase of hydrocarbons in the water saturated system. In addition, the results provide the basis for a strategy that has the potential to successfully detect and delineate residual LNAPL contamination in the water-saturated system at field sites where the conditions are similar to those simulated in the physcial models described herein.
Kim Ji-Soo;Han Soo-Hyung;Seo Yong-Seok;Lee Yong-Jae
The Journal of Engineering Geology
/
v.15
no.1
/
pp.41-55
/
2005
This research is aimed at investigating the ground characterization of the Cheongju granite area using the geophysical methods. Test site was chosen from the building site in Chungbuk University, Chongju, Chungbuk province. Furthermore, geophysical methods are employed on the outcrops in the east to map the distribution of fault and intrusion and reveal the degree of weathering. The subsurface structure mapped from seismic re-fraction survey mainly consists of two units of weathered soil and rock. Threshold of the units were determined on the basis of seismic velocity of 800 m/s, supported from the standard classification table. From the results of standard penetrating test(SPT), these units are found to show medium-high and high density, respectively. Weathering soil is subdivided in unsaturated layer and saturated layer with thresholds of seismic velocity (500 m/s) and resistivity (200 ohm-m). In particular, unsaturated layer is again classified into dry and wet portions using the GPR section. The boundary between unsaturated and saturated weathering soils corresponds to the groundwater table at depth of approximately 5~6.2 m, which is well correlated with the one from drill-core data. However, bedrock is not delineated by geophysical methods. In the GPR section, fault and intrusion observed on the outcrop are revealed not to extend to the building site. With respect to weathering degree, the outcrop characterized by low resistivity and velocity corresponds to the grade of 'completely weathered' from the geotechnical investigations.
Although geophysical methods are useful and generally provide valuable information about the subsurface, it is important to recognize their limitations. A common limitation is the lack of sufficient contrast in physical properties between different layers. Thus, multiple methods are commonly used to best constrain the physical properties of different layers and interpret each section individually. Ground penetrating radar (GPR) and shallow seismic reflection (SSR) methods, used for shallow and very shallow subsurface imaging, respond to dielectric and velocity contrasts between layers, respectively. In this study, we merged GPR and SSR data from a test site within the Cheongui granitic mass, where the water table is ~3 m deep all year. We interpreted the data in combination with field observations and existing data from drill cores and well logs. GPR and SSR reflections from the tops of the sand layer, water table, and weathered and soft rocks are successfully mapped in a single section, and they correlate well with electrical resistivity data and SPS (suspension PS) well-logging profiles. In addition, subsurface interfaces in the integrated section correlate well with S-wave velocity structures from multi-channel analysis shear wave (MASW) data, a method that was recently developed to enhance lateral resolution on the basis of CMP (common midpoint) cross-correlation (CMPCC) analysis.
Journal of the Korean Society for Library and Information Science
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v.45
no.2
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pp.209-228
/
2011
Web search behavior has evolved. People now search using many diverse information devices in various situations. To monitor these scattered and shifting search patterns, an improved way of learning and analysis are needed. Traditional web search studies relied on the server transaction logs and single query instance analysis. Since people use multiple smart devices and their searching occurs intermittently through a day, a bundled query research could look at the whole context as well as penetrating search needs. To observe and analyze bundled queries, we developed a proprietary research software set including a log catcher, query bundling tool, and bundle monitoring tool. In this system, users' daily search logs are sent to our analytic server, every night the users need to log on our bundling tool to package his/her queries, a built in web survey collects additional data, and our researcher performs deep interviews on a weekly basis. Out of 90 participants in the study, it was found that a normal user generates on average 4.75 query bundles a day, and each bundle contains 2.75 queries. Query bundles were categorized by; Query refinement vs. Topic refinement and 9 different sub-categories.
Objectives : The purpose of this randomized, placebo-controlled, cross-over trial was to examine how acupuncture treatment at Shinmun(HT7) affects the brain activity and the autonomic nervous system(ANS), using electroencephalograms(EEG) and heart rate variability(HRV). Methods : Eighteen healthy volunteers participated in two separate experiments: in each experiment, either real acupuncture(RA) or non-penetrating sham acupuncture(SA) was applied at HT7 in random sequences to each person. The EEG and HRV measurements were conducted simultaneously before and during the acupuncture stimulation for 5 minutes, respectively. Resulting EEG and HRV parameters were compared between RA and SA groups. To assess differences according to the stress levels for participants, subgroup analysis was performed based on the results of the stress response index questionnaire. Results : In the results, acupuncture stimulation at HT7 increased ${\alpha}$ band in EEG. In the HRV analysis, heart rate was decreased significantly but HF and RMS-SD were increased in the RA group, compared with those of the SA group. In the subgroup analysis by stress level, participants in the RA group with high stress exhibited an increased in ${\alpha}$ band in their EEG while the low stress participants showed decrease or little increase in the band. For the SA group, ${\alpha}$ band reported relatively moderate changes in all channels. Conclusions : Our results showed that acupuncture induces changes in brain activation and the ANS. Acupuncture was related to the activation of the parasympathetic nervous system. The brain activities of the participants were different depending on the stress level.
Korean society suffers from severe divisions represented by bi-polarization and collapse of the middle class. Intensive demanding on expanding social welfare budget has emerged in accordance with such a dramatic shift. Social consensus moving toward well-financed welfare policy, however, happens to meet political opposition supported by the discourse of fiscal soundness. This paper thus pays particular attention to deciphering the discursive structure in way of understanding how discourses bring public policy into play. For this purpose, news articles about fiscal soundness collected from 8 national newspapers have been analyzed in terms of frame, attitude, perspective and world view. Research results show, first of all, that there exist persistent competition between two frames identified as 'reduced tax with fiscal discipline' and 'increased tax with welfare money.' While the 'reduced tax' frame favors in maintaining tax cut at the expense of welfare budjet, the frame of 'increased tax' supports such arguments as the flexible employment of fiscal soundness and prosperity of national community helped by widening tax revenues. Also did these frames include a number of sub-frames like welfare populism, partisan politics, trickle down effect, tax bonanza for the rich, universal welfare and market over-reactions in order to bolster its logical authority. Media's active taking a part in penetrating supportive frames in line with political stance was found as well. Taking into account both the discursive structure upheld by frames and politics materialized by the media, the authors argue that public policies should be considered more as discourse than fixed reality. Shedding additional light on understanding the interplay among public opinion, policies and media discourse is of another importance for further study.
Recently, ground-penetrating radar (GPR) surveys have been actively carried out for precise subsurface void investigation because of the rapid increase of subsidence in urban areas. However, since the interpretation of GPR data was conducted based on the interpreter's subjective decision after applying only the basic data processing, it can result in reliability problems. In this research, to solve these problems, we analyzed the difference between the events generated from subsurface voids and those of strong diffraction sources such as the buried pipeline by applying the edge detection technique, which is one of image processing technologies. For the analysis, we applied the image processing technology to the GRP field data containing events generated from the cavity or buried pipeline. As a result, the main events by the subsurface void or diffraction source were effectively separated using the edge detection technique. In addition, since subsurface voids associated with the subsidence has a relatively wide scale, it is recorded as a gentle slope event unlike the event caused by the strong diffraction source recorded with a sharp slope. Therefore, the directional analysis of amplitude variation in the image enabled us to effectively separate the events by the subsurface void from those by the diffraction source. Interpretation based on these kinds of objective analysis can improve the reliability. Moreover, if suggested techniques are verified to various GPR field data sets, these approaches can contribute to semiautomatic interpretation of large amount of GPR data.
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