• Title/Summary/Keyword: 집중법

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Death in the Neonatal Intensive Care Unit (신생아 중환자실의 사망에 관한 연구)

  • Koo, So-Eun;Kim, Hee-Young;Park, Kyoung-A;Lim, Gin-A;Park, Hye-Won;Lee, Byoung-Sop;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.154-162
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    • 2009
  • Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

Pathogens and Prognotic Factors for Early Onset Sepsis in Very Low Birth Weight Infants (극소 저체중 출생아에서 조기 패혈증의 원인균과 예후인자)

  • Kim, Yi-Sun;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Seo, Hyun-Ju;Choi, Seo-Heui;Park, Soo-Kyung;Jung, Yu-Jin;Kim, Myo-Jing;Jeon, Ga-Won;Koo, Soo-Hyun;Lee, Kyung-Hoon;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.163-171
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    • 2009
  • Purpose: This study was conducted to determine the incidence, causative pathogens, risk factors and mortality for early onset sepsis in the first three days in very low birth weight infants. Methods: The medical records of 1,124 very low birth weight infants admitted to the neonatal intensive care unit of Samsung Medical Center between November 1994 and December 2008 were retrospectively reviewed. The incidence, causative pathogens, risk factors, and mortality for early onset sepsis in the first 3 days of life in very low birth weight infants were evaluated. Results: Early onset sepsis, as confirmed by positive blood cultures, was present in 17 of 1,124 infants (1.5%). Sixty-four percent of the isolated pathogens were gram-positive bacteria and 35% of the isolated pathogens were gram-negative bacteria. The dominant pathogens of early onset sepsis included Staphylococcus aureus (23.5%), Esherichia coli (23.5%), and Enterococcus (17.6%). Vaginal delivery (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.3-10.3; P=0.01) was associated with early onset sepsis. The overall mortality (adjusted hazard ratio, 3.0; 95% CI, 1.4-6.5; adjusted P=0.0039) and mortality within 72 hours of life (adjusted hazard ratio, 6.5; 95% CI, 2.2-18.9; adjusted P=0.0005) of infants with early onset sepsis were higher than that of uninfected infants. Conclusion: Early onset sepsis remains an uncommon, but potentially lethal problem among very low birth weight infants. Knowledge of the likely causative organisms and risk factors for early onset sepsis can aid in instituting prompt and appropriate therapy, in order to minimize mortality.

Effect of Bone Quality on Insertion Torque during Implant Placement; Finite Eelement Analysis (임플란트 식립 시 골질이 주입회전력에 미치는 영향에 관한 삼차원 유한요소 분석)

  • Jeong, Jae Doug;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.109-123
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    • 2009
  • The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.

Functional Magnetic Resonance Imaging of Brain Reactivity to Insomnia-Related vs. General Anxiety-Inducing Stimuli in Insomnia Patients with Subjective-Objective Discrepancy of Sleep (주관적-객관적 수면시간 차이를 보이는 불면증 환자에서 일반적 불안에 비해 불면증 관련 자극으로 인한 뇌활성에 관한 기능적 자기공명영상 연구)

  • Kim, Nambeom;Lee, Jae Jun;Cho, Seo-Eun;Kang, Seung-Gul
    • Sleep Medicine and Psychophysiology
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    • v.27 no.1
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    • pp.24-31
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    • 2020
  • Objectives: Subjective-objective discrepancy of sleep (SODS) is a common symptom and one of the major phenotypes of insomnia. A distorted perception of sleep deficit might be related to abnormal brain reactivity to insomnia-related stimuli. We aimed to investigate differences in brain activation to insomnia-related stimuli vs. general anxiety-inducing stimuli among insomnia patients with SODS, insomnia patients without SODS, and healthy controls (HCs). Methods: All participants were evaluated for subjective sleep status using a sleep diary and questionnaires; occult sleep disorders and objective sleep status were assessed using polysomnography and actigraphy. Task functional magnetic resonance imaging was performed during insomnia-related stimuli (Ins) and general anxiety-inducing stimuli (Gen). Brain reactivity to Ins versus Gen was compared among insomnia with SODS, insomnia without SODS, and HC groups, and a combined insomnia disorder group (ID, insomnia with and without SODS) was also compared with HCs. Results: In the insomnia with SODS group compared to the insomnia without SODS group, the right precuneus and right supplementary motor areas showed significantly increased BOLD signals in response to Ins versus Gen. In the ID group compared to the HC group, the left anterior cingulate cortex showed significantly increased BOLD signals in response to Ins versus Gen. Conclusion: The insomnia with SODS and ID groups showed higher brain activity in response to Ins versus Gen, while this was not observed in the insomnia without SODS and HC groups, respectively. These results suggest that insomnia patients with sleep misperception are more sensitive to sleep-related threats than general anxiety-inducing threats.

Analysis of Sleep Questionnaires of Patients who Performed Overnight Polysomnography at the University Hospital (한 대학병원에서 철야 수면다원검사를 시행한 환자들의 수면설문조사 결과 분석)

  • Kang, Ji Ho;Lee, Sang Haak;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik;Park, Yong Moon
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.76-82
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    • 2006
  • Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

'Jangseong Pyunbaek Healing Forest(JPHF)' Visitors: Socio-demographic Characteristics, Use Patterns and Motivational Factors by Types of Visitors ('장성 편백치유의 숲' 방문객 유형에 따른 인구사회학적 특성, 이용행태 및 방문동기 요인)

  • Kim, Sang-Oh;Kim, Sang-Mi
    • Korean Journal of Environment and Ecology
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    • v.32 no.2
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    • pp.203-214
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    • 2018
  • This study was conducted to investigate the types, socio-demographic characteristics, use patterns, and visit motivations of visitors to "Jangseong Pyunbaek Healing Forest (JPHF)." Data were collected from 216 samples selected by convenient sampling method using questionnaire survey between October and November 2016. Data obtained from 476 respondents of the same type of survey during the same period were partly used to examine the types of activities of visitors to the study site. The results showed that 77.0 percent of respondents were categorized as "visitor for recreation" (VR: Those who visit JPHF for the purpose of general recreational experiences such as appreciating landscapes, tourism, social interactions rather than better health or healing). On the other hand, only 10.3 percent of respondents were "visitor for healing" (VH: Those who visit JPHF for the purpose of better health or physical and mental healing). VH showed a higher level of visit experiences to JPHF than VR and tended to expect JPHF as "the place to enjoy calm and natural experiences" more than VR did. VH tended to visit JPHF "alone" more, and their group size was also smaller than VR. About 26.8 percent of all respondents were not aware that JPHF was the "healing forest," and VH showed higher awareness of it than VR. About 66.8% of respondents assessed the managerial and operating states of JPHF positively while only 6.2% assessed them negatively. There was no difference in the assessment of managerial and operating states between VR and VH. The visitors of JPHF showed the markedly high use in main forest roads (use rate: 47.4%) and "Healing Field" (use rate: 59.2%) of JPHF. Regarding the visit motivations to JPHF, VH showed higher importance on "quietude," "health," and "tension release" than VR while VR rated higher importance on "social interaction." The paper discussed the managerial implications, findings, limitations and further studies.

Bias Correction for GCM Long-term Prediction using Nonstationary Quantile Mapping (비정상성 분위사상법을 이용한 GCM 장기예측 편차보정)

  • Moon, Soojin;Kim, Jungjoong;Kang, Boosik
    • Journal of Korea Water Resources Association
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    • v.46 no.8
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    • pp.833-842
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    • 2013
  • The quantile mapping is utilized to reproduce reliable GCM(Global Climate Model) data by correct systematic biases included in the original data set. This scheme, in general, projects the Cumulative Distribution Function (CDF) of the underlying data set into the target CDF assuming that parameters of target distribution function is stationary. Therefore, the application of stationary quantile mapping for nonstationary long-term time series data of future precipitation scenario computed by GCM can show biased projection. In this research the Nonstationary Quantile Mapping (NSQM) scheme was suggested for bias correction of nonstationary long-term time series data. The proposed scheme uses the statistical parameters with nonstationary long-term trends. The Gamma distribution was assumed for the object and target probability distribution. As the climate change scenario, the 20C3M(baseline scenario) and SRES A2 scenario (projection scenario) of CGCM3.1/T63 model from CCCma (Canadian Centre for Climate modeling and analysis) were utilized. The precipitation data were collected from 10 rain gauge stations in the Han-river basin. In order to consider seasonal characteristics, the study was performed separately for the flood (June~October) and nonflood (November~May) seasons. The periods for baseline and projection scenario were set as 1973~2000 and 2011~2100, respectively. This study evaluated the performance of NSQM by experimenting various ways of setting parameters of target distribution. The projection scenarios were shown for 3 different periods of FF scenario (Foreseeable Future Scenario, 2011~2040 yr), MF scenario (Mid-term Future Scenario, 2041~2070 yr), LF scenario (Long-term Future Scenario, 2071~2100 yr). The trend test for the annual precipitation projection using NSQM shows 330.1 mm (25.2%), 564.5 mm (43.1%), and 634.3 mm (48.5%) increase for FF, MF, and LF scenarios, respectively. The application of stationary scheme shows overestimated projection for FF scenario and underestimated projection for LF scenario. This problem could be improved by applying nonstationary quantile mapping.

Correlation of serum total hydroperoxide levels and diseases of prematurity (미숙아 합병증 발생과 혈중 활성 산화물 농도와의 관계)

  • Kim, Shin-Hye;Hur, Hae Young;Lee, Kyu Hyoung;Moon, Ja Young;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.746-752
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    • 2007
  • Purpose : Total hydroperoxide (TH), free radical-mediated oxidation product can be used as a measure of free radical injury. The aim of the present study was to see if preterm newborns are at increased risk for oxidative stress compared with term newborns, and to determine whether oxidative stress during postnatal first 1 week is associated with clinical outcomes in preterm infants. Methods : Serum TH levels of preterm infants (n=39) were compared with those of term infants (n=24) on the postnatal day 1. Among the preterm infants, serum TH levels of uncomplicated group (n=23) were also compared with those of complicated group (n=16) who developed oxygen radical related diseases on the postnatal day 1 and 7. Retrospective analysis was performed to find out risk factors for oxygen radical injuries based on birth history, laboratory data, neuroimaging findings and clinical progress in two preterm groups. Results : Serum TH levels on postnatal day 1 were higher in the preterm infant group than the term infant group. Serum TH levels on postnatal day 1 in the complicated preterm infant group were significantly higher compared with uncomplicated group, but there was no significant difference in serum TH levels on postnatal day 7. Also, there was no significant difference in serum TH levels between uncomplicated preterm infants and term infants. Serum TH level on postnatal day 1 was independently associated with higher morbidity after adjusting for gestational age, Apgar score (5 min), arterial blood gas analysis. Conclusion : Complicated preterm newborns are at increased risk for oxidative stress compared with uncomplicated newborns and term newborns. Oxidative injury during the prenatal or postnatal day 1 is associated with adverse outcomes in preterm infants. Elevated TH levels on postnatal day 1 may have a value to predict clinical outcomes in preterm infants.

Soil Mechanical Properties and Stability Analysis on Fill Slope of Forest Road (임도성토사면(林道盛土斜面)의 토질역학적(土質力學的) 특성(特性)과 안정해석(安定解析))

  • Ji, Byoung Yun;Oh, Jae Heun;Cha, Du Song
    • Journal of Korean Society of Forest Science
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    • v.89 no.2
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    • pp.275-284
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    • 2000
  • This study was carried out to analyze the mechanical properties of soil and the slope stability on the fill slope of forest road constructed in the regions which consist of igneous and metamorphic rock area. The results were summarized as follows. 1) Soil type by Unified Soil Classification System(USCS) was classified as SW in soil slope, GP in weathered rock slope, GP in soft rock slope for both types of parent rock, but gravelly soil slopes in igneous and metamorphic rock area were classified as SP and GW, respectively. 2) Dry unit weight was $1.34g/cm^2{\sim}1.59g/cm^2$, specific gravity 0.57~0.61, and void ratio 0.66~0.93 in the case of igneous rock area, a dry unit weight was $1.35g/cm^2{\sim}1.51g/cm^2$, specific gravity 2.67~2.77, and void ratio 0.78~1.01 in the case of metamorphic rock area. 3) The strength parameters such as internal friction angle(${\phi}$) and cohesion(c) were selected and tested for slope stability analysis. ${\phi}$ and c of soil in igneous rock area were within the range of $29.51^{\circ}{\sim}41.82^{\circ}$ and $0.03kg/cm^2{\sim}0.38kg/cm^2$, respectively, and $21.43^{\circ}{\sim}41.43^{\circ}$ and $0.05kg/cm^2{\sim}0.44kg/cm^2$ in metamorphic rock area, respectively. 4) Result of the slope stability analysis of forest road showed that, in the weathered rock slope of igneous rock and the weathered rock and soil slope of metamorphic rock area, the possibility of slope failure was high as safety factor was below 1.0.

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Evaluation of Maritime Safety Technology for Official Development Assistance (ODA) (국제협력사업 추진을 위한 해사안전기술 평가 연구)

  • Oh, Se-Woong;Jeon, Tae-Byung;Lee, Moon-Jin;Suh, Sang-Hyun;Cho, Dong-Oh
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.16 no.1
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    • pp.81-91
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    • 2010
  • IMO(International Maritime Organization) and the Shipping World rave complied with various kinds of international regulations for maritime safety and marine environmental protection, but the main reason of maritime accidents is that developing countries cannot implement maritime safety related regulations. Although Korea has been a member of the "A group" council of IMO, maritime technology transfer records of Korea are not good. To promote the project of official development assistance in Korea, it is required to select the technology which has a high degree of importance in the fields of maritime safety and has a high degree of demand on the transfer to developing countries, and to concentrate on the selected technology. So, it is necessary to draw valuation factors for maritime safety technology and to decide the priority in order among maritime safety technologies on the basis of valuation factors. Because the weights which show the degree of importance among valuation factors are different from factor to factor, interdependent relationship between factors should be considered on evaluation. In this study, the valuation factors were divided into three groups as the maturity of maritime safety technology, the promotion probability of projects and the degree of importance of technology, and the detailed factors of each group were drawn. A model which used Fuzzy AHP and limiting probability to consider the weights of importance and correlation among valuation factors was developed. To adopt this model, nine types of maritime safety technology in the field of maritime safety information were selected and points were scored for each technology through evaluation. In conclusion, first, ENC related technology was scored to be the highest as 0.0139. Second, the point of ship monitoring technology was scored as 0.0133. Last, oil spill response technology was scored as 0.0132.