• 제목/요약/키워드: N4SID

검색결과 24건 처리시간 0.016초

중증 급성 중독 환자에서 급성 신장 손상과 병원 내 사망률을 예측하기 위한 강이온차(Strong Ion Gap)의 중요성 (The Significance of the Strong Ion Gap in Predicting Acute Kidney Injury and In-hospital Mortality in Critically Ill Patients with Acute Poisoning)

  • 심태진;조재완;이미진;정해원;박정배;서강석
    • 대한임상독성학회지
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    • 제19권2호
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    • pp.72-82
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    • 2021
  • Purpose: A high anion gap (AG) is known to be a significant risk factor for serious acid-base imbalances and death in acute poisoning cases. The strong ion difference (SID), or strong ion gap (SIG), has recently been used to predict in-hospital mortality or acute kidney injury (AKI) in patients with systemic inflammatory response syndrome. This study presents a comprehensive acid-base analysis in order to identify the predictive value of the SIG for disease severity in severe poisoning. Methods: A cross-sectional observational study was conducted on acute poisoning patients treated in the emergency intensive care unit (ICU) between December 2015 and November 2020. Initial serum electrolytes, base deficit (BD), AG, SIG, and laboratory parameters were concurrently measured upon hospital arrival and were subsequently used along with Stewart's approach to acid-base analysis to predict AKI development and in-hospital death. The area under the receiver operating characteristic curve (AUC) and logistic regression analysis were used as statistical tests. Results: Overall, 343 patients who were treated in the intensive care unit were enrolled. The initial levels of lactate, AG, and BD were significantly higher in the AKI group (n=62). Both effective SID [SIDe] (20.3 vs. 26.4 mEq/L, p<0.001) and SIG (20.2 vs. 16.5 mEq/L, p<0.001) were significantly higher in the AKI group; however, the AUC of serum SIDe was 0.842 (95% confidence interval [CI]=0.799-0.879). Serum SIDe had a higher predictive capacity for AKI than initial creatinine (AUC=0.796, 95% CI=0.749-0.837), BD (AUC=0.761, 95% CI=0.712-0.805), and AG (AUC=0.660, 95% CI=0.607-0.711). Multivariate logistic regression analyses revealed that diabetes, lactic acidosis, high SIG, and low SIDe were significant risk factors for in-hospital mortality. Conclusion: Initial SIDe and SIG were identified as useful predictors of AKI and in-hospital mortality in intoxicated patients who were critically ill. Further research is necessary to evaluate the physiological nature of the toxicant or unmeasured anions in such patients.

Vibration characteristics change of a base-isolated building with semi-active dampers before, during, and after the 2011 Great East Japan earthquake

  • Dan, Maki;Ishizawa, Yuji;Tanaka, Sho;Nakahara, Shuchi;Wakayama, Shizuka;Kohiyama, Masayuki
    • Earthquakes and Structures
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    • 제8권4호
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    • pp.889-913
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    • 2015
  • Structural vibration characteristics of a semi-active base-isolated building were investigated using seismic observation records including those of the 2011 Great East Japan earthquake (Tohoku earthquake). Three different types of analyses were conducted. First, we investigated the long-term changes in the natural frequencies and damping factors by using an ARX model and confirmed that the natural frequency of the superstructure decreased slightly after the main shock of the Tohoku earthquake. Second, we investigated short-term changes in the natural frequencies and damping factors during the main shock by using the N4SID method and observed different transition characteristics between the first and second modes. In the second mode, in which the superstructure response is most significant, the natural frequency changed depending on the response amplitude. In addition, at the beginning of the ground motion, the identified first natural frequency was high possibly as a result of sliding friction. Third, we compared the natural frequencies and damping factors between the conditions of a properly functional semi-active control system and a nonfunctional system, by using the records of the aftershocks of the Tohoku earthquake. However, we could not detect major differences because the response was probably influenced by sliding friction, which had a more significant effect on damping characteristics than did the semi-active dampers.

Performance of Broiler Chickens Fed Low Protein, Limiting Amino Acid Supplemented Diets Formulated Either on Total or Standardized Ileal Digestible Amino Acid Basis

  • Kumar, C. Basavanta;Gloridoss, R.G.;Singh, K.C.;Prabhu, T.M.;Suresh, B.N.
    • Asian-Australasian Journal of Animal Sciences
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    • 제29권11호
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    • pp.1616-1624
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    • 2016
  • The aim of present experiment was to investigate the effect of protein reduction in commercial broiler chicken rations with incorporation of de-oiled rice bran (DORB) and supplementation of limiting amino acids (valine, isoleucine, and/or tryptophan) with ration formulation either on total amino acid (TAA) or standardized ileal digestible amino acids (SIDAA). The experimental design consisted of $T_1$, TAA control; $T_2$ and $T_3$, 0.75% and 1.5% protein reduction by 3% and 6% DORB incorporation, respectively by replacing soybean meal with supplemental limiting amino acids to meet TAA requirement; $T_4$, SIDAA control, $T_5$ and $T_6$, 0.75% and 1.5% protein reduction by DORB incorporation (3% and 6%) with supplemental limiting amino acids on SIDAA basis. A total of 360 dold fast growing broiler chicks (Vencobb-400) were divided into 36 homogenous groups of ten chicks each, and six dietary treatments described were allocated randomly with six replications. During 42 days trial, the feed intake was significantly (p<0.05) reduced by TAA factor compared to SIDAA factor and protein factor significantly (p<0.05) reduced the feed intake at 1.5% reduction compared to normal protein group. This was observed only during pre-starter phase but not thereafter. The cumulative body weight gain (BWG) was significantly (p<0.05) reduced in TAA formulations with protein step-down of 1.5% ($T_3$, 1,993 g) compared to control ($T_1$, 2,067 g), while under SIDAA formulations, BWG was not affected with protein reduction of 1.5% ($T_6$, 2,076 g) compared to $T_4$ (2,129 g). The feed conversion ratio (FCR) was significantly (p<0.05) reduced in both TAA and SIDAA formulations with 1.5% protein step-down ($T_3$, 1.741; $T_6$, 1.704) compared to respective controls ($T_1$, 1.696; $T_4$, 1.663). The SIDAA formulation revealed significantly (p<0.05) higher BWG (2,095 g) and better FCR (1.684) compared to TAA formulation (2,028 g; 1.721). Intake of crude protein and all limiting amino acids (SID basis) was higher in SIDAA group than TAA group with resultant higher nitrogen retention (4.438 vs 4.027 g/bird/d). The nitrogen excretion was minimized with 1.5% protein reduction (1.608 g/bird) compared to normal protein group (1.794 g/bird). The serum uric acid concentration was significantly reduced in $T_3$ (9.45 mg/dL) as compared to $T_4$ (10.75 mg/dL). All carcass parameters were significantly (p<0.05) higher in SIDAA formulation over TAA formulation and 1.5% protein reduction significantly reduced carcass, breast and thigh yields. In conclusion, the dietary protein can be reduced by 0.75% with TAA formulation and 1.5% with SIDAA formulation through DORB incorporation and supplementation of limiting amino acids and among formulations, SIDAA formulation was better than TAA formulation.

Evaluation of energy and amino acids of brown rice and its effects on laying performance and egg quality of layers

  • An, Byoung-Ki;An, Su Hyun;Jeong, Han-Seul;Kim, Kwan-Eung;Kim, Eun Jip;Lee, Sang-Rak;Kong, Changsu
    • Journal of Animal Science and Technology
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    • 제62권3호
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    • pp.374-384
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    • 2020
  • Two experiments were conducted to determine apparent metabolizable energy (AME), nitrogen-corrected AME (AMEn), and ileal digestible amino acid (AA) content of brown rice (BR) and to investigate the effect of dietary supplementation of BR on laying performance and egg quality of laying hens. In Exp. 1, 72 Hy-line Brown layers (49-week-old) were allocated to two treatments using a completely randomized block design, and each treatment included six cages per treatment and six hens per cage. A semi-purified diet was formulated to include BR as the sole source of AA and energy and an N-free diet was used to determine basal endogenous loss of AA. The hens were fed a commercial layer diet for adaptation to the experimental environment and diet for 7 days from d 0, and then fed experimental diets for 5 days from d 7. Excreta were collected from d 10 to 11 and ileal digesta were collected on d 12. On a dry matter (DM) basis, the AME and AMEn of BR was determined at 3,773 and 3,729 kcal/kg, respectively. The apparent ileal digestibility (AID) of BR ranged from 32.7% for Thr to 73.7% for Arg. The range of the standardized ileal digestibility (SID) value was between 79.4% for Met and 96.6% for Lys. In Exp. 2, 252 Hy-line Brown layers (44-week-old) were divided into four groups, comprising seven replicates of nine birds each and assigned to four experimental diets containing 0 (Control), 5%, 10%, or 15% BR for 5 weeks. The BR-containing diets were formulated to be equal in the content of AMEn and digestible AA to those of the diet without BR. No significant differences were observed in laying performances. Egg quality and blood profiles were not linearly or quadratically affected by dietary treatments. These results suggest that up to 15% BR can be included into layer feed without any adverse effects on laying performance and egg quality, if its energy and digestible AA values are well evaluated.