• Title/Summary/Keyword: 기계 순환 보조

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Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery (흉골절개술을 이용한 개심술 후 발생한 흉골 감염 및 종격동염의 위험인자 분석)

  • Chang, Won-Ho;Park, Han-Gyu;Kim, Hyun-Jo;Youm, Wook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.583-589
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    • 2003
  • With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. Material and Method: From March 200f to March 2003 at the depart-ment of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, post-operative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. Result: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardio-pulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p< 0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p< 0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). Conclusion: Contamination of pa-tients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.

Korean Aspect of the Medical Problems of the Aged (노인의료문제의 한국적 측면)

  • Kwun, Koing-Bo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.191-202
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    • 1985
  • As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.

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The Production, Distribution, and Utilization of Rice in Japan (일본의 쌀 생산, 유통 및 이용 현용)

  • Inouchi, Naoyoshi
    • Food preservation and processing industry
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    • v.1 no.1
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    • pp.17-26
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    • 2002
  • 일본은 기후적으로도 쌀의 생산에 적합하며 쌀은 일본의 주곡이다. 1893년 국립농업연구소가 설치된 이래로 쌀은 품질과 단보당 생산량이 꾸준히 개선되어와 116의 노동시간으로 생산량은 2.5배의 증가를 가져왔다. 이러한 진전은 재배방법의 개선, 비료, 농약, 재배기술, 기계화, 관개배수, 농지개량 등의 요인들로 볼 수 있다. 현재 일본에서 생산되고 있는 주요 쌀 품종으로는 코시히카리($35.5\%$), 히토메보레($9.7\%$), 히노히카리($9.0\%$), 아키다코마치($8.5\%$), 키라라($4.8\%$) 등 10여 품종이며 최근에는 형질전환 품종의 연구와 함께 생물공학적 연구 ,생리, 품질, 곤충과 잡초, 토양, 식품가공 등 기본적인 연구에 심혈을 기울이고 있다. 새로운 형태의 쌀 품종으로는 냉동조리쌀밥, 초밥, 레토르트룡 쌀 등 가공용으로 적합하도록 하기 위하여 아밀로오즈의 함량을 $5-15\%$로 낮춘 쌀이나 카레, 필라프, 튀김 쌀 등의 용도에 적합하도록 아밀로오스의 함량을 $30\%$이상으로 높인 쌀뿐만 아니라 곡립의 크기와 길이 등을 변형시킨 쌀, 유색미, 향미, 단백질 함량 조절 쌀, 거대 배아미, lipoxygenase 활성을 없앤 쌀, 단맛나는 쌀 등이 연구, 생산되고 있다. 일본에서의 쌀이용은 먼저 가공용 쌀을 들 수 있다. 밥, 청주, 스낵, 쌀가루, 미소발효 등 다양하게 이용이 되고 있으며 parboiled rice와 이의 색과 향을 개선한 converted rice, 현미를 이용한 가공쌀, 쌀빵, 현미가루, 세척미, 쌀국수, 쌀스낵, 당과, 죽, 쌀은 채소아 함께하는 타키코미고한, 초밥, 냉동쌀밥, 무균포장밥, 건조밥, 즉석밥 등 매우 다양하다.는 일, 쌀 재배구조 조정과 함께 높은 미질을 가지는 품종육종, 기계화를 비롯한 경작기술의 발달, 쌀과 부산물 가공기술의 개발연구, 특정기능을 함유하는 유전공학적 기술의 적용, 토지와 도시화 그리고 식량순환에 시스템의 개혁 등 과학기술을 고양하는 일 등을 들 수 있다.하는데 도움이 되리라 생각된다.=0.002)가 통계적으로 유의한 인자였다. 결론 : 본 기관에서 시행되어진 근침윤성 방광암에 대한 방광보존치료법은 기존의 근치적 방광절제술에 비하여 대등한 치료성적을 내는 동시에 $63\%$에서 장기보존이 가능하였다. 따라서 본 치료법이 방광암의 치료에 적극적으로 적용되어야 할 것으로 생각하며 향후 여러 기관이 참여하는 활발한 연구를 통해 한국인에게 가장 적절한 치료법을 개발해야 될 것으로 생각한다. B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$$75\%$ (p=0.88), $100\%$$100\%,\;44\%$$68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기

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A Study on Spatial Downscaling of Satellite-based Soil Moisture Data (토양수분 위성자료의 공간상세화에 관한 연구)

  • Shin, Dae Yun;Lee, Yang Won;Park, Mun Sung
    • Proceedings of the Korea Water Resources Association Conference
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    • 2017.05a
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    • pp.414-414
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    • 2017
  • 토양수분은 지면환경에서 일어나는 수문 및 에너지 순환을 이해하는 데 있어 중요한 기상인자이다. 토양수분 현장관측은 땅속에 매설된 센서에 의해 상당히 정확하게 이루어지만, 관측점 수가 충분치 않아 공간적 연속성을 확보하지 못하는 어려움이 존재한다. 이에 광역적 및 연속적 관측이 가능한 마이크로파 위성센서가 토양수분 정보 획득을 위한 보조수단으로서 그 중요성이 부각되고 있다. 마이크로파 위성센서는 구름 등 기상조건의 제약을 받지 않으며, 1978년 이래 현재까지 여러 위성에 의해 25 km 및 10 km 해상도의 전지구 토양수분자료가 생산되어 왔다. 마이크로파 센서를 이용한 토양수분자료는 동일지점에 대하여 하루 2회 정도 산출되므로 적절한 시간분해능을 가지지만, 공간해상도가 최고 10 km로서 지역규모의 수문분석에 적용하기에는 충분치 않다. 이러한 토양수분자료의 공간해상도 문제 해결을 위하여 다양한 지면환경요소를 활용한 통계적 다운스케일링이 대안으로 제시되었다. 최근의 선행연구들은 대부분 방정식을 이용한 결합모형을 통해 통계적 다운스케일링을 수행하였는데, 회귀식과 같은 선형결합뿐 아니라 신경망이나 기계학습 등의 비선형결합에서도, 불가피하게 발생할 수밖에 없는 잔차(residual)로 인하여 다운스케일링 전후의 공간분포 패턴이 달라져버리는 문제를 안고 있었다. 회귀분석에 잔차의 공간내삽을 결합시킨 회귀크리깅(regression kriging)은 잔차보정을 통해 이러한 문제를 해결함으로써 다운스케일링 전후의 공간분포 일관성을 보장하는 기법이다. 이 연구에서는 회귀크리깅을 이용하여 일자별 AMSR2(Advanced Microwave Scanning Radiometer 2) 토양수분 자료를 10 km에서 1 km 해상도로 다운스케일링하고, 다운스케일링 전후의 자료패턴 일관성을 평가한다. 지면온도(LST), 지면온도상승률(RR), 식생온도건조지수(TVDI)는 일자별로 DB를 구축하였고, 식생지수(NDVI), 수분지수(NDWI), 지면알베도(SA)는 8일 간격으로 DB를 구축하였다. 이러한 8일 간격의 자료를 일자별로 변환하기 위하여 큐빅스플라인(cubic spline)을 이용하여 시계열내삽을 수행하였다. 또한 상이한 공간해상도의 자료는 최근린법을 이용하여 다운스케일링 목표해상도인 1 km에 맞도록 변환하였다. 우선 저해상도 스케일에서 추정치를 산출하기 위해서는 저해상도 픽셀별로 이에 해당하는 복수의 고해상도 픽셀을 평균화하여 대응시켜야 하며, 이를 통해 6개의 설명변수(LST, RR, TVDI, NDVI, NDWI, SA)와 AMSR2 토양수분을 반응변수로 하는 다중회귀식을 도출하였다. 이식을 고해상도 스케일의 설명변수들에 적용하면 고해상도 토양수분 추정치가 산출되는데, 이때 추정치와 원자료의 차이에 해당하는 잔차에 대한 보정이 필요하다. 저해상도 스케일로 존재하는 잔차를 크리깅 공간내삽을 통해 고해상도로 변환한 후 이를 고해상도 추정치에 부가해주는 방식으로 잔차보정이 이루어짐으로써, 다운스케일링 전후의 자료패턴 일관성이 유지되는(r>0.95) 공간상세화된 토양수분 자료를 생산할 수 있다.

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An Experimental Study on Radiation/Convection Hybrid Air-Conditioner (복사-대류 겸용 하이브리드 냉방기에 대한 실험 연구)

  • Kim, Nae-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.6
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    • pp.288-296
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    • 2019
  • Radiation cooling has used ceilings or floors as cooling surfaces. In such cases, to avoid moisture condensation on the surface, the surface temperature needs be higher than the dew point temperature or an additional dehumidifier is added. In this study, with a goal for residential application, intentional moisture condensation on the cooling surface was attempted, which increased the cooling capacity and improved the indoor comfortness. This method included two separate refrigeration cycles - convection-type dehumidifying cycle and the panel cooling cycle. Test results on the panel cooling cycle showed that, at the standard outdoor ($35^{\circ}C/24^{\circ}C$) and indoor ($27^{\circ}C/19.5^{\circ}C$) condition, the refrigerant flow rate was 8.8 kg/h, condensation temperature was $51^{\circ}C$, evaporation temperature was $8.8^{\circ}C$, cooling capacity was 376 W and COP was 1.75. Furthermore, the panel temperature was uniform within $1^{\circ}C$ (between $13^{\circ}C$ and $14^{\circ}C$). As the relative humidity decreased, the cooling capacity decreased. However, the power consumption remained approximately constant. In the convection-type dehumidification cycle, the refrigerant flow rate was 21.1 kg/h, condensation temperature was $61^{\circ}C$, evaporation temperature was $5.0^{\circ}C$, cooling capacity was 949 W and COP was 2.11 at the standard air condition. When both the radiation panel cooling and the dehumidification cycle operated simultaneously, the cooling capacity of the radiation panel cycle was 333 W and that of the dehumidification cycle was 894 W, and the COP was 1.89. As the fan flow rate decreased, both the cooling capacity of the radiation panel and the dehumidification cycle decreased, with that of the dehumidification cycle decreasing at a higher rate. Finally, a possible control logic depending on the change of the cooling load was proposed based on the results of the present study.

Establishment of the Heart Failure Model by Coronary Artery Ligation in Sheep (양에서 관상동맥 결찰에 의한 심부전 모델의 확립)

  • 나찬영;홍장수;박정준;김원곤;강문철;서정욱
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.1-10
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    • 2002
  • Background: Despite the relatively high mortality rates in the chronic heart failure model induced by coronary artery ligation are relatively high, this model has been a subject of continuos research because of its clinical correlation. Chronic heart failure model of large-sized animals is very useful to analyse mechanical or biological effects on circulatory system which is difficult in small-sized animals. The purpose of this study is to establish the heart failure model by coronary artery ligation in sheep. Material and Method: Among 9 Corridale sheep, the homonymous artery and the diagonal branch were ligated simultaneously in 2 sheep and remaining 7 sheep were assigned to successive ligation of both arteries at an interval of 1 hour. Both coronary arteries were ligated from the point 40% proximal to the apex of the heart. Hemodynamic and echocardiographic parameters were analyzed before the ligation of the coronary artery, after the ligation of the homonymous artery, and after additional ligation of the diagonal branch. The experimental animals were sacrificed after 2 or 3 months of growth and histopathologic studies were performed Result: Immediate postoperative death occurred in the 2 sheep that had received simultaneous ligation of the homonymous artery and diagonal branch. On the other hand, all the 7 sheep that were lifated in succession were survived up to 3 months. Arterial pressure was sifnificantly decreased immediately after ligation of the homonymous artery(p<0.05), and the cardiac output was decreased and pulmonary capillary wedge pressure was increased after further ligation of the diagonal branch(p<0.05). Central venous pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, left ventricular end-diastolic dimension and end-systolic dimension were markedly increased 3 months after ligation of coronary arteries. Anteroseptal akinesia or dyskinesia was developed after the ligation of coronary arteries. Histopathologic study revealed we]1-demarcated ischemic area of fibrosis. Conclusion: Using methods of successive ligation of the homonymous artery and diagonal branch, chronic heart failure model could be reliably established in sheep.

A Study of Below Knee Surrounding Dose depends on whether Using Collimator Shielding or not while Percutaneous Coronary Intervention (경피적 관상동맥 중재술 시 차폐 유·무에 따른 슬 하부 주변부 선량에 관한 연구)

  • Park, Jae Jin;Ko, Seong Jin;Kang, Se Sik;Kim, Chang Soo;Kim, Jung Hoon;Kim, Dong Hyun
    • Journal of the Korean Society of Radiology
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    • v.7 no.5
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    • pp.353-358
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    • 2013
  • Recently, the Percutaneous Coronary Intervention has become a main treatment for treating Coronary because of increase of Circulatory Disease. Because of this reason, the increase of intervention using radiation causes the radiation exposure to workers. Therefore, the latent radiation injury can be increased. Thus, this study/experiment measured around under knee whether using radiation collimator shielding or not. We measured the exposure does by the experiment methods which are using 60kV, 200mA, and 10ms of Automatic exposure conditions and using the major method of the Cinefluography of Coronary in our hospital. As the result of right coronary artery test cases, LAO $30^{\circ}$ when the curtains if you use lead 98.4%, $Cranial30^{\circ}$ 98.3% have a protective effect of the radiation. left circumflex coronary artery test cases, Caudal $30^{\circ}$ if the shielding effect of 90.2%, Caudal $30^{\circ}LAO$ $30^{\circ}$ 88.7% have a protective effect of the radiation. left anterior descending artery test cases, Cranial $30^{\circ}$ 98.3%, Cranial $30^{\circ}RAO$ $30^{\circ}$ 80.3%, Cranial $30^{\circ}$LAO $30^{\circ}$ 98% of the radiation has a protective effect. OS(Spider view) in the case of test Caudal $40^{\circ}LAO$ $40^{\circ}$ 71.2% appeared to have the effect of radiation shielding. For these reasons, radiation workers need to be aware on taking care of their radiation exposure by using the radiation collimator shielding even though it is uncomfortable for them.

Effect of Saengmaec-san on the Level of Blood Glucose and Serum Components in Streptozocin-Induced Diabetic Rats (생맥산의 식이가 Streptozocin으로 유도된 당뇨 Rat의 혈당과 혈청 성분 함량에 미치는 영향)

  • Kim, Hyeong-Jin;Yang, Hye-Jin;Kim, Mi-Hwan;Ryu, Gi-Hyung;Jung, Ji-Youn
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.9
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    • pp.1179-1186
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    • 2009
  • This study was carried out to investigate the effect of saengmaec-san on the level of blood glucose and serum components in streptozocin (STZ)-induced diabetic rats. The experimental groups were divided into normal group (normal), diabetic control group (Dia-control), 10% saengmaec-san (white ginseng) group (DA), 10% saengmaec-san (fermented white ginseng) group (DB), 10% saengmaec-san (fermented red ginseng) group (DC), 5% saengmaec-san (extruded and fermented white ginseng) group (DDL), 10% saengmaec-san (extruded and fermented white ginseng) group (DDH). The body weight after induction of diabetes was 85.4% in the Dia-control group compared with the normal group. But in the DA group, the body weight showed clear sign of recovery almost normal level after administration of saengmaec-san for two weeks. The food efficiency ratios (FER) were 5.94% in the normal group. But it was significantly decreased in the Dia-control group (0.58%). All the treatment groups showed increase of FER compared with the Dia-control group. The level of blood glucose was significantly increased in the STZ-induced diabetes groups but it was decreased in all the treatment groups after administration for 2 weeks. Serum creatinine level were significantly higher in the STZ-induced diabetes groups and after administration of saengmaeg-san for 2 weeks while the level of serum creatinine was decreased 33.3% in the DB group. After administration of saengmaec-san for two weeks, serum total cholesterol level were significantly lower in all treatment groups than the first day of the total cholesterol level. The level of serum triglyceride was increased in all the treatment groups compared with the first day of triglyceride level. The level of serum HDL-cholesterol, after STZ-induced diabetes, was decreased in all treatment groups but particularly in the DDL and DDH groups increased HDL-cholesterol level compared with the first day of the saengmaec-san administration. Compared with the beginning of experiment, Atherogenic index (AI) were significantly decreased in all treatment groups than the Dia-control group and showed clear sign of recovery almost normal level. These results suggested that the saengmaec-san could be developed as an antidiabetic agent.