• Title/Summary/Keyword: Operating Range

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Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea

  • Yu Jin Lee;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Kyounghwan Kim;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.20-27
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    • 2024
  • Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

Comparison of CNG and LPG Combustion Characteristics in a Large-sized Gas Engine (대형 가스엔진에서 CNG와 LPG 연료의 연소 특성 비교)

  • Yongrae Kim;Cheolwoong Park;Hyungjun Jang;Sangho Lee;Young Choi;Sunyoep Lee
    • Journal of the Korean Institute of Gas
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    • v.28 no.2
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    • pp.1-6
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    • 2024
  • An easy approach to replacing older diesel engines is to replace them with gas engines using fuels such as CNG or LPG. However, fuels such as LPG have not been applied to large gas engines in many cases, so it is not easy to predict the performance of gas engines based on CNG fuel. Accordingly, in this study, we applied LPG fuel to a CNG-based large gas engine and examined the performance and emission characteristics. In particular, the results were confirmed through tests to see how effective EGR, which is widely used for NOx reduction, is applied. As a result, in the case of LPG, even though the operating conditions were secured to a level that excludes serious knocking, mild knocking at high loads was still found to be more frequent than CNG. However, it was possible to secure an output level similar to CNG in the high-speed range. Efficiency was higher due to a faster combustion speed than CNG, and it was confirmed that it was possible to simultaneously reduce NOx and the frequency of mild knocking through the application of EGR.

Preoperative MRI Features Associated With Axillary Nodal Burden and Disease-Free Survival in Patients With Early-Stage Breast Cancer

  • Junjie Zhang;Zhi Yin;Jianxin Zhang;Ruirui Song;Yanfen Cui;Xiaotang Yang
    • Korean Journal of Radiology
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    • v.25 no.9
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    • pp.788-797
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    • 2024
  • Objective: To investigate the potential association among preoperative breast MRI features, axillary nodal burden (ANB), and disease-free survival (DFS) in patients with early-stage breast cancer. Materials and Methods: We retrospectively reviewed 297 patients with early-stage breast cancer (cT1-2N0M0) who underwent preoperative MRI between December 2016 and December 2018. Based on the number of positive axillary lymph nodes (LNs) determined by postoperative pathology, the patients were divided into high nodal burden (HNB; ≥3 positive LNs) and non-HNB (<3 positive LNs) groups. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors associated with ANB. Predictive efficacy was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Univariable and multivariable Cox proportional hazards regression analyses were performed to determine preoperative features associated with DFS. Results: We included 47 and 250 patients in the HNB and non-HNB groups, respectively. Multivariable logistic regression analysis revealed that multifocality/multicentricity (adjusted odds ratio [OR] = 3.905, 95% confidence interval [CI]: 1.685-9.051, P = 0.001) and peritumoral edema (adjusted OR = 3.734, 95% CI: 1.644-8.479, P = 0.002) were independent risk factors for HNB. Combined peritumoral edema and ultifocality/multicentricity achieved an AUC of 0.760 (95% CI: 0.707-0.807) for predicting HNB, with a sensitivity and specificity of 83.0% and 63.2%, respectively. During the median follow-up period of 45 months (range, 5-61 months), 26 cases (8.75%) of breast cancer recurrence were observed. Multivariable Cox proportional hazards regression analysis indicated that younger age (adjusted hazard ratio [HR] = 3.166, 95% CI: 1.200-8.352, P = 0.021), larger tumor size (adjusted HR = 4.370, 95% CI: 1.671-11.428, P = 0.002), and multifocality/multicentricity (adjusted HR = 5.059, 95% CI: 2.166-11.818, P < 0.001) were independently associated with DFS. Conclusion: Preoperative breast MRI features may be associated with ANB and DFS in patients with early-stage breast cancer.

Development of Three-Dimensional Trajectory Model for Detecting Source Region of the Radioactive Materials Released into the Atmosphere (대기 누출 방사성물질 선원 위치 추적을 위한 3차원 궤적모델 개발)

  • Suh, Kyung-Suk;Park, Kihyun;Min, Byung-Il;Kim, Sora;Yang, Byung-Mo
    • Journal of Radiation Protection and Research
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    • v.41 no.1
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    • pp.31-39
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    • 2016
  • Background: It is necessary to consider the overall countermeasure for analysis of nuclear activities according to the increase of the nuclear facilities like nuclear power and reprocessing plants in the neighboring countries including China, Taiwan, North Korea, Japan and South Korea. South Korea and comprehensive nuclear-test-ban treaty organization (CTBTO) are now operating the monitoring instruments to detect radionuclides released into the air. It is important to estimate the origin of radionuclides measured using the detection technology as well as the monitoring analysis in aspects of investigation and security of the nuclear activities in neighboring countries. Materials and methods: A three-dimensional forward/backward trajectory model has been developed to estimate the origin of radionuclides for a covert nuclear activity. The developed trajectory model was composed of forward and backward modules to track the particle positions using finite difference method. Results and discussion: A three-dimensional trajectory model was validated using the measured data at Chernobyl accident. The calculated results showed a good agreement by using the high concentration measurements and the locations where was near a release point. The three-dimensional trajectory model had some uncertainty according to the release time, release height and time interval of the trajectory at each release points. An atmospheric dispersion model called long-range accident dose assessment system (LADAS), based on the fields of regards (FOR) technique, was applied to reduce the uncertainties of the trajectory model and to improve the detective technology for estimating the radioisotopes emission area. Conclusion: The detective technology developed in this study can evaluate in release area and origin for covert nuclear activities based on measured radioisotopes at monitoring stations, and it might play critical tool to improve the ability of the nuclear safety field.

Establishment of Biotin Analysis by LC-MS/MS Method in Infant Milk Formulas (LC-MS/MS를 이용한 조제유류 중 비오틴 함량 분석법 연구)

  • Shin, Yong Woon;Lee, Hwa Jung;Ham, Hyeon Suk;Shin, Sung Cheol;Kang, Yoon Jung;Hwang, Kyung Mi;Kwon, Yong Kwan;Seo, Il Won;Oh, Jae Myoung;Koo, Yong Eui
    • Journal of Food Hygiene and Safety
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    • v.31 no.5
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    • pp.327-334
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    • 2016
  • This study was conducted to establish the standard method for the contents of biotin in milk formulas. To optimize the method, we compared several conditions for liquid extraction, purification and instrumental measurement using spiked samples and certified reference material (NIST SRM 1849a) as test materials. LC-MS/MS method for biotin was established using $C_{18}$ column and binary gradient 0.1% formic acid/acetonitrile, 0.1% formic acid/water mobile phase is applied for biotin. Product-ion traces at m/z 245.1 ${\rightarrow}$ 227.1, 166.1 are used for quantitative analysis of biotin. The linearity was over $R^2=0.999$ in range of $5{\sim}60{\mu}g/L$. For purification, chloroform was used as a solvent for eliminating lipids in milk formula. The linearity was over 0.999 in range of 5~60 ng/mL. The detection limit and quantification limit were 0.10, 0.31 ng/mL. The accuracy and precision of LC-MS/MS method using CRM were 103%, 2.5% respectively. Optimized methods were applied in sample analysis to verify the reliability. All the tested milk formulas were acceptable contents of biotin compared with component specification and standards for nutrition labeling. The standard operating procedures were prepared for biotin to provide experimental information and to strengthen the management of nutrient in milk formula.

A Practice-Oriented Study on Sawdust File Filteration Composting of High Moisture Pig Slurry (고수분 돈분슬러리의 톱밥여과 퇴비화 현장적용 연구)

  • Ryoo, J.W.
    • Journal of Animal Environmental Science
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    • v.14 no.2
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    • pp.129-138
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    • 2008
  • This study was carried out to investigate the operating characteristics, water balance and chemical properties of compost during the composting with pig slurry on-farm trial. The composting plant with sawdust pile filteration was done in a forced aeration inside a house and equipped with a turning machine moving on a rails. The composting pit was 4.6m wide, 53m long and the maximum height was 2m. A field scale aerobic composting facility was tested the composting efficiency of high moisture pig slurry. The sawdust materials remained 6 months. Pig slurry was added to compost pile every other day during 6 months run. The temperature in compost pile and compost house, and input and output of moisture were measured during composting process. The result are summarized as follows; 1. The temperature of compost was varied in range of at $22.4^{\circ}C{\sim}71.1^{\circ}C$. After turning, the composting temperature decreased to $50^{\circ}C{\sim}36^{\circ}C$ during $3{\sim}5$ hours, and then raised to $64.5^{\circ}C$ 2. The temperature of compost house was maintained $20^{\circ}C{\sim}30^{\circ}C$, and relative humidity was varied in range of $50{\sim}99%$. 3. BOD, CODcr and SS of leachate water was reduced 89.5%, 81.2%, 97.5%, respectively. 4. The content of heavy metal in the final compost was lower those of Korea standards. 5. The amount of effluent was 10.2%. Total evaporation during composting Period were 74.8%. The amount of slurry per $1m^3$ sawdust was $3.16m^3$ without treatment of effluent output.

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Consideration of Radioactive Contamination Materials Disposal (방사성오염물질 처분에 대한 고찰)

  • Im, Hyun-Jin;Kim, Tae-Yeob;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.128-132
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    • 2010
  • Purpose: Nuclear medicine general operation room is radioactive control room which is used for the handling of radioisotope(R.I). Radioactive contamination materials must be under control and separated from general trash. With this experiments, we want to actively suggest the guideline of controling and operating radioactive contamination materials by measuring contamination degree and analyzing the causes which is not realized so far. Materials and Methods: Materials are selected from Oct. 2009 to March. 2010. salines which are used for labelling radiophamaceuticals and generator cap, saline needle cap, $^{99m}Tc$-needle cap saline vial which is generated from $^{99}Mo$/$^{99m}Tc$ generator. After measuring each surface contamination degree by survey meter, mean value and standard deviation one were solved out. Results: In result, After measuring surface contamination degree, radioactivity of saline for labelling radiophamaceuticals showed $14429{\pm}26378$ cpm (p<0.05) and in measured generators, foreign imported things showed that generator cap : $9{\pm}21$ cpm, saline vial : $17{\pm}28$ cpm. saline needle cap : $35{\pm}66$ cpm, $^{99m}Tc$-needle cap : $9{\pm}21$ cpm, saline vial $13{\pm}28$ cpm. domestic things showed that generator cap : $22852{\pm}52545$ cpm, saline needle cap : $87367{\pm}109711$ cpm, $^{99m}Tc$-needle cap : $9008{\pm}10459$ cpm, saline vial : $186416{\pm}158196$ cpm (p<0.05). Conclusion: The saline which is used for labelling, exceeded 1/10 of maximum permissible range. this is generated from radiophamaceuticals dilution procedure. and In generators, radioactive value of foreign import things showed closely background value. but which of domestic thing showed that exceeded more than 1000 values 1/10 of maximum permissible range. the causes of that is domestic generator is contaminated in manufacturing procedure. So, to dispose radioactive contamination materials which is could betaken out of, the control and operation must be radical under controlled by radioactive measuring, recording and equipping of its own. if this is kept well, we can prevent surely that radioactive waste could be disposed like as general trash.

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A STUDY OF THE MECHANISM OF IMPROVING ACID RESISTANCE OF BOVINE TOOTH ENAMEL AFTER PULSED Nd-YAG LASER IRRADIATION (펄스형 Nd-YAG 레이저 조사에 의한 법랑질 내산성 증가 기전에 관한 연구)

  • Lee, Young-Soon;Shon, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.640-658
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    • 1996
  • The purpose of this study was to examine the mechanism of improving acid resistance of Nd-YAG laser irradiated tooth enamel and determine the most effective energy density for improving acid resistance. The bovine tooth enamel were lased with a pulsed Nd-YAG laser. The energy densities of exposed laser beam were varied from 10 to $70\;J/cm^2$. To investigate the degree of improving acid resistance by irradiation, all the samples were submerged to demineralize in 0.5 N $HClO_4$ solution for 1 minute. After 1 minute, 0.05 % $LaCl_3$ was added to the solution for interrupting the demineralization reaction. The amounts of dissolved calcium and phosphate in the solution were measured by using an atomic absorption spectrophotometer and the UV/VIS spectrophotometer, respectively. To examine the mechanism of improving acid resistance, X-ray diffraction analysis, infrared spectroscopy, and scanning electron microscopy were taken. The X-ray diffraction pattern of the samples were obtained in the $10^{\circ}{\sim}80^{\circ}2{\theta}$ range with $Cu-K{\alpha}$ radiation using M18HF(Mac Science Co.) with X-ray diffractometer operating at 40 KV and 300 mA. The infra-red spectra of the ground samples in 300 mg KBr pellets 10 mm diameter were obtained in the $4000cm^{-1}\;to\;400cm^{-1}$ range using JASCO 300E spectrophotometer. The scanning electron microscopy was carried out using JSM6400(JEOL Co.) with $500{\sim}2000$ times magnification. The results were as follow 1. The concentration of calcium dissolved from laser irradiated enamel with $50J/cm^2$ was significantly lesser than that of unlased control group (p<0.05) 2. From the result of the X-ray diffraction analysis, $\beta$-TCP, which increases acid solubility, was identified in lased enamel but the diffraction peaks of (002) and (004) became sharp with increasing energy density of laser irradiation. This means that the crystals in lased samples were grown through the c-axis and subsequently, the acid solubility of enamel decreased. 3. The a-axis parameter was slightly increased by laser irradiation, whereas the c-axis parameter was almost constant except for a little decrease at $50J/cm^2$. 4. In the infra-red spectra of lased enamels, phosphate bands ($600{\sim}500cm^{-1}$), B-carbonate bands (870, $1415{\sim}1455cm^{-1}$), and A-carbonate band ($1545cm^{-1}$) were observed. The amounts of phosphate bands and the B-carbonate bands were reduced, on the other hand, the amount of the A-carbonate band was increased by increase the energy density. 5. The SEM experiments reveal that the surface melting and recrystallization were appeared at $30J/cm^2$ and the cracks were observed at $70J/cm^2$. From above results, It may be suggested that the most effective energy density for improving acid resistance of tooth enamel with the irradiation of Nd-YAG laser was $50J/cm^2$. The mechanism of improving acid resistance were reduction of permeability due to surface melting and recrystallization of lased enamel and reduction of acid solubility of enamel due to decrease of carbonate content and growth of crystal.

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Cutoff Values of Body Mass Index and Body Fat Measures for Metabolic Syndrome in Korean Population (한국인에서 대사증후군의 선별검사로서 체성분 분석 및 체질량지수의 타당성연구)

  • Lee, Hyun-Jae;Kim, Byoung-Gwon;Kim, Joon-Youn;Kim, Jung-Man;Yoo, Byung-Chul;Kim, Eun-Jeong;Hong, Young-Seoub
    • Journal of Life Science
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    • v.20 no.1
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    • pp.9-16
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    • 2010
  • This study investigated cut-off values of body mass index (BMI) and body fat measures for metabolic syndrome (MS) in elderly Koreas. Questionnaire surveys, anthropometric measurements, medical examinations, and body composition analyses were conducted for 10,077 subjects aged 40-65 years in the health examinee cohort in Korea between 2004 and 2006. Cut-off values were identified using receiver-operating characteristic (ROC) curve analysis for both men and women. Stratified analyses by weight range (<60, 60-69, 70-79, and 80-89, ${\geq}90\;kg$ for men; <50, 50-59, 60-69, 70-79, ${\geq}80\;kg$ for women) were conducted. Among male subjects, the cut-off points were $25.5\;kg/m^2$ for BMI with a sensitivity of 70.0% and a specificity of 72.0%, and 26.1% for body fat percentage with a sensitivity of 60.6% and a specificity of 76.4%. Among female subjects, the cutoff points were $24.1\;kg/m^2$ for BMI with a sensitivity of 73.3% and a specificity of 68.8%, and 31.5% for body fat percentage with a sensitivity of 76.7% and a specificity of 65.6%. Stratified analysis by weight range showed that the cutoff points of BMI and body fat measures tended to higher as weight level increased. The results of our study suggest cut-off values of BMI and body fat measure for MS were similar to the general obesity criteria in Korea.

Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer (위암 환자에서 위 절제술 후 결장 간치술)

  • Lee, Jun-Hyun;Hur, Hoon;Jeon, Hae-Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.217-224
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    • 2008
  • Purpose: For most surgeons, colon interposition after gastrectomy remains an infrequently performed procedure because of its complexity. The aim of this study was to assess its technical feasibility and safety as a post-gastrectomy reconstruction method by reviewing our experience with colon interposition. Materials and Methods: From March 2001 to February 2002, 30 colon interpositions after-gastrectomy were done with using the ileo-ascending or transverse colon. We analyzed the clinicopathologic features and the surgical outcomes. Results: There were 16 males and 14 females in this study with a mean age of 67.5 years (range: 31 to 76 years). Twenty-five ascending colons and 5 transverse colons were used for the interposition, respectively. The mean operation time was 373 minutes (range: 204 to 600 minutes). There were 9 operative morbidities (30%) and 1 operative mortality. The restoration of bowel motility was noted at 3.8 postoperative days; a soft diet was started at 4.9 postoperative days and the duration of the hospital stay was 18.2 days. The percentage of weight loss in the patients with total, proximal and distal gastrectomy was 16.3%, 14.0% and 8.8%, respectively, at 6 months, and thereafter the weight loss gradually recovered as 8.1%, 7.5% and 5.6%, respectively, at 5 years postoperatively. Gastric stasis was the one of the most meaningful long-term complications, and especially in the patients who underwent distal gastrectomy with colon interposition. Conclusion: Colon interposition after gastrectomy was a very complex procedure with a long operating time and many anastomosis sites. The postoperative outcomes failed to achieve satisfactory weight gain and the patients displayed postprandial symptoms. This suggested that this procedure was not an appropriate procedure for conventional reconstruction after gastrectomy.

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