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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

Comparison of nutrient removal efficiency of an infiltration planter and an infiltration trench (침투도랑(IT)과 침투화분(IP)의 영양염류 저감효율 비교분석)

  • Yano, K.A.V.;Geronimo, F.K.F.;Reyes, N.J.D.G.;Jeon, Minsu;Kim, Leehyung
    • Journal of Wetlands Research
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    • v.21 no.4
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    • pp.384-391
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    • 2019
  • Nutrients in stormwater runoff have raised concerns regarding water quality degradation in the recent years. Low impact development (LID) technologies are types of nature-based solutions developed to address water quality problems and restore the predevelopment hydrology of a catchment area. Two LID facilities, infiltration trench (IT) and infiltration planter (IP), are known for their high removal rate of nutrients through sedimentation and vegetation. Long-term monitoring was conducted to assess the performance and cite the advantages and disadvantages of utilizing the facilities in nutrient removal. Since a strong ionic bond exists between phosphorus compounds and sediments, reduction of total phosphorus (TP) (more than 76%), in both facilities was associated to the removal of total suspended solids (TSS) (more than 84%). The efficiency of nitrogen in IP is 28% higher than IT. Effective nitrification occurred in IT and particulate forms of nitrogen were removed through sedimentation and media filters. Decrease in ammonium- nitrogen (NH4-N) and nitrite-nitrogen (NO2-N), and increase in nitrate-nitrogen (NO3-N) fraction forms indicated that effective nitrification and denitrification occurred in IP. Hydrologic factors such as rainfall depth and rainfall intensity affected nutrient treatment capabilities of urban stormwater LID facilities The greatest monitored rainfall intensity of 11 mm/hr for IT yielded to 34% and 55% removal efficiencies for TN and TP, respectively, whereas, low rainfall intensities below 5 mm resulted to 100 % removal efficiency. The greatest monitored rainfall intensity for IP was 27 mm/hr, which still resulted to high removal efficiencies of 98% and 97% for TN and TP, respectively. Water quality assessment showed that both facilities were effective in reducing the amount of nutrients; however, IP was found to be more efficient than IT due to its additional provisions for plant uptake and larger storage volume.

The Scale-dependent of Hydraulic Conductivity in Leaky Confined Aquifer with High Permeability at the Ttaan Isle, Gimhae City (김해 딴섬의 고투수성 누수 피압대수층에서 수리전도도의 규모종속효과)

  • Kim, Tae-Yeong;Kang, Dong-Hwan;Kim, Sung-Soo;Kim, Byung-Woo;Kwon, Byung-Hyuk
    • The Journal of Engineering Geology
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    • v.18 no.4
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    • pp.415-422
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    • 2008
  • Pumping test was conducted to understand hydraulic conductivity for leaky confined aquifer with high permeability. Test aquifer was formed in $25{\sim}35\;m$ below ground surface at predetermined site of riverbank filtration which junction of Nakdong river and Milyang river in the Ttaan isle, Gimhae city, Korea Monitoring wells were located at intervals of 2 m and 5 m from pumping well in south-west direction (MW1 and MW2 wells) and northeast direction (MW3 and MW4 wells), respectively. Pumping test was continuously conducted for constant pumping rate of $2,500m^3/day$, hydraulic conductivity was estimated using AQTESOLV 3.5 program. Hydraulic conductivity were estimated to be $1.745{\times}10^{-3}m/sec$ for pumping well (PW), $2.452{\times}10^{-3}m/sec$ for between PW and MW1 wells, $2.161{\times}10^{-3}m/sec$ for between PW and MW2 wells, $2.270{\times}10^{-3}m/sec$ for between PW and MW3 wells and $2.591{\times}10^{-3}m/sec$ for between PW and MW4 wells. The function of hydraulic conductivity (K) as monitoring distance (d) were estimated to be logK = 0.0693logd - 2.671 for south-west direction (PW-MW1-MW2 line), logK = 0.0817logd - 2.655 for north-east direction (PW-MW3-MW 4 line). Scale exponent of hydraulic conductivity as test volume was estimated using Schulze-Makuch et al.(1999) method. Scale exponent of this aquifer was estimated to be 0.15. It means that test aquifer has very low heterogeneity. The radius of influence estimated using transmissivity, maximum groundwater level displacement, distance from pumping well and pumping rate during pumping test were 7.148 m for south-west direction and 6.912 m for north-east direction. The increasing rate of hydraulic conductivity from pumping well to maximum radius of influence were estimated to be 1.40 times for south-west direction and 1.49 times for north-east direction. Thus, heterogeneity of test aquifer was a little higher in north-east direction.

Treatment of N, P of Auto-Thermal Thermophilic Aerobic Digestion Filtrate with Struvite Crystallization (Struvite 결정화 반응을 이용한 고온 소화 여과액의 N, P 처리 특성)

  • Choo, Yeon-Duk;Kim, Keum-Yong;Ryu, Hong-Duck;Lee, Sang-Ill
    • Journal of Korean Society of Environmental Engineers
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    • v.33 no.11
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    • pp.783-789
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    • 2011
  • Recently, auto-thermal thermophilic aerobic digestion (ATAD) has a great attention for destruction of wasted sludge biomass in wastewater treatment plant. Reduction of sludge concentration has been successfully achieved with pilot scale ATAD and ceramic filtration process in field condition. However, high concentration of COD, total nitrogen (TN) and total phosphorus (TP) was observed in filtrate, which should be treated before recirculation of filtrate to biological wastewater treatment plant. This study was focused on removal of nitrogen and phosphorus contained in the filtrate of ATAD, using struvite crystallization method. The effect of operational and environmental parameters (such as, N, P and Mg ion concentration and molar ratio, pH, reaction time, agitation strength, seed dosage, and reaction temperature) on the treatment of TN and TP with struvite crystallization were evaluated. Magnesium (as $MgCl_26H_2O$) and phosphorus (as $K_2HPO_4$) ions were, if necessary, added to increase nitrogen removal efficiency by the crystal formation. Average concentration of $NH_4^+-N$ and $PO_4^{3-}-P$ of the filtrate were 1716.5 mg/L and 325.5 mg/L, respectively. Relationship between removal efficiencies of nitrogen and phosphorus and molar ratios of $Mg^{2+}$ and $PO_4^{3-}-P$ to $NH_4^+-N$ was examined. Crystal formation and nitrogen removal efficiencies were significantly increased as increasing molar ratios of magnesium and phosphorus to nitrogen. As molar ratio of $Mg^{2+}:PO_4^{3-}-P:NH_4^+-N$ were maintained to 2 : 1 : 1 and 2 : 2 : 1, removal efficiencies of nitrogen and phosphorus were 71.6% and 99.9%, and 93.8% and 98.6%, respectively. However, the effect of reaction time, mixing intensity, seed dose and temperature on the struvite crystallization reaction was not significant, comparing to those of molar ratios. Settled sludge volume after struvite crystallization was observed to be reduced with increase of seed dose and to be increased at high temperature.

A Numerical and Experimental Study for Fry-drying of Various Sludge (슬러지 유중 건조에 대한 전산 해석 및 실험적 연구)

  • Shin, Mi-Soo;Kim, Hey-Suk;Kim, Byeong-Gap;Hwang, Min-Jeong;Jang, Dong-Soon;Ohm, Tae-In
    • Journal of Korean Society of Environmental Engineers
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    • v.32 no.4
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    • pp.341-348
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    • 2010
  • The basic principle of fry drying process of sludge lies in the rapid pressure change of sludge material caused by the change of temperature between oil and moisture due to the difference of specific heat. Therefore, the rapid increase of pressure in drying sludge induces the efficient moisture escape through sludge pores toward heating oil media. The object of this study is to carry out a systematic investigation of the influence of various parameters associated with the sludge fry drying processes on the drying efficiency. To this end, a series of parametric experimental investigation has been made together with the numerical calculation in order to obtain typical drying curves as function of important parameters such as drying temperature, sludge diameter, oil type and sludge type. In the aspect of frying temperature, especially it is found that the operation higher than $140^{\circ}C$ was favorable in drying efficiency regardless of type of waste oil employed in this study. The same result was also noted consistently in the investigation of numerical calculation, that is, in that the sludge particle drying was efficiently made over $140^{\circ}C$ irrespective of the change of particle diameter. As expected, in general, the decrease of diameter in sludge was found efficient both experiment and numerical calculation in drying due to the increased surface area per unit volume. In the investigation of oil type and property, the effect of the viscosity of waste oil was found to be more influential in drying performance. In particular, when the oil with high viscosity, a visible time delay was noticed in moisture evaporation especially in the early stage of drying. However, the effect of high viscosity decreased significantly over the temperature of $140^{\circ}C$. There was no visible difference observed in the study of sludge type but the sewage sludge with a slightly better efficiency. The numerical study is considered to be a quite useful tool to assist in experiment with more detailed empirical modeling as further work.

Predictive Clustering-based Collaborative Filtering Technique for Performance-Stability of Recommendation System (추천 시스템의 성능 안정성을 위한 예측적 군집화 기반 협업 필터링 기법)

  • Lee, O-Joun;You, Eun-Soon
    • Journal of Intelligence and Information Systems
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    • v.21 no.1
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    • pp.119-142
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    • 2015
  • With the explosive growth in the volume of information, Internet users are experiencing considerable difficulties in obtaining necessary information online. Against this backdrop, ever-greater importance is being placed on a recommender system that provides information catered to user preferences and tastes in an attempt to address issues associated with information overload. To this end, a number of techniques have been proposed, including content-based filtering (CBF), demographic filtering (DF) and collaborative filtering (CF). Among them, CBF and DF require external information and thus cannot be applied to a variety of domains. CF, on the other hand, is widely used since it is relatively free from the domain constraint. The CF technique is broadly classified into memory-based CF, model-based CF and hybrid CF. Model-based CF addresses the drawbacks of CF by considering the Bayesian model, clustering model or dependency network model. This filtering technique not only improves the sparsity and scalability issues but also boosts predictive performance. However, it involves expensive model-building and results in a tradeoff between performance and scalability. Such tradeoff is attributed to reduced coverage, which is a type of sparsity issues. In addition, expensive model-building may lead to performance instability since changes in the domain environment cannot be immediately incorporated into the model due to high costs involved. Cumulative changes in the domain environment that have failed to be reflected eventually undermine system performance. This study incorporates the Markov model of transition probabilities and the concept of fuzzy clustering with CBCF to propose predictive clustering-based CF (PCCF) that solves the issues of reduced coverage and of unstable performance. The method improves performance instability by tracking the changes in user preferences and bridging the gap between the static model and dynamic users. Furthermore, the issue of reduced coverage also improves by expanding the coverage based on transition probabilities and clustering probabilities. The proposed method consists of four processes. First, user preferences are normalized in preference clustering. Second, changes in user preferences are detected from review score entries during preference transition detection. Third, user propensities are normalized using patterns of changes (propensities) in user preferences in propensity clustering. Lastly, the preference prediction model is developed to predict user preferences for items during preference prediction. The proposed method has been validated by testing the robustness of performance instability and scalability-performance tradeoff. The initial test compared and analyzed the performance of individual recommender systems each enabled by IBCF, CBCF, ICFEC and PCCF under an environment where data sparsity had been minimized. The following test adjusted the optimal number of clusters in CBCF, ICFEC and PCCF for a comparative analysis of subsequent changes in the system performance. The test results revealed that the suggested method produced insignificant improvement in performance in comparison with the existing techniques. In addition, it failed to achieve significant improvement in the standard deviation that indicates the degree of data fluctuation. Notwithstanding, it resulted in marked improvement over the existing techniques in terms of range that indicates the level of performance fluctuation. The level of performance fluctuation before and after the model generation improved by 51.31% in the initial test. Then in the following test, there has been 36.05% improvement in the level of performance fluctuation driven by the changes in the number of clusters. This signifies that the proposed method, despite the slight performance improvement, clearly offers better performance stability compared to the existing techniques. Further research on this study will be directed toward enhancing the recommendation performance that failed to demonstrate significant improvement over the existing techniques. The future research will consider the introduction of a high-dimensional parameter-free clustering algorithm or deep learning-based model in order to improve performance in recommendations.

Development and Application of the High Speed Weigh-in-motion for Overweight Enforcement (고속축하중측정시스템 개발과 과적단속시스템 적용방안 연구)

  • Kwon, Soon-Min;Suh, Young-Chan
    • International Journal of Highway Engineering
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    • v.11 no.4
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    • pp.69-78
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    • 2009
  • Korea has achieved significant economic growth with building the Gyeongbu Expressway. As the number of new road construction projects has decreased, it becomes more important to maintain optimal status of the current road networks. One of the best ways to accomplish it is weight enforcement as active control measure of traffic load. This study is to develop High-speed Weigh-in-motion System in order to enhance efficiency of weight enforcement, and to analyze patterns of overloaded trucks on highways through the system. Furthermore, it is to review possibilities of developing overweight control system with application of the HS-WIM system. The HS-WIM system developed by this study consists of two sets of an axle load sensor, a loop sensor and a wandering sensor on each lane. A wandering sensor detects whether a travelling vehicle is off the lane or not with the function of checking the location of tire imprint. The sensor of the WIM system has better function of classifying types of vehicles than other existing systems by detecting wheel distance and tire type such as single or dual tire. As a result, its measurement errors regarding 12 types of vehicle classification are very low, which is an advantage of the sensor. The verification tests of the system under all conditions showed that the mean measurement errors of axle weight and gross axle weight were within 15 percent and 7 percent respectively. According to the WIM rate standard of the COST-323, the WIM system of this study is ranked at B(10). It means the system is appropriate for the purpose of design, maintenance and valuation of road infrastructure. The WIM system in testing a 5-axle cargo truck, the most frequently overloaded vehicle among 12 types of vehicles, is ranked at A(5) which means the system is available to control overloaded vehicles. In this case, the measurement errors of axle load and gross axle load were within 8 percent and 5 percent respectively. Weight analysis of all types of vehicles on highways showed that the most frequently overloaded vehicles were type 5, 6, 7 and 12 among 12 vehicle types. As a result, it is necessary to use more effective overweight enforcement system for vehicles which are seriously overloaded due to their lift axles. Traffic volume data depending upon vehicle types is basic information for road design and construction, maintenance, analysis of traffic flow, road policies as well as research.

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Result of Radiation Therapy for the Lung Cancer (폐암의 방사선치료 결과)

  • Kim Joo-Young;Choi Myung-Sun;Suh Won-Hyck
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.213-225
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    • 1989
  • An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.

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The Influences of Coastal Upwelling on Phytoplankton Community in the Southern Part of East Sea, Korea (동해 남부 연안 해역에서 냉수대 발생이 식물플랑크톤 군집에 미치는 영향)

  • Kim, A-Ram;Youn, Seok-Hyun;Chung, Mi-Hee;Yoon, Sang-Chol;Moon, Chang-Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.4
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    • pp.287-301
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    • 2014
  • In order to understand environment condition and phytoplankton community before and after coastal upwelling, the influences of upwelling events on phytoplankton community were studied at 18 stations located the Southern part of East Sea, Korea from May to August 2013. The surface water masses showed low temperature and high salinity due to upwelling events at coastal stations (A1, B1, C1). Correlation between temperature and nutrients (DIP, r=-0.218, p<0.01; DIN, r=-0.306, p<0.01; silicate, r=-0.274, p<0.01) was significantly negative. This result could be explained that nutrients were supplied to surface water by the upwelling of bottom water. Phytoplankton communities were composed of 186 species. Phytoplankton abundance were relatively high in May (C1, $726{\times}10^3cells\;L^{-1}$) and July (A1, $539{\times}10^3cells\;L^{-1}$). Total chlorophyll a and micro-size fraction ($&gt;20{\mu}m$) increased at coastal stations in July and August, while phytoplankton abundance and total chl. a was much low in June. Dominant species in June was Pseudo-nitzschia spp. of which the cell size was $309{\mu}m^3$. Cell size of Pseudo-nitzschia spp. was smaller than dominant species in other period. Therefore, the increase in total chloro-phyll a and the size of phytoplankton was resulted in the sufficient supply of nutrients. In contrast, these tendencies were not observed at outside stations. These results suggested that coastal upwelling was an important influencing factor to determine the species composition and standing stock of phytoplankton community in the coastal waters of the Southern part of East Sea, Korea.

Feasibility Study of Wetland-pond Systems for Water Quality Improvement and Agricultural Reuse (습지-연못 연계시스템에 의한 수질개선과 농업적 재이용 타당성 분석)

  • Jang, Jae-Ho;Jung, Kwang-Wook;Ham, Jong-Hwa;Yoon, Chun-Gyeong
    • Korean Journal of Ecology and Environment
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    • v.37 no.3 s.108
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    • pp.344-354
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    • 2004
  • A pilot study was performed from September 2000 to April 2004 to examine the feasibility of the wetland-pond system for the agricultural reuse of reclaimed water. The wetland system was a subsurface flow type, with a hydraulic residence time of 3.5 days, and the subsequent pond was 8 $m^3$ in volume (2 m ${\times}$ 2 m ${\times}$ 2 m) and operated with intermittent-discharge and continuous flow types. The wetland system was effective in treating the sewage; median removal efficiencies of $BOD_5$ and TSS were above 70.0%, with mean effluent concentrations of 27.1 and 16.8 mg $L^{-1}$, respectively, for these constituents. However, they did often exceed the effluent water quality standards of 20 mg $L^{-1}$. Removal of T-N and T-P was relatively less effective and mean effluent concentrations were approximately 103.2 and 7.2 mg $L^{-1}$, respectively. The wetland system demonstrated high removal rate (92 ${\sim}$ 90%) of microorganisms, but effluent concentrations were in the range of 300 ${\sim}$ 16,000 MPN 100 $mL^{-1}$ which is still high for agricultural reuse. The subsequent pond system provided further treatment of the wetland effluent, and especially additional microorganisms removal in addition to wetland-pond system could reduce the mean concentration to 1,000 MPN 100 $mL^{-1}$ from about $10^5$ MPN 100 $mL^{-1}$ of wetland influent. Other parameters in the pond system showed seasonal variation, and the upper layer of the pond water column became remarkably clear immediately after ice melt. Overall, the wetland system was found to be adequate for treating sewage with stable removal efficiency, and the subsequent pond was effective for further polishing. This study concerned agricultural reuse of reclaimed water using natural systems. Considering stable performance and effective removal of bacterial indicators as well as other water quality parameters, low maintenance, and cost-effectiveness, wetland- pond system was thought to be an effective and feasible alternative for agricultural reuse of reclaimed water in rural area.