Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.
Purpose: Although radionuclide cisternography (RNC) is an useful study to detect cerebrospinal fluid (CSF) leakage in the patient with spontaneous intracranial hypotension (SIH), it sometimes fails to demonstrate the site of CSF leakage. The aim of the study is to improve the detection of leakage site of CSF and to reduce time for the study in RNC using modified protocol (m-RNC). Materials & methods : The study consists of 8 studies of 7 patients ($38{\pm}8$ years, M:F=2:5) with SIH, who underwent m-RNC following administration of 185-222 MBq of $^{99m}Tc$-DTPA into the lumbar subarachnoid space. Sequential images were obtained the whole spine with the head including urinary bladder at 10 minute, 30 minute, 1 hour, 2 hour, 4 hour and 6 hour. Radioactivity of extradural space and urinary bladder was evaluated. Results: Leakage site of CSF was identified in all 8 cases by m-RNC. Leakage site was cervicothoracic junction (CTJ, n=3), CTJ with C1-2 (n=2), CTJ with thoracic spine, thoracolumbar spine and lumbar spine (each n=1). All cases presented leakage sites within 1 hour and multiple sites, where CTJ was included in 6 cases. Only one case presented additional site in 6 hour image. Early radioactivity within the urinary bladder was noted in 6 cases, but that was fellowing after identification of the leakage site. Conclusion: Radionuclide cisternography is sensitive to detect the leakage site of CSF and is expected to improve the detection of CSF leakage site and reduce time for the study using modified protocol.
The study area is located in the western part of the Precambrian stock type of Sancheong anorthosite complex, the Jirisan province of the Yeongnam massif, in the southern part of the Korean Peninsula. We perform a detailed field geological investigation on the Sancheong anorthosite complex, and report the characteristics of lithofacies, occurrences, foliations, and research formation process and its mechanism of the Sancheong anorthosite complex. The Sancheong anorthosite complex is classified into massive and foliation types of Sancheong anorthosite (SA), Fe-Ti ore body (FTO), and mafic granulite (MG). Foliations are developed in the Sancheong anorthosite complex except the massif type of SA. The foliation type of SA, FTO, MG foliations are magmatic foliations which were formed in a not fully congealed state of SA from a result of the flow of FTO and MG melts and the kinematic interaction of SA blocks, and were continuously produced in the comagmatic differentiation. The Sancheong anorthosite complex is formed as the following sequence: the massive type of SA (a primary fractional crystallization of parental magmas under high pressure)${\rightarrow}$ the foliation type of SA [a secondary fractional crystallization of the plagioclase-rich crystal mushes (anorthositic magmas) primarily differentiated from parental magmas under low pressure]${\rightarrow}$the FTO (an injection by filter pressing of the residual mafic magmas in the last differentiation stage of anorthositic magmas into the not fully congealed SA)${\rightarrow}$the MG (a solidification of the finally residual mafic magmas). It indicates that the massive and foliation types of SA, the FTO, and the MG were not formed from the intrusion and differentiation of magmas which were different from each other in genesis and age but from the multiple fractionation and polybaric crystallization of the coeval and cogenetic magma.
Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.
Journal of The Korean Association For Science Education
/
v.35
no.2
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pp.313-323
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2015
The purpose of this study is to investigate the cognitive process of student's modeling on a modeling-emphasized argument-based general chemistry experiment. The participants were twenty-one freshman students. Six topics were carried out during the first semester and semi-structured interview was implemented at the end of the semester. Semi-structured interview questions were used to elicit elements of effective model, modeling strategies, difficulties that students have experienced during modeling, and resolving the difficulties that students have experienced during modeling. All student interview data were collected and transcribed. The results of this study are summarized as follows: (1) Elements of effective model were considered to be visual expression, persuasive explanation, and rhetorical structure. (2) Modeling strategies included arranging important keywords or writing the outline, and during the modeling process, students used various data, suggested data after reconstructing, suggested definitions and explanations of core concepts, used meta-cognition, and considering rhetorical structure. (3) Difficulties students have experienced during modeling could be categorized as lack of modeling strategy and understanding. (4) Resolving difficulties students have experienced during modeling could be categorized as modeling strategy and understanding. Students learn the strategy by feedback, modeling experience, evaluation of experimental report, models which they constructed previously and references, and the understanding of contents were achieved through arguments which occurred during classes and during the process of writing the experimental reports. These results suggest that when using modeling in teaching and learning, the argument-based learning strategy can be effective in enhancing students' modeling by helping them to understand meta-modeling with scientific concepts.
Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.
Journal of Fisheries and Marine Sciences Education
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v.8
no.1
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pp.92-107
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1996
Based on the act.ivity report for the coastal fisheries resources conducted from 1982 to 1989 by West, East Research Institute of Fisheries, some other reports from Korea Rural Economics Institute and etc., and the questionnaire results for the senses of fishermen, the fishing efficiency and conditions of by - catch of small fish in winged stow net were analized, and then some ways to prevent from by - catch of small fishes were suggested in this paper. The nationwide conditions of Permission and Disposal in winged stow net fishery arc that number of cases of coastal winged stow net fishery has dropped to 757 by 1994 while it was 961 in 1991 and that the number of cases of a sectional winged stow net fishery on the contrary has increased to 302 by 1994 while it was 11 in 1991. Regardless of region, catch per net by year in general has been on gradual increase in 1982 through 1989, but that showed decrease in 1994. From the view of region, the proportion of by - catch of shrimps and blenny is higher in Kyonggi, Chungnam with West Sea and that of anchovy and blenny is higher in Chonbuk, Chonnam, Kyongnam with South Sea. The average proportions of by - catch of small fish for 5 years from 1985 to 1989 are 86.9% for sand lance, 69% for anchovy, 63% for big eyed herring, 51% for blenny, 22% for Southern rough shrimp and 19% for akiami paste shrimp, hence sand lance and anchovy are highly by - catch effective while shrimps is not. Ways to prevent the over fishing of small fish in winged stow net fishery includes reduction of fishing frequency during April and August through November, the very season for small fish, use of meshes large enough for small fish to go through and assignment of fishing area to other than habitats of stationary fish.
Multi-anvil press (MAP) is one of the high pressure apparatuses and often generates the pressure-conditions ranging from 5 to 25 GPa and temperature-conditions up to $2,300^{\circ}C$. The MAP is, therefore, suitable to explore the pressure-induced structural changes in diverse earth materials from Earth's mantle and the bottom of the mantle transition zone (~660 km). In this study, we present the experimental results for pressure-load calibration of the 1,100-ton multi-anvil press equipped in the authors' laboratory. The pressure-load calibration experiments were performed for the 14/8 step, 14/8 G2, 14/8 HT, and 18/12 assembly sets. The high pressure experiments using ${\alpha}$-quartz, wollastonitestructure of $CaGeO_3$, and forsterite as starting materials were analyzed by powder X-ray diffraction spectroscopy. The phase transition of each mineral indicates the specific pressure that is loaded to a sample at $1,200^{\circ}C$: a transition of ${\alpha}$-quartz to coesite at 3.1 GPa, that of garnet-structure of $CaGeO_3$ to perovskite-structure at 5.9 GPa, that of coesite to stishovite at 9.2 GPa, and that of forsterite to wadsleyite at 13.6 GPa. While the estimated pressure-load calibration curve is generally consistent with those obtained in other laboratories, the deviation up to 50 tons is observed at high pressure above 10 GPa. This is partly because of the loss of oil pressure at high pressure resulting from the differences in a sample chamber, and the frictional force between pressure medium and second anvil. We also report the ${\sim}200^{\circ}C/mm$ of thermal gradient in the vertical direction of the sample chamber of 14/8 HT assembly. The pressure-load calibration curve and the observed thermal gradient within the sample chamber can be applied to explain the structural changes and the relevant macroscopic properties of diverse crystalline and amorphous earth materials in the mantle.
Korean Journal of Agricultural and Forest Meteorology
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v.9
no.2
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pp.149-160
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2007
KoFlux Gwangneung Supersite comprises complex topography and diverse vegetation types (and structures), which necessitate complementary multi-disciplinary measurements to understand energy and matter exchange. Here, we report the results of this ongoing research with special focuses on carbon/water budgets in Gwangneung forest, implications of inter-dependency between water and carbon cycles, and the importance of hydrology in carbon cycling under monsoon climate. Comprehensive biometric and chamber measurements indicated the mean annual net ecosystem productivity (NEP) of this forest to be ${\sim}2.6\;t\;C\;ha^{-1}y^{-1}$. In conjunction with the tower flux measurement, the preliminary carbon budget suggests the Gwangneung forest to be an important sink for atmospheric $CO_2$. The catchment scale water budget indicated that $30\sim40%$ of annual precipitation was apportioned to evapotranspiration (ET). The growing season average of the water use efficiency (WUE), determined from leaf carbon isotope ratios of representative tree species, was about $12{\mu}mol\;CO_2/mmol\;H_2O$ with noticeable seasonal variations. Such information on ET and WUE can be used to constrain the catchment scale carbon uptake. Inter-annual variations in tree ring growth and soil respiration rates correlated with the magnitude and the pattern of precipitation during the growing season, which requires further investigation of the effect of a monsoon climate on the catchment carbon cycle. Additionally, we examine whether structural and functional units exist in this catchment by characterizing the spatial heterogeneity of the study site, which will provide the linkage between different spatial and temporal scale measurements.
We have reported the petrographic properties on the soda straw primarily based on the field measurements and discussed the causes of their traits. 156 soda straws in district B of the Baeg-nyong Cave nominated with the natural monument No. 260 have been investigated to estimate physical, sedimentological and textural characteristics. The soda straws have an average length of 3.05 cm with a standard deviation of 1.7 cm and a mean diameter of 6.0 mm. This result shows that the average diameter of the soda straws measured in this study is thicker than previous reports by 20%. Although the drip rates of cave water from 85.3% of all the soda straws are exceedingly lower than 1 drop per 10 minutes, almost all soda straws have a dripping water. We firstly report growth lamina in the Korean soda straw from 85.3% of all samples, and this textural dominance indicates that the growth lamina are one of the common features of the soda straws at least in the study area. Secondary precipitations inside the soda straw were identified from 68.6%. Notably, the strong inverse correlation between growth lamina and secondary precipitates was represented from 70.5% of all samples. This finding might be explained by the seasonality of cave drip water supplied into the soda straws or the increased opacity caused by secondary precipitates. Based on petrograhic characteristics, the soda straws in the study area can be classified into normal and erratic types. Hopefully our results on the soda straws in Baeg-nyong Cave would provide a basis for the descriptions of soda straws from other caves and paleoclimatic applications.
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