Purpose : Percutaneous cannulation of the central vein in children and infants may be technically difficult and can cause serious complications. There are many techniques to improve the success rate and to decrease the complications in central vein cannulation. This study was undertaken to determine whether audible Doppler guidance can help operators improve the results of central vein cannultion in pediatric ICU. Methods : A total of 46 central vein cannulations were performed using audible Doppler guidance technique. Using an 8-MHz Doppler ultrasound device(Pocket-Dop II. iMex. USA), the artery and the vein were identified by their characteristic Doppler sounds. Results : There was a total of 46 patients with 20 boys and 26 girls, respectively. The mean age was $3years{\pm}45months$(range : 1-156 months). The number of infants was 18 and the mean age was $6.3{\pm}3.8$ months(range : 1-12 months). The most common site of central vein cannulation was the right internal jugular vein(63%). The cannulation was successful in 44 out of 46 procedures(96%). The success rate at the first attempt was 59% with 48% in the patients who had the history of previous cannulation and 70% in the patients who did not, respectively. The success rate in infants was 94%(17 out of 18). The average access time was $5.2{\pm}8.3$ minutes in children contrary to $7.5{\pm}10.3$ minutes in infants. There were no serious complications, but six patients had complications including four hematoma, one arterial puncture, and one pneumothorax. Conclusion : This central vein cannulation using Doppler guidance may improve the success rate of central vein cannulation and decrease the development of serious complications in infants and children.
This study aimed at evaluating the effects of a molting diet method in molt induction and post-molt performance of laying hens. Eighty-one ISA Brown hens at 62 wk of age were randomly divided into three groups. After a 4-wk preliminary period, a control group was fed a corn-soybean-based layer diet, and for the other groups, molting was induced by starvation (MS) or feeding a molting diet (MD). For the MS group, feed was withdrawn for 2 wk; this was followed by feeding a layer diet every other day for 1 wk and then the control diet. The MD group was fed a molting diet containing low-protein and low-energy diet based for 4 wk; this was followed by feeding a layer diet. They had a free access to their diet and water. Egg production, egg quality, feed intake, and ovary and oviduct weights were measured throughout the experimental period. During molting, the feed intake in the MD group was lower than that of the control. Body weight of the molted groups was significantly reduced. The MS group feeding totally ceased egg production within 4d; after the initiation of feeding and decreased; in the MD group, egg production to 9.3% by d 10. On d 14, the ovaries and oviducts of the molted groups were distinctly lighter than those of the control. Throughout the post-molt period, egg production and egg shell thickness of the molted group improved; but there were no significant differences. Eggs from the MD-fed or control group were heavier than those of the MS-fed or control group. Finally, feeding of a low-protein and low-energy diet effectively induces molting and increase post-molt production, but further research will be conducted to determine the effects of the molt diet with other ingredients and to reduce the energy level of the molt diet for maximizing molt induction and post-molt egg quality.
This study attempted to investigate if the soy isoflavone, genistein, influences bone metabolism in ovariectomized, 4-week-old female Wister rats. All the rats were divided into sham (SH) and ovariectomized (OVX) groups consisting of OVX-17${\beta}$-estradiol($10\;{\mu}g/kg$ b.w.), OVX-1mg or 5 mg or 10mg of genistein/kg b.w. The rates were allowed ad libitum access to foods and water for 8 weeks. The Results showed that body weight had significantly increased in the OVX group compared to the SH group (p<0.05) and was not different among the OVX-GEN and OVX-ES groups and the OVX group. The liver and uterus weights in the OVX groups were slighter than those in SH group (p<0.05). The kidney weight in the OVX groups was decreased compared to in that in the SH group but was not significantly different among all OVX groups. Femoral length in the OVX groups was longer than in the SH group and was not different. Rats in the OVX groups had higher creatinine levels than those in the SH group and hydroxyproline level did not differ significantly among any of the groups. Serum ALP activity and Ca in bone, feces, urine and serum did not change among the groups. Bone mineral density (BMD) decreased in the OVX groups compared to the SH group and was slightly increased by feeding genistein (p>0.05). Breaking force and stiffness did not change by ovariectomy and feeding genistein. Hence, these results suggested that estrogen may affect bone mineralization in growing rats and that genistein be may involved in the prevention of bone loss. However, more studies are needed to identify the proper mechanism of genistein and bone formation.
The purpose of this study is to analyze the performance of Virtual Desktop Infrastructure(VDI) adoption. VDI performance was measured by IS manager (system quality, security, and managerial operation) and business user (usability, access, and user satisfaction). The survey questionnaires were developed for measuring VDI performance. 84 data samples were collected from the companies that had adopted cloud-based VDI. This research model was verified by Smart-PLS and SPSS. The research findings were as follows: First, the companies using VDI experienced actual performance, but they did not attain their expectation. Second, as results of comparing between IS managers and business users, IS administrators had considerably higher performance than business users, which indicates that there were big differences in performance perception among users. Compared with prior research such as technical trend, system construction, and performance improvement, this study has the following implications. First, by comparing the expected performance with the actual performance of the companies that have implemented and operating VDI, it was suggested how a company that wants to adopt VDI can manage the expectation level of VDI and achieve higher actual performance. Second, because the perception of VDI performance differs between business users and system managers, it is meaningful that a fair evaluation of VDI performance requires a balanced consideration of business users and system managers.
Objectives of this study is develop security services through determinants analysis on the efficiency of security works regarding security and guarding business in Korea because nowadays the modern society like Korea let alone all over the world faces the increase of dangerous factors in every security field of the human societies, and also it is the very present situation that an individual's life even the national security itself can be at the risk without guaranteeing the efficiency of the security services. For this purpose, this study reviewed related documents, surveyed and interviewed security personnels to identify what the potentially influential factors are in both the public and private security organizations regarding the efficiency of present security services and organizations, and what differences are. Also, comparing the public and private security sectors, this study intended to suggest policy agendas how to enhance the efficiency of security services in the future. This study surveyed the 177 agents and former agents of the Presidential Security Service(PSS) for the public security sector, and also surveyed, interviewed, and internet-based polled 821 randomly selected personnels for the private security sector. This research showed that regarding the efficiency of the security services number of independent variables which had positive responses in the public security sector was more than that in the private security sector. Among the 21 questions regarding this issue, there were all of 21 positive responses in the public security sector while there were 18 negative responses in the private security sector. As a result of synthesizing all the answers of the both sides, it is possible to understand that mostly the ratio of the positive response was much higher. In the public security service, statistically significant variables were budget support for events, prior access of information, an integrated teamwork training, organizational atmosphere, morale of organization personnel. However, practical training of the security service and mutual communication showed unexpectedly negative(-) signs. In the private security service, statistically significant variables were budget support for events, integrated teamwork training, socially friendly atmosphere, compensation for the personnels, bullet-proof equipments and vehicles, mood of organization, personnel recruit and disposition, unexpected incidents and basic attitude for security services. In sum, while organizational personnel variables and organizational management variables were significant in the public security service, some organizational management variables and all socio-environment variables were statistically significant at 5% significance level.
Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.
The increase in the consumption of herb medicines have made their use a public health problem due to the potential fungal contamination and the risk of the presence of my cot ox ins. 360 samples of herb medicines were evaluated for the aflatoxin contamination. The natural occurrence of aflatoxins in these samples were determined using immunoaffinity column clean up and high performance liquid chromatography (HPLC) with post-column derivatization. For samples analyzed, mean levels (incidence) of AFB1, AFB2, AFG1 and AFG2 in positive samples were $1.4\;{\mu}g/kg$(46.4%), $0.4\;{\mu}g/kg$(25.4%), $1.1\;{\mu}g/kg$(37.8%) and $0.9\;{\mu}g/kg$(24.3%), respectively. Recoveries of the full analytical procedure were 71.7~99.7% for AFB1, 88.1~99.2% for AFB2, 82.8~95.5% for AFG1 and 77.9~90.0% for AFG2. The excess cancer risk estimated using the cancer potency of aflatoxin B1 (7 $(mg/kg/day)^{-1}$ for $HBsAg^-$ and 230 $(mg/kg/day)^{-1}$ for $HBsAg^+$) were $1.30{\times}10^{-5}{\sim}1.22{\times}10^{-7}$ for hepatits B surface antigen negative ($HBsAg^-$) and $3.31{\times}10^{-4}{\sim}3.12{\times}10^{-6}$ for hepatits B surface antigen positive ($HBsAg^+$) respectively. In conclusion, although the contamination levels of samples used in the study were low, further actions are also required to undertake a program of herbal surveys in order to access mycotoxin contamination overall so that the safety of public will be protected.
The 'hands-on' craftsmanship of the 20th century has came and gone. Today, we are dealing with whole new, 'cerebral approach,' to concept and design with this new approach, design and function are very much dependant upon planning, sales, promotion, and the formative technique of the design industry. The innovative process of design constantly change as it reflects the needs and wants of society. It is and industry that constantly change as it reflects the needs and wants of society. It is and industry that constantly remakes and reshapes itself to suit current trend and outlook. The current idea being that consumers are looking for quality over quantity. Due to the 20th centuries dominant philosophy of functionalism, production intended to standardize the individual's purchasing choice. Aesthetic, or philosophic qualities played a second fiddle to the functional bias of a product, With production, Marketing, and research and development are integrated into the management process. This translates as good which include efficiency, quality, durability, and credibility an trademark and style. There is a definite 'post-modernist' movement and style in 21st century. Every possibility is available as the old boundaries of the 20th century are laid aside. There is a new, transformative quality to the current paradigm of design. The old "should" and "should not" of design no longerapplies. The integrated rative of design solves the usual disparity between aesthetic qualities and production. Design and profirability need not be stranger to one another. It can differentiate the image perceived of both enterprises and consumers by making use of integrated goods services. With an integrated system. both producers and designers win. While design gets full access to design in turn. All consumers make decisions based upon the evaluation of quality, service, and image ; even though it may not be a conscious decision to do so. Consumers are fully integrated human beings ; therefore producers who apply the new, integrated paradigmatic approach to concept, design, and production will reap the harvest of making a true relationship with individual buyer.
Kim, Soo Young;Lee, Soon Joo;Kim, Mi Jeong;Song, Eun Song;Choi, Young Youn
Clinical and Experimental Pediatrics
/
v.50
no.7
/
pp.636-642
/
2007
Purpose : Fluconazole prophylaxis for very low birth weight (VLBW) infants has been shown to reduce invasive fungal infection and its mortality. This study aims to evaluate the effect of fluconazole prophylaxis in VLBW infants on the incidence and mortality of fungal infection. Methods : VLBW infants with endotracheal intubation and central vascular access admitted to the Neonatal Intensive Care Unit (NICU) at Chonnam University Hospital were enrolled. Twenty eight infants of 7-month baseline period from January to July 2005 ('non-fluconazole group') were compared with 29 infants of a 7-month fluconazole period from January to July 2006 ('fluconazole group'). Results : Gestational age, birth weight, sex, mode of delivery, frequency of twin pregnancy, chorioamnionitis, antenatal steroid and rupture of membranes were similar between the fluconazole and non-fluconazole groups. The rate of extremely low birth weight (ELBW) infants, frequency and duration of prophylactic antibiotics, total parenteral nutrition and umbilical catheters, duration of intralipid, mechanical ventilation and nasal continuous positive airway pressure (CPAP) were also not significant. However, frequency of percutaneous central venous catheterization (PCVC) and intralipid administration, and duration of PCVC were significant between the two groups. The overall incidence and mortality of fungal infection were not different between the two groups. Although the Malassezia infection was increased in the fluconazole group (P<0.05), candida was significantly decreased compared to the non-fluconazole group (P<0.05). Conclusion : Fluconazole prophylaxis in high risk VLBW infants decreased the candida infection significantly. Antifungal prophylaxis is recommended in terms of cost effectiveness, but further study is needed to clarify the reason for the increase of Malassezia infection.
In this study, we investigated the use of satellite-derived flow (SDF) signals and a data-based model for the estimation of outflow for the river reach where in situ measurements are either completely unavailable or are difficult to access for hydraulic and hydrology analysis such as the upper basin of Imjin River. It has been demonstrated by many studies that the SDF signals can be used as the river width estimates and the correlation between SDF signals and river width is related to the shape of cross sections. To extract the nonlinear relationship between SDF signals and river outflow, Artificial Neural Network (ANN) model with SDF signals as its inputs were applied for the computation of flow discharge at Imjin Bridge located in Imjin River. 15 pixels were considered to extract SDF signals and Partial Mutual Information (PMI) algorithm was applied to identify the most relevant input variables among 150 candidate SDF signals (including 0~10 day lagged observations). The estimated discharges by ANN model were compared with the measured ones at Imjin Bridge gauging station and correlation coefficients of the training and validation were 0.86 and 0.72, respectively. It was found that if the 1 day previous discharge at Imjin bridge is considered as an input variable for ANN model, the correlation coefficients were improved to 0.90 and 0.83, respectively. Based on the results in this study, SDF signals along with some local measured data can play an useful role in river flow estimation and especially in flood forecasting for data-scarce regions as it can simulate the peak discharge and peak time of flood events with satisfactory accuracy.
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