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급성중독 응급실 환자에서 Zolpidem 검출과 농도: 일개 중독분석실 229명 사례 (Zolpidem Detection and Blood Level in Acute Poisoning-suspected Patients in Emergency Departments: Review of 229 Cases)

  • 유재형;장한석;원신애;염정훈;이아름;박나연;오범진
    • 대한임상독성학회지
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    • 제17권2호
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    • pp.118-125
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    • 2019
  • Purpose: Non-benzodiazepine hypnotic drugs (including zolpidem) are associated with an increased risk of suicide and suicidal ideation. Considering the wide usage of zolpidem, this drug should be considered a possible etiology for stupor or coma in any patient exposed to this drug. However, there are no reports on zolpidem blood levels in emergency department patients in Korea. We therefore reviewed the analyzed data of a toxicology laboratory at one university affiliated hospital. Methods: The sex, age, chief symptoms, suspiciousness of poisoning, and presumption of poison were analyzed from January 2018 to June 2019. The detection frequency and level of zolpidem in the patient blood were compared to the mental changes presented, which is the main consequence of zolpidem. Results: A total of 229 toxicological analyses, requested to a toxicological laboratory at one university affiliated hospital, were reviewed. Among 229 patients, the mean age was 54.3±20.7 years old with 113 women and 116 men. 8.7% of patients have psychiatric illness and 39.7% were poisoned intentionally. The chief symptoms detected were: mental change 55.0%, gastrointestinal 14.4%, cardiovascular 10.5%, focal neurological 7.4%, respiratory 3.5%, none 8.7%, and unknown 0.4%. A request for detailed reports revealed that causative poisons were specified only in 20.1% cases. Zolpidem was detected in 22.3% cases (51/229), with median blood level 1.26 mg/L (interquartile 0.1, 5.06 mg/L) and urine 0.90 mg/L (interquartile 0.11, 5.6 mg/L). Furthermore, zolpidem was more frequently detected in toxicology analysis of patients where mental change was the primary symptom, as compared to other symptoms (32.5% vs. 9.7%, p<0.01). Conclusion: This study reported the blood level of zolpidem in suspected poisoning patients admitted to the emergency department.

통계분석 알고리즘 프로그램을 활용한 동시 인상 3D 콘크리트 프린팅의 성능 분석 (Performance Analysis of Simultaneous Liftable 3D Concrete Printing Based on Statistical Analysis Algorithm)

  • 김윤철;김성조;김봉식;지용수;한동석
    • 한국전산구조공학회논문집
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    • 제36권6호
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    • pp.407-414
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    • 2023
  • 본 논문에서는 다양한 분야에 적용할 수 있는 자동화 동시 인상 시스템을 3D 콘크리트 프린팅에 적용하여 동시 인상이 가능한 3D 콘크리트 프린팅 시스템으로 개발하였다. 개발된 시스템은 3D 콘크리트 프린팅 작업 중 측정되는 인상량을 피어슨 상관계수를 통해 분석하고, 유압시스템을 사분위수 기법으로 실시간 모니터링하여 안전하고 정밀한 인상이 가능하다. 이를 활용하면 3D 콘크리트 프린팅 구조물의 출력 품질을 확보함과 동시에 3D 콘크리트 프린팅의 규모보다 큰 구조물을 출력할 수 있다. 시스템의 성능을 평가하기 위해 기존의 3D 콘크리트 프린팅과 동시 인상이 가능한 3D 콘크리트 프린팅을 각각 이용하여 시편을 출력하였다. 출력된 시편은 3D 스캐너를 활용하여 측정하였다. 스캔한 시편의 층별 직경과 시편의 교차각을 측정하였으며, 분석을 통해 동시 인상이 가능한 3D 콘크리트 프린팅의 성능을 검증하였다.

Effect of Stent Placement on Survival in Patients with Malignant Portal Vein Stenosis: A Propensity Score-Matched Study

  • Dong Jae Shim;Jong Woo Kim;Doyoung Kim;Gi-Young Ko;Dong Il Gwon;Ji Hoon Shin;Yun-Jung Yang
    • Korean Journal of Radiology
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    • 제23권1호
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    • pp.68-76
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    • 2022
  • Objective: Percutaneous portal vein (PV) stent placement can be an effective treatment for symptoms associated with portal hypertension. This study aimed to evaluate the effect of PV stenting on the overall survival (OS) in patients with malignant PV stenosis. Materials and Methods: Two groups of patients with malignant PV stenosis were compared in this retrospective study involving two institutions. A total of 197 patients who underwent PV stenting between November 2016 and August 2019 were established as the stent group, whereas 29 patients with PV stenosis who were treated conservatively between July 2013 and October 2016 constituted the no-stent group. OS was compared between the two groups before and after propensity score matching (PSM). Risk factors associated with OS were evaluated using the Cox proportional hazards model. Procedure-associated adverse events were also evaluated. Results: The stent group finally included 100 patients (median age, 65 [interquartile range, 58-71] years; 64 male). The no-stent group included 22 patients (69 [61-75] years, 13 male). Stent placement was successful in 95% of attempted cases, and the 1- and 2-year stent occlusion-free survival rate was 56% (95% confidence interval, 45%-69%) and 44% (32%-60%), respectively. The median stent occlusion-free survival time was 176 (interquartile range, 70-440) days. OS was significantly longer in the stent group than in the no-stent group (median 294 vs. 87 days, p < 0.001 before PSM, p = 0.011 after PSM). The 1- and 3-year OS rates before PSM were 40% and 11%, respectively, in the stent group. The 1-year OS rate after PSM was 32% and 5% in the stent and no-stent groups, respectively. Anemia requiring transfusion (n = 2) and acute thrombosis necessitating re-stenting (n = 1) occurred in three patients in the stent group within 1 week. Conclusion: Percutaneous placement of a PV stent may be effective in improving OS in patients with malignant PV stenosis.

Why Is a b-value Range of 1500-2000 s/mm2 Optimal for Evaluating Prostatic Index Lesions on Synthetic Diffusion-Weighted Imaging?

  • So Yeon Cha;EunJu Kim;Sung Yoon Park
    • Korean Journal of Radiology
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    • 제22권6호
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    • pp.922-930
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    • 2021
  • Objective: It is uncertain why a b-value range of 1500-2000 s/mm2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000-3000 s/mm2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm2. We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses. For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRI-suggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI. The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761-1805 s/mm2 and 1640-1771 s/mm2 (median, 1790 s/mm2 vs. 1705 s/mm2; p = 0.003) for reader 1, and 1835-1895 s/mm2 and 1705-1841 s/mm2 (median, 1872 s/mm2 vs. 1763 s/mm2; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735-1873 s/mm2 and 1573-1867 s/mm2 for reader 1, and 1775-1945 s/mm2 and 1591-1955 s/mm2 for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm2 between qualitatively and quantitatively selected optimal b-values. Conclusion: b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500-2000 s/mm2.

Prognostic Implication of Right Ventricle Parameters Measured on Preoperative Cardiac MRI in Patients with Functional Tricuspid Regurgitation

  • Yura Ahn;Hyun Jung Koo;Joon-Won Kang;Won Jin Choi;Dae-Hee Kim;Jong-Min Song;Duk-Hyun Kang;Jae-Kwan Song;Joon Bum Kim;Sung-Ho Jung;Suk Jung Choo;Cheol Hyun Chung;Jae Won Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제22권8호
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    • pp.1253-1265
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    • 2021
  • Objective: To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR). Materials and Methods: The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51-66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality. Results: For the median follow-up duration of 5.4 years (interquartile range, 1.2-6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m2, p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m2 RVMI = 1.75, p < 0.001). After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005). Conclusion: RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.

Short-term Associations of Air Pollution with Postneonatal Infant Death in Seoul, Korea, 1999-2003

  • Lee, Jong-Tae;Cho, Yong-Sung;Son, Ji-Young
    • 한국환경보건학회지
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    • 제34권5호
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    • pp.361-368
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    • 2008
  • Objective to assess whether exposure to air pollutants is associated with postneonatal infant death, using a timeseries methodology, between 1999 and 2003 in Seoul, Korea.. Methods We investigated the short-term effects of air pollution for 548,725 live births during the study period. The daily count of postneonatal infant deaths from all causes and from SIDS (sudden infant death syndrome) by birth order was analyzed by a Generalized Additive Poisson model, with controlling for the effects of seasonal trends, air temperature, relative humidity, barometric pressure, and day of the week as covariates. Results During the study period, we observed 699 deaths from all causes and 47 deaths from SIDS. We did not find any significant associations between daily mortality and ambient levels of air pollutants except for CO and $NO_2$. The estimated relative risk of postneonatal infant death from all causes was 1.17 (95% CI=1.04-1.32) and 1.16 (95% CI=1.03-1.29) by IQR (interquartile range) for CO and $NO_2$ respectively. Also, we observed no clear trend of the mortality effects of air pollution by birth orders. Conclusion In conclusion, our findings suggest that air pollution, in general, influenced adversely postneonatal infant death from all-cause and SIDS although it was not statistically significant. This study may support that the rationale.

20대 여성의 표준체형과 인대 적합성에 관한 연구 (Standardized Body Type and the Suitability of Figures for the Twenties Women)

  • 구미지;이정임
    • 한국의류산업학회지
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    • 제7권6호
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    • pp.601-608
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    • 2005
  • This research investigated the present state of the dress forms used by clothing manufacturers and proposed procedure to bring out the standardized body type and figure for women in twenties. The result of questionnaire showed chief pattern maker's thoughts that dress form should be differently made for each age group and should be more reflected the standard body than the idea body. The standardized body type was made from the standardized posture and size which were analyzed from the interquartile range(IQR) of 314 subjects. The standardized size could be verified as for the balanced body shape of twenties through making the standard dress form. The standardized form(S form) was compared with three kinds of forms(A, K and P) for investigating the suitability of forms. K form was very similar to S form, Educational P form and manufacturer's A form had quite big differences from S form at the important areas for making clothing. The side shapes of A, K and P forms showed differences at back bending, neck angle and hip shape from S form. A form was comparatively smooth and flat. This results could be used as the practical standard to improve the suitability of size and shape in the dress forms of manufacturers and educators.

확률강우량의 공간분포에 대한 불확실성 해석: CEM과 SGS 기법의 비교 (Uncertainty Analysis of Spatial Distribution of Probability Rainfall: Comparison of CEM and SGS Methods)

  • 서영민;여운기;이승윤;지홍기
    • 한국수자원학회논문집
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    • 제43권11호
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    • pp.933-944
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    • 2010
  • 본 논문에서는 확률강우량에 대한 공간분포 추정에 있어서 공간변동성에 따른 불확실성을 평가하기 위하여 지구통계 학적 추계모의기법인 CEM과 SGS 기법을 비교하였다. CEM과 SGS를 이용한 추계모의에 있어서 공간상관구조의 재생성, 확률강우량에 대한 불확실성 평가측도로서 실현치에 대한 통계치(표준편차, 변동계수, 사분위수 범위 및 범위)의 공간분포, 유역평균강우량의 불확실성 분포의 경우 두 기법이 대체로 비슷한 결과를 보이는 것으로 분석되었다. 그러나 모의 효율성 측면에서는 CEM이 SGS에 비해 우수한 결과를 나타내는 것으로 분석되었다.

파노라마방사선사진을 이용한 경상돌기에 관한 연구 (A study on the styloid process in panoramic radiographs)

  • 황지영;황의환;이상래
    • Imaging Science in Dentistry
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    • 제35권2호
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    • pp.105-110
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    • 2005
  • Purpose : To find statistically based information about the natural variation in the length of the styloid process and to show the influence of the gender and age on the length of the styloid process. Materials and Methods : 1,300 panoramic radiographs were retrieved from inactive files at the Dental Hospital of Kyung Hee University. Measurements of the length of the styloid process were made directly on the radiographs from the inferior margin of the tympanic plate to the tip of the styloid process. Results The mean length of 948 styloid processes was $25.2mm{\pm}6.6$. The median was 24.5 mm, and the interquartile range was 7 mm. The mean length was 25.7 mm for male and 24.6 mm for female. All percentile was greater for male than for female. The median is 25 mm for male and 24 mm for female. Conclusion : This study suggests that the difference of the styloid process length between genders was statistically significant and the length of styloid process was significant increased with age until 30 years.

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기능성 소화불량증 환자에 대한 복부(腹部) 수기치료의 효과 (Effectiveness of Abdominal Manipulation Therapy in Functional Dyspepsia Patients)

  • 맹태호;이종수
    • 한방재활의학과학회지
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    • 제25권4호
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    • pp.113-121
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    • 2015
  • Objectives Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disorders. The aim of this study was to evaluate changes in symptoms, quality of life, HRV (Heart Rate Variability) before and after abdominal manipulation therapy in functional dyspepsia patients. Methods We recruited twenty functional dyspepsia patients from the volunteers who applied for this clinical trial. State of Patients were assessed by NDI-K (Nepean Dyspepsia Index Korean Version), HRV (Heart Rate Variability) before treatment. After 4 times of abdominal manipulation therapy for 2 weeks, state of patients were assessed by the same methods. Results Total symptom score and total quality of life score of NDI-K were significantly improved by the abdominal manipulation therapy. After the treatment, the number of subjects within normal range of LF/HF ratio was significantly increased. Although the median of LF/HF ratio did not significantly changed, interquartile range was reduced. Conclusions Abdominal manipulation therapy possibly can be an effective treatment for functional dyspepsia patients, but further studies are needed to demonstrate the effectiveness of abdominal manipulation therapy for functional dyspepsia patients.