• Title/Summary/Keyword: 기관평가

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Analysis of Effect and Prognostic Factors Associated with Catheter Intervention on Ascites in Terminal Cancer Patient (복수가 있는 말기 암환자에서 복수 배액관 시술의 효과와 예후요인 분석)

  • Jang, Mungsun;Kim, Chul-Min;Yoon, Johi;Nah, Jung-Ran;Chang, Seung-Nam;Kim, Myung Ok;Lee, Ja Young
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.303-309
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    • 2016
  • Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.

Method Development for the Sample Preparation and Quantitative Analysis of Synthetic Colors in Foods (식품 중 식용타르색소의 시료별 전처리방법 확립 및 함량 분석)

  • Park, Sung-Kwan;Lee, Tal-Su;Park, Seung-Kook
    • Korean Journal of Food Science and Technology
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    • v.36 no.6
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    • pp.893-899
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    • 2004
  • Method for sample preparation and quantitative analysis of 19 permitted and non-permitted synthetic colors in foods was developed based on reversed-phase ion-pairing high performance liquid chromatography. For color extraction of samples, deionized water was added, and pH was appropriately adjusted with 1% ammonia water. Any undissolved matters were extracted with 50% ethanol or 70% methanol. Lipid in snacks was first removed using n-hexane with centrifugation, water was added to extract colors, followed by clean-up and concentration using Sep-Pak $C_{18}$ cartridge. Recovery efficiencies at known concentrations of 19 standard food colors spiked into foods were in 90.3-97.9% range far soft drink, 79.2-101.9% for candy, 84.1-103.4% for jelly, 86.4-100.8% for chewing gum, 83.5-103.4% for ice cream, and 78.5-95.6% for snack.

The usefulness of the contrast agent high in gadolinium for the contrast-enhanced magnetic resonance hip arthrography (고관절의 자기공명관절조영검사 시 가돌리늄 함유량이 높은 조영제의 유용성)

  • Choi, Kwan-Woo;Kim, Yoon-Shin;Son, Soon-Yong;Lee, Ho-Beom;Na, Sa-Ra;Min, Jung-Whan;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.11
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    • pp.5682-5688
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    • 2013
  • The purpose of this study is to maximize diagnositc usefulness with increasing signal to noise ratio(SNR) and contrast to noise ratio(CNR) by using a 1mmol/mL gadolinium contrast agent. From January 2012 to June 2013 fourty-seven patients were underwent the MRI scanning to investigate the contrast difference in gadolinium content. Twenty of the patients were injencted the commercial contrast agent containing 0.5mmol/mL gadolinium and the rest of them were injected the new contrast agent containing 1mmol/mL gadolinium called gadobutrol. We measured and evaluated each SNR and CNR of the hip joint space, iliopsoas muscle and femoral head. As a result, using the 1mmol/mL gadolinium contrast agent had the higher SNR results than using the 0.5mmol/mL agent(27% in the hip joint, 30.01% in the femoral head). Also CNR using the 1mmol/mL gadolinium agent was proved to be higher than that of using 0.5mmol/mL agent(28.31% in the ilopsoas muscle and 26.74% in the femoral head). Therefore, the contrast agent containing more gadolinium like 1mmol/mL used in this study is more effective to shorten T1 relaxation time, so it increases the signal intensity and CNR and furthermore maximizes diagnostic value. This study reports the usefulness of the 1mmol/mL contrast agent in the contrast-enhanced magnetic resonance hip arthrography for the first. Therefore, it can be considered to have an meaningful academic value as showing the method for increasing the diagnostic usefulness by using the 1mmol/mL contrast agent.

Validity of Referral of High Risk Pregnancy in MCH Center (모자 보건 센터에서의 고위험 산모 의뢰 기준의 타당성)

  • Kim, Gui-Yeon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.146-152
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    • 1989
  • To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

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A study on Evaluating Validity of SNR Calculation Using a Conventional Two Region Method in MR Images Applied a Multichannel Coil and Parallel Imaging Technique (다중채널코일과 병렬영상기법 이용 시 두영역측정법을 사용한 신호대잡음비 측정의 문제점)

  • Choi, Kwan-Woo;Son, Soon-Yong;Min, Jung-Whan;Kwon, Kyung-Tae;Yoo, Beong-Gyu;Lee, Jong-Seok
    • Journal of radiological science and technology
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    • v.38 no.4
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    • pp.403-410
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    • 2015
  • The purpose of this study was to investigate the problems of a signal to noise ratio measurement using a two region measurement method that is conventionally used when using a multi-channel coil and a parallel imaging technique. As a research method, after calculating the standard SNR using a single channel head coil of which coil satisfies three preconditions when using a two region measurement method, we made comparisons and evaluations after calculating an SNR by using a two region measurement method of which method is problematic because it is used without considering the methods recommended by reputable organizations and the preconditions at the time of using a multi-channel coil and a parallel imaging technique. We found that a two region measurement method using a multi-channel coil and a parallel imaging technique shows the highest relative standard deviation, and thus shows a low degree of precision. In addition, we found out that the difference of SNR according to ROI location was very high, and thus a spatial noise distribution was not uniform. Also, 95% confidence interval through Blend-Altman plot is the widest, and thus the conformity degree with a two region measurement method using the standard single channel head coil is low. By directly comparing an AAPM method, which serves as a standard of a performance evaluation test of a magnetic resonance imaging device under the same image acquisition conditions, an NEMA method which can accurately determine the noise level in a signal region and the methods recommended by manufacturers of a magnetic resonance imaging device, there is a significance in that we quantitatively verified the inaccurate problems of a signal to noise ratio using a two region measurement method when using a multi-channel coil and a parallel imaging technique of which method does not satisfy the preconditions that researchers could overlook.

Professionalism raising of the escort which leads an instance analysis (사례분석을 통한 경호 전문성 제고)

  • Yu, Hyung-Chang
    • Korean Security Journal
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    • no.18
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    • pp.73-99
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    • 2009
  • There are three assassination and treatening cases in this thesis introduced as analysis data. They are shooting accidents of the U.S.A's President Reagun (1981,3.30), and the President Park Jeong Hee of South Korea(1974.8.15), assassination of the Prime Minister Lavin of Israel (1995.11.4) In March 30, 1981, there was an accident where criminal, Hinckley, fired ball cartridges right before the President Reagan got into the car to move to White House after completing the announcement of Hilton Hotel of Washington. As a result, the chest of president was shot and public information secretary and safeguard were wounded. In August, 15, pm 10:23, where the 29th 8.15 independent anniversay event was being celebrated by the people at the National theater in Jangchungdong, Seoul, the criminal Moon Sekwang fired ball cartridges, he failed to assassinate the President Park Jeong Hee of Korea, but shot the First lady Yuk Young Soo. She was wounded right part of head and died. In November 4, Saturday, pm 22:00 the Prime Minster Lavin had finished the supporting event of Middle Asia's Peace project and was taking on the car when he was killed by the criminal Amir's shooting, The accidents left very important lesson from the aspect of security analysis and it has been frequently used as a material for the education and training of safeguard organization. In Korea, as well as Presidential Security Service, national security departments have selected it as an important model for the subjects such as 'Security Analysis, 'Security Practice' and 'Security Methodology'. In the performance of security duty, security skill is the most important matter. Moreover, it has a close relationship with politics, society and culture. The purpose of this study is to analyze and reevaluate the case, which has been treated as a usual model from the aspect of security analysis, beyond its introduction. Attempted assassination of President Reagan was evaluated as a positive success example because of its rapid response of adjacent guards to evacuate Reagan, who is a guard target, within 10 seconds after the shot. When comparing it to President Kennedy Assassination of 1963, it was evaluated that guards were significantly specialized. In the study, however, it was possible to found many problems such as carelessness of guard, who is in charge of external area of event place, idle attitude for frequently used event place, confusion of wireless communication, risk of wireless security disclose, insufficient provision of compulsory record file, insufficient profiling of dangerous person and unsecured hospital and first-aid room.

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Evaluation of Electron Boost Fields based on Surgical Clips and Operative Scars in Definitive Breast Irradiation (유방보존술 후 방사선치료에서 수술 흉터와 삽입된 클립을 이용한 전자설 추가 방사선 조사야 평가)

  • Lee, Re-Na;Chung, Eun-Ah;Lee, Ji-Hye;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.236-242
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    • 2005
  • Purpose: To evaluate the role of surgical clips and scars in determining electron boost field for early stage breast cancer undergoing conserving surgery and postoperative radiotherapy and to provide an optimal method in drawing the boost field. Materials and Methods: Twenty patients who had $4{\sim}7$ surgical clips in the excision cavity were selected for this study. The depth informations were obtained to determine electron energy by measuring the distance from the skin to chest wall (SCD) and to the clip implanted in the most posterior area of tumor bed. Three different electron fields were outlined on a simulation film. The radiological tumor bed was determined by connecting all the clips implanted during surgery Clinical field (CF) was drawn by adding 3 cm margin around surgical scar. Surgical field (SF) was drawn by adding 2 cm margin around surgical clips and an Ideal field (IF) was outlined by adding 2 cm margin around both scar and clips. These fields were digitized into our planning system to measure the area of each separate field. The areas of the three different electron boost fields were compared. Finally, surgical clips were contoured on axial CT images and dose volume histogram was plotted to investigate 3-dimensional coverage of the clips. Results : The average depth difference between SCD and the maximal clip location was $0.7{\pm}0.55cm$. Greater difference of 5 mm or more was seen in 12 patients. The average shift between the borders of scar and clips were 1.7 1.2, 1.2, and 0.9 cm in superior, inferior, medial, and lateral directions, respectively. The area of the CF was larger than SF and IF in 6y20 patients. In 15/20 patients, the area difference between SF and if was less than 5%. One to three clips were seen outside the CF in 15/20 patients. In addition, dosimetrically inadequate coverage of clips (less than 80% of prescribed dose) were observed in 17/20 patients when CF was used as the boost field. Conclusion: The electron field determined from clinical scar underestimates the tumor bed in superior-inferior direction significantly and thereby underdosing the tissue at risk. The electron field obtained from surgical clips alone dose not cover the entire scar properly As a consequence, our technique, which combines the surgical clips and clinical scars in determining electron boost field, was proved to be effective in minimizing the geographical miss as well as normal tissue complications.

The effects of selenium on fetal growth and development in CD-1 mice exposed with mercury for the gestation period (임신 중 수은을 섭취한 CD-1 마우스 태아의 성장발육과 기형발생에 미친 셀레늄의 효과)

  • Kim, Jin-suk;Lee, Sang-mok;Choi, Seok-wha;Lee, Won-chang
    • Korean Journal of Veterinary Research
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    • v.34 no.2
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    • pp.361-368
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    • 1994
  • Teratogenic and embryotoxic effects of mercury have been reported, however, there is little information about possible antidotes against mercury exposure during gestation. In order to evaluate therapeutic effects of selenium as an antidote against mercury poisoning, pregnant CD-1 mice were exposed to methylmercury chloride(20ppm) through the drinking water with treatment of sodium selenite (1.0mg, 2.0mg or 3.0mg/kg b.w., subcutaneously) or BAL(5.0mg/kg b.w., subcutaneously) under the single or combination base as the therapeutic agents from day 6 to 15 of gestation. Fetal growth parameters such as body weight and crown-rump length in the mice exposed to mercury, were reduced as was placental weight compared to those in the control. Treatment of selenium(alone, combination with BAL) reduced the harmful effects induced by mercury on the fetal growth parameters even though no specific relationship between dose and therapeutic effect. The incidence of dead fetuses/resorptions and malformed fetuses(especially cleft palate) was also increased in the mercury only treated group. Selenium treatment demonostrated reduced the incidence of abnormal fetuses under the exposure of mercury. Relative maternal organ weights(liver, kidney, spleen) were increased significantly but relative brain weight was decreased as evidenced by decreased in the mercury treated mice compared to that in the control. A subtle indication of maternal mercury toxicity evidenced by changes of relative maternal organ weights, decreased water and feed consumption were also prevented efficiently by selenium treatment. The present study suggests that methylmercuric chloride is embrytoxic and teratogenic in CD-1 mice when exposured during organogenesis and that selenium administration may have therapeutic application for the treatment of mercury poisoning although more applicable study in human should be performed with caution in the future.

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Development and Validation of an Analytical Method for Determination of Fungicide Tridemorph in Agricultural Commodities Using LC-MS/MS (LC-MS/MS를 이용한 농산물 중 살균제 tridemorph의 시험법 개발 및 검증)

  • Pak, Won-Min;Do, Jung-Ah;Lim, Seung-Hee;Park, Shin-Min;Yoon, Ji-Hye;Lee, Dong-seouk;Chang, Moon-Ik
    • Journal of Food Hygiene and Safety
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    • v.32 no.4
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    • pp.290-297
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    • 2017
  • The purpose of this study was developed for the determination of tridemorph in agricultural commodities samples. Tridemorph residues in samples were extracted with acetonitrile, partitioned with saline water, and then purified using and aminopropyl ($NH_2$) SPE catridge. The purified samples were quantified and confirmed via liquid chromatograph-tandem mass spectrometer (LC-MS/MS) in positive ion mode using multiple reaction monitoring (MRM). Matrix-matched calibration curves were linear over the calibration ranges (0.005~2.5 ng) into a blank extract with $r^2$ > 0.999. The limits of detection and quantification were 0.001 and 0.005 mg/kg, respectively. The average recovery ranged between 75.9% and 103.7% at different concentration levels (LOQ, 10 LOQ, 50 LOQ, n = 5) with relative standard deviations (RSDs) less than 9.0%. An interlaboratory study was conducted to validate the method by Korea Advanced Food Research Institute. The average recovery ranged between 87.0% and 109.2% at different concentration levels (LOQ, $10{\times}LOQ$, $50{\times}LOQ$, n = 5) with relative standard deviations (RSDs) less than 8.0%. All values were consistent with the criteria ranges requested in the Codex guidelines (CAC/GL40, 2003) and Food Safety Evaluation Department guidelines (2016). The results prove that the developed analytical methods is accurate, effective and sensitive for tridemorph determination.

Effects of Feeding Whole Crop Rice Silage Harvested at Different Mature Stages on Rumen Fermentation and Blood Metabolites in Hanwoo Steers (수확시기별 총체벼 사일리지 급여가 거세한우 반추위 발효성상 및 혈액생리대사에 미치는 영향)

  • Choi, Chang-Weon;Oh, Young-Kyoon
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.31 no.2
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    • pp.191-200
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    • 2011
  • Four ruminally cannulated Hanwoo steers (BW 600 ${\pm}$ 48.4 kg) fed whole crop rice silage (WRS) as forage were used to investigate the effects of its dietary on rumen fermentation and blood metabolites at different harvesting time such as milk, dough, yellow ripe and mature stages of WRS, respectively. Mean ruminal pH sampled at 0, 1, 2, 4, 6 and 8 h after the morning feeding was not significantly (p>0.05) different between the WRS by the harvesting time. In diurnal pattern in ruminal pH, the lowest pH for the mature stage treatment (Mature) appeared at 6 h after the feeding while it appeared at 2-4 h for the other treatments. This may indicate that retention time in the rumen of Hanwoo fed WRS harvested at the Mature increased. Although feeding WRS harvested at different stages did not significantly (p>0.05) affect ruminal ammonia N concentration, the ammonia N for WRS harvested at the milk stage (Milk) tended (p=0.11) to decrease compared with that for the yellow stage treatment (Yellow). In the blood metabolites analysis, BUN concentration for Yellow numerically decreased compared with that for Milk. This, taking lower concentration of ruminal ammonia N for Milk than the other treatments into account, clearly indicates that the BUN concentrations may not increase in proportion to ruminal ammonia N concentration according to ammonia N concentration entering into the lower gastric tracts. Lower (p=0.03) concentration of blood albumin for the dough stage treatment than that for Mature may indicate high protein synthesis in Hanwoo fed WRS at the dough stage, but further studies in terms of mechanism of nutrients distribution should be required. Present results indicate that different harvesting time did not affect rumen fermentation and blood metabolites in Hanwoo. Thus, based on the results of the present and the previous studies, utilizing WRS harvested at yellow stage could be recommendable for Hanwoo steers.