• Journal of Korean Neurosurgical Society
• /
• v.30 no.4
• /
• pp.437-442
• /
• 2001

Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

• The Korean Journal of Blood Transfusion
• /
• v.23 no.2
• /
• pp.145-151
• /
• 2012

배경: 채혈 후 제제 경과시간에 따른 동결혈장의 혈액응고인자의 활성도와 이에 영향을 미치는 요인을 분석하여, 혈액응고인자제제의 원료혈장의 사용범위를 확장 가능한지 확인하고자 동결혈장의 채혈시간과 응고인자 특성을 측정하였다. 방법: ALT 부적격 혈장을 채혈 후 동결시간의 특성에 따라 4단계로 구분하였고, 6종류의 혈액 응고인자 활성도와 혈액형을 검사하였고, SAS 9.2 프로그램을 사용하여 통계처리 하였다. 결과: 혈액제제간 FVIII 활성도를 분석한 결과 PL-A>FFP>FP(8-24)${\approx}$FP(24-72) 순으로 유의하게 낮아졌고 혈액형에 따라서는 AB형이 제일 높고, O형이 제일 낮았다. 대한적십자사의 원료혈장에 대한 FVIII 활성 품질기준을 적용할 경우 PL-A, FFP와 FP24는 각각 85.0%와 82.5%로 적합하였다. 캐나다 퀘백 주처럼 FP24의 FVIII 활성이 0.52 IU/mL 이상을 적용할 경우 PL-A, FFP와 FP24는 각각 95.0%, 96.3%, 82.6%로 적합하였다. 또한 FP(8-24)의 A형과 AB형, FP(24-72)의 경우 AB형이 각각 82.1%, 83.3%, 100%로 적합하였다. 결론: 혈액응고인자제제용 원료혈장의 범위는 외국의 기준에 비추어 채혈 후 24시간 내에 동결된 혈장(FP24)으로 확대 사용이 가능하다. 이를 위해서는 채혈 후 동결시간과 혈액응고인자에 대한 품질기준을 유럽약전 또는 WHO 가이드라인과 비교하여 완화하는 것이 필요하다.

• The Journal of the Korea Contents Association
• /
• v.18 no.8
• /
• pp.469-482
• /
• 2018

This research has developed the criteria and index for systematically and objectively assessing the quality of river water by fixing the various factors that affect Gyeongin ARA waterway's water quality through analysis with the Delphi Technique and analytic hierarchy program (AHP) Method. Based on the results, the highest criteria are, in order of importance, physical and environmental factors 28%, administrative factors 26%, natural fixed factors 26% and finally, cultural and social factors 20%. The three dimensions of the criteria show that for the internal physical and environmental factors, the most important are the loss of self-purification capacity, and the external factors are Gulpocheon and the sludge deposit due to Gyulhweon-weir the bridge. The facility factor in management was affected by the coagulation and waste water disposal facilities. The problem for the policy and institutional factors was seen in the regulatory area. The aquatic ecology/ point pollution source for the natural fixed factors show that it is due to the polluted water of Gulpo-cheon and the living environment/ non-point pollution source is shown through the inflow water from other rivers. Cultural and social factors show that the economical causes were due to the cargo and passenger flight operations and the external factors of having a lack of sewage treatment equipment have an importance effect. In order to estimate the order of priority through logical evidence and objectivity, future research must be continued on the evaluation indexes to measure the specific methodology and technique needed to improve the Gyeongin ARA Waterway.

• Journal of Korean Society for Atmospheric Environment
• /
• v.18 no.3
• /
• pp.213-221
• /
• 2002

The emission characteristics of particulate matter (PMs) and heavy metals from hazardous industrial wast incinerators were investigated. The particle size distribution (PSD) of PM-10 showed different patterns for two tripes of incinerators; stoker and rotary kiln. However both types showed bimodal form at inlet of air pollution control devices (APCD) and each peak (mode) is located at smaller than 1 ${\mu}{\textrm}{m}$ and near 10 ${\mu}{\textrm}{m}$. It could explain the growth of fine PM by nucleation/coagulation/condensation of metal vapors for fine mode. The PSD of PM-10 after APCD was also influenced by APCD types that had different collection mechanism, and both electrostatic precipitator and bag filter showed less collection efficiency for particles ranged from 0.2 to 0.4 ${\mu}{\textrm}{m}$ and led to a mode in the range of 0.2 to 0.8 ${\mu}{\textrm}{m}$. However the hag filter showed two modes of PSD, while the electrostatic precipitator had one peak. The PMs and heavy metals emission factors, the representative value of emission quantity for sources, for tested facilities were developed. The emission factor of uncontrolled total PM and PM-10 were 14.7 and 7.05 kg/ton waste, respectively. The emission factors from this study were a little bit different with those from US EPA AP-42. It may thus be appropriate to use these results in the course of developing national emission factors.

• Korean Journal of Materials Research
• /
• v.13 no.5
• /
• pp.328-332
• /
• 2003

Characteristics of $TiO_2$nanoparticles controlled by precursor flow rate and reaction temperature in chemical vapor condensation process were interpreted in the view of decisive reaction factors, i.e. supersaturation ratio, concentration of vapor molecule, collision frequency and rate, and residence time, which directly affect the particle size and size distribution in CVC reactor. As results, the increases of precursor flow rate and reaction temperature induced the increase in the average sizes of $TiO_2$ nanoparticles in CVC reactor by acceleration of coagulation growth due to the increase of collision between $TiO_2$vapor molecules and particles. The effects of reaction factors on the characteristics of$TiO_2$nanoparticles were discussed with considering particle formation process in CVC reactor under given process parameters.

• Journal of Trauma and Injury
• /
• v.26 no.4
• /
• pp.291-296
• /
• 2013

Purpose: Prolonged ventilation leads to a higher incidence of ventilator-associated pneumonia (VAP), resulting in weaning failure and increased medical costs. The aim of this study was to analyze clinical results and prognostic factors of VAP in patients with blunt chest trauma. Methods: From 2007 to 2011, one hundred patients undergoing mechanical ventilation for more than 48 hours were divided into two groups: a VAP-negative group, (32 patients, mean age; 53 years, M:F=25:7) and a VAP- positive group, (68 patients, mean age; 60 years, M:F=56:12). VAP was diagnosed using clinical symptoms, radiologic findings and microorganisms. The injury severity score (ISS), shock, combined injuries, computerized tomographic pulmonary findings, transfusion, chronic obstructive lung disease (COPD), ventilation time, stay in intensive care unit (ICU) and hospital stays, complications such as sepsis or disseminated intravascular coagulation (DIC) and microorganisms were analyzed. Chi square, t-test, Mann-Whitney U test and logistic regression analysies were used with SPSS 18 software. Results: Age, sex, ISS, shock and combined injuries showed no differences between the VAP - negative group and - positive group (p>0.05), but ventilation time, ICU and hospital stays, blood transfusion and complications such as sepsis or DIC showed significant differencies (p<0.05). Four patients(13%) showed no clinical symptoms eventhough blood cultures were positive. Regardless of VAP, mortality-related factors were shock (p=0.036), transfusion (p=0.042), COPD (p=0.029), mechanical ventilation time (p=0.011), ICU stay (p=0.032), and sepsis (p=0.000). Microorgnisms were MRSA(43%), pseudomonas(24%), acinetobacter(16%), streptococcus(9%), klebsiela(4%), staphillococus aureus(4%). However there was no difference in mortality between the two groups. Conclusion: VAP itself was not related with mortality. Consideration of mortality-related factors for VAP and its aggressive treatment play important roles in improving patient outcomes.

• Korean Journal of Head & Neck Oncology
• /
• v.34 no.1
• /
• pp.15-19
• /
• 2018

Background and Objectives: Thunderbeat (TB) and Harmonic scalpel (HS) have been applied to variable head and neck surgery, which are useful for both coagulation and cutting of tissues. However, there have been no comparative studies covering the usefulness of these energy devices in surgery for major salivary gland. In this study, we analyzed the surgical outcomes of two devices in surgery for parotidectomy and submandibular gland (SMG) resection. Materials and Methods: A retrospective chart review of 90 patients including two groups (HS group, n=45 versus TB group, n=45) of patients matched for their patient factors was conducted. Clinicopathologic factors of the patients and surgical outcomes such as the operation time, intraoperative bleeding, amount and duration of drain, hospital stay and complications were compared between two groups. Results: There were no significant difference between two groups regarding the clinicopathologic factors and short-term surgical outcomes. Conclusion: Thunderbeat and HS are both effective and safe for parotidectomy and SMG resection in variable benign disease of major salivary gland.

• Journal of Chest Surgery
• /
• v.31 no.9
• /
• pp.867-872
• /
• 1998

Background: The fixed dose regimen with activated coagulation time(ACT) is the most commonly employed method for determining the required dosage of heparin and protamine during cardiopulmonary bypass(CPB). Material and Method: We performed a prospective study on a fixed dose regimen for analyzing adequate dosages of heparin and protamine, the incidence of heparin resistance and heparin-induced thrombocyt openia, factors affecting ACT during CPB, and changes of ACT during aprotinin usage. 300 units/kg of heparin were administered to patients, and ACTs were measured after 5 mins. ACTs were checked at 10 mins and 30 mins after the onset of CPB, and then at 30 min intervals thereafter. If the measured ACT was under 400 secs, we added 100 units/kg of heparin. The heparin was reversed with 1 mg of protamine for each 100 units administered. If the measured ACT was longer than 130 secs 30 mins after protamine administration or if there was definitive evidence of a coagulation defect, we administered a further 0.5 mg/kg of protamine. Result: We studied 80 patients(50 adults and 30 children) who underwent open heart surgery(OHS) at Seoul National University Hospital. Preoperative ACT was 114.3${\pm}$19.3 secs in adults, and 119.5${\pm}$18.2 secs in children. There were no differences in preoperative ACT due to age, body weight, body surface area, or sex. The preoperative ACT was not influenced by a positive past history of OHS. Ten adults(20%) and 3 pediatric patients(10%) needed additional doses of heparin to maintain the ACT above 400 secs. Additional protamine administration was needed in 9 adults(18%) and 10 children(33%). Heparin resistance was found in only two adults. Heparin-induced thrombocytopenia was detected in 2 adults and 1 child. During CPB, ACT was prolonged. 12 adult patients received a low dose of aprotinin and showed longer celite activated ACT compared to the control group.The kaolin activated ACT showed a lower tendency than the celite activated ACT in aprotinin users. Conclusion: In conclusion, fixed dose regimen of heparin and protamine can be used without significant problems, but the incidence of need of additional dosage remains unsatisfactory.

• Journal of Chest Surgery
• /
• v.13 no.4
• /
• pp.356-363
• /
• 1980

Even now, the hemorrhagic syndrome after cardiac surgery with the aid or a pump oxygenator constitutes a significant problem. The purpose of this study is to postulate the possible causes of the bleeding after open hear surgery [OHS]. Fifteen consecutive OHS patients with various heart diseases were selected and platelet count, plasma fibrinogen, serum calcium level were observed pre-, intra- and post- operatively until 21 th postoperative day [POD]. The platelet count was significantly decreased with initiation of extracorporeal circulation [ECC] and continued to decrease slowly until cessation of ECC. Within 10 minutes after ECC the platelet count stared to increase. But it was significantly less than preoperative count until 5th POD. The peak count was found on 14th POD and the platelet count was gradually decreased. Plasma fibrinogen also decreased significantly during operation, but it recovered up to preoperative amount within 5 hours after termination of ECC. Thereafter it rapidly increased until 3rd POD when it reached its peak. From 3rd POD it showed slow downward slope until 21st POD, but it remained in significantly higher level than preoperative amount. Serum calcium levels showed minimum fluctuations during the whole course of study. Conclusively, the decrease in platelet count and fibrinogen amount may play a considerable role for the postoperative hemorrhage. But numerous other effects of ECC must be accounted for.

• Macromolecular Research
• /
• v.12 no.2
• /
• pp.225-232
• /
• 2004

We have successfully synthesized relatively monodisperse and cross-linked melamine-formaldehyde (M-F) microspheres by dispersed polycondensation and subsequent pH adjustment with serum replacement cleaning. The average particle sizes (equation omitted): weight-average and (equation omitted) : number-average), the polydispersity index (equation omitted), the number of particles N$\_$p/ and the gel content of the M-F microspheres were observed by varying the pH, the surfactant concentration, and the polymerization temperature. We observed that both the pH and the polymerization temperature were predominant factors in determining (equation omitted) and N$\_$p/, but the effect that the temperature and pH had on the gel content ( ＞ 94% for all samples) was negligible. The exponents of the slopes of plots of N$\_$p/ versus pH and surfactant concentration were －10 and 0.6, respectively. Particle nucleation and growth were achieved within short periods; the incessant coagulation occurred even in the presence of surfactants.