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Prediction of 6-Month Mortality Using Pre-Extracorporeal Membrane Oxygenation Lactate in Patients with Acute Coronary Syndrome Undergoing Veno-Arterial-Extracorporeal Membrane Oxygenation

  • Kim, Eunchong;Sodirzhon-Ugli, Nodirbek Yuldashev;Kim, Do Wan;Lee, Kyo Seon;Lim, Yonghwan;Kim, Min-Chul;Cho, Yong Soo;Jung, Yong Hun;Jeung, Kyung Woon;Cho, Hwa Jin;Jeong, In Seok
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.143-150
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    • 2022
  • Background: The effectiveness of extracorporeal membrane oxygenation (ECMO) for patients with refractory cardiogenic shock or cardiac arrest is being established, and serum lactate is well known as a biomarker of end-organ perfusion. We evaluated the efficacy of pre-ECMO lactate for predicting 6-month survival in patients with acute coronary syndrome (ACS) undergoing ECMO. Methods: We reviewed the medical records of 148 patients who underwent veno-arterial (VA) ECMO for ACS between January 2015 and June 2020. These patients were divided into survivors and non-survivors based on 6-month survival. All clinical data before and during ECMO were compared between the 2 groups. Results: Patients' mean age was 66.0±10.5 years, and 116 (78.4%) were men. The total survival rate was 45.9% (n=68). Cox regression analysis showed that the pre-ECMO lactate level was an independent predictor of 6-month mortality (hazard ratio, 1.210; 95% confidence interval [CI], 1.064-1.376; p=0.004). The area under the receiver operating characteristic curve of pre-ECMO lactate was 0.64 (95% CI, 0.56-0.72; p=0.002; cut-off value=9.8 mmol/L). Kaplan-Meier survival analysis showed that the cumulative survival rate at 6 months was significantly higher among patients with a pre-ECMO lactate level of 9.8 mmol/L or less than among those with a level exceeding 9.8 mmol/L (57.3% vs. 31.8%, p=0.0008). Conclusion: A pre-ECMO lactate of 9.8 mmol/L or less may predict a favorable outcome at 6 months in ACS patients undergoing VA-ECMO. Further research aiming to improve the accuracy of predictions of reversibility in patients with high pre-ECMO lactate levels is essential.

Evaluation of forage production, feed value, and ensilability of proso millet (Panicum miliaceum L.)

  • Wei, Sheng Nan;Jeong, Eun Chan;Li, Yan Fen;Kim, Hak Jin;Ahmadi, Farhad;Kim, Jong Geun
    • Journal of Animal Science and Technology
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    • v.64 no.1
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    • pp.38-51
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    • 2022
  • Whole-plant corn (Zea may L.) and sorghum-sudangrass hybrid [Sorghum bicolor (L.) Moench] are major summer crops that can be fed as direct-cut or silage. Proso millet is a short-season growing crop with distinct agronomic characteristics that can be productive in marginal lands. However, information is limited about the potential production, feed value, and ensilability of proso millet forage. We evaluated proso millet as a silage crop in comparison with conventional silage crops. Proso millet was sown on June 8 and harvested on September 5 at soft-dough stage. Corn and sorghum-sudangrass hybrid were planted on May 10 and harvested on September 10 at the half milk-line and soft-dough stages, respectively. The fermentation was evaluated at 1, 2, 3, 5, 10, 15, 20, 30, and 45 days after ensiling. Although forage yield of proso millet was lower than corn and sorghum-sudangrass hybrid, its relative feed value was greater than sorghum-sudangrass hybrid. Concentrations of dry matter (DM), crude protein, and water-soluble carbohydrate decreased commonly in the ensiling forage crops. The DM loss was greater in proso millet than those in corn and sorghum-sudangrass hybrid. The in vitro dry matter digestibility declined in the forage crops as fermentation progressed. In the early stages of fermentation, pH dropped rapidly, which was stabilized in the later stages. Compared to corn and sorghum-sudangrass hybrid, the concentration of ammonia-nitrogen was greater in proso millet. The count of lactic acid bacteria reached the maximum level on day 10, with the values of 6.96, 7.77, and 6.95 Log10 CFU/g fresh weight for proso millet, corn, and sorghum-sudangrass hybrid, respectively. As ensiling progressed, the concentrations of lactic acid and acetic acid of the three crops increased and lactic acid proportion became higher in the order of sorghum-sudangrass hybrid, corn, and proso millet. Overall, the shorter, fast-growing proso millet comparing with corn and sorghum-sudangrass hybrid makes this forage crop an alternative option, particularly in areas where agricultural inputs are limited. However, additional research is needed to evaluate the efficacy of viable strategies such as chemical additives or microbial inoculants to minimize ammonia-nitrogen formation and DM loss during ensiling.

Improvement of lower hybrid current drive systems for high-power and long-pulse operation on EAST

  • M. Wang;L. Liu;L.M. Zhao;M.H. Li ;W.D. Ma;H.C. Hu ;Z.G. Wu;J.Q. Feng ;Y. Yang ;L. Zhu ;M. Chen ;T.A. Zhou;H. Jia;J. Zhang ;L. Cao ;L. Zhang ;R.R. Liang;B.J. Ding ;X.J. Zhang ;J.F. Shan;F.K. Liu ;A. Ekedahl ;M. Goniche ;J. Hillairet;L. Delpech
    • Nuclear Engineering and Technology
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    • v.54 no.11
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    • pp.4102-4110
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    • 2022
  • Aiming at high-power and long-pulse operation up to 1000 s, some improvements have been made for both 2.45 GHz and 4.6 GHz lower hybrid (LH) systems during the recent 5 years. At first, the guard limiters of the LH antennas with graphite tiles were upgraded to tungsten, the most promising material for plasma facing components in nuclear fusion devices. These new guard limiters can operate at a peak power density of 12.9 MW/m2. Strong hot spots were usually observed on the old graphite limiters when 4.6 GHz system operated with power >2.0 MW [B. N. Wan et al., Nucl. Fusion 57 (2017) 102019], leading to a reduction of the maximum power capability. With the new limiters, 4.6 GHz LH system, the main current drive (CD) and electron heating tool for EAST, can be operated with power >2.5 MW routinely. Long-pulse operation up to 100 s with 4.6 GHz LH power of 2.4 MW was achieved in 2021 and the maximal temperature on the guard limiters measured by an infrared (IR) camera was about 540 ℃, much below the permissible value of tungsten material (~1200 ℃). A discharge with a duration of 1056 s was achieved and the 4.6 GHz LH energy injected into the plasma was up to 1.05 GJ. Secondly, the fully-active-multijunction (FAM) launcher of 2.45 GHz system was upgraded to a passive-active-multijunction (PAM), for which the density of optimum coupling was relatively low (below the cut-off value). Good coupling with reflection coefficient ~3% has been achieved with plasma-antenna distance up to 11 cm for the new PAM. Finally, in order to eliminate the effect of ion cyclotron range of frequencies (ICRF) wave on 4.6 GHz LH wave coupling, the location of the ICRF launcher was changed to a port that is located 157.5° toroidally from the 4.6 GHz LH system and is not magnetically connected.

Comparative Tield and Quality of Summe Annual Grasses as Fresh-cut Forage (하형 청예 사료작물의 생산성과 사료가치 비교)

  • Jo, M.H.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.6 no.3
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    • pp.169-173
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    • 1986
  • This experiment was conducted to provide comparative data on the newly imported thirteen sorghum-sudangrass hybrids(Sorghum bicolor(L.) Moench), TE Goldmaker sorghum hybrid (S. Bicolor (L.) Moench), NC+ 88SS sudangrass hybrid (S, bicolor (L.) Moench), Supermill pearlmillet (Pennisetum americanum (L.) Leeke) and teosinte (Euchlaena mexicana Schrad,) in comparison with the check variety Pioneer 988 sorghum-sudangrass hybrid for dry matter yield, protein content, in vitro dry matter digestibility(IVDMD), and other desirable agronomic characteristics, SX-17 and NC+855 gave significantly higher dry matter yield than the check variety. There was no significant difference in total dry matter yield of the remaining 14 varieties with the exception of teosinte and TE Goldmaker which had the lowest yield. The most varieties were moderately resistant to leaf diseases although differences exist among varieties. No diseases were found in pearlmillet and teosinte, but NC+ 88SS was very susceptible to leaf blight. The mean percent crude protein of sorghum-sudangrass hybrids was lower than that of pearlmillet and sorghum hybrid, but was higher than that of sudangrass hybrid, The IVDMD of G-83F, TE Goldmaker, teosinte and HW 5111 was higher than that of the check variety. There was no consistent relationship between the percent of crude protein and IVDMD of the summer annual grasses.

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Food Habits and Nutrient Intakes by Self-reported Food Consumption of Middle and High School Students In Seoul, Gyeonggi, and Gyeongnam Area (서울, 경기, 경남 일부 지역의 중${\cdot}$고등학생의 식습관과 자가 섭취 상태 조사법을 통한 영양 섭취 평가)

  • Yi, Na-Young;Lee, Kyung-Eun;Kwak, Tong-Kyung
    • Journal of the Korean Society of Food Culture
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    • v.21 no.5
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    • pp.473-480
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    • 2006
  • The purpose of this study were to investigate middle and high school students' food habits and food attitudes, and to assess student's nutrient consumption. A self-administered questionnaire was developed based on review of literature. The questionnaire consisted of three sections (food habits, food attitudes, and food consumption). The questionnaires were distributed to 4,050 students enrolled in 34 middle and high schools located in Seoul, Gyeonggi, and Gyeongnam provinces. A final response rate was 88.2% (3,570) excluding responses that had significant missing data. Data of the food habits and food attitudes were analyzed with descriptive analysis, $x^2$-test, and t-test using SPSS WIN(ver.11.0). The student's self-reported food consumption data was converted into nutrient consumption using conversion factor. Many middle and high school students skipped breakfast and/or dinner. Approximately 29% of the students did not eat vegetables and fruits. Scores of the middle school student's attitudes(19.1) towards foods were significantly higher than those of the high school student's attitudes(18.7)(p<.001). Student's nutrient intakes were estimated according to the student's self-reported food consumption data. The nutrient intakes were compared with DRIs(Dietary Reference Intakes: DRIs) for their age groups. The result of EAR(Estimated Average Requirement: EAR) cut-point method demonstrated 57.7% of middle school boys, 64.4% of middle school girls, 70.2% of high school boys, and 71.0% of high school girls did not meet EAR for Calcium. Additionally, it showed that 39.0% of middle school boys, 23.7% of middle school girls, 58.4% of high school boys, and 24.4% of high school girls did not consume EAR for Vitamin $B_1$. 25.7% of middle school boys did not meet EAR for Vitamin $B_2$, while 44.4% high school boys did not satisfy EAR for Vitamin $B_2$.

Evaluation of Changes in Particle Size and Production of Sand and Cake Produced in Wet Aggregate Production Process (습식 골재 생산 공정에서 모래 및 케이크 발생량 평가)

  • Young-Wook Cheong;Jin-Young Lee;Sei-Sun Hong
    • Economic and Environmental Geology
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    • v.57 no.2
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    • pp.177-184
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    • 2024
  • This study was conducted to find a way to reduce the production of cakes generated in the domestic aggregate production process. Cakes from 8 wet aggregate producers were collected and particle size was analyzed. Samples were collected step by step from an aggregate producer A, particle size analysis was performed, and the material balance was calculated before and after an sand recovery unit by modeling the production process. As a result of the particle size analysis of eight cakes, one sample contained 50% sand, and the rest contained about 5% to 25% sand. The results showing that the cake contained a variety of sand in cakes may indicate that the recovery efficiency of the sand recovery units in the field varied. Sieve analysis of the samples showed that the generation of sand particles increased 2.8 times during the third crushing compared to the second crushing, and more cake particles were generated. As a result of simulating the sand recovery unit model, the lower the cut point of the cyclone and dewatering screen, the higher the sand production and the less cake production appeared. In order to reduce the production of cake in the field, it was determined that an optimal operation of the sand recovery unit was necessary in the aggregate production process.

Adverse events following immunisation with the first dose of sputnik V among Iranian health care providers

  • Reza Jafarzadeh Esfehani;Masood Zahmatkesh;Reza Goldozian;Javad Farkhonde;Ehsan Jaripour;Asghar Hatami;Hamid Reza Bidkhori;Seyyed Khosro Shamsian;Seyyed AliAkbar Shamsian;Faezeh Mojahedi
    • Clinical and Experimental Vaccine Research
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    • v.12 no.1
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    • pp.25-31
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    • 2023
  • Purpose: Since late 2019, the novel coronavirus disease has been a global concern, and alongside preventive strategies, including social distancing and personal hygiene, vaccination is now the primary hope for controlling the pandemic. Sputnik V is an adenovirus vector vaccine used against coronavirus disease 2019 (COVID-19) among Iranian health care providers, and there is a lack of information regarding the Adverse Events Following Immunisation (AEFI) by Sputnik V among the Iranian population. The present study aimed to evaluate AEFI by Sputnik V vaccine among Iranian population. Materials and Methods: Every member of the Islamic Republic of Iran Medical Council received their first dose of the Sputnik V vaccine in Mashhad (Iran) and was referred to receive their second dose enrolled in the present study and asked to fill an English language checklist asking about development of any AEFI following immunization with the first dose of Sputnik V vaccine. Results: A total number of 1,347 with a mean±standard deviation age of 56.2±9.6 years filled the checklist. Most of the participants were male (838 [62.2%]). The present study demonstrated that immunization with the first dose of Sputnik V results in at least one AEFI in 32.8% of the Iranian medical council members. Most of the AEFI was related to musculoskeletal symptoms, including myalgia. By considering the age of 55 years as a cut-off point, individuals younger than 55 had a higher rate of AEFI (41.3% vs. 22.5%, p=0.0001). Male gender, use of analgesics, beta-blockers, and previous COVID-19 infection have a lower chance of developing AEFI (p<0.05). Conclusion: The present study demonstrated that most of the AEFI was related to musculoskeletal symptoms, including myalgia, and older individuals, male gender and those receiving analgesics and beta-blockers were less likely to develop AEFI following immunization with the first dose of Sputnik V.

CT Quantitative Analysis and Its Relationship with Clinical Features for Assessing the Severity of Patients with COVID-19

  • Dong Sun;Xiang Li;Dajing Guo;Lan Wu;Ting Chen;Zheng Fang;Linli Chen;Wenbing Zeng;Ran Yang
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.859-868
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    • 2020
  • Objective: To investigate the value of initial CT quantitative analysis of ground-glass opacity (GGO), consolidation, and total lesion volume and its relationship with clinical features for assessing the severity of coronavirus disease 2019 (COVID-19). Materials and Methods: A total of 84 patients with COVID-19 were retrospectively reviewed from January 23, 2020 to February 19, 2020. Patients were divided into two groups: severe group (n = 23) and non-severe group (n = 61). Clinical symptoms, laboratory data, and CT findings on admission were analyzed. CT quantitative parameters, including GGO, consolidation, total lesion score, percentage GGO, and percentage consolidation (both relative to total lesion volume) were calculated. Relationships between the CT findings and laboratory data were estimated. Finally, a discrimination model was established to assess the severity of COVID-19. Results: Patients in the severe group had higher baseline neutrophil percentage, increased high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and lower baseline lymphocyte count and lymphocyte percentage (p < 0.001). The severe group also had higher GGO score (p < 0.001), consolidation score (p < 0.001), total lesion score (p < 0.001), and percentage consolidation (p = 0.002), but had a lower percentage GGO (p = 0.008). These CT quantitative parameters were significantly correlated with laboratory inflammatory marker levels, including neutrophil percentage, lymphocyte count, lymphocyte percentage, hs-CRP level, and procalcitonin level (p < 0.05). The total lesion score demonstrated the best performance when the data cut-off was 8.2%. Furthermore, the area under the curve, sensitivity, and specificity were 93.8% (confidence interval [CI]: 86.8-100%), 91.3% (CI: 69.6-100%), and 91.8% (CI: 23.0-98.4%), respectively. Conclusion: CT quantitative parameters showed strong correlations with laboratory inflammatory markers, suggesting that CT quantitative analysis might be an effective and important method for assessing the severity of COVID-19, and may provide additional guidance for planning clinical treatment strategies.

A STUDY ON MICROLEAKAGE OF SEALED AMALGAM RESTORATION (Sealed amalgam restoration의 미세누출에 관한 연구)

  • Lee, Sang-Heon;Lee, Jae-Cheoun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.1
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    • pp.54-61
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    • 2000
  • Amalgam, though a widely used dental material, does not bond to the tooth substrate Therefore, retentive preparation of the cavity is necessary. Such amalgam restorations, until corrosion products form and plug the margin, will show significant marginal leakage. Unless this is prevented early on, saliva and bacteria may enter the cavity causing postoperative hypersensitivity, dissolution and collapse of the restoration, discoloration of the margin and secondary caries, leading to shortened life-span of the restoration and pulpal pathosis. Recently, a method of restoration has been introduced whereby tooth material can be preserved, cavity margin can be sealed and preventive treatment of pit and fissure can be administered while retaining all the advantages of conventional amalgam restorations. Such sealed amalgams involve removing the carious lesion without extending the cavity for prevention and using pit and fissure sealants to seal cavity margins and pit and fissures to reduce microleakage. In this study, finishing of the amalgam and sealant application were performed after different intervals following of amalgam restoration to compare the microleakage of sealed and conventional amalgam restorations. Thirty bicuspids were prepared with Class V cavity preparations on the buccal and lingual surfaces. After amalgam placement, they were divided into the following groups and treated accordingly. Group 1 : Polishing after 24 hours Group 2 : Immediate sealant application without polishing Group 3 : No polishing, but sealant applied after thermocycling 500 times After treatment, the samples were thermocycled 500 times between $5^{\circ}C$ and $55^{\circ}C$ with a dwell time of 30 seconds. After thermocycling, the samples were dipped into 1% methylene blue kept in a $37^{\circ}C$ incubator at 100% humidity for 24 hours. The teeth were then embedded in resin and cut bucco-lingually along the tooth axis and observed with a stereomicroscope to determine the degree of microleakage, The following results were obtained : 1. Group 2 showed the least microleakeage, while group 1 showed the greatest. 2. Group 1 showed significantly greater microleakage compared to group 2 (p<0.05). However, no significant differences were found between group 1 and 3(p>0.05). No significant differences in microleakage were also found between cup 2 and 3(p<0.05).

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Study on the effect of soldering methods on the characteristics of the Ni-Cr alloy (납착 방법이 치과용 금속의 성상(性狀)에 미치는 영향에 관한 연구)

  • Kim, Chul-Hyung;Song, Young-Gyun;Lee, Jong-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.53-60
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    • 2012
  • Purpose: The purpose of this study was to compare Ni-Cr alloy property of gas-oxygen torch soldering and infrared welding using optical microscope and Electron Probe Micro Analyzer (EPMA). Materials and methods: Ni-Cr alloys were casted for specimens. Specimens had 3.0 mm diameter, 30.0 mm length and were divided into two groups. Each group had 4 specimens. One group was for gas-oxygen torch soldering and the other was infrared welding. Specimens were cut with low-speed disc and soldered each other with gas-oxygen torch and infrared machine. After soldering and polishing, specimens were observed at 3 points (soldering point, 5 mm distance point, 10 mm distance point) with optical microscope and analyzed 3 points (soldering point, 5 mm distance point, 10 mm distance point with EPMA. Results: The results of this study were as follows: 1. The observation of gas-oxygen torch soldering at 10 mm distance point under the optical microscope was not founded any specific surface properties, but some crack lines were observed at 5 mm distance and soldering point. 2. There were no crack lines were founded at the observation of infrared welding at 10 mm distance and 5 mm distance points under the optical microscope. However, at the 5 mm distance, the surface was not smooth enough compared with at 10 mm distance point. Some crack lines were observed at the welding point as well. 3. In the EPMA analysis of the gas-oxygen torch soldering, the component of Ni was increased by 4.5%, Cr was increased by 7.5% than that of the Ni-Cr alloy at the 10.0 mm distance. At the 5 mm distance, the component of Ni was decreased by 6.1%, Mo was increased by 9.0% than that of the Ni-Cr alloy but Cr was equally shown at the 5.0 mm distance. Only Ni was shown at the soldering point. 4. In the EPMA analysis of the infrared welding, the component of Ni was increased by 9.1%, Cr was increased by 0.4% than that of the Ni-Cr alloy but Al was equal at the 10.0 mm distance. At the 5 mm distance, the component of Ni was increased by 4.7%, Cr was increased by 4.7% and Al was increased by 0.1% than that of the Ni-Cr alloy. At the welding point, the component of Ni was increased by 8.8%, Cr was increased by 8.2% than that of the Ni-Cr alloy. Conclusion: From these results, at the 5 mm distance from the soldering point, the surface of the infrared welding was more smoother than that of the gas-oxygen torch soldering. On the EPMA analysis, the component of the specimens with infrared welding was more similar than that of the gas-oxygen torch soldering compared with the component of the Ni-Cr alloy.