• Journal of Hospice and Palliative Care
• /
• v.14 no.1
• /
• pp.28-33
• /
• 2011

Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.

• Journal of Chest Surgery
• /
• v.39 no.8 s.265
• /
• pp.588-597
• /
• 2006

Background: The surgical repair of a tetralogy of Fallot (TOF) has been performed successfully with a favorable early and late outcome. However, the later development of pulmonary regurgitation and stenosis remains a problem. The development of pulmonary regurgitation and stenosis may be changed by the size of right ventricular outflow tract (RVOT) reconstruction at the initial total correction. Hence, it is necessary to investigate the ideal size of RVOT reconstruction. Material and Method: This prospective study was carried out to determine how a surgical strategy and the RVOT size affect the occurrence of pulmonary regurgitation and stenosis. From January 2002 to December 2004, 62 patients underwent the TOF total correction. The RVOT size (diameter of pulmonary valve annulus) of each case was measured after the RVOT reconstruction and converted to a Z value. A pre-scheduled follow up (at discharge, 6 months, 1 year, 2 years and 3 years) was carried out by echocardiography to evaluate the level of pulmonary regurgitation and stenosis. Result: The patients were divided to two groups (transannular group n=12, nontransannular group n=50) according to the method of a RVOT reconstruction. The Z value of RVOT=iameter of pulmonary valve annulus) (transannular group -1, $range\;-3.6{\sim}-0.8;$ nontransannular group -2.1, $range\;-5.2{\sim}-1.5)$ and the average pRV/LV after surgery ${(transannular group 0.44{\pm}0.09,\;nontransannular group\;0.42{\pm}0.09)}$ did not show any significant difference between two groups. The occurrence of pulmonary regurgitation above a moderate degree was more frequent in the transannular group (p<0.01). In nontransannular group, the development of pulmonary regurgitation more than moderate degree occurred to the patients with larger RVOT size (Z value>0, p<0.02) and the progressing pulmonary stenosis more than mild to moderate degree developed in the patients with smaller RVOT size (Z value<-1.5, p<0.05). A moderate degree of pulmonary stenosis developed for 4 nontransannular patients. Three underwent additional surgery and one underwent a balloon valvuloplasty. Their Z value of RVOT were -3.8, -3.8 -2.9, -1.8, respectively. Conclusion: When carring out a TOF total correction, transannular RVOT reconstruction group has significantly more pulmonary regurgitation. In the nontransannular RVOT reconstruction. the size of the RVOT should be maintained from Z value -1.5 to 0. If the Z value is less than -1.5, we should follow up carefully for the possibility of pulmonary stenosis.

• Fire Science and Engineering
• /
• v.26 no.2
• /
• pp.59-68
• /
• 2012

Predicting occupants' behaviors from the start of the fire to egress and reducing the time required for such process are critical matters that can decide success and failure of safe egress. In this research, research literatures and theories and fire cases were compared and analyzed so as to prepare logical grounds that could predict the process of beginning egress. As a result of this research, there was a significant difference in the time elapsed until people start evacuating due to spatial positions and quarantine from the place from which the fire originated and their auditive and olfactory signs did not recognize the fire instantly and they showed a strong tendency to recognize the fire by visual sign, warning announcement for egress and notice by others. And the results also showed that only a very small minority of occupants evacuated as soon as they perceived the fire and that variation in the time elapsed until evacuation begun for occupants were wider as the size of building was bigger and that accommodations such as hotel had wider variation in the time elapsed regardless of the size of buildings.

• Journal of Chest Surgery
• /
• v.29 no.11
• /
• pp.1197-1201
• /
• 1996

From October, 1987 to December, 1995, nine patients underwent total correction of tetralogy of Fallot in adults over 20 years of age. There were 5 male and 4 female patients aged from 22 to 42 years(mean, 29.6 years). Three patients were in New York Heart Association(NYHA) functional class II, and 6 patients in class III. The hemoglobin values ranged from 10.8 to 20.7 gm/㎗ (average, l5.6gm/㎗). The preoperative clinical features were as follows: cyanosis, 8 patients; dyspnea on exertion, 6 patients; clubbing of fingers, 5 patients; frequent upper respiratory infection, 3 patients. At the operation both infundibular and valvular stenosis were present in all patients. Reconstruction of right ventricular outflow tract(RVOT) using Goretex was required in 7 patients, and transannular patching with Goretex in 2 pateints. Left pulmonary angioplasty with pericardium was done in 2 patients. No hospital deaths occurred. Four of 9 patients(44.4%) had postoperative low cardiac output syndrome, and postoperative bleeding in 5. One patient required reoperation due to residual ventricular septal defect and tricuspid regurgitation 3 months after the first operation. The mean follow-up period was 25 months, range 11 to 77 months. All was asymptomatic and in NYHA class I. We suggest that advanced age is not contraindication to surgery in tetralogy of Fallot, and tetralogy of Fallot in adults could be operated on due to low mortality.

• Pediatric Infection and Vaccine
• /
• v.13 no.1
• /
• pp.78-84
• /
• 2006

Retropharyngeal abscess and descending necrotizing mediastinitis is a potentially life-threatening condition that rarely develops following trauma to the oropharynx in children. We describe a case of a 17-month-old girl with a retropharyngeal abscess that extended to the posterior mediastinum, producing an acute descending necrotizing mediastinitis and pyopneumothorax. Culture of blood and pleural pus yielded Streptococcus pyogenes. The patient underwent repeated drainage and debridement, was treated with antibiotics and recovered. This report aims to review the retropharyngeal abscess with descending necrotizing mediastinitis in children and to highlight the fact that minor pharyngeal trauma, although not significant at first, should be observed with suspicion for serious potential complications.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.7
• /
• pp.492-498
• /
• 2016

It is well known that since abrupt faults in induction motors tend to lead to subsequent faults and deterioration of the drive apparatus, motor faults may lead to several operating restrictions, such as security problems and economic loss. A lot of research has been done in the area of diagnosis to detect machine faults and to prevent catastrophic hazards in the motor drive system. This paper presents a new method of motor current signature analysis in which the DC-link current of the inverter-driven induction motor system, where a single current sensor is employed instead of three AC current sensors, is measured, and fast Fourier transform analysis is performed. This proposed method makes it possible to easily discern and clearly separate the motor fault current signature from the normal operation current flowing through the stator and rotor windings.

• The Journal of Engineering Geology
• /
• v.17 no.2 s.52
• /
• pp.253-261
• /
• 2007

The failure of the road cut-slope due to heavy rains brings about lots of injuries and damage on national properties. KICT has developed CSMS system by means of prevention to manage the dangerous cut slopes. In spite of the continuous management the frequency of cut-slopes failure is increasing the past due to changes of earth-environment. KICT has installed the "Real-Time Monitoring System" on dangerous slopes. The operation of Real-Time Monitoring System is used as a positive system to reduce injuries and damages. However, Although the slope manager is aware of the signs collapsed in advance, it has temporal and spatial limits until the slope manager performs the works which are preventing the accidents. When real time monitoring system finds out an indication of slope collapse, the Rock-fall Signal Lamp System makes road-users indicated the risk of cut slopes. It is a kind of prevention system that it will minimize the damages of the properties as suspension of traffic automatically or passively.

• Proceedings of the Korean Society of Propulsion Engineers Conference
• /
• 2007.11a
• /
• pp.178-182
• /
• 2007

This paper reviews on the LRE health monitoring and emergency protection system to protect test object engine system and engine test facility, in case of various fault occurrence at LRE testing. General composition and major technical consideration of LRE health monitoring system and emergency protection system are reviewed. Moreover, some application of LRE health monitoring/emergency protection system to development test of major LRE component such as turbopump testing, gas generator and combustion chamber test are reviewed.

• Proceedings of the Korean Information Science Society Conference
• /
• 2003.04a
• /
• pp.386-388
• /
• 2003

인터넷 발전의 대표적인 역기능인 시스템 공격 방법 중 분산 서비스거부 공격은 공격 도구가 분산되어 있고 도구를 분산화 하는 과정을 찾기 힘들다는 특징 때문에 현재까지의 연구 대부분에서 공격이 발생한 시점에서의 대응 방법이 제안됐다. 그러나 이 시점에서는 대응은 시스템에 대한 보호가 늦어질 가능성이 높기 때문에, 공격이 발생되기 이전에 네트워크 상의 패킷의 흐름을 거시적으로 판단해서 공격의 징후를 찾고 이에 대해 대처할 수 있는 방법이 필요하다. 따라서 본 논문에서는 분산화 된 보안 에이전트들에 의해 공격 시점 이전에 분산 서비스거부 공격 도구의 위상을 탐지하는 기법을 제안한다. 이 기법은 분산된 공격 도구에서 발생할 수 있는 의심스러운 접속들을 포괄적으로 판단하여 공격이 발생하기 전에 공격도구들이 설치된 일치를 찾게 된다.

• Clinical and Experimental Pediatrics
• /
• v.51 no.4
• /
• pp.372-376
• /
• 2008

Purpose : To identify clinical characteristics of severe respiratory syncytial virus (RSV) in neonatal period and early infancy and provide information in clinical practice. Methods : Twelve neonates and young infants (<6 months) who were infected by respiratory syncytial virus and required mechanical ventilation between March 2005 and July 2007 were enrolled. Diagnosis of RSV infection was made based on the positive results by rapid antigen immunoassay or polymerase chain reaction. Results : There were four premature infants, of whom three were near-term. Birth weight of subject patients was $2.8{\pm}0.6kg$, gestational age was $37{\pm}2weeks$ and the age at the time of admission was $35{\pm}15days$. Nine of them showed apnea and in five patients, apnea itself was an indication for mechanical ventilation. In seven of the apneic patients, apnea was the first manifestation of RSV infection. In three of these seven apneic patients, apnea preceded definite respiratory distress signs or typical stethoscopic findings by 1-3 days. Mean duration of mechanical ventilation was $3{\pm}2days$, and mean duration of stay in intensive care unit was $6{\pm}2days$. Conclusion : RSV is a major cause of severe respiratory tract infection in term or near-term infant younger than 2 months. For apnea could be the first manifestation of the RSV infection, high level of suspicion is required in practice of neonates or young infants who show any upper respiratory infection symptoms during RSV season.