• Title/Summary/Keyword: Discharge Control

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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.

The Influence of Nutrients Addition on Phytoplankton Communities Between Spring and Summer Season in Gwangyang Bay, Korea (광양만에서 춘계와 하계 영양염류 첨가가 식물플랑크톤군집의 성장에 미치는 영향)

  • Bae, Si Woo;Kim, Dongseon;choi, Hyun-Woo;Kim, Young Ok;Moon, Chang Ho;Baek, Seung Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.1
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    • pp.53-65
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    • 2014
  • In order to estimate the effect of nutrients addition for phytoplankton growth and community compositons in spring and summer season, we investigated the abiotic and biotic factors of surface and bottom waters at 20 stations of inner and offshore areas in Gwangyang Bay, Korea. Nutrient additional experiments were also conducted to identify any additional nutrient effects on phytoplankton assemblage using the surface water for the assay. Bacillariophyceae occupied more than 90% of total phytoplankton assembleges. Of these, diatom Eucampia zodiacus and Skeletonema costatum-like species was mainly dominated in spring and summer, respectively. Here, we can offer the season why the two diatom population densities were maintained at high levels in both seasons. First, light transparency of spring season in the euphotic zone was greatly improved in the bay. This improvement is one of important factor as tigger of increase in E. zodiacus population. Second, low salinity and high nutrient sources supplied by Seomjin River discharge are a main cue for strong bottom-up effects on S. costatum-like species during the summer rainy season. Based on the algal bio-assays, although maximum growth rate of phytoplankton communities at inner bay (St.8) were similar to those of outer bay (St.20), half-saturation constant ($K_s$) for phosphate at outer bay was slightly lower than those of inner bay. This implied that adapted cells in low nutrient condition of outer bay may have enough grown even the low phosphate and they also have a competitive advantage against other algal species under low nutrient condition. In particular, efficiency of N (+) addition in summer season was higher compared to control and P added experiments. In the bay, silicon was not a major limiting factor for phytoplankton growth, whereas nitrogen (N) was considered as a limiting factor during spring and summer. Therefore, a sufficient silicate supply form water mixing Si recycled from diatom decomposition and river water is favorable form maintaining diatom ecosystems in Gwangyang Bay.

Treatment of Animal Wastewater Using Woodchip Trickling Filter System and Physical and Microbial Characteristics of Wood Chip Media (목편살수여상조를 이용한 축산뇨오수 처리와 목편여재의 물성 및 부착미생물 특성)

  • Ryoo, Jong-Won
    • Journal of Animal Environmental Science
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    • v.17 no.2
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    • pp.71-80
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    • 2011
  • Trickling filter has been extensively studied for the domestic wastewater treatment especially for the small scale plants in rural area. The purpose of this research is to survey the physical and microbial characteristics of wood chip media and the removal efficiency of animal wastewater using wood chip trickling filter system. The trickling filtration system comprises a filtration bed packed with wood chip media having a particle dia. of 5~7cm. The method comprises natural air from the bottom of the bed. The system also comprises a control mechanism including a time a constant discharge pump for controlling supply of the wastewater into the bed. The following conclusions were obtained from the results of this research. 1. The specific surface area of wood chip was 0.4123 $m^2$/g, pore volume was 0.0947 $cm^3$/g, density was 0.49 g/$cm^3$. It has forms of parallelogram and oblong which have numerous small pore space. This wood chip has been good condition for microorganism's habitat, having very larger specific surface area by complex the three dimension structure of cellulose at wood's major ingredients. 2. The total counts of in attached aerobic microbes were ranged from $10^6$ to $10^8$ CFU/g, and anaerobes microbial numbers were from $10^4$ to $10^7$. The aerobic microbial numbers appeared to be much more than those of anaerobic microbial numbers. 3. The average efficiency of $BOD_5$ and CODcr were 74.5% and 51.5%, respectively. The removal efficiency of T-N and T-P were 61.4%, 56.2%, respectively. But SS removal levels remain 19.3%.

The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.

Medicinal Herb Extracts Attenuate 1-Chloro-2,4dinitrobenzene-induced Development of Atopic Dermatitis-like Skin Lesions (한약재 단일 추출물 및 복합 추출물을 이용한 아토피성 피부염 억제 효과)

  • Lee, Moon Hee;Han, Min Ho;Yoon, Jung Jeh;Song, Myung Kyu;Kim, Min Ju;Hong, Su Hyun;Choi, Byung Tae;Kim, Byung Woo;Hwang, Hye Jin;Choi, Yung Hyun
    • Journal of Life Science
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    • v.24 no.8
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    • pp.851-859
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    • 2014
  • The present study was designed to investigate whether ethanol extracts of Sophora flavescens (GS), Glycyrrhiza uralensis (GC), Dictamnus dasycarpus (BSP), and their mixtures (GGB-1, -2, -3, and -4) inhibit 1-chloro-2,4-dinitrobenzene (DNCB)-induced atopic dermatitis (AD) in a mouse model. DNCB was topically applied on the dorsal surface of Balb/c mice to induce AD-like skin lesions. The pathological phenotypes of AD, such as erythema, ear thickness, edema, scabs, and discharge, were significantly decreased in the GGB (DNCB + GS:GC:BSP = 3:1:1 mixture)-1-treated groups compared with the other treated groups. The weight of the spleen in immune organs was significantly decreased in the GGB-1-treated groups, whereas the weight of the liver in a control group was similar to that of the groups treated with the samples. Furthermore, toluidine blue staining analysis, a method used to specifically identify mast cells, showed that master cell infiltration into the dermis of the GGB-1-treated group was significantly decreased. The immunoglobulin E concentration was lower in the GGB-1-treated group. In addition, the levels of inflammatory cytokines (interferon-${\gamma}$, interleukin-1, 4, 5, 6, and 13, $1{\beta}$, and tumor necrosis factor-${\alpha}$) were also significantly reduced in the GGB-1-treated group. Taken together, these results suggest that a mixture of GS, GC, and BSP in a proportion of 3:1:1 (GGB-1) may contribute to the relief of AD symptoms and may be considered an excellent candidate for an AD therapeutic drug.

Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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A Comparison of Minilaparotomy and Laparoscopic Sterilization (Minilaparotomy 불임술(不妊術)과 복강경불임술(腹腔鏡不妊術)에 관(關)한 비교연구(比較硏究))

  • Bai, Byoung-Choo
    • Clinical and Experimental Reproductive Medicine
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    • v.4 no.1
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    • pp.17-25
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    • 1977
  • Anderson(1937), Power and Barnes(1941) reported a study concerning a method of tubal sterilization in association with peritoneoscopy or laparoscopy in which they cauterized the tubes. There appears to have been a hiatus of interest in sterilization (cold or hot) associated with laparoscopy until reintroduction by Palmer(1963), Frangenheim(1964) and Steptoe(1967). On the other hand, for interval female sterilization, however, minilaparotomy is relatively new. By Saunder and Munsick(1972), John Lyle(1974), Frank Stubb(1974), Vitoon(1973) and B.C. Bai(1975), their own technique for interval female sterilization requires 2.0 to 2.5cm, incision at the margin of the mons pubis. In Korea, female sterilization by means of minilaparotomy firstly reported by B.C. Bai using Bai's uterine elevator, of his own device, early in 1975. Recently inteval female sterilization by laparoscopy and minilaparotomy are widely accepted throughout the world especially in Asian countries. Minilaparotomy is carried out from 1974, laparoscopic sterilization from 1976, and in this study each of 250 cases of those were analysed and discussed for the comparison at Seoul Red Cross Hospital. (1) In the age distribution, numerous clients were in their age of $31{\sim}35$ in laparoscopy as well as minilaparotomy. Average 33.7 years in L and 33.2 years in M. (M=minilaparotomy, L=laparoscopic sterilization) (2) As regarding living children, women having 3 children represented the greatest number, 113 cases out of 250 in M group and 102 cases out of 250 in L group. Average No. of child are 2.9 in Land 3.1 in M. (3) Concidering the operation day in the menstrml cycle, the greatest number of cases, those who underwent tubal sterilization during the days of $26{\sim}$, next during the $6{\sim}10$ days of the cycle in both group. (4) Concidering the operation time, 188 cases by laparoscopy were performed in $6{\sim}10$ minutes, 33 cases within 5 minutes and 24 cases in $11{\sim}15$ minutes. Maximum 50 minutes, minimum 4 minutes and average 8.3 minutes. The majority of cases (154 cases) by minilaparotomy required $6{\sim}10$ minutes and 67 cases $11{\sim}15$ minutes, 6 cases within 5 minutes. Maximum 30 minutes, minimum 4 minutes and average 10.4, minutes. In both groups, most of the reasons for the extra length were surgical difficulties such as thick abdominal wall, pelvic adhesion, less cooperation of patients in early period of this study. (5) Hospital stay after operation in L group required $3{\sim}4$ hours in 125 cases, $2{\sim}3$ hours in 41 cases, $4{\sim}5$ hours in 32 cases out of 250. Maximum 8 hours, minimum 1 hour and average 3.8 hours. In M group hospital stay required $6{\sim}7$ hours in 100 cases, over 7 hours in 85 cases, $5{\sim}6$ hours in 46 cases and so on. Maximum 14 hours, minimum 2 hours and average 6.5 hours. (6) The time between operation and gas passing in the majority cases of both groups, were $12{\sim}36$ hours. A veragetime 20.3 hours in L and 27.2 in M. (7) Laparoscopic sterilization coincident with induced abortion were carried out in 27 cases, laparoscopy with minilaparotomy to control for mesosalpingeal hemorrhage in 1 case. Minilaparotomy coincident with induced abortion were performed in 65 cases, D and C whit polypectomy, menstrual regulatian, and remaval of IUD in 1 case respectively. (8) In L group, 1 case of mesosalpingeal hemorrhage, 1 case of abdominal wall infection were complicated during operation. In M group, 1 case of uterine perfaration, 1 case of abdominal wall infection, 1 case of hemorrhage from omentum and 1 case of bloody vaginal discharge were complicated. No intensive medical treatment was required for those minor complications in both groups. (9) No failure has been recognized and these two sterilization techniques might be the simple, safe and the most effective method for permanent contraception at present time. There is no significant clinical defference between L and M group in this study.

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Marine Algal Flora and Community Structure of Igidea Area in Busan, Korea (부산 이기대 지역의 해조상 및 군집구조)

  • Shin, Bong-Kyun;Kwon, Chun-Jung;Lee, Suk-Mo;Choi, Chang-Geun
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.20 no.2
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    • pp.121-129
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    • 2014
  • Marine algal flora and community structure were seasonally investigated at four sites in the vicinity of the Igidae on the southern east coast of Korea from May 2010 to February 2011. A total of 66 species including 9 of Chlorophyta, 14 of Phaeophyta, 43 of Rhodophyta were found during the survey period. Among these species, 16 species were found throughout the year. Seasonal mean biomass in wet weight was 123.6 (spring), 2,061.6 (summer), 412.0 (autumn), 678.9 (winter) $g{\cdot}m^{-2}$. Maximum biomass was recorded in summer($2,061.6g{\cdot}m^{-2}$), and minimum was recorded in spring($123.6g{\cdot}m^{-2}$). Spatial maximum and minimum species number were recorded at station 3 and 4(50 species) and at station 1(47 species). At station 1, 2 directly exposure on Yongho and Daeyeon cheon (stream) run off, and discharge from Nambu sewage treatment plants near coastal area, species diversity was relatively low and dominant species were similar throughout four seasons. The R/P, C/P and (R+C)/P value reflecting flora characteristics were 3.07, 0.64 and 3.71, respectively. The flora investigated could be classified into six functional groups such as coarsely branch form 39.39 %, sheet form 30.30 %, thick leather form 13.64 %, filamentous form 12.12 %, crustose form 3.03% and jointed calcareous form 1.52 % during survey period. The number of marine algae species in Igidea were 96 species at 1996 to 1997 and 66 species at 2010 to 2011, respectively. The change of seaweed species is due to the pollution loaded from sewage treatment plant and stream. We thus recommend that the positive maintenance control method like sewage treatment, for the protection of seaweed bed should be proceeded to near coastal area.

In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.32-36
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    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

Analysis and Design of Profiling Adaptor for XML based Energy Storage System (XML 기반의 에너지 저장용 프로파일 어댑터 분석 및 설계)

  • Woo, Yongje;Park, Jaehong;Kang, Mingoo;Kwon, Kiwon
    • Journal of Internet Computing and Services
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    • v.16 no.5
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    • pp.29-38
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    • 2015
  • The Energy Storage System stores electricity for later use. This system can store electricity from legacy electric power systems or renewable energy systems into a battery device when demand is low. When there is high electricity demand, it uses the electricity previously stored and enables efficient energy usage and stable operation of the electric power system. It increases the energy usage efficiency, stabilizes the power supply system, and increases the utilization of renewable energy. The recent increase in the global interest for efficient energy consumption has increased the need for an energy storage system that can satisfy both the consumers' demand for stable power supply and the suppliers' demand for power demand normalization. In general, an energy storage system consists of a Power Conditioning System, a Battery Management System, a battery cell and peripheral devices. The specifications of the subsystems that form the energy storage system are manufacturer dependent. Since the core component interfaces are not standardized, there are difficulties in forming and operating the energy storage system. In this paper, the design of the profile structure for energy storage system and realization of private profiling system for energy storage system is presented. The profiling system accommodates diverse component settings that are manufacturer dependent and information needed for effective operation. The settings and operation information of various PCSs, BMSs, battery cells, and other peripheral device are analyzed to define profile specification and structure. A profile adapter software that can be applied to energy storage system is designed and implemented. The profiles for energy storage system generated by the profile authoring tool consist of a settings profile and operation profile. Setting profile consists of configuration information for energy device what composes energy saving system. To be more specific, setting profile has three parts of category as information for electric control module, sub system, and interface for communication between electric devices. Operation profile includes information in relation to the method in which controls Energy Storage system. The profiles are based on standard XML specification to accommodate future extensions. The profile system has been verified by applying it to an energy storage system and testing charge and discharge operations.