• 제목/요약/키워드: Off-hours

검색결과 345건 처리시간 0.03초

Impact of Off-Hour Hospital Presentation on Mortality in Different Subtypes of Acute Stroke in Korea : National Emergency Department Information System Data

  • Kim, Taikwan;Jwa, Cheolsu
    • Journal of Korean Neurosurgical Society
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    • 제64권1호
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    • pp.51-59
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    • 2021
  • Objective : Several studies have reported inconsistent findings among countries on whether off-hour hospital presentation is associated with worse outcome in patients with acute stroke. However, its association is yet not clear and has not been thoroughly studied in Korea. We assessed nationwide administrative data to verify off-hour effect in different subtypes of acute stroke in Korea. Methods : We respectively analyzed the nationwide administrative data of National Emergency Department Information System in Korea; 7144 of ischemic stroke (IS), 2424 of intracerebral hemorrhage (ICH), and 1482 of subarachnoid hemorrhage (SAH), respectively. "Off-hour hospital presentation" was defined as weekends, holidays, and any times except 8:00 AM to 6:00 PM on weekdays. The primary outcome measure was in-hospital mortality in different subtypes of acute stroke. We adjusted for covariates to influence the primary outcome using binary logistic regression model and Cox's proportional hazard model. Results : In subjects with IS, off-hour hospital presentation was associated with unfavorable outcome (24.6% off hours vs. 20.9% working hours, p<0.001) and in-hospital mortality (5.3% off hours vs. 3.9% working hours, p=0.004), even after adjustment for compounding variables (hazard ratio [HR], 1.244; 95% confidence interval [CI], 1.106-1.400; HR, 1.402; 95% CI, 1.124-1.747, respectively). Off-hours had significantly more elderly ≥65 years (35.4% off hours vs. 32.1% working hours, p=0.029) and significantly more frequent intensive care unit admission (32.5% off hours vs. 29.9% working hours, p=0.017) than working hours. However, off-hour hospital presentation was not related to poor short-term outcome in subjects with ICH and SAH. Conclusion : This study indicates that off-hour hospital presentation may lead to poor short-term morbidity and mortality in patients with IS, but not in patients with ICH and SAH in Korea. Excessive death seems to be ascribed to old age or the higher severity of medical conditions apart from that of stroke during off hours.

골조직의 신속한 진단을 위한 탈회방법의 비교 연구 (Comparative Research of Decalcification Methods for Quick Diagnosis on Bone Tissue)

  • 김성철;백운철;김태전;배형준;강희규
    • 대한임상검사과학회지
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    • 제37권1호
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    • pp.47-55
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    • 2005
  • These studies were done to know decalcification methods to reduce the time of decalcification for quick bone tissue diagnosis. When bone tissue was decalcified with 10 % formic acid at room temperature, decalcification and hematoxylin & eosin (H&E) stains were complete and satisfactory after 12 hours, but some of the tissue sections fell off during staining. In this way, decalcification, H&E stains were complete and satisfactory after 24 hours, 36 hours and 48 hours, tissue sections didn't fall off during staining. When bone tissue was decalcified with 10 % formic acid in a $60^{\circ}C$ paraffin oven, decalcification and H&E stains were complete and satisfactory after 6 hours, but some tissue sections fell off during staining. In this way, decalcification and tissue sections were complete, with no falling off during staining after 8 hours, 10 hours, 12 hours, 14 hours, 24 hours, or H&E stains were satisfactory from 8 hours to 12 hours, but H&E stains appeared to reddish nucleus after 14 hours and 24 hours. Bone tissue was decalcified with 10 % formic acid for 6 hours, 12 hours and 24 hours at DECAL machine frequencies of 15 Hz and 45 Hz, and for 6 hours, 12 hours and 24 hours at a DECAL machine frequency of 90 Hz. Decalcification and H&E stains were complete and satisfactory after 6 hours at the 15 Hz and 45 Hz DECAL settings. Some of the tissue sections fell off during staining at the 15 Hz DECAL machine setting. At the 90 Hz setting, decalcification, H&E stains, and tissue sections were complete and satisfactory with no falling off during staining after 4 hours. In this way, decalcification, H&E stains, and tissue section were complete and satisfactory with no falling off during staining after 12 hours, 24 hours at all machine settings. Bone tissue was decalcified with 10 % formic acid for 6 hours, 12 hours and 24 hours at $37^{\circ}C$ 3 hours, 6 hours and 12 hours at $45^{\circ}C$ and 1 hours, 5 hours and 10 hours at $60^{\circ}C$ with the RHS-1 machine setting at 60Hz. At the temperatures of $37^{\circ}C$, $45^{\circ}C$, and $60^{\circ}C$ decalcification, H&E stains, and tissue sections were complete and satisfactory, with no falling off during staining except for after 6 hours at $37^{\circ}C$. 3 hours, 1 hours, or decalcification, H&E stains, and tissue sections were complete and satisfactory with no falling off during staining after 12 hours and 24 hours at $37^{\circ}C$, 6 hours and 12 hours at $45^{\circ}C$, and 5 hours at $60^{\circ}C$. But H&E stains appeared to reddish nucleus after 10 hours at $60^{\circ}C$. From the above reults, the authors were able to deduce that decalcification is accelerated by heat and frequency. We therefore think that it is necessary for machines which are similar to the RHS-1 machine to be maintained at the temperature evenly with agitation effect for quick decalcification.

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The Five Day Work Week System and Changes in Living Culture $\sim$Two Day-Off School System and Its Affects on Parents in Japan

  • Seiko SaWai
    • International Journal of Human Ecology
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    • 제3권1호
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    • pp.127-136
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    • 2002
  • According to the Labor Standard Law in Japan which was enacted after World War II in 1947, all work hours for adult men, women, and youth were set at a maximum of eight hours per day and forty-eight hours per week. In other words, a six-day work week, with only one-day off, was set. Now we are in the full five-day and two-day off school system. The five-day school week influences on our home life. Students are highly enthused by the new system, in looking forward to their personal time they now have to play with friends, to relax, or just watch TV. To implement this new five-day school system positively and effectively, we should see the point at issue related to the two-day off system from a different angle, which suggests that we should see far ahead into the future.

수확 전 단수처리가 치콘 저장성에 미치는 영향 (Effect of Nutrient Supply Cut-off Periods Before Harvest on Storability of Chicon)

  • 정현진;최인이;손진성;서현택;원재희;강호민
    • 생물환경조절학회지
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    • 제20권4호
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    • pp.406-411
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    • 2011
  • 본 연구는 수확 전 단수처리가 치콘 저장성에 미치는 영향을 알아보고자 실시하였다. 단수처리 후 수확한 치콘은 단수처리 없이 수확한 치콘에 비해 처리시간별로 건물함량의 차이를 보임에 따라 예건효과가 있을 것으로 보여 실험에 임하였다. 단수처리는 치콘의 수확후 호흡률과 에틸렌 발생률에도 영향을 주었는데, 호흡률과 에틸렌 발생률은 각각 12시간과 6시간 처리에서 가장 높은 수준을 보였고, 이보다 처리시간이 길어지면 감소하는 경향을 보였다. 저장 중 생체중 변화를 조사 해 본 결과 6시간 단수처리의 경우 다른 단수처리들에 비해 변화율이 적게 나타났다. 그리고 포장재내의 대기조성 변화를 보았을 때 저장기간이 길어짐에 따라 포장내 산소농도와 이산화탄소 농도는 6시간 단수처리 시 약간의 예건효과를 보이는 듯 보였으나 통계적 유의성은 없는 것으로 판단되었다. 포장내 에틸렌농도는 저장 4일째에 전체적으로 단수처리하지 않은 대조구에 비해 에틸렌 농도가 높게 나타났으나 저장기간이 길어짐에 따라 저장 16일차에는 대조구에 비해 농도가 낮게 나타났으나 통계적 유의성은 없었다. 전체 외관품질을 보았을 때는 단수처리 3시간, 6시간, 24시간 순으로 좋은 평가를 받았으며, 절단면 갈변정도를 보았을 때는 단수처리 6시간이 가장 갈변의 정도가 심하지 않았다. 이상의 결과로 보아 치콘 생산시 수확 전 6시간부터 양액 공급을 중지시키는 단수처리를 할 경우 예건 효과를 가져옴으로써, 치콘의 저장기간 중 수분 손실량을 줄여주고 절단부 갈변 억제 효과를 가져와 저장기간동안 외관상 품질을 유지해줄 수 있을 것으로 생각되어진다.

Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

  • Peter Pin-Sung Liu;Jui-Chih Chang;Jin-Yi Hsu;Huei-Kai Huang;Ching-Hui Loh;Jih-I Yeh
    • Korean Circulation Journal
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    • 제54권3호
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    • pp.126-137
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    • 2024
  • Background and Objectives: The impact of off-hours admission (such as weekends, nighttime, and non-working hours) vs. regular hours (weekdays and daytime working hours) on the mortality risk of patients undergoing surgery for type A aortic dissection (TAAD) repair is still uncertain. To address this uncertainty, we undertook a comprehensive systematic review and meta-analysis. We aimed to assess the potential link between off-hours admission and the risk of mortality in patients undergoing TAAD repair surgery. Methods: We conducted a thorough search of the PubMed, Embase, and Cochrane Library databases, covering the period from their inception to May 20, 2023. Our inclusion criteria encompassed all studies that examined the potential relationship between off-hour admission and mortality in individuals who had undergone surgery for TAAD repair. The odds ratios (ORs) were extracted and combined utilizing a random effects model for our synthesis. Results: Nine studies with 16,501 patients undergoing TAAD repair surgery were included in the meta-analysis. Overall, patients who underwent surgery during the weekend had higher in-hospital mortality (pooled OR, 1.41; 95% confidence interval [CI], 1.14-1.75; p=0.002) than those treated on weekdays. However, the mortality risks among patients who underwent TAAD surgery during nighttime and non-working hours were not significantly elevated compared to daytime and working hours admission. Conclusions: Weekend surgery for TAAD was associated with a higher in-hospital mortality risk than weekday surgery. However, further studies are warranted to identify and develop strategies to improve the quality of round-the-clock care for patients with TAAD.

The "Weekend Effect" in Extracorporeal Cardiopulmonary Resuscitation

  • Kinam Shin;Won Chul Cho;Pil Je Kang
    • Journal of Chest Surgery
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    • 제57권3호
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    • pp.272-280
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    • 2024
  • Background: The phenomenon known as the "weekend effect" impacts various medical disciplines. We compared outcomes between regular hours and off hours to investigate the presence of the weekend effect in extracorporeal cardiopulmonary resuscitation (ECPR). Methods: Between January 2018 and December 2020, 159 patients at our center were treated with veno-arterial extracorporeal membrane oxygenation (ECMO) for cardiac arrest. We assessed the time required for ECMO preparation, the rate of successful weaning, and the rate of in-hospital mortality. These factors were compared among regular hours ("daytime": weekdays from 7:00 AM-7:00 PM), off hours on weekdays ("nighttime": weekdays from 7:00 PM-7:00 AM), and off hours on weekends and holidays ("weekend": Fridays at 7:00 PM to Mondays at 7:00 AM). Results: The time from the recognition of cardiac arrest to the arrival of the ECMO team was shortest for the daytime group and longest for those treated over the weekend (daytime, 10.0 minutes; nighttime, 12.5 minutes; weekend, 15.0 minutes; p=0.064). The time from the ECMO team's arrival to ECMO initiation was shortest for the daytime and longest for the nighttime group (daytime, 13.0 minutes; nighttime, 18.5 minutes; weekend, 14.0 minutes; p=0.028). No significant difference was observed in the rate of successful ECMO weaning (daytime, 48.3%; nighttime, 39.5%; weekend, 36.1%; p=0.375). Conclusion: In situations involving CPR, the time to arrival of the ECMO team was longer during off hours. Furthermore, ECMO insertion required more time at night than during the other periods. These findings warrant specific training in decision-making and emergent ECMO insertion.

서해 태안반도 북서 연안해역에서의 연안류 특성 (The Characteristics of Coastal Currents to the Northwest of the Taean Peninsula in the Yellow Sea)

  • 신홍렬
    • Ocean and Polar Research
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    • 제27권4호
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    • pp.433-441
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    • 2005
  • To investigate the characteristics of tidal currents and water circulation in the coastal waters off the Taean Peninsula, tidal currents and sea levels were measured at the study area from 1998 to 2004. In the central waterway to the south of Changan Sand Ridge, mean speed of tidal currents and residual currents were 74.0cm/s, 17.8cm/s respectively; the dominant residual currents flowed northeastward, and the amplitudes of semi-diurnal components $(M_2,\;S_2)$ were larger than diurnal components $(O_1,\;K_1)$. The flood and ebb tidal currents were northeastward and southwestward, respectively, and each period was about 6 hours for them, which was consistent with the period of sea levels at the study area. In the coastal region near Hakampo, Taean, mean velocities of tidal currents and residual currents were 46.1cm/s, 30.8cm/s respectively, and the dominant residual currents flowed southwestward. The amplitudes of shallow water constituents $(M_4,\;MS_4)$ were relatively laige, which were weaker to the northeastern coastal region off Mineodo. The northeastward flow continued for about $2{\sim}3$ hours, while the southwestward flow continued for about $9{\sim}10$ hours near Hakampo during the tidal period. Tidal currents flowed northeastward in the central area of the waterway during the period from the Low Water Level (LWL) to the High Water Level (HWL). While the currents in the coastal region flowed northeastward for the first 3 hours after the LWL, southwestward counter-currents flowed between 3 and 6 hours after the LWL. During the period from the HWL to the LWL, the dominant currents flowed southwestward in the study area except to the northeastern coastal region off Mineodo. Along the shorelines, the counter-currents flowed northward between 4 and 6 hours after the HWL. It seems that the counter-currents near the coastal region are caused by the topography and the geography of the shorelines at the study area.

On Pump-CABG와 Off Pump-CABG의 임상적 고찰에 관한 비교연구 (The Comparison of Clinical Study of Off Pump and On Pump CABG)

  • 유경종;임상현;송석원;김치영;홍유선;장병철
    • Journal of Chest Surgery
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    • 제35권4호
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    • pp.261-266
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    • 2002
  • 배경 및 목적; 심폐체외순환의 부작용을 피하기 위해 최근 들어 심폐체외순환 없이 시행하는 관상동맥우회로술(Off pump CABG)이 시도되고 있다. 이 연구는 Off pump CABG와 심폐체외순환하에서 시행하는 관상동맥우회로술(On Pump CABG) 의 수술 전 위험요소와 수술 후 결과를 비교하였다. 방법; 2001년 1월부터 2001년 7월까지 CABG를 시행 받았던 178명중에서 판막수술이나 심실절제술 등 동반 수술이 없었던 166명을 대상으로 하였다. 이 중 Off Pump CABG환자는 52명이었고 On Pump CABG환자가 114명이었으며, 이 환자들을 대상으로 수술전 위험인자와 관상동맥 질환의 정도 및 수술 후 결과를 비교하였다. 결과; 두 군간의 연령, 남녀 비, 수술전 당뇨, 고혈압, 흡연력, 고지질증, 가족력 등 위험요소에 대한 통계적인 유의성은 없었으며, 폐쇄성 폐 질환이나 말초 동맥혈관 협착증 및 뇌경색의 기왕력, 심근경색의 기왕력이나 흉통의 정도(Canadian Class),관상동맥 질환의 정도 및 심박출계수도 통계적인 차이를 보이지 않았다. 수술시간은 Off Pump CABG에서 통계적으로 유의하게 짧았고(234 $\pm$ 37 min vs 290 $\pm$ 48 min, p<0.001), 이 식편수는 On Pump CABG에서 유의하게 많았다(3.4 $\pm$ 0.9개 vs 2.6 $\pm$ 0.8개, p<0.001). 수술 후 사망은 없었으며, 수술 후 측정한 CK-MB는 Off Pump CABG에서 통계적으로 유의하게 낮았고(10.1 $\pm$ 13.5 IU/L vs 33.1 $\pm$ 18.2 lU/L, p<0.001) 호흡기 사용시간도 통계적으로 유의하게 낮았다(14.8 $\pm$ 3.5 hours vs 16.2 $\pm$ 4.9 hours, p=0.048). 그 외 24시간 출혈량, 출혈로 인한 재수술, 중환자실 입원 기간, 수술 후 심근경색증, 감염, 신부전증, 신경과적 합병증 및 수술 후 입원 기간 등 수술 후 결과와 유병율에는 두 군간의 통계적 유의성이 없었다. 결론; Off Pump CABG는 On Pump CABG에 비해 수술시간의 단축과 수술 후 심근 손상의 정도가 낮고, 호흡기 사용시간이 짧게 나타났으나 On Pump CABG에 비해 이식편수가 적었다. 대체로 Off Pump CABG는 On Pump CABG에 비해 수술 후 결과에서 약간의 장점을 보여주었으나 Off Pump CABG의 장점을 알아보기 위해서는 더 많은 연구가 있어야 할 것으로 생각된다.

대형발전기 고정자권선 절연재료의 열 사이클에 의한 열화에 관한 연구 (A study on the heat cycle aging of insulation materials in large generator stator windings)

  • 김희곤;박영관
    • 대한전기학회논문지
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    • 제45권4호
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    • pp.553-557
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    • 1996
  • Heat cycle aging of insulating materials in large generator stator winding has been investigated using both on-line and off-line test methods. On this study, principally, off-line test against actual generator in service was carried out to acquire information about polarization index(PI) and dissipation factor, dissipation factor tip-up, maximum partial discharge for the purpose of remnant breakdown voltage and life assessment. It was found from the tests that both dissipation factor and maximum partial discharge decreased with the increase of operating hours and starting numbers. It was found from off-line tests that the remnant breakdown voltage had a strong relationship with both dissipation factor and maximum partial discharge the remnant breakdown voltage as a results of both operating hours and starting number and the nondestructive tests were proposed as parameters which can predict the remnant lifetime of insulating materials in large generator stator windings. (author). 8 refs., 8 figs., 2 tabs.

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米麥농가 부부의 노동시간과 노동분담 (Labor time and Labor Division of the rural couples cultivating rice and barley)

  • 김희순;최현자
    • 가정과삶의질연구
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    • 제18권3호통권47호
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    • pp.1-14
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    • 2000
  • This study was to find out the status of labor division between rural husband and wife by measuring the labor time for tasks, the ratio of relative contribution toward work, and work segregation. Data used in this study were collected fro 424 persons of 212 farm households mainly cultivating rice and barley. The results of this study were as follows : 1) In the case of work directly related to farming, working hours of husband were significantly longer than those of wife during the farming and off-farming season. In contrast working hours of wife for housekeeping were significantly longer than those of husband during both seasons. 2) The ratio of relative contribution toward farming work of husband was a little higher than that of wife during farming and off-farming season. But this toward housekeeping work was less than that of wife. 3) The degree of gender segregation in farming was 0.33 during the farming season and 0.01 during the off-farming season. The kinds of work and time distribution were relatively same. The degree of gender segregation in housekeeping was 0.79 during the farming season and 0.72 during the off-farming season. These values showed inequality of work segregation in the kind of work and time distribution.

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