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Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke

  • Kim, Sang Hwa;Choi, Jae Hyung;Kang, Myung Jin;Cha, Jae Kwan;Kim, Dae Hyun;Nah, Hyun Wook;Park, Hyun Seok;Kim, Sang Hyun;Huh, Jae Taeck
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.405-413
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    • 2019
  • Objective : We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. Methods : We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. Results : The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ${\geq}11$ or National Institutes of Health Stroke Scale ${\leq}1$ at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ${\leq}2$) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group. Conclusion : The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.

Optimal Path Finding Considering Smart Card Terminal ID Chain OD - Focused on Seoul Metropolitan Railway Network - (교통카드 단말기ID Chain OD를 반영한 최적경로탐색 - 수도권 철도 네트워크를 중심으로 -)

  • Lee, Mee Young
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.17 no.6
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    • pp.40-53
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    • 2018
  • In smart card data, movement of railway passengers appears in order of smart card terminal ID. The initial terminal ID holds information on the entering station's tag-in railway line, the final terminal ID the exit station tag-out railway line, and the middle terminal ID the transfer station tag subway line. During the past, when the metropolitan city rail consisted of three public corporations (Seoul Metro, Incheon Transit Corporation, and Korail), OD data was expressed in two metrics of initial and final smart card terminal ID. Recently, with the entrance of private corporations like Shinbundang Railroad Corporation, and UI Corporation, inclusion of entering transfer line terminal ID and exiting transfer line terminal ID as part of Chain OD has become standard. Exact route construction using Chain OD has thus become integral as basic data for revenue allocation amongst metropolitan railway transport corporations. Accordingly, path detection in railway networks has evolved to an optimal path detection problem using Chain OD, hence calling for a renewed solution method. This research proposes an optimal path detection method between the initial terminal ID and final terminal ID of Chain OD terminal IDs within the railway network. Here, private line transfer TagIn/Out must be reflected in optimal path detection using Chain OD. To achieve this, three types of link-based optimum path detection methods are applied in order of 1. node-link, 2. link-link, 3. link-node. The method proposed based on additional path costs is shown to satisfy the optimal conditions.

Protective effect of Thymus quinquecostatus extracts UVB-induced matrix metalloproteinase-1 via suppressing MAPKs phosphorylation in human keratinocyte (사람의 각질세포에서 UVB 유도에 따른 MMP-1의 발현 조절과 MAPKs 인산화에 타임 추출물이 미치는 효과)

  • Jung, Hana;Jeong, Hyun Ju;Shin, Kyounghee;Kim, Yung Sun;Moon, Jae Heon;Lee, Tae Hoon
    • Journal of Applied Biological Chemistry
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    • v.61 no.4
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    • pp.417-421
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    • 2018
  • Ultraviolet rays are electromagnetic waves with a shorter wavelength than visible light, and ultraviolet rays that pass through the ozone layer are the main cause of skin aging. Chronic exposure of skin tissue to ultraviolet light activates the Mitogen-activated Protein Kinases (MAPKs) signaling pathways in human keratinocytes, resulting in increased production of matrix metalloproteinases (MMPs). In this study, we investigated the herbal extracts from Jeju Island on the anti-aging effect in human keratinocytes (HaCaTs) by ultraviolet stimulation. We examined that herb extract from Jeju Island were decreased in anti-aging activity on measuring the level of MMP-1 gene and protein expression in ultraviolet-induced keratinocytes. As a result, it was confirmed that Thymus quinquecostatus extract (TQE) significantly reduced the expression of MMP-1 in a dose-dependent manner by UV irradiated HaCaTs. According to our data, TQE significantly attenuated UV-induced phosphorylation of the MAPKs signaling elements ERK1/2, JNK1/2 and p38 proteins. These results suggest that the MAPKs pathway may contribute to the inhibitory effect of TQE on UV-induced MMP-1 production in human keratinocytes. Our results suggest that TQE may be a protective agent against skin aging by preventing UV-induced MMP-1 production.

Pansori master Bak songhui's life and her activities (박송희 명창의 삶과 예술 활동)

  • Chae, Soo-jung
    • (The) Research of the performance art and culture
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    • no.36
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    • pp.255-287
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    • 2018
  • This article deals with one of the pansori master's life and activities. Bak Songhui(1927~2017), who was the holder of National Intangible Cultural Asset No. 5 for pansori Heungboga. She had played a significant role through the modern history of pansori genre including Yeoseong Gukkeuk(Korean classical opera by women) and Changgeuk(Korean traditional opera in pansori style) as well as original pansori itself. In the article, the early stage of her learnings and the way she got involved to pansori from Gwonbeon period are offered, and the activities by group, solo recitals, and educational activity lists are also provided. Bak Songhui began to learn pansori, Geommu(dance), Seungmu(dance), Gayageum, Yanggeum, and Gagok genres at her age of 13 in Gwangju. She fulfilled 5 years of study in Gwangju Gwonbeon, and entered to a Hyeomnyulsa-travelling theater company, led by Gim Yeonsu at her age around 19. Later, Bak used to be an actress in Yeoseong Gugak Donghohoe(Female Korean music fans' club) led by Gim sohui as well as in Haennim Gukkeukdan, and Saehan Gukkeukdan at around her age of 30. She took the main actress' role in several performances. And thanks to her effort, the Yeoseong Gukkeuk can be one of the representative genre in history. As she entered to the National Changgeuk company, her brilliant talents worked well by leading the company's big hit with her talents of taking many different characters, devotions, and know-hows from her experience. After her 70s, she kept the pansori go on its right way to pass down. She unfolded pansori performances as well as her own students' public presentations, recordings, TV and radio broadcasting activities as the holder of National Intangible Cultural Asset. The activities that Bak Songhui showed us can become another chance to make her a great master of pansori, especially in Dongpyeonje style.

Numerical Analysis and Exploring of Ground Condition during Groundwater Drawdown Environment in Open-cut Type Excavation (개착식 굴착공사시 지하수위 저하로 인한 지반상태 탐사 및 해석기법 연구)

  • Han, Yushik
    • Journal of the Korean Geotechnical Society
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    • v.34 no.11
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    • pp.93-105
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    • 2018
  • Precise investigation and interpretation of the ground subsidence risk factors needed to predict and evaluate the settlement problems of the surrounding ground due to the ground excavation. There are various geophysical exploration methods to investigate the ground subsidence risk factors. However, there are factors that influence the characteristics of the underground medium in these geophysical methods, and the actual soil contains complex factors affecting geophysical exploration. Therefore, it is necessary to analyze the effects on the geophysical methods based on the understanding of the geotechnical properties of soil. In this study, a test bed was constructed to consider various complicated factors in the complex ground and the ground behavior was analyzed by numerical analysis. In addition, we analyzed the limitations on investigating the ground subsidence risk factors through ground penetration radar (GPR) survey. As a result, ground subsidence of Open-cut Type Excavation is caused by various factors. Especially, in the case of soft ground condition, it was found that it was greatly influenced by the flow change of groundwater level. At the center frequency of GPR of 250 MHz, the attenuation of the electromagnetic wave is severely attenuated in the clay with high electrical conductivity, making it difficult to penetrate deeply into the ground (4 m below the surface). As the electromagnetic waves pass through the groundwater level below the groundwater, the attenuation of the electromagnetic waves becomes severe.

Analysis of Factors Affecting Length Of Stay for A Serious Patients Using Medical Records (의무기록자료를 이용한 중증질환자의 재원일수에 미치는 요인 분석)

  • Kim, Seok Hwan;Lee, Jung A
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.2
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    • pp.69-80
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    • 2019
  • Objectives: In this study, we tried to analyze the factors affecting Length Of Stay for serious patients in Republic of Korea. Methods: The study included 139,172 serious patients in the 2012-2016 discharge details. Using the SPSS 23.0 program, we conducted a rank regression analysis with social and social demographic characteristics as control variables, medical institution characteristics and medical use characteristics as independent variables, and Average Length Of Stay as a dependent variable. Results: Average Length Of Stay for participants was found to be 9.92days. And the location and bed size of medical institutions were not statistically significant, the hospitalization path was more urgent(B=0.43) than the outpatient (p<0.001), and there was no secondary diagnosis(B=0.35). However, Average Length Of Stay was higher (p<0.001) than there was no main surgery(B=0.80). After discharge, Average Length Of Stay for funding(B=0.43) and death(B=0.72) was long (p<0.001). Average Length Of Stay for participants was found to be 9.92days. And the location and the bed size of the medical institution were not statistically significant, and the hospitalization pass had longer Length Of Stay for emergency patients(B=0.43) than for outpatients(p<0.001). There was a longer Length Of Stay(B=0.35) than none was diagnosed. There were longer Length Of Stay(p<0.001) than there was no major surgery(B=0.80). After discharge, the outpatients had longer Average Length Of Stay(B=0.43) and deaths(B=0.72) than those who returned home(p<0.001). Conclusion: As a result of analyzing the factors affecting Average Length Of Stay of the participants, it was confirmed that regardless of the location and bed size of medical institutions, hospitalization route, department diagnosis, main surgery, and whereabouts after discharge. Therefore, appropriate interventions and necessary support must be provided so that efficient Length Of Stay can be managed according to the medical use characteristics of serious patient.

Comparison of Recognition and Fit Factors according to Education Actual Condition and Employment Type of Small and Medium Enterprises (중소규모 사업장의 교육 환경과 고용형태에 따른 호흡보호구 인식도 및 밀착계수 비교)

  • Eoh, Won Souk;Choi, Youngbo;Shin, Chang Sub
    • Journal of the Korean Society of Safety
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    • v.33 no.6
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    • pp.28-36
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    • 2018
  • There was a difference in recognition of respirators according to the educational performance environment. they were showed higher recognition of respirators of group by internal and external mix trainer, less than 6 months, over 1hour, more than 5 times, variety of education. To identify the relationship between types of job classification(typical and atypical)and the levels of recognition of respirators, a total of 153 workers in a business workplace. mainly, typical workers showed higher recognition of respirators than atypical workers. Training of correct wearing showed high demands both typical and atypical workers. Descriptive statistics(SAS ver 9.2)was performed. the results of recognition of respirators were analyzed the mean and standard deviation by t-test, and anova, fit factor is used geometric means(geometric standard deviation), paired t-test, Wilcoxon analysis(P=0.05). Particulate filtering facepiece respirators (PFFR) is one of the most widely used items of personal protective equipments, and a tight fit of the respirators on the wearers is critical for the protection effectiveness. In order to effectively protect the workers through the respirators, it is important to find and evaluate the ways that can be readily applicable at the workplace to improve the fit of the respirators. This study was designed to evaluate effects of mask style (cup or foldable type) and donning training on fit factors (FF) of the respirators, since these are available at various workplace, especially at small business workplace. A total of 40 study subjects, comprised of employment type workers in metalworking industries, were enrolled in this study. The FF were quantitatively measured before and after training related to the proper donning and use of cup or foldable-type respirators. The pass/fail criterion of FF was set at 100. After the donning training for the cup-type mask, fit test were increased by 769%. but foldable-type mask was also increased after the donning training, the GM of FF for the foldable-type mask and it's increase rate were smaller as compared to the cup-type mask. Furthermore, the differences of the increase rates of the GM of FF in employment type of the subjects were not significantly for the foldable-type mask. These results imply that the raining on the donning and use of PFFR can enhance the protection effectiveness of cup or foldable-type mask, and that the training effects for the foldable-type mask is less significant than that for the cup-type mask. Therefore, it is recommended that the donning training and fit tests should be conducted before the use of the PFFR, and listening to workers opinion regularly.

Corrosion Behaviors of Dental Implant Alloy after Micro-sized Surface Modification in Electrolytes Containing Mn Ion

  • Kang, Jung-In;Son, Mee-Kyoung;Choe, Han-Cheol
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.71-81
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    • 2018
  • Purpose: The purpose of this study was to investigate the corrosion behaviors of dental implant alloy after microsized surface modification in electrolytes containing Mn ion. Materials and Methods: $Mn-TiO_2$ coatings were prepared on the Ti-6Al-4V alloy for dental implants using a plasma electrolytic oxidation (PEO) method carried out in electrolytes containing different concentrations of Mn, namely, 0%, 5%, and 20%. Potentiodynamic method was employed to examine the corrosion behaviors, and the alternatingcurrent (AC) impedance behaviors were examined in 0.9% NaCl solution at $36.5^{\circ}C{\pm}1.0^{\circ}C$ using a potentiostat and an electrochemical impedance spectroscope. The potentiodynamic test was performed with a scanning rate of $1.667mV\;s^{-1}$ from -1,500 to 2,000 mV. A frequency range of $10^{-1}$ to $10^5Hz$ was used for the electrochemical impedance spectroscopy (EIS) measurements. The amplitude of the AC signal was 10 mV, and 5 points per decade were used. The morphology and structure of the samples were examined using field-emission scanning electron microscopy and thin-film X-ray diffraction. The elemental analysis was performed using energy-dispersive X-ray spectroscopy. Result: The PEO-treated surface exhibited an irregular pore shape, and the pore size and number of the pores increased with an increase in the Mn concentration. For the PEO-treated surface, a higher corrosion current density ($I_{corr}$) and a lower corrosion potential ($E_{corr}$) was obtained as compared to that of the bulk surface. However, the current density in the passive regions ($I_{pass}$) was found to be more stable for the PEO-treated surface than that of the bulk surface. As the Mn concentration increased, the capacitance values of the outer porous layer and the barrier layer decreased, and the polarization resistance of the barrier layers increased. In the case of the Mn/Ca-P coatings, the corroded surface was found to be covered with corrosion products. Conclusion: It is confirmed that corrosion resistance and polarization resistance of PEO-treated alloy increased as Mn content increased, and PEO-treated surface showed lower current density in the passive region.

An Empirical Study of Soundproof wall with Reduced Wind Load (풍하중 저감형 방음판의 실증 연구)

  • Choi, Jin-Gyu;Lee, Chan-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.272-278
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    • 2018
  • Traffic volume has been greatly increasing due to urban development and the improvement of living standards, and many complaints are being raised due to the increasing road noise. As a countermeasure against these problems, highly soundproof walls are installed on the sides of roads. However, the ability to bear wind loads is a major design requirement for soundproof walls, which contributes to the exponential increases in construction costs and restricts the height of the walls. The aim of this study is to improve the performance of soundproof walls and to dramatically reduce wind loads while maintaining excellent price competitiveness. Based on Helmholz's resonator theory, a new concept is proposed for a ventilation-type soundproofing plate that can pass through a fluid like air and reduce noise. A full-scale metal soundproofing plate was produced to satisfy the quality standards of highways by conducting a sound-pressure transmission-loss test, wind tunnel test, and material quality test. To verify the reliability, the wall was manufactured and installed, and the sound insulation effect was examined by measuring the noise over time. In the future, ventilated soundproof walls on roads could create a pleasant living environment due to the high noise-insulation effect.

Estimation of installation spacing by analyzing the lateral behavior of the safety fence fixed to rail bottom (레일저부고정형 안전펜스의 횡 방향 거동 분석을 통한 설치간격 산정)

  • Park, Seonghyeon;Sung, Deokyong;Lee, Changho;Jung, Hyuksang;Youg, Seungkyong
    • Journal of The Korean Society For Urban Railway
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    • v.6 no.4
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    • pp.249-257
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    • 2018
  • The number of deaths for railway traffic accidents is mainly caused by working close to the track, or when unauthorized passage pass through the track. The safety fences are being used to ensure safety for workers close to the track, and to improve the efficiency of the work, without interfering with the passage of trains. However, a safety fence for railway tracks needs to be examined to see if it will interfere with the passage of trains. The purpose of this study is to analyze the safe distance between train and safety fence developed in Korea. In addition, the lateral load condition of wind pressure by trains is estimated and numerical analysis is carried out according to the installation intervals of railway safety fences. It has been confirmed that the proper spacing between the train and the railway safety fence should be at least 200 mm from the vehicle limit, and that the proper spacing of railway safety fence must be calculated in consideration of the wind pressure by trains.