• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.566-578
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• 2024

Purpose This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

• Journal of Korean Society of Environmental Engineers
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• v.31 no.11
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• pp.947-956
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• 2009

Residual petroleum hydrocarbons after an oil spill may accumulate in the marine benthic ecosystem due to their high hydrophobicity. A lot of monitoring data are required for the estimation of ecosystem exposure to residual petrochemicals in an ecological risk assessment in the affected region. To save time and cost, the environmental exposure to them in the affected ecosystem can also be assessed using a simple food-web bioaccumulation model. In this study, we evaluated residual concentrations of four selected polycyclic aromatic hydrocarbons (phenanthrene, anthracene, pyrene, and benzo[a]pyrene) in a hypothetic benthic ecosystem composed of six species under two exposure scenarios. Body-residue concentration ranged 5~250 mg/kg body depending on trophic positions in an extreme scenario in which the aqueous concentrations of PAHs were assumed to be one-tenth of their aqueous solubility. In addition, bioconcentration factors (BCFs) and bioaccumulation factors (BAFs) were evaluated for model species. The logarithm of bioconcentration factor (log BCF) linearly increased with increasing the logarithm of 1-octanol-water partition coefficient (log $K_{OW}$) until log $K_{OW}$ of 7.0, followed by a gradual decrease with further increase in log $K_{OW}$ without metabolic degradation. Biomagnification became significant when log $K_{OW}$ of a pollutant exceeded 5.0 in the model ecosystem, indicating that investigation of food-web structure should be critical to predict biomagnifications in the affected ecosystem because log $K_{OW}$ values of many petrochemicals are higher than 5.0. Although further research is required for better site-specific evaluation of exposure, the model simulation can be used to estimate the level of the ecosystem exposure to residual oil contaminants at the screening level.

• Journal of Korean Academy of Nursing
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• v.16 no.1
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• pp.67-80
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• 1986

The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.105-110
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• 2011

Purpose: Chest injuries in multiple trauma patients are major predisposing factor for increased length of stay in intensive care unit, prolonged mechanical ventilator, and respiratory complications such as pneumonia. The aim of this study is the evaluation of lung injury score as a risk factor for prolonged management in intensive care unit (ICU). Methods: Between June to August in 2011, 46 patients admitted to shock and trauma center in our hospital and 24 patients had associated chest damage without traumatic brain injury. Retrospectively, we calculated injury severity score (ISS), lung injury score, and the number of fractured ribs and performed nonparametric correlation analysis with length of stay in ICU and mechanical ventilator support. Results: Calculated lung injury score(<48 hours) was median 1(0-3) and ISS was median 30(8-38) in study population. They had median 2(0-14) fractured ribs. There were 2 bilateral fractures and 2 flail chest. Ventilator support was needed in 11(45.8%) of them for median 39 hours(6-166). The ISS of ventilator support group was median 34(24-34) and lung injury score was median 1.7(1.3-2.5). Tracheostomy was performed in one patient and it was only complicated case and ICU stay days was median 9(4-16). In correlation analysis, Lung injury score and ISS were significant with the length of stay in ICU but the number of fractured ribs and lung injury score were predicting factors for prolonged mechanical ventilator support. Conclusion: Lung injury score could be a possible prognostic factor for the prediction of increased length of stay in ICU and need for mechanical ventilator support.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.164-171
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• 2009

Purpose: The number of patients who take warfarin is growing and so is the number of complications. Hemorrhage is the major complication, but the clinical characteristics and outcomes have not been determined for Korean patients. Therefore, we tried to evaluate the characteristics of the patients with hemorrhagic complications after taking warfarin as anticoagulation therapy. Methods: We retrospectively reviewed the medical records of the patients who visited the emergency room with bleeding complications after taking warfarin anticoagulation at the out-patient clinic for 1 year from 1 st January 2008. We compared between two groups (the major hemorrhage group vs. the minor hemorrhage group) according to the clinical criteria, the unstable vital signs that required blood transfusion, transfusion more than 2 units of blood, the need for further laboratory follow-up, the need for interventional treatment and the development of critical complications or death due to bleeding. Results: There were 150 patients who met the criteria and had acute hemorrhagic complications (the major group: 90 patients and the minor group: 60 patients). In the major hemorrhage group, the frequent sites of bleeding were the gastro-intestinal system (40 patients), lung (14 patients) and intracranium (7 patients). At the emergency room, the major group showed a higher initial INR of the activated prothrombin time than did the minor group (p=0.02). The bleeding sites of the fatal cases were the gastro-intestinal system (3 patients), lung (3 patients) and intracranium (3 patients), but the percentage of fatality was the highest for intracranium bleeding. Conclusion: In the major hemorrhage group, gastrointestinal bleeding was the most frequent complication and fatality was the highest for intracranium bleeding. An initially higher INR showed a greater risk of major bleeding, but not more fatalities.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.129-139
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• 1997

The data collected to date indicate that sleep-related breathing disorders, including sleep-disordered breathing(sleep apnea) and underlying respiratory system diseases, are one of the important risk factors for cardiovascular dysfunction. Sleep-disordered breathing(sleep apnea) is now recognized as one of the leading causes of systemic hypertension, cardiac arrhythmias, coronary heart disease, pulmonary hypertension, right heart failure, and stroke. Sleep may exert a profound effect on breathing in patients with underlying respiratory system disease including bronchopumonary diseases, chest wall abnormalities, central alveolar hypoventilation syndromes or respiratory neuromuscular disorders. Chronic hypoxia and hypercapnia in these patients may accelerate the development of long term cardiovascular complications such as cardiac arrhythmias, pulmonary hypertension, and right heart failure(cor pulmonale). Several recent studies reported that sleep-related breathing disorders are associated with long-term cardiovascular morbidity and mortality. Careful assessment of respiratory and cardiovascular function in these patients is critical. Aggressive and highly effective treatment of sleep-related breathing disorders using tracheostomy, mechanical ventilation, nasal continuous positive airway pressure therapy(nCPAP), intercurrent oxygen therapy or other interventions can reduce the prevalence of cardiovascular dysfunction and the long-term mortality.

• Perspectives in Nursing Science
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• v.13 no.2
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• pp.88-95
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• 2016

Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.

• Toxicological Research
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• v.27 no.4
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• pp.253-259
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• 2011

Transforming growth factor ${\beta}$ (TGF-${\beta}$) is involved in cellular processes including growth, differentiation, apoptosis, migration, and homeostasis. Generally, TGF-${\beta}$ is the inhibitor of cell cycle progression and plays a role in enhancing the antagonistic effects of many growth factors. Unlike the antiproliferative effect of TGF-${\beta}$, E2, an endogeneous estrogen, is stimulating cell proliferation in the estrogen-dependent organs, which are mediated via the estrogen receptors, $ER{\alpha}$ and $ER{\beta}$, and may be considered as a critical risk factor in tumorigenesis of hormone-responsive cancers. Previous researches reported the cross-talk between estrogen/$ER{\alpha}$ and TGF-${\beta}$ pathway. Especially, based on the E2-mediated inhibition of TGF-${\beta}$ signaling, we examined the inhibition effect of 4-tert-octylphenol (OP) and 4-nonylphenol (NP), which are well known xenoestrogens in endocrine disrupting chemicals (EDCs), on TGF-${\beta}$ signaling via semi-quantitative reverse-transcription PCR. The treatment of E2, OP, or NP resulted in the downregulation of TGF-${\beta}$ receptor2 (TGF-${\beta}$ R2) in TGF-${\beta}$ signaling pathway. However, the expression level of TGF-${\beta}1$ and TGF-${\beta}$ receptor1 (TGF-${\beta}$ R1) genes was not altered. On the other hand, E2, OP, or NP upregulated the expression of a cell-cycle regulating gene, c-myc, which is a oncogene and a downstream target gene of TGF-${\beta}$ signaling pathway. As a result of downregulation of TGF-${\beta}$ R2 and the upregulation of c-myc, E2, OP, or NP increased cell proliferation of BG-1 ovarian cancer cells. Taken together, these results suggest that E2 and these two EDCs may mediate cancer cell proliferation by inhibiting TGF-${\beta}$ signaling via the downregulation of TGF-${\beta}$ R2 and the upregulation of c-myc oncogene. In addition, it can be inferred that these EDCs have the possibility of tumorigenesis in estrogen-responsive organs by certainly representing estrogenic effect in inhibiting TGF-${\beta}$ signaling.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2965-2972
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• 2016

Background: China carries a heavy burden of cervical cancer (CC) and substantial disparities exist across regions within the country. In order to reduce regional disparities in CC, the government of China launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Critical to the success of the program are the health care workers who play a pivotal role in preventing and managing CC by encouraging and motivating women to use screening services and by providing identification and treatment services. This study aimed to assess cervical cancer knowledge among these health care workers at the county level in maternal and child health (MCH) hospitals across different socio-economic regions of China. Materials and Methods: A cross-sectional survey was conducted and self-administered questionnaires were sent to all health care workers (a total of 66) providing cervical cancer screening services in 6 county level MCH hospitals in Liaoning, Hubei and Shaanxi provinces, representing eastern, central and western regions of China; 64 (97.0%, 64/66) of the workers responded. ANOVA and Chi-square test were used to compare the knowledge rate and scores in subgroups. Results: The knowledge level of the respondents was generally low. The overall combined knowledge rate was 46.9%. The knowledge rates for risk factors, prevention, clinical symptoms, screening and diagnostic tests and understanding of positive results were 31.3%, 37.5%, 18.1%, 56.3% and 84.4%, respectively. Statistically significant differences in scores or rates of CC knowledge were seen across the different regions. The total and sectional scores in the less developed regions were statistically significantly lower than in the other regions. Conclusions: The majority of the health care workers who provide CC screening service in NCCSPRA at county level MCH hospitals do not have adequately equipped with knowledge about CC. Given the importance of knowledge to the program's success in reducing CC burden in rural women in China, efforts are needed to improve the knowledge of health care workers, especially in less developed regions.

• The Korean Journal of Archival Studies
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• no.52
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• pp.119-170
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• 2017

This study aims to analyze the environment for the open-source records system and to identify the risk and requirements for the success of the strategy in Korea. For this, Chapter 2 presented a review of the strategic benefits of open source to public organizations, developers, and users. It also discussed the process of cooperatively developing and releasing the source code and the technology infrastructure supporting open source. In Chapter 3, six representative open-source projects in the field of records management were selected, and case studies were conducted. To derive comprehensive implications, we have divided the main development body of open-source projects into international organizations, international cooperation systems, national archives, and software development companies. We also analyzed the background and purpose of each project, the agents of development and funding, the governance model, the development period and cost, the business model and software architecture, the community composition, and the licensing strategy. Through this, we have derived four critical success factors. In terms of technology, a component-based design was required; therefore, we proposed a microservice architecture and a model-view-controller design pattern. Next, it was necessary to reestablish system requirements of records center and archives. Moreover, we also proposed a dual licensing strategy to allow developers to easily participate in open-source projects. Lastly, we emphasized a strong governance structure and an effective cooperation framework to create a sustainable community. For a record system to be open-source successfully in an organization-centered market, the roles of software developers and end users should be exercised more in the community. To achieve this, it is important to build various collaborative tools and development infrastructure from a planning stage to a centralized one.