• Title/Summary/Keyword: residual time

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Effect of Herbricide Treatments on Botanical Composition and Dry Matter Yields in Ladino Clover Dominated Pasture Mixtures (Ladino clover가 우점된 혼파초지에서 제초제 처리가 식생구성 및 초지생산성에 미치는 영향)

  • Kim, J.G.;Lee, S.B.;Seo, S.;Lee, J.Y.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.6 no.2
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    • pp.71-77
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    • 1986
  • The field experiment was conducted to evaluate the effect of herbicide treatment (Banvel: 100, 200, U-46: 150, 300, Hedonal: 150, 300, Simazin: 100, 200g/10 a) on change in the botanical composition and dry matter productivity of ladino clover (Trifolium repens L.) dominated pasture mixtures. The experiment was laid down as a randomized block design with 4 replications at experimental field of Livestock Experiment Station in Suweon from 1983 to 1985. The results obtained are summarized as follows: 1. Against ladino clover in mixie grass-clover swards Banvel, U-46 and Hedonal gave good control. The percentage of ladino clover under herbicide tratment decreased to about 1-2%(Banvel), 11-18%(U-46) and 22-31%(Hedonal), respectively, while it increased to 71% in untreated pastures. However, in the second year this trend stated to reverse and occurred clover dominance again in U-46 and Hedonal application, while those remained approximately constant until end of the years under Banvel treatment. Simazin is to be not recommended. 2. The best time for herbicide treatment was found to be late summer before autumn sown 20-25 days. When it applied in early summer weed infestigation by Digitaria spp., Echinochloa spp. and other species was a severe problem. 3. Emergence and early development of introduced pastures were less satisfactory, if it oversown immediatley after herbicide treatments due to its phytotoxical damage. Residual chemicals remained about 7-10 days in topsoils. Perennial ryegrass and orchardgrass were slightly less tolerant than the other species. 4. In dry matter, taken as average of three year results, Banvel applied pastures produced the remarkably high yield of 1023 kg/10 a, which is as much as 44% higher than that of untreated plot. Dry matter yields under U-46 and Hedonal treatment were 842 and 811 kg/10 a, respectively. 5. Weender components and net energy concentration were affected by change in the botanical composition. Crude protein and NEL value were slightly higher in clover dominance than those in herbicide treatments. Total yields of net energy lactation, however, were the highest in Banvel application with 5401 MJ and the lowest in untreatment with 3889 MJ-NEL/10 a DM.

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Recurrence Analysis of Giant Cell Tumor after Curettage and Cementation (거대 세포종에서 골 소파술 및 시멘트 충전술 후의 재발 분석)

  • Hahn, Soo-Bong;Lee, Won-Jun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.71-78
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    • 2004
  • Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

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A comparative study on bond strength and adhesive failure pattern in bracket bonding with self-etching primer (Self-etching Primer를 이용한 교정용 브라켓 부착시 전단결합강도와 파절양상에 관한 비교연구)

  • Kim, You-Kyoung;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.325-332
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    • 2004
  • A self-etching primer that combines the etchant and primer in one chemical compound saves time and should be mote cost-effective to the clinician and patient. The purpose of this study was to evaluate the clinical effectiveness of a self-etching primer by measuring shear bond strengths according to various conditions and observing adhesive failure patterns. For this Investigation, 120 upper and lower premolars extracted for orthodontic purposes were used and randomly divided into six groups of twenty teeth each. Human premolars were embedded in a metal cylinder with orthodontic resin. Metal brackets and ceramic brackets were bonded with XT primer and self-etching primer by means of XT adhesive. Upon curing, plasma arc light and visible light were used. After bonding, the shear bond strength was tested by Instron universal testing machine, and the amount of residual adhesive that remained on the tooth after debonding was measured by stereoscope and assessed with an adhesive remnant index. The results were as fellows: 1. When brackets were bonded, if other conditions remained the same, there was no significant difference in shear bond strength due to the type of primer - either self-etching primer or XT primer. 2. When metal brackets were bonded, there was no significant difference in shear bond strength according to the source of light - plasma arc light or visible light - and type of primer. 3. There was a very significant difference in shear bond strength according to the type of brackets - metal or ceramic brackets. The shear bond strength of ceramic brackets was stronger than metal brackets. 4. When the adhesive failure patterns of metal brackets bonded with self-etching primer were observed by using the adhesive remnant index, the bond failure of the metal bracket occurred more frequently at the bracket-adhesive. The failure of the ceramic bracket, however, occurred more frequently at the enamel-adhesive interface. The adhesive failure patterns of metal brackets bonded with XT primer observed the same patterns. The above results suggest that self-etching primer can be clinically useful for bonding the brackets without fear of a decrease in shear bond strength.

Outcomes of the arterial switch operation in complete transposition of the great arteries (완전 대혈관 전위에서 대혈관 치환술 후의 예후)

  • Cho, Min-Jung;Park, Ji-Ae;Lee, Hyoung-Doo;Sung, Si-Chan;Choo, Ki-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.910-916
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    • 2009
  • Purpose : The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. Methods : Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). Results : Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig- Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. Conclusion : The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.

Structural Safety Assessment of a Sunken Ship Considering Hull Corrosion and Damaged Members - Focus on the Sunken Ship 'No. 7 HaeSung' - (선체 부식 및 손상 부재를 고려한 침몰선박의 구조 안전성 평가에 관한 연구 - 제7 해성호를 중심으로 -)

  • Lee, Seung Hyun;Kim, Won Don;Suh, Jae-Joon
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.19 no.4
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    • pp.332-340
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    • 2016
  • Sunken ships cause damage to the environment due to the dispersal of fuel oil and harmful cargo goods in the hull. Since the sunken ship is mostly flooded by the seabed, it tends to be in a relatively stable condition. However, the heavy body, together with the load of remaining goods in the cargo hold, the constant contact with the seabed, and ocean currents and tidal waves, can affect dispersal of residual fuel oils out of the sunken ship. Corrosion of the sunken ship starts upon sinking, decreasing the thickness of the hull structure and sub-materials. Therefore, it is necessary to assess the structural stability against the potential breakdown of the sunken ship. Whilst evaluating the danger of the sunken ship, this result should be reflected in 'the possible discharge'. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship. The structural stability assessment to estimate the collapsibility of the hull was structure targeted at the sunken ship 'No. 7 HaeSung', which was classified as the prime example for the intensive management of sunken ships. This study was undertaken to suggest a procedure for a step by step evaluation to assess the structural stability a sunken ship and to propose a method to conduct a structural safety assessment that estimates the collapsibility of the hull by targeting the sunken ship 'No. 7 HaeSung',which was classified as the prime example for the intensive management of sunken ships. The collapsibility of the hull structure was estimated Based on the damage size of the hull structure, and the corrosion rate of the hull structure and sub-materials due to the seawater after sinking. It was confirmed that there was a low possibility of the total destruction of the hull structure at the current time. However, there is a high possibility in the potential failure of the hull structure due to increased rate of corrosion thereafter. Therefore, we believe continuous study on influence of corrosion and marine environment change to sunken ship's structural safety is necessary.

Crop Injury (Growth Inhibition) Induced by Herbicides and Remedy to Reduce It (제초제(除草劑) 약해발생(藥害發生) 양상(樣相)과 경감대책(輕減對策))

  • Kim, K.U.
    • Korean Journal of Weed Science
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    • v.12 no.3
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    • pp.261-270
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    • 1992
  • Many herbicides that are applied at the soil before weed emergence inhibit plant growth soon after weed germination occurs. Plant growth has been known as an irreversible increase in size as a result of the processes of cell divison and cell enlargement. Herbicides can influence primary growth in which most new plant tissues emerges from meristmatic region by affecting either or both of these processes. Herbicides which have sites of action during interphase($G_1$, S, $G_2$) of cell cycle and cause a subsequent reduction in the observed frequency of mitotic figures can be classified as an inhibitor of mitotic entry. Those herbicides that affect the mitotic sequence(mitosis) by influencing the development of the spindle apparatus or by influencing new cell plate formation should be classified as causing disruption of the mitotic sequence. Sulfonylureas, imidazolinones, chloroacetamides and some others inhibit plant growth by inhibiting the entry of cell into mitosis. The carbamate herbicides asulam, carbetamide, chlorpropham and propham etc. reported to disrupt the mitotic sequence, especially affecting on spindle function, and the dinitroaniline herbicides trifluralin, nitralin, pendimethalin, dinitramine and oryzalin etc. reported to disrupt the mitotic sequence, particularly causing disappearence of microtubles from treated cells due to inhibition of polymerization process. An inhibition of cell enlargement can be made by membrane demage, metabolic changes within cells, or changes in processes necessary for cell yielding. Several herbicides such as diallate, triallate, alachlor, metolachlor and EPTC etc. reported to inhibit cell enlargement, while 2, 4-D has been known to disrupt cell enlargement. One potential danger inherent in the use of soil acting herbicides is that build-up of residues could occur from year to year. In practice, the sort of build-up that would be disastrous is unikely to occur for substances applied at the correct soil concentration. Crop injury caused by soil applied herbicides can be minimized by (1) following the guidance of safe use of herbicides, particularly correct dose at correct time in right crop, (2) by use of safeners which protect crops against injury without protecting any weed ; interactions between herbicides and safeners(antagonists) at target sites do occur probably from the following mechanisms (1) competition for binding site, (2) circumvention of the target site, and (3) compensation of target site, and another mechanism of safener action can be explained by enhancement of glutathione and glutathione related enzyme activity as shown in the protection of rice from pretilachlor injury by safener fenclorim, (3) development of herbicide resistant crops ; development of herbicide-resistant weed biotypes can be explained by either gene pool theory or selection theory which are two most accepted explanations, and on this basis it is likely to develop herbicide-resistant crops of commercial use. Carry-over problems do occur following repeated use of the same herbicide in an extended period of monocropping, and by errors in initial application which lead to accidental and irregular overdosing, and by climatic influence on rates of loss. These problems are usually related to the marked sensitivity of the particular crops to the specific herbicide residues, e.g. wheat/pronamide, barley/napropamid, sugarbeet/ chlorsulfuron, quinclorac/tomato. Relatively-short-residual product, succeeding culture of insensitive crop to specific herbicide, and greater reliance on postemergence herbicide treatments should be alternatives for farmer practices to prevent these problems.

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Rhizofiltration Process with Helianthus annuss L., Phaseolus vulgaris var., and Brassica juncea (L.) Czern. to Remediate Uranium Contaminated Groundwater (해바라기, 갓, 강낭콩을 이용한 수생법(Rhizofiltration)의 우라늄으로 오염된 지하수 정화 효율 규명)

  • Yang, Min-June;Lee, Min-Hee
    • Journal of Soil and Groundwater Environment
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    • v.13 no.4
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    • pp.30-39
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    • 2008
  • The uranium removal efficiency of rhizofiltration was investigated in lab scale experiment. Three plants such as sunflower (Helianthus annuus L.), bean (Phaseolus vulgaris var.), and Indian mustard (Brassica juncea (L.) Czern.) were cultivated in artificially contaminated solution by uranium at 30 ${\mu}g$/L and 80 ${\mu}g$/L for 72 hours. The removal efficiencies of three cultivars were calculated from the ICP/MS analysis of uranium mass in solution and the plant. For Helianthus annuus L., more than 80% of initial uranium were removed from the solution and the uranium concentration of residual solution maintained lower than 10 ${\mu}g$/L. For Phaseolus vulgaris var. and Brassica juncea (L.) Czern., their uranium removal efficiencies ranged from 60 to 80%. Even the uranium concentration of solution was higher than 500 ${\mu}g$/L, these cultivars removed more than 70% of initial uranium by rhizofiltration, suggesting that the rhizofiltration has a great capability to remove uranium in the contaminated groundwater. The removal efficiency of rhizofiltration by using Brassica juncea (L.) Czern decreased from 83% to 42% with the increase of pH in solution. From the results of the analysis for the uranium accumulation in plants, 99% of uranium transferred into the plant from solution were accumulated in the root and only 1% of uranium existed in the shoot part (including leaves), suggesting that the cost and the time to treat massive grown plants after the rhizofiltration could be dramatically cut down because only their root parts needs to be treated. Finally, the genuine groundwater having high uranium concentration (81.4 ${\mu}g$/L), sampled from Daejoun area, was used in the experiment. The uranium removal efficiency of Helianthus annuus L. for the real groundwater was higher than 95%, investigating that the rhizofiltration is the very useful method to remediate uranium contaminated groundwater.

Management of the Development of Insecticide Resistance by Sensible Use of Insecticide, Operational Methods (실행방식 측면에서 살충제의 신중한 사용에 의한 저항성 발달의 관리)

  • Chung, Bu-Keun;Park, Chung-Gyoo
    • Korean journal of applied entomology
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    • v.48 no.2
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    • pp.123-158
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    • 2009
  • An attempt was made to stimulate future research by providing exemplary information, which would integrate published knowledge to solve specific pest problem caused by resistance. This review was directed to find a way for delaying resistance development with consideration of chemical(s) nature, of mixture, rotation, or mosaics, and of insecticide(s) compatible with the biological agents in integrated pest management (IPM). The application frequency, related to the resistance development, was influenced by insecticide activity from potentiation, residual period, and the vulnerability to resistance development of chemical, with secondary pest. Chemical affected feeding, locomotion, flight, mating, and predator avoidance. Insecticides with negative cross-resistance by the difference of target sites and mode of action would be adapted to mixture, rotation and mosaic. Mixtures for delaying resistance depend on each component killing very high percentage of the insects, considering allele dominance, cross-resistance, and immigration and fitness disadvantage. Potential disadvantages associated with mixtures include disruption of biological control, resistance in secondary pests, selecting very resistant population, and extending cross-resistance range. The rotation would use insecticides in high and low doses, or with different metabolic mechanisms. Mosaic apply insecticides to the different sectors of a grid for highly mobile insects, spray unrelated insecticides to sedentary aphids in different areas, or mix plots of insecticide-treated and untreated rows. On the evolution of pest resistance, selectivity and resistance of parasitoids and predator decreased the number of generations in which pesticide treatment is required and they could be complementary to refuges from pesticides To enhance the viability of parasitoids, the terms on the insecticides selectivity and factors affecting to the selectivity in field were examined. For establishment of resistant parasitoid, migration, survivorship, refuge, alternative pesticides were considered. To use parasitoids under the pressure of pesticides, resistant or tolerant parasitoids were tested, collected, and/or selected. A parasitoid parasitized more successfully in the susceptible host than the resistant. Factors affecting to selective toxicity of predator are mixing mineral oil, application method, insecticide contaminated prey, trait of individual insecticide, sub-lethal doses, and the developmental stage of predators. To improve the predator/prey ratio in field, application time, method, and formulation of pesticide, reducing dose rate, using mulches and weeds, multicropping and managing of surroundings are suggested. Plant resistance, predator activity, selective insect growth regulator, and alternative prey positively contributed to the increase of the ratio. Using selective insecticides or insecticide resistant predator controlled its phytophagous prey mites, kept them below an economic level, increased yield, and reduced the spray number and fruits damaged.

The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis (수장부 다한증환자의 흉부 교감신경절단술후 교감신경 피부반응)

  • 김오곤;홍종면;이석재;홍장수;이광래;김상규
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.579-583
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    • 1999
  • Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

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