• Title/Summary/Keyword: Mean period

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Drug Evaluation of Ursodeoxycholic Acid Use for Treatment of Cholestasis Associated with TPN Therapy in Neonate (신생아의 TPN 요법 시 발생되는 Cholestasis 치료를 위한 Ursodeoxycholic Acid의 약물사용 평가)

  • Lee, Jung-Ok;Song, Tae-Beom;Lee, Myung-Koo;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.270-281
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    • 2010
  • Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

Relationship between the Occurrence of Thromboembolism and INR Measurement Interval in Low Intensity Anticoagulation after Aortic Mechanical Valve Replacement

  • Rhie, Sang-Ho;Choi, Jun-Young;Jang, In-Seok;Kim, Jong-Woo;Lee, Chung-Eun;Park, Hyun-Oh
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.220-224
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    • 2011
  • Background: We investigated changes in the International Normalized Ratio (INR) and its measurement interval in patients with thromboembolic events who were treated by low intensity anticoagulation therapy after isolated mechanical aortic valve replacement. Materials and Methods: Seventy-seven patients who underwent surgery from June 1990 to September 2006 were enrolled in the study and observed until August 2008. The patients were followed up at 4~8 week intervals and their warfarin (Coumadin)$^{(R)}$ dosage was adjusted aiming for a target range of INR 1.5~2.5. The rate of thromboembolic events was obtained. Changes in the mean INR and INR measurement interval were comparatively analyzed between the normal group (event free group, N=52) who had no anticoagulation-related complications and the thromboembolic group (N=10). Hospital records were reviewed retrospectively. Results: The observation period was 666.75 patient-years. Thromboembolic events occurred in 10 patients. The linearized occurrence rate of thromboembolism was 1.50%/patient-years. Actuarial thromboembolism-free rates were $97.10{\pm}2.02%$ at 5 years, $84.30{\pm}5.22%$ at 10 years, and $67.44{\pm}12.14%$ at 15 years. The percentages of INR within the target range and mean INR were not statistically significantly different for the normal and thromboembolic groups. However, the mean INR during the segmented period just before the events showed a significantly lower level in the thromboembolic group (during a 4 month period: normal group, $1.86{\pm}0.14$ vs. thromboembolic group, $1.50{\pm}0.28$, p<0.001). The mean intervals of INR measurement during the whole observation period showed no significant differences between groups, but in the segmented period just before the events, the interval was significantly longer in thromboembolic group (during a 6 month period: normal group, $49.04{\pm}9.47$ days vs. thromboembolic group, $65.89{\pm}44.88$ days, p<0.01). Conclusion: To prevent the occurrence of thromboembolic events in patients who receive isolated aortic valve replacement and low intensity anticoagulation therapy, we suggest that it would be safe to maintain an INR level above 1.8 and to measure the INR at least every 7~8 weeks.

A Case Report on the Effect of Jeongjeongamiijin-tang-gamibang on Halitosis Patients (정전가미이진탕가미방으로 치료한 구취환자 증례보고)

  • Kang, Kiwon;An, Jihye;Jang, Younyong;Park, Jisan;Jo, Youngju;Jung, Seungwon;Kim, Jeongkyun
    • Herbal Formula Science
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    • v.28 no.4
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    • pp.443-450
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    • 2020
  • Objectives : The aim of this study is to evaluate the long-term effect of Jeongjeongamiijin-tang-gamibang by measuring the symptom-free-period after treatment through sensory and subjective evaluation. Methods : We administered Jeongjeongamiijin-tang-gamibang to 10 patients diagnosed with stomach heat pattern. The asymptomatic period was measured from the end of treatment by sensory and subjective evaluation. Results : The total dose of medication administered to the patients was dose of 3 to 7 months and the mean was 4.1 months. Symptom-free period from the end of treatment was 24.5 to 69.4months, and the mean of treatment was 46.97 months. Conclusions : Jeongjeongamiijintanggamibang is effective for the treatment of halitosis and its effect is sustained for a long time.

Inventory Control Policies for a Hospital Blood Bank: A Simulation and Regression Approach (병원의 혈액 재고관리를 위한 평가 모형 : 시뮬레이션 및 회귀분석 방법)

  • Suh, Jeong-Dae
    • IE interfaces
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    • v.10 no.1
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    • pp.119-134
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    • 1997
  • The management of blood inventory is very important within the medical care system. The efficient management of blood supplies and demands for transfusions is of great economic and social importance to both hospitals and patients. For any blood type, there is a complex interaction among the optimal inventory level, daily demand level, daily supply level, transfusion to crossmatch ratio, crossmatch release period, issuing policy and the age of arriving units that determine the shortage and outdate rate. In this paper, we develop an efficient decision rule for blood inventory management in a hospital blood bank which can support efficient hospital blood inventory management using simulation. The primary use of the efficient decision rule will be to establish minimum cost function which consists of inventory levels, period in inventory, outdate and shortage rate for whole blood and various component inventories for a hospital blood bank or a transfusion service. If the administrator compute the mean daily demand for each blood type, the mean daily supply for each blood type, the length of the crossmatch release period and the average transfusion to crossmatch ratio, then it is possible to apply the efficient decision rule to compute the optimal inventory level, inventory period, outdate and shortage rate. This rule can also be used as a decision support system that allows the blood bank administrator to do sensitivity analysis related to controllable blood inventory parameters.

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Development of an Efficient Decision Rule for Blood Inventory Management (효율적인 혈액 재고 관리를 위한 결정룰의 도출)

  • 서정대
    • Journal of the Korea Society for Simulation
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    • v.5 no.1
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    • pp.13-27
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    • 1996
  • The management of blood inventory is very important within the medical care system. The efficient management of blood supplies and demands for transfusion is of great economic and social importance to both hospitals and patients. Fro any blood type, there is a complex interaction among the optimal inventory level, daily demand level , daily supply level, transfusion to crossmatch ratio, crossmatch release period, issuing policy and the age of arriving units that determine the shortage and outdate rate. In this paper, we develop an efficient decision rule for blood inventory management in a hospital blood bank which can support efficient hospital blood inventory management using simulation, The primary use of the efficient decision rule will be to establish minimum cost function which consists of inventory levels , period in inventory, outdate and shortage rate for whole blood and various component inventories for a hospital blood bank or a transfusion service, If the adminstrator compute the mean daily demand for each blood type, the mean daily supply for each blood type, the length of the crossmatch release period and the average transfusion to crossmatch ratio , then it is possible to apply the efficient decision rule to compute the optimal inventory level, inventory period , outdate and shortage rate. This rule can also be used as a decision support system that allows the blood bank adminstrator to do sensitivity analysis related to controlled blood inventory parameters.

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Seismicity and seismic hazard assessment for greater Tehran region using Gumbel first asymptotic distribution

  • Bastami, Morteza;Kowsari, Milad
    • Structural Engineering and Mechanics
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    • v.49 no.3
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    • pp.355-372
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    • 2014
  • Considering the history of severe earthquakes and the presence of active faults in the greater Tehran region, the possibility of a destructive earthquake occurring is high and seismic hazard analysis is crucial. Gumbel distributions are commonly-used statistical distributions in earthquake engineering and seismology. Their main advantage is their basis on the largest earthquake magnitudes selected from an equal-time predefined set. In this study, the first asymptotic distribution of extremes is used to estimate seismicity parameters and peak ground acceleration (PGA). By assuming a Poisson distribution for the earthquakes, after estimation of seismicity parameters, the mean return period and the probable maximum magnitude within a given time interval are obtained. A maximum probable magnitude of 7.0 has a mean return period of 100 years in this region. For a return period of 475 years, the PGA in the greater Tehran region is estimated to be 0.39g to 0.42g, depending on local site conditions. This value is greater than that of the Iranian Code for Seismic Design of Buildings, indicating that a revision of the code is necessary.

A Study of Mycoplasmal Pneumonia developed around a Chunnam Coastal Area in 1993 (1993년 전남의 한 해안지역에서 발생한 Mycoplasmal 폐렴에 대한 고찰)

  • Byun, Joo-Nam;Yang, Eun-Suck
    • Journal of agricultural medicine and community health
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    • v.18 no.2
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    • pp.161-171
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    • 1993
  • Mycoplasma pneumoniae(M. pneumoniae) is a primary pathogene of the respiratory tract in children. Most studies of such pneumonia involve a group of admitted patients in hospital, usually with major medical illness. We retrospectively studied the epidemiologic and clinical feature of 105 patients with serologically proven M. pneumoigic pneumonia treated at Gwang-Yang Hospital during a epidemic period of Jun. 1993 to Dec. 1993. All cases of pneumonia developed in this period were also reviewed and compared with serologically proven group. The results were as follows. 1. There were 63 males and 42 females, and the male /female ratio was 1.5 : 1. 2. More than half(57%) of cases belonged to 5-9 years of age group, and mean age was 6.5 years old. 3. Mean age was steadily decreased as prevalence of mycoplasmal pneumonia had been subsided. 4. The date of index case was June 26th, and that of median case was 3 months after the index case. 5. A major determinant of the outbreak seemed to be the population density rather than the population size. 6. Recurrence and serious complication were not observed in this period. 7. All cases of pneumonia developed in this period might be attributed to M. pnemoniae. These epidemiologic and clinical characteristics would contribute to the prevention and diagnosis of mycoplasmal pneumonia.

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Time-resolved Fluoroimmunoassay (TR-FIA) Analysis of Fecal Progesterone and Estradiol in Leopard Cats (Prionailurus bengalensis) (삵에서 TR-FIA를 이용한 분변내 Estradiol과 Progesterone의 검사)

  • Kim, Young-Seob;Kim, Ji-Yong;Jung, So-Young;Lee, Bong-Joo;Shin, Nam-Shik
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.693-697
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    • 2010
  • This study, conducted with four leopard cats (Prionailurus bengalensis), used time-resolved fluoroimmunoassay (TR-FIA) to analyze estradiol and progesterone concentrations in fecal samples. We measured fecal samples taken during estrus period, diestrus period, pregnancy and non-pregnancy period. During estrus (February), the mean minimum estradiol concentration was $4.02{\pm}1.9$ng/g, and the mean maximum was $86.01{\pm}35.2$ng/g (dry fecal weight). During diestrus (November), the mean minimum estradiol concentration was $4.42{\pm}1.32$ng/g and mean maximum was $15.62{\pm}6.48$ng/g (dry fecal weight). Midgestation (April), the mean minimum progesterone concentration was $427{\pm}24.49$ng/g and the mean maximum was $1490{\pm}265.27$ng/g. During non-pregnancy (November), the mean minimum progesterone concentration was $71.25{\pm}29.61$ng/g and the mean maximum was $291.75{\pm}90.30$ng/g. These results suggest that steroid hormone analysis of feces using TR-FIA is a valid method for noninvasively determining ovarian activity associated with estrus and pregnancy in leopard cats. This study will contribute to building breeding management and reproductive plans for endangered species.

Responses of Holstein Cows to Different Bovine Somatotropin (bST) Treatments during the Transition Period and Early Lactation

  • Gulay, M.S.;Garcia, A.N.;Hayen, M.J.;Wilcox, C.J.;Head, H.H.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.6
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    • pp.784-793
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    • 2004
  • Major objective was to evaluate three doses of bST (POSILAC(R)) injected into Holstein cows during the transition period and through 56 d of lactation for potential to improve DMI, BCS, BW, metabolites, hormones, IGF-I and milk production. Biweekly injections of bST (0, 5.1, 10.2, or 15.3 mg bST/d) began 28 d before expected parturition and continued through 56 d postpartum. Twenty-three of the 25 multiparous Holstein cows assigned randomly to four groups completed experiment (7, 5, 6 and 5 cows/group, respectively). The DMI, BW and BCS were recorded weekly throughout the prepartum and postpartum periods and blood samples were collected thrice weekly for analyses of ST, insulin, $T_{4}$, $T_{3}$, IGF-I, glucose and NEFA. Milk yields were recorded daily through 60 d postpartum and milk components measured once weekly. Mathematical model for data analyses for prepartum and postpartum periods included treatment, calving month, and the two-factor interaction. Cows injected with 10.2 and 15.3 mg bST prepartum had greater mean prepartum concentrations of ST and IGF-I. Prepartum injections of bST did not affect prepartum BW or BCS. On average, cows injected postpartum better maintained their BCS during first 60 d of lactation (3.15$\pm$0.06, 3.12$\pm$0.007, 3.20$\pm$0.006 and 3.58$\pm$0.009). Treatments did not affect mean prepartum DMI but cows injected with 15.3 mg bST/d had greatest DMI and greatest mean daily MY during the first 3 wk and tended to be greater during first 60 d of lactation. Cows injected with two highest bST doses (10.1 and 15.2 mg/d) had greater mean postpartum concentrations of ST and $T_{3}$, but IGF-I, $T_{4}$, glucose and NEFA did not differ across groups. No adverse effects of bST treatment were observed.

Post-Laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament : Does It Cause Neurological Deterioration?

  • Cho, Won-Sang;Chung, Chun-Kee;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.259-264
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    • 2008
  • Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.