• Title/Summary/Keyword: Failure Rate

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A COMPARISON OF THE SEDATIVE EFFECT ON CHLORAL HYDRATE DOSAGE IN THE SEDATION OF THE PEDIATRIC DENTAL PATIENTS (소아환자 진정요법에서 chloral hydrate의 용량에 따른 진정효과에 관한 연구)

  • Rho, Seung-Chul;Kim, Young-Jae;Jang, Ki-Taeg;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.517-524
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    • 2005
  • Despite the widespread use of chloral hydrate with hydroxyzine in the sedation of children, there is little agreement among pediatric dentists regarding its therapeutic dosage for the management of very uncooperative young children. Also, increasing concern has been raised with respect to its frequent failure to provide adequate levels of sedation when used according to the manufacturer's recommended dosage. Therefore, there has been many suggestions with respect to sedative effectiveness and safety of varying drug dosage, and some pediatric dental articles have advocated dosages exceeding manufacturer's recommendations. This study was performed to compare the effectiveness and safety in behavior management of the manufacturer's recommended dose of chloral hydrate(50mg/kg) with those of a higher dose(70mg/kg) used together with hydroxyzine(2mg/kg) and nitrous oxide(50%) when young children were sedated for dental treatment. The following results were obtained; 1. II group(70mg/kg) displayed higher mean score compared to I group(50mg/kg) with regard to the degree of sleep, crying, movement and overall behavior. The difference was statistically significant(p<0.05). 2. In comparison of success rates for sedation between the two groups, I group and II group showed 38.7% and 71.0% success rates respectively. An analysis of variance was statistically significant(p<0.05). 3. Comparing the occurrence rate hypoxia between the two groups, there were 22.6% and 19.4% occurrence of hypoxia in I group and II group. An analysis of variance was not statistically significant(p>0.05).

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The Effects of Intra-Abdominal Hypertension on the Prognosis of Critically Ill Patients in the Intensive Care Unit (ICU) (복강 내압 항진증이 내과계 중환자의 예후에 미치는 영향)

  • Kim, Se Joong;Seo, Jeong-Su;Son, Myeung-Hee;Kim, Soo-Youn;Jung, Ki Hwan;Kang, Eun-Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.46-53
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    • 2006
  • Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.

Discounted Cost Model of Condition-Based Maintenance Regarding Cumulative Damage of Armor Units of Rubble-Mound Breakwaters as a Discrete-Time Stochastic Process (경사제 피복재의 누적피해를 이산시간 확률과정으로 고려한 조건기반 유지관리의 할인비용모형)

  • Lee, Cheol-Eung;Park, Dong-Heon
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.29 no.2
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    • pp.109-120
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    • 2017
  • A discounted cost model for preventive maintenance of armor units of rubble-mound breakwaters is mathematically derived by combining the deterioration model based on a discrete-time stochastic process of shock occurrence with the cost model of renewal process together. The discounted cost model of condition-based maintenance proposed in this paper can take into account the nonlinearity of cumulative damage process as well as the discounting effect of cost. By comparing the present results with the previous other results, the verification is carried out satisfactorily. In addition, it is known from the sensitivity analysis on variables related to the model that the more often preventive maintenance should be implemented, the more crucial the level of importance of system is. However, the tendency is shown in reverse as the interest rate is increased. Meanwhile, the present model has been applied to the armor units of rubble-mound breakwaters. The parameters of damage intensity function have been estimated through the time-dependent prediction of the expected cumulative damage level obtained from the sample path method. In particular, it is confirmed that the shock occurrences can be considered to be a discrete-time stochastic process by investigating the effects of uncertainty of the shock occurrences on the expected cumulative damage level with homogeneous Poisson process and doubly stochastic Poisson process that are the continuous-time stochastic processes. It can be also seen that the stochastic process of cumulative damage would depend directly on the design conditions, thus the preventive maintenance would be varied due to those. Finally, the optimal periods and scale for the preventive maintenance of armor units of rubble-mound breakwaters can be quantitatively determined with the failure limits, the levels of importance of structure, and the interest rates.

An Analysis of the Hail Damages to Korean Forests in 2017 by Meteorology, Species and Topography (2017년 우박에 의한 산림피해의 기상, 수종 및 지형 특성 분석)

  • Lim, Jong-Hwan;Kim, Eunsook;Lee, Bora;Kim, Sunhee;Jang, Keunchang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.4
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    • pp.280-292
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    • 2017
  • Hail is not a frequently occurring weather event, and there are even fewer reports of hail damages to forest stands. Since the 2000s, an increase in hail incidence has been documented in Europe and the United States. In Korea, severe hails occurred in Jeollanam-do province on May 31 and in Gyeongsangbuk-do province on June 1, 2017. Hail size was ranged from 0.5 to 5.0 cm in diameter in Jeollanam-do, and from 1.5 to 3.0 cm in Gyeongsangbuk-do. This study was aimed to analyze the hail damages to forests by species and topography based on damage-categorized maps created by using drones and aerial photographs, and to analyze relationships of the damages with meteorological factors. The total damaged forest area was 1,163.1ha in Jeollanam-do, and 2,942.3ha in Gyeongsangbuk-do. Among the 'severe' damaged area 326.7ha, 91% was distributed in Jeollanam-do, and concentrated in the city of Hwasun which covers 57.2% of the total 'severe' damaged area. The most heavily damaged species was Korean red pine(Pinus densiflora S. & Z.) followed by P. rigida. Most broad-leaved trees species including oaks were recovered without any dead trees found. Liliodendron tulipifera was the most severely damaged in terms of the rate of 'severe' degree individuals which are needed to be checked whether they will die or be recovered. Cause of the death of pines was considered as the combination of physical damage caused by the hail and long-lasting drought with high air temperature that occurred before and after the hail event. No pathogens and insects were found which might have affected to tree deaths. We suggested a dieback mechanism of the pine trees damaged by hail and drought.

Cause-specific Analysis of Risk Factors in Completely Resected Pathologic Stage Ia Non-small Cell Lung Cancer (병리학적 병기 Ia기 비소세포폐암 환자에서 완전절제술 후 사망의 원인에 따른 위험인자 분석)

  • Park, Seong-Yong;Park, In-Kyu;Byun, Chun-Sung;Lee, Chang-Young;Bae, Mi-Kyung;Kim, Dae-Joon;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.725-731
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    • 2009
  • Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.

Adenocarcinoma of the Uterine Cervix (자궁경부선암의 방사선 치료)

  • Chung Eun Ji;Shin Hyun Soo;Lee Hyung Sik;Kim Gwi Eon;Loh John Juhn-Kyu;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.277-284
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    • 1991
  • Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents $4.1\%$ of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49 years (range, $27\~79$ years) and the peak incidence was in the group 50 to 59 years of age. More half of the patients were postmenopausal (46/76= $60.5\%$). Most patients ($76\%$) had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage IIb was $43.4\%$. There were 4 major histologic subtypes: pure adenocarcinoma (48/76=$63.2\%$), adenosquamous carcinoma (20/76=$26.3\%$), papillary (5/76=$6.6\%$) and clear cell carcinoma (3/76=$3.9\%$). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was $68\%$, and the 5-year survival rates for stage Ib, II and III were $90\%,\;66\%\;and\;54\%$, respectively. Control of pelvic tumors was achieved in $93.8\%,\;90.2\%\;and\;50.0\%$ of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

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Treatment Outcome of Thymic Epithelial Tumor: Prognostic Factors and Optimal Postoperative Radiation Therapy (흉선상피종의 치료 성적: 예후 인자 및 방사선치료 방법에 대한 연구)

  • Oh Dong Ryul;Ahn Yong Chan;Kim Kwan Min;Kim Jhingook;Shim Young Mog;Han Jung Ho
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.85-91
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    • 2005
  • Purpose : This study was conducted to analyze treatment outcome and prognostic significance of World Health Organization (WHO)-defined thymic epithelial tumor (TET) subtype and to assess optimal radiation target volume in patients receiving surgery and adjuvant radiation therapy with TET. Materials and Methods: The record of 160 patients with TET, who received surgical resection at the Samsung medical Center, from December 1994 to June 2004, were reviewed. 99 patients were treated with postoperative radiation therapy (PORT). PORT was recommended when patients had more than one findings among suspicious Incomplete resection or positive resection margin or Wasaoka stage $II\~IV$ or WHO type $B2\~C$. PORT peformed to primary tumor bed only with a mean dose of 54 Gy. The prognostic factor and pattern of failure were analyzed retrospectively. Results : The overall survival rate at 5 years was $87.3\%$. Age (more than 60 years $77.8\%$, less than 60 years $91.1\%$; p=0.03), Wasaoka stage (I $92.2\%$, II $95.4\%$, III $82.1\%$, IV $57.5\%$; p=0.001), WHO tumor type (A-Bl $96.0\%$, B2-C $82.3\%$; p=0.001), Extent of resection (R0 resection $92.3\%$, R1 or 2 resection $72.6\%$, p=0.001) were the prognostic factors according to univariate analysis. But WHO tumor type was the only significant prognostic factor according to multivariate analysis. Recurrence was observed in 5 patients of 71 Masoka stage I-III patients who received grossly complete tumor removal (R0, R1 resection) and PORT to primary tumor bed. Mediastinal recurrence was observed In only one patients. There were no recurrence within irradiation field. Conclusion : WHO tumor type was the important prognostic factor to predict survival of patients with TET. This study suggest that PORT to only primary tumor bed was optimal. To avoid pleura- or pericardium-based recurrence, further study of effective chemotherapy should be investigated.

Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients with community acquired urinary tract infections (소아 원외 요로감염 환아에서 분리된 E. coli에 대한 cefixime을 포함한 경구 항생제의 감수성 연구)

  • Lee, Soo Young;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kim, Sun Mi;Ma, Sang Hyuk;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.777-783
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    • 2006
  • Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

Fragment Analysis for Detection of the FLT3-Internal Tandem Duplication: Comparison with Conventional PCR and Sanger Sequencing (FLT3-ITD 검출을 위한 절편분석법: 일반 중합효소연쇄반응 및 직접염기서열분석법과의 비교)

  • Lee, GunDong;Kim, Jeongeun;Lee, SangYoon;Jang, Woori;Park, Joonhong;Chae, Hyojin;Kim, Myungshin;Kim, Yonggoo
    • Laboratory Medicine Online
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    • v.7 no.1
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    • pp.13-19
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    • 2017
  • Background: We evaluated a sensitive and quantitative method utilizing fragment analysis of the fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD), simultaneously measuring mutant allele burden and length, and verified the analytical performance. Methods: The number and allelic burden of FLT3-ITD mutations was determined by fragment analysis. Serial mixtures of mutant and wild-type plasmid DNA were used to calculate the limit of detection of fragment analysis, conventional PCR, and Sanger sequencing. Specificity was evaluated using DNA samples derived from 50 normal donors. Results of fragment analysis were compared to those of conventional PCR, using 481 AML specimens. Results: Defined mixtures were consistently and accurately identified by fragment analysis at a 5% relative concentration of mutant to wild-type, and at 10% and 20% ratios by conventional PCR and direct sequencing, respectively. No false positivity was identified. Among 481 AML specimens, 40.1% (193/481) had FLT3-ITD mutations. The mutant allele burden (1.7-94.1%; median, 28.2%) and repeated length of the mutation (14-153 bp; median, 49 bp) were variable. The concordance rate between fragment analysis and conventional PCR was 97.7% (470/481). Fragment analysis was more sensitive than conventional PCR and detected 11 additional cases: seven had mutations below 10%, three cases represented conventional PCR failure, and one case showed false negativity because of short ITD length (14 bp). Conclusions: The new fragment analysis method proved to be sensitive and reliable for the detection and monitoring of FLT3-ITD in patients with AML. This could be used to simultaneously assess ITD mutant allele burden and length.

Establishment of the High-Throughput Hair Roots' DNA Isolation System and Verification of Its Appicability for Hanwoo Traceability Using the 11 Microsatellite Makes (대량 모근 시료 DNA 분리 체계 확립과 11 microsatellite maker를 사용하는 한우 생산이력제로의 적용가능성 검증)

  • Lim, Hyun-Tae;Lee, Sang-Ho;Yoo, Chae-Kyoung;Sun, Du-Won;Cho, In-Cheol;Yoon, Du-Hak;Yang, Dae-Young;Cheong, Il-Cheong;Lee, Jung-Gyu;Jeon, Jin-Tae
    • Journal of agriculture & life science
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    • v.44 no.6
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    • pp.91-99
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    • 2010
  • We used a multiplex PCR primer set composed of 11 microsatellite (MS) markers and two sexing markers for gender detection. Genomic DNA extracted from hair roots of 3,510 Hanwoo were genotyped. Based on the 11MS markers, no animals had identical genotypes(TGLA227, BM2113, TGLA53, ETF10, SPS115, TGLA122, ETH3, ETH225, BM1824 and INRA23). The expected probability of identity among genotypes of random individuals (PI), the probability of identity among genotypes from random half-sibs ($PI_{half-sibs}$) and among genotypes of random individuals, and the probability of identity among genotypes from random sibs ($PI_{sibs}$) were estimated as $1.31{\times}10^{-23}$, $2.52{\times}10^{-16}$and $1.09{\times}10^{-6}$, respectively using the API-CALC program, version 1.0. We successfully completed the genotype analysis of 3,510 Hanwoo with a 3.93% genotyping failure rate. It was revealed that extracting DNA from the hair root was a time-efficient and cost-effective method to collect specimens for DNA isolation from live animals. This method also minimized stress for the animals during specimen collection. Among the hair roots from the back, belly, upper tail and lower tail, 5~13 hair roots of the lower tail led to the best genotype analysis results. Finally, we established a 96-well-format method of DNA preparation applicable for high- throughput genotype analysis.