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Clinical Analysis of Arteriovenous Fistula in Chronic Renal Failure Patients (만성 신부전 환자에서의 동정맥루 조성술의 임상고찰)

  • Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Shin Yong-Chul;Yoo Hwan-Kuk;Kim Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.692-698
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    • 2006
  • Background: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. Material and Method: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending or age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. Result: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70 : 64 (52% : 48%). The average age was $56.3{\pm}12.26$ years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was $93{\pm}2.4%,\;91{\pm}2.7%,\;89{\pm}3.0%$ at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ and below 64-year-old patient group's was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. Conclusion: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hyper- tension do not make statistically significant effect on the arteriovenous inosculation rate.

Experimental Studies on the Properties of Epoxy Resin Mortars (에폭시 수지 모르터의 특성에 관한 실험적 연구)

  • 연규석;강신업
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.26 no.1
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    • pp.52-72
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    • 1984
  • This study was performed to obtain the basic data which can be applied to the use of epoxy resin mortars. The data was based on the properties of epoxy resin mortars depending upon various mixing ratios to compare those of cement mortar. The resin which was used at this experiment was Epi-Bis type epoxy resin which is extensively being used as concrete structures. In the case of epoxy resin mortar, mixing ratios of resin to fine aggregate were 1: 2, 1: 4, 1: 6, 1: 8, 1:10, 1 :12 and 1:14, but the ratio of cement to fine aggregate in cement mortar was 1 : 2.5. The results obtained are summarized as follows; 1.When the mixing ratio was 1: 6, the highest density was 2.01 g/cm$^3$, being lower than 2.13 g/cm$^3$ of that of cement mortar. 2.According to the water absorption and water permeability test, the watertightness was shown very high at the mixing ratios of 1: 2, 1: 4 and 1: 6. But then the mixing ratio was less than 1 : 6, the watertightness considerably decreased. By this result, it was regarded that optimum mixing ratio of epoxy resin mortar for watertight structures should be richer mixing ratio than 1: 6. 3.The hardening shrinkage was large as the mixing ratio became leaner, but the values were remarkably small as compared with cement mortar. And the influence of dryness and moisture was exerted little at richer mixing ratio than 1: 6, but its effect was obvious at the lean mixing ratio, 1: 8, 1:10,1:12 and 1:14. It was confirmed that the optimum mixing ratio for concrete structures which would be influenced by the repeated dryness and moisture should be rich mixing ratio higher than 1: 6. 4.The compressive, bending and splitting tensile strenghs were observed very high, even the value at the mixing ratio of 1:14 was higher than that of cement mortar. It showed that epoxy resin mortar especially was to have high strength in bending and splitting tensile strength. Also, the initial strength within 24 hours gave rise to high value. Thus it was clear that epoxy resin was rapid hardening material. The multiple regression equations of strength were computed depending on a function of mixing ratios and curing times. 5.The elastic moduli derived from the compressive stress-strain curve were slightly smaller than the value of cement mortar, and the toughness of epoxy resin mortar was larger than that of cement mortar. 6.The impact resistance was strong compared with cement mortar at all mixing ratios. Especially, bending impact strength by the square pillar specimens was higher than the impact resistance of flat specimens or cylinderic specimens. 7.The Brinell hardness was relatively larger than that of cement mortar, but it gradually decreased with the decline of mixing ratio, and Brinell hardness at mixing ratio of 1 :14 was much the same as cement mortar. 8.The abrasion rate of epoxy resin mortar at all mixing ratio, when Losangeles abation testing machine revolved 500 times, was very low. Even mixing ratio of 1 :14 was no more than 31.41%, which was less than critical abrasion rate 40% of coarse aggregate for cement concrete. Consequently, the abrasion rate of epoxy resin mortar was superior to cement mortar, and the relation between abrasion rate and Brinell hardness was highly significant as exponential curve. 9.The highest bond strength of epoxy resin mortar was 12.9 kg/cm$^2$ at the mixing ratio of 1:2. The failure of bonded flat steel specimens occurred on the part of epoxy resin mortar at the mixing ratio of 1: 2 and 1: 4, and that of bonded cement concrete specimens was fond on the part of combained concrete at the mixing ratio of 1 : 2 ,1: 4 and 1: 6. It was confirmed that the optimum mixing ratio for bonding of steel plate, and of cement concrete should be rich mixing ratio above 1 : 4 and 1 : 6 respectively. 10.The variations of color tone by heating began to take place at about 60˚C, and the ultimate change occurred at 120˚C. The compressive, bending and splitting tensile strengths increased with rising temperature up to 80˚ C, but these rapidly decreased when temperature was above 800 C. Accordingly, it was evident that the resistance temperature of epoxy resin mortar was about 80˚C which was generally considered lower than that of the other concrete materials. But it is likely that there is no problem in epoxy resin mortar when used for unnecessary materials of high temperature resistance. The multiple regression equations of strength were computed depending on a function of mixing ratios and heating temperatures. 11.The susceptibility to chemical attack of cement mortar was easily affected by inorganic and organic acid. and that of epoxy resin mortar with mixing ratio of 1: 4 was of great resistance. On the other hand, when mixing ratio was lower than 1 : 8 epoxy resin mortar had very poor resistance, especially being poor resistant to organicacid. Therefore, for the structures requiring chemical resistance optimum mixing of epoxy resin mortar should be rich mixing ratio higher than 1: 4.

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A Study on the Correspondence and the Autonomy between the Act on the Guarantee of Rights of and Support for Persons with Developmental Disabilities and the Similar Ordinances of the Local Governments (발달장애인 권리보장 및 지원에 관한 법률과 지방자치단체 유사조례 간의 연계성과 자치성에 관한 연구)

  • Jeon, Jihye;Lee, Sehee
    • 한국사회정책
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    • v.25 no.2
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    • pp.367-402
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    • 2018
  • This study analyzed the relationship between the act on the guarantee of rights of and support for persons with developmental disabilities(Act for PWDD) and the similar ordinance of the local governments based on this law and focused on the correspondence(the rate of reflection) and the autonomy(differentiation). As of October 2017, 63 local government regulations and Act for PWDD were analyzed in this study. The results of the analysis are as follows: First, the rate of reflection in the ordinance of Act for PWDD was different according to the clause. In the aspect of emphasizing welfare support, the agreement between local ordinance and rate was high. While the Act for PWDD emphasized the rights of persons with developmental disabilities, there was little information about their right in the ordinance of local governments. This is evidence that current ordinance is based on the protective point of view for people with developmental disabilities. In the future, policy measures will be needed to ensure that respect for decision-making by persons with developmental disabilities and rights guarantees are included in the bylaws. Second, there is a provision that the rate of ordinance reflection is 0%, which may be guaranteed by other laws in the area, so it does not mean the absence of related system in the region, but there is possibility of institutional blind spot. In the future, consideration should be given to the complementarity of other legal systems in the area with developmental disabilities, so that persons with developmental disabilities should not be placed in institutional blind spots. Third, the autonomy(differentiation) of local ordinance was examined from the contents aspect and the administrative aspect to help practical implementation. The differentiation between the ordinances vary. Emphasizing the responsibilities of the head of the organization, emphasizing the fact-finding survey, setting up the welfare committee, or adding local needs were included to the ordinance. Local governments considering the enactment of ordinances in the future should refer to these cases and establish enactable local ordinances that take advantage of the characteristics of local autonomy.

Effect of Acclimation Methods on Physiological Status of White Shrimp, Litopenaeus vannamei Larvae to Low Salinities (흰다리새우 유생의 저염분 순치방법에 따른 생화학적 특성변화)

  • Kim, Su Kyoung;Shim, Na Young;Jang, Jin Woo;Jun, Je Cheon;Kim, Su-Kyoung;Shin, Yoon Kyong
    • Korean Journal of Environmental Biology
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    • v.35 no.1
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    • pp.6-12
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    • 2017
  • This study focused on the physiological change of the shrimp, Litopenaeus vannamei postlarvae 15 stages, under different acclimation methods up to the endpoint of 4 practical salinity unit (psu). Besides using sea water as the control, two acclimation methods, fast acclimation (50% salinity reduction every 8 hours) and slow acclimation (50% salinity reduction every day), were adapted. Results show that the survival rate, glucose and blood uric nitrogen of each group were not significantly different. However, the ion profile differed according to the acclimation methods. Magnesium and sodium of shrimps acclimated to low salinity in both the methods, showed lower concentration than shrimps at 32 psu sea water. Especially, $Na^+$ concentration, which directly influences the osmolality of shrimp, decreased sharply in the fast acclimated group during the first eight hours (from 32 psu to 16 psu). To reduce acclimation stress, it is recommended to take more than eight hours during the first step for reducing the salinity.

Spinal cord stimulation in chronic pain: technical advances

  • Isagulyan, Emil;Slavin, Konstantin;Konovalov, Nikolay;Dorochov, Eugeny;Tomsky, Alexey;Dekopov, Andrey;Makashova, Elizaveta;Isagulyan, David;Genov, Pavel
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.99-107
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    • 2020
  • Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

The quality investigation of 6H-SiC crystals grown by conventional PVT method with various SiC powders

  • Yeo, Im-Gyu;Lee, Won-Jae;Shin, Byoung-Chul
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2009.06a
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    • pp.113-114
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    • 2009
  • Silicon carbide is one of the most attractive and promising wide band-gap semiconductor material with excellent physical properties and huge potential for electronic applications. Up to now, the most successful method for growth of large SiC crystals with high quality is the physical vapor transport (PVT) method [1, 2]. Since further reduction of defect densities in larger crystal are needed for the true implementation of SiC devices, many researchers are focusing to improve the quality of SiC single crystal through the process modifications for SiC bulk growth or new material implementations [3, 4]. It is well known that for getting high quality SiC crystal, source materials with high purity must be used in PVT method. Among various source materials in PVT method, a SiC powder is considered to take an important role because it would influence on crystal quality of SiC crystal as well as optimum temperature of single crystal growth, the growth rate and doping characteristics. In reality, the effect of powder on SiC crystal could definitely exhibit the complicated correlation. Therefore, the present research was focused to investigate the quality difference of SiC crystal grown by conventional PVT method with using various SiC powders. As shown in Fig. 1, we used three SiC powders with different particles size. The 6H-SiC crystals were grown by conventional PVT process and the SiC seeds and the high purity SiC source materials are placed on opposite side in a sealed graphite crucible which is surrounded by graphite insulation[5, 6]. The bulk SiC crystal was grown at $2300^{\circ}C$ of the growth temperature and 50mbar of an argon pressure. The axial thermal gradient across the SiC crystal during the growth is estimated in the range of $15\sim20^{\circ}C/cm$. The chemical etch in molten KOH maintained at $450^{\circ}C$ for 10 min was used for defect observation with a polarizing microscope in Nomarski mode. Electrical properties of bulk SiC materials were measured by Hall effect using van der Pauw geometry and a UV/VIS spectrophotometer. Fig. 2 shows optical photographs of SiC crystal ingot grown by PVT method and Table 1 shows electrical properties of SiC crystals. The electrical properties as well as crystal quality of SiC crystals were systematically investigated.

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Rapid diagnosis and control of sulfonylurea resistant Monochoria korsakowii (Sulfonylurea계 제초제 저항성 물옥잠의 조기진단과 방제)

  • Park, Tae-Seon;Moon, Byeong-Chul;Cho, Jeong-Rae;Kim, Chang-Suk;Kim, Moo-Sung;Kim, Kil-Ung
    • The Korean Journal of Pesticide Science
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    • v.8 no.1
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    • pp.63-70
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    • 2004
  • Sulfonylurea(SU)-resistant Monochoria korsakowii has resently been found in rice fields in Korea. A quick, practical and accurate test of confirming herbicide resistance is necessary to take timely management decision. This article describes a rapid reliable assay to detect SU-resistant biotype of Monochoria korsakowii. Up to now, the resistance to SU has been usually checked by application seedlings with herbicide. This application technique is time consuming and not practical. Therefore, we have developed efficient, rapid and practical diagnosis which allow easy detection of the SU-resistant Monochoria korsakowii by survival rate and regenerated plant length to herbicide application after cutting plants $0.5\sim1cm$ from the planted surface. This new rapid diagnosis can determine the SU resistance of the Monochoria korsakowii within 7 days at least. If the resistance of Monochoria korsakowii is identified by the rapid diagnosis, the selection of herbicide according to the stages of plants for the effective control is very important. The resistant biotype which treated with SU herbicide-based mixtures survived from the fields could effectively be controlled by soil application of butachlor+pyrazolate GR or by foliar application of the mixtures of bentazone SL and 2,4-D SL.

State of the Art of the Cyclic Plasticity Models of Structural Steel (구조용 강재의 반복소성모델 분석 연구)

  • Lee, Eun Taik
    • Journal of Korean Society of Steel Construction
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    • v.14 no.6
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    • pp.735-746
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    • 2002
  • The task of plastic theory is twofold: first, to set up relationships between stress and strain that adequately describe the observed plastic deformation of metals, and second, to develop techniques for using these relationships in studying of the mechanics of metal forming processes, and the anlaysis and design of structures. One of the major problems in the theory of plasticity is to describe the behavior of work-hardening materials in the plastic range for complex loading histories. This can be achieved by formulating constitutive laws either in the integral or differential forms. To adequately predict the response of steel members during cyclic loading, the hardening rule must account for the features of cyclic stress-strain behavior. Neithe of the basic isotropic and kinematic hardening rules is suitable for describing cyclic streess-strain behavior, although a kinematic hardening rule describes the nearly linear portions of the stabilized hystersis loops. There is also a limited expansion of the yield surface as predicted by the isotropic hardening rule. Strong ground motions or wind gusts affect the complex and nonproportional loading histories in the inelastic behavior of structues rather than the proportional loading. Nonproportional loading is defined as externally applied forces on the structure, with variable ratios during the entire loading history. This also includes the rate of time-dependency of the loads. For nonproportional loading histories, unloading may take place along a chord instead of the radius of the load surface. In such cases, the shape of the stress-strain curve has to be determined experimentally for all non-radial loading conditions. The plasticity models including two surface models ae surveyed based on a yield surface and a bound surface that represent a state of maximum stress. This paper is concerned with the improvement of a plasticity models of the two-surface type for structural steel. This is follwed by an overview of plasticity models on structural steel. Finally the need for further research is identified.

An Adaptive Materialized Query Selection Method in a Mediator System (미디에이터 시스템의 적응적 구체화 질의 선택방법)

  • Joo, Kil-Hong;Lee, Won-Suk
    • The KIPS Transactions:PartD
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    • v.11D no.1
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    • pp.83-94
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    • 2004
  • Recent researches which purport to Integrate distributed information have been concentrated on developing efficient mediator systems that not only provide a high degree of autonomy for local users but also support the flexible integration of required functions for global users. However, there has been little attention on how to evaluate a global query in a mediator. A global query is transformed into a set of its sub-queries and each sub-query is the unit of evaluation in a remote server. Therefore, it is possible to speed up the execution of a global query if the previous results of frequently evaluated sub-queries are materialized in a mediator. Since the Integration schema of a mediator can be incrementally modified and the evaluation frequency of a global query can also be continuously varied, query usage should be carefully monitored to determine the optimized set of materialized sub-queries. Furthermore, as the number of sub-queries increases, the optimization process itself may take too long, so that the optimized set Identified by a long optimization process nay become obsolete due to the recent change of query usage. This paper proposes the adaptive selection of materialized sub-queries such that available storage in a mediator can be highly utilized at any time. In order to differentiate the recent usage of a query from the past, the accumulated usage frequency of a query decays as time goes by.

Analysis of Consumer's Recognition and Satisfaction for the Improvement of the Doctor-Designation System (선택 진료 제도 개선을 위한 소비자 인식도와 만족도)

  • Im, Bock-Hee
    • Journal of Digital Convergence
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    • v.12 no.6
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    • pp.385-396
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    • 2014
  • The purpose of this study was to examine the recognition of citizens in Busan on the doctor-designation system, the awareness of medical consumers with experience of using this system and their satisfaction in an effort to seek ways of improving this system. The subjects in this study were the selected citizens in Busan who were at the age of 20 and up. As a result, it's found that the largest group of the respondents was female, in their 20s, received college or higher education, students and in the service industry, and that the most common monthly mean income was between two and 2.99 million won. 27.7 percent were aware of the doctor-designation system, and 23.7 percent became cognizant of the system through others who had used it. The rate of knowing the rules of the doctor-designation system (the right answer) stood at 66.3 percent. They got to know about the system through mass media(31.9%), and used it since it offered highly specialized treatment(57.5%). The respondents who had used it intended to reuse it(76.3%), and the reason was that they were provided with high-class medical services (35.2%). The respondents who had used this system got a mean of 2.96 in satisfaction level, which was not high in general. They mentioned more publicity efforts(91.2%), offering information in a conspicuous place (96.7%) and cutting doctor-designation treatment fee as a means of improving this system. As for how to ensure the operating efficiency of the system, sustained publicity seem to be necessary to raise awareness of the system among patients, and it's required to take measures to relieve patients of financial burden caused by medical bills.