• Title/Summary/Keyword: 예견인자

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Evaluation of the Risk Factors Predicting Morbidity and Mortality after Major Pulmonary Resection (주요 폐절제술시 이환율과 사망률을 예견하는 위험인자의 평가)

  • Choi, Ho;Lee, Cheol-Joo;Soh, Dong-Moon;Kim, Jung-Tae;Hong, Jun-Wha;Ryu, Han-Young;Park, Jae-Beom
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.549-555
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    • 1999
  • Background: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. Material and Method: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and $\chi$2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. Result: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). Conclusion: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.

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Computational Estimation of Process Parameters in Structural Reaction Injection Molding (SRIM/RIM을 위한 공정 인자의 수치 해석적 평가)

  • ;R.J. Duh
    • Journal of the Korean Society for Precision Engineering
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    • v.13 no.11
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    • pp.143-151
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    • 1996
  • Structural reaction injection molding을 이용한 복합재료의 제품 셩형을 위한 모델링 전략을 설명하였다. 사용된 모델은 두 평행한 원판형 mold에 있는 불 균일한 온도조건의 fiber preform을 통과하는 reactive srsin의 방사형 유동을 시뮬레이션 한다. 이러한 모델은 중요한 작동인자와 공정인자(주입온도, mold의 온도, 유량, cavity의 두께와 섬유의 조밀도)등이 유동속도, 변화(monomer, radical, inhibitor) 및 온도분포 등에 미치는 영향을 예견한다. 열전달과 질량전달 및 화학반응을 고려하여 모델을 개발하였다. 중요한 공정인자를 평가하기 위한 효울적인 공정창( process window)을 제공하는데 본 연구의 목적을 두었다. 2차원적인 Lagrangian 방식에 1차원적인 유동과 제한적인 2차원 열전달을 가정하여 모델을 유도하였고, 방정식은 implicit difference scheme에 의해 전개하였다. 이 모델은 Gonzalez-Romero의 실험 결과와 비교함에 의해 확인되었고, 실험결과가 잘 일치함을 보였다.

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Factors Related to Patients' Satisfaction Level of Treatment Outcome of Oral Malodor (구취치료 후 만족도에 영향을 미치는 예견인자)

  • Lee, Jeong-Yun;Kho, Hong-Seop;Kim, Young-Ku;Chung, Sung-Chang;Lee, Sung-Woo
    • Journal of Oral Medicine and Pain
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    • v.26 no.1
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    • pp.27-38
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    • 2001
  • 본 연구에서는 환자들에 의해 구취와 관련이 있다고 일반적으로 믿어지고 있는 여러 요인들이 치료 후의 환자의 만족도에 미치는 영향에 대해 알아봄으로써 환자의 만족도의 예후를 판단할 수 있는 자료를 마련하고자 하였다. 서울대학교 치과병원 구강진단과에 구취를 주소로 내원한 환자 194명을 대상으로 설문지를 이용하여 구취와 관련성이 있는 것으로 알려져 있는 항목들을 조사하였다. 조사 항목으로는 1) 본인확인가능여부, 2) 타인확인가능 여부, 3) 구취의 기간, 4) 구취의 빈도, 5) 축농증, 6) 비염, 7) 코수술 병력, 8) 콧물이 목뒤로 넘어감, 9) 코막힘, 10) 비호흡 곤란, 11) 구강건조감, 12) 편도선부종, 13) 가래, 14) 신물의 역류, 15) 소화불량, 16) 흡연여부가 포함되었다. 구취의 평가는 portable sulfide monitor인 $Halimeter^{(R)}$(Interscan Co., Chatsworth, CA, USA)를 이용하여 치료 전, 후에 각각 측정하였고, 혀배면의 세정, 치면 세균막 조절, 0.25% $ZnCl_2$ 양치액의 사용을 내용으로 하는 구취의 치료를 시행한 뒤 자신의 구취개선정도에 대해 %로 질문하여 치료 후 만족도를 조사하였다. 각 조사 항목과 치료 후 만족도 사이의 상관관계 및 실제 $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 상관관계를 분석하였으며, Symptom Checklist - 90 Revised(SCL-90R)의 분석결과에 따라 환자를 두 그룹으로 분류하고 두 그룹 사이의 치료 후 만족도의 차이를 조사한 결과 다음과 같은 결론을 얻었다. 1. 본인 및 타인 확인가능여부, 구취가 항상 나는지 여부, 구취의 기간, 축농증, 비염, 코수술 병력, 코막힘, 비호흡 곤란, 콧물이 목뒤로 넘어감, 흡연여부에 따른 치료 후 만족도의 유의한 차이는 없었다. 2. 신물의 역류(p=0.003), 소화불량(p=0.007), 구강건조감(p=0.016), 편도선 부종(p=0.018), 가래(p=0.033)에 따른 치료 후 만족도는 통계적으로 유의한 수준의 차이를 보였다. 3. $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 유의한 상관관계는 관찰되지 않았다(r=0.092, p=0.201).

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Risk Factors of Redo-valve Replacement (판막재치환술의 위험인자)

  • 최강주;조광현;김성룡;이상권;전희재;윤영철;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.785-791
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    • 2002
  • The results of reoperative valve replacement can be improved if appropriate analysis for the risk of reoperation was achieved. The purpose of our study was to analyze the results of reoperations for failure of bioprosthesis, and to define the risk factors in high-risk populations for reoperative procedures. Material and Method The series of 46 consecutive patients who had undergone first reoperative replacement for failed bioprosthesis between 1993 and 2001 were reviewed retrospectively. Mean age was 42 $\pm$ 12 years, mean body surface area was 1.52 $\pm$0.15 $m^2$. The reoperative procedure comprised of 36 MVR, 8 DVR, and 2 AVR. The first operation comprised of 2 DVR, 1 AVR, and 43 MVR. Factors which were choose to assess a predictor of results in reoperative valve replacement were sex, old age(>60 years), early age at first operation(<30 years), long interval between first and redo operation(.15years), poor NYHA functional class(>3), LV dysfunction(LVEF<45%), long operation time(>8hours), endocarditis, combined procedures, and renal insufficiency, Result : Overall mortality was 4.3%(2 cases). The risk factors that influenced postoperative complications and unexpected postoperative results were lower ejection fraction(p=0.012), older age(p=0.045), endocarditis(p=0.023), long operation time above 8 hours(p=0.027). There was no statistically significant factor influencing hospital mortality. Conclusion : No factor influenced the mortality. Better results could be achieved if reoferation was performed carefully in poor left ventricular function, old aged patient, and with endocarditis. Effort to shorten the operation time would be helpful on postoperative results.

Model-Prediction-based Collision-Avoidance Algorithm for Excavators Using the RLS Estimation of Rotational Inertia (회전관성의 순환최소자승 추정을 이용한 모델 예견 기반 굴삭기의 충돌회피 알고리즘 개발)

  • Oh, Kwang Seok;Seo, Jaho;Lee, Geun Ho
    • Journal of Drive and Control
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    • v.13 no.4
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    • pp.59-67
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    • 2016
  • This paper proposes a model-prediction-based collision-avoidance algorithm for excavators for which the recursive-least-squares (RLS) estimation of the excavator's rotational inertia is used. To estimate the rotational inertia of the excavator, the RLS estimation with multiple forgetting and two updating rules for the nominal parameter and the forgetting factors was conducted based on the excavator-swing dynamics. The average value of the estimated rotational inertia that is for the minimizing effects of the estimation error was computed using the recursive-average method with forgetting. Based on the swing dynamics, the computed average of the rotational inertia, the damping coefficient for braking, and the excavator's braking angle were predicted, and the predicted braking angle was compared with the detected-object angle for a safety evaluation. The safety level defined in this study consists of the three levels safe, warning, and emergency braking. The analytical rotational-inertia-based performance evaluation of the designed estimation algorithm was conducted using a typical working scenario. The results of the safety evaluation show that the predictive safety-evaluation algorithm of the proposed model can evaluate the safety level of the excavator during its operation.

The Role of B-type Natriuretic Peptide in Predicting Postoperative Complications and Outcomes in Patients Undergoing Coronary Artery Bypass Graft (관상동맥 우회술 환자의 술 후 합병증 예견에 대한 BNP의 역할)

  • Jung, Tae-Eun;Lee, Jang-Hoon;Do, Hyung-Dong;Han, Sung-Sae;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.55-60
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    • 2008
  • Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age $60.0{\pm}9.6$ years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r=-0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=$99{\pm}23\;pg/mL$ vs. $296{\pm}74\;pg/mL$, p<0.05) and presence (mean BNP=$212{\pm}29\;pg/mL$ vs. $408{\pm}23\;pg/mL$, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receiving CABG.

Plasma Levels of Brain Natriuretic Peptide Predict Postoperative Atrial Fibrillation in Patients Undergoing Heart Surgery (심장 수술 후 심방세동 발생의 예측 인자로서 혈중 BNP 농도)

  • Kwon, Jin-Tae;Jung, Tae-Eun;Lee, Jang-Hoon;Lee, Dong-Hyup
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.407-413
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    • 2007
  • Background: The brain natriuretic peptide (BNP) level has been reported in some studies to be associated with the occurrence of atrial fbrillation (AF). The aim of this study is to evaluate the potential usefulness of the BNP level as a predictor of the occurrence of postoperative (postop) AF and to assess the relationship of the BNP level with the onset of AF and the restoration of sinus rhythm. Material and Method: From January 1, 2005 to February 28, 2006, 82 patients without a history of atrial arrhythmia that had undergone cardiac surgery were enrolled in the study. Blood samples for plasma BNP were drawn daily for all these patients from the preoperative (preop) day to the 7th postop day. The patient records were reviewed and postop EKGs were checked daily for AF until the time of discharge. Result: Patients were divided into two groups based on development of postop AF. Postoperative AF developed in 26 patients (31.7%). There was no significant statistical difference in age, sex distribution, preop left ventricle ejection fraction, hypertension, left ventricular hypertrophy, or the use of beta blockers between the non-postop AF and postop AF group. More patients in the AF group had undergone valve surgery (39.3% versus 76.9%, p=0.002). The preop left atrium size was significantly larger in the AF patients ($43.8{\pm}10.3 mm$ versus $49.8{\pm}11.5 mm$, p=0.029). The preop plasma BNP levels were higher in the postop AF patients ($144.1{\pm}20.8 pg/mL$ versus $267.5{\pm}68 pg/mL$, p=0.034). In the postop AF group, the plasma BNP level was the highest on the 3rd postop day. Postop AF developed in most patients by the 3rd postop day; restored sinus rhythm developed by the 7th postop day. Conclusion: Elevated plasma BNP levels may lead to the occurrence of postop AF in patients undergoing cardiac surgery. Patients who have a high risk of postop AF should be considered for aggressive prophylactic antiarrhythmic therapy.

Determination of Optimized Operational Parameters for Photocatalytic Oxidation Reactors Using Factorial Design (요인분석법을 이용한 광촉매 산화반응조의 최적 운영인자 도출)

  • Hur, Joon-Moo;Cheon, Seung-Yul;Rhee, In-Hyoung;Kim, Jong-Soo
    • Korean Journal of Environmental Agriculture
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    • v.23 no.2
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    • pp.85-91
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    • 2004
  • The objective of this study is to determine the optimum conditions of operational parameters using factorial design for phenol degradation in photocatalytic oxidation reactors. Factorial design is widely used to select the dominant factors and their ranges in experiments involving several factors where it is necessary to study the effect of factors on a response. The effects of initial concentration of phenol, intensity of UV light and surface area of catalyst on phenol degradation were investigated. Two levels were considered in this study so that the experiment was a $2^3$ factorial design with three replicates. The experimental results show that an increase in initial concentration of phenol from 5 to 50 mg/L intensity of UV light from 5,000 to $20,000\;{\mu}W/cm^2$, and surface area of catalyst from 740 to $2,105\;cm^2$ enhanced the phenol degradation rate by an average of 1.86, 1.79, and 2.10 mg/L hr, respectively. Interaction effects do not appear to be as large on the phenol degradation rate as the main effects of single factors. The optimum working condition for photocatalytic oxidation reactors, despite the higher three factors the better removal rate, is the highest surface area or catalyst.

Synthesis and biological activity of 6'-phenylgriseofulvin as analogs of antibiotic griseofulvin (항진균성항생물질 griseofulvin 유도체인 6'-phenylgriseofulvin의 합성과 항균활성)

  • Ko, Byoung-Seob;Oritani, Takayuki;Yamashita, Kyohei
    • Applied Biological Chemistry
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    • v.35 no.5
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    • pp.395-398
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    • 1992
  • In order to study the influence of a 6'-methyl group in ring C of griseofulvin ${\underline{(1)}}$ on the fungicidal activity, 6'-methyl group was replaced with a larger phenyl group as $({\pm})-6'-phenylgriseofulvin$ ${\underline{(3)}}$, $({\pm})-6'-epiphenylgriseofulvin$ ${\underline{(4)}}$, synthesized by a Diels-Alder cycloaddition. Their biological activities were examined against Botrytis allii (IFO 9430) and B. cinerea (AHU 9573). $({\pm})-6'-Phenylgriseofulvin $ ${\underline{(3)}}$ showed high activity in $25\;{\mu}g/disc$.

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