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Clinical Differences and Outcomes of Continuous Renal Replacement Therapy between Critically Ill Neonates and Children (신생아와 소아의 지속적 신대체요법(CRRT) 적용 특성 및 결과)

  • Choi, Aeng Ja;Choi, Su Jung;Choi, Hee Jung;You, Mi Young
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.40-50
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    • 2016
  • Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

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Frequency of Unnecessarily Biopsies among Patients with Suspicion of Prostate Cancer in Syrian Men

  • Bachour, Dala-Maria;Chahin, Emil;Al-Fahoum, Sahar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5967-5970
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    • 2015
  • Background: The prevalence of prostate cancer is considered high in many countries, and screening tests are very important in order to detect prostate cancer in its early stages; however false positivity with these screening tests means that a lot of patients undergo unnecessary biopsy, which is an invasive procedure, for the confirmatory test. The purpose of this study was to estimate the frequency of unnecessary biopsy cases in patients referred for prostate biopsy in one of the most important and overload cancer centers in Syria. Materials and Methods: Retrospective data for a period of four years between January 2009 and December 2012 were collected in Al-Bayrouni University Medical hospital in Damascus, Syria. The patients from whom data were collected were referred to our histopathological department because of elevated prostate specific antigen (PSA) serum or an abnormal digital rectal examination (DRE). All patients underwent prostatic TRUS-guided biopsies. Diagnosis of prostate cancer (PCa) or benign prostatic hyperplasia (BPH) was based on histopathological examination and prostate cancers cases were graded and scored according to the Gleason score system. Results: For the 406 patients referred to biopsy, the $mean{\pm}SD$ age was $58.4{\pm}23.3$ years. The $mean{\pm}SD$ PSA level was $49.2{\pm}21.5ng/ml$. Of the total we found 237 patients diagnosed with PCa (58. 4%), 166 patients with BPH (40.9%) and 3 cases were unable to be diagnosed (0.7%) because of biopsy collection errors. Conclusions: Our study shows that a high percentage of patients are undergoing unnecessary biopsy, which suggests that the performed screening tests had a high level of false positive and may need re-evaluation.

Hybrid S-ALOHA/TDMA Protocol for LTE/LTE-A Networks with Coexistence of H2H and M2M Traffic

  • Sui, Nannan;Wang, Cong;Xie, Wei;Xu, Youyun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.11 no.2
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    • pp.687-708
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    • 2017
  • The machine-to-machine (M2M) communication is featured by tremendous number of devices, small data transmission, and large uplink to downlink traffic ratio. The massive access requests generated by M2M devices would result in the current medium access control (MAC) protocol in LTE/LTE-A networks suffering from physical random access channel (PRACH) overload, high signaling overhead, and resource underutilization. As such, fairness should be carefully considered when M2M traffic coexists with human-to-human (H2H) traffic. To tackle these problems, we propose an adaptive Slotted ALOHA (S-ALOHA) and time division multiple access (TDMA) hybrid protocol. In particular, the proposed hybrid protocol divides the reserved uplink resource blocks (RBs) in a transmission cycle into the S-ALOHA part for M2M traffic with small-size packets and the TDMA part for H2H traffic with large-size packets. Adaptive resource allocation and access class barring (ACB) are exploited and optimized to maximize the channel utility with fairness constraint. Moreover, an upper performance bound for the proposed hybrid protocol is provided by performing the system equilibrium analysis. Simulation results demonstrate that, compared with pure S-ALOHA and pure TDMA protocol under a target fairness constraint of 0.9, our proposed hybrid protocol can improve the capacity by at least 9.44% when ${\lambda}_1:{\lambda}_2=1:1$and by at least 20.53% when ${\lambda}_1:{\lambda}_2=10:1$, where ${\lambda}_1,{\lambda}_2$ are traffic arrival rates of M2M and H2H traffic, respectively.

The Differences in Job Stress, Teacher Efficacy, Emotion-Focused Coping Strategies and Depression, and Their Influences on Depression (보육교사의 직무스트레스, 교사효능감, 정서중심 스트레스 대처방식 및 우울의 차이와 우울에 미치는 변인들의 영향)

  • Lee, Kyung-Sook;Chae, Jin-Young;Kim, Myung-Sik;Park, Jin-Ah;Lee, Jeong-Min
    • Korean Journal of Childcare and Education
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    • v.12 no.4
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    • pp.23-40
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    • 2016
  • The purposes of this study were 1) to examine the differences in job stress, teacher efficacy, emotion-focused coping strategies and depression of teachers in early childhood education and care according to their demographic backgrounds, 2) to investigate the influences of these variables on depression. 586 teachers in ECEC answered the questionnaires and the collected data were analyzed through frequence, percentages, Pearson's correlations, One-Way ANOVA, Bonferroni post hoc test, and stepwise regression using SPSS 21.0. The findings are as follows. First, job stress was significantly different according to ECEC teachers' ages and types of centers they were employed at teacher efficacy was significantly different according to their ages and education levels, emotion-focused coping strategies and depression were respectively significantly different according to ages, types of centers and education levels. Second, ECEC teachers' depression was influenced by undercontrolled expressionof emotion-focused coping strategies, home connection and promotion of positive learning environment of teacher efficacy, undercontrolled thinkingof emotion-focused coping strategies and work overload and job stress in order. These results imply that a support system and a policy should be established for ECEC teachers to express and understand their emotions in a positive way and related information should be provided to them through workshops.

KR-39038, a Novel GRK5 Inhibitor, Attenuates Cardiac Hypertrophy and Improves Cardiac Function in Heart Failure

  • Lee, Jeong Hyun;Seo, Ho Won;Ryu, Jae Yong;Lim, Chae Jo;Yi, Kyu Yang;Oh, Kwang-Seok;Lee, Byung Ho
    • Biomolecules & Therapeutics
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    • v.28 no.5
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    • pp.482-489
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    • 2020
  • G protein-coupled receptor kinase 5 (GRK5) has been considered as a potential target for the treatment of heart failure as it has been reported to be an important regulator of pathological cardiac hypertrophy. To discover novel scaffolds that selectively inhibit GRK5, we have identified a novel small molecule inhibitor of GRK5, KR-39038 [7-((3-((4-((3-aminopropyl)amino)butyl)amino)propyl)amino)-2-(2-chlorophenyl)-6-fluoroquinazolin-4(3H)-one]. KR-39038 exhibited potent inhibitory activity (IC50 value=0.02 µM) against GRK5 and significantly inhibited angiotensin II-induced cellular hypertrophy and HDAC5 phosphorylation in neonatal cardiomyocytes. In the pressure overload-induced cardiac hypertrophy mouse model, the daily oral administration of KR-39038 (30 mg/kg) for 14 days showed a 43% reduction in the left ventricular weight. Besides, KR-39038 treatment (10 and 30 mg/kg/day, p.o.) showed significant preservation of cardiac function and attenuation of myocardial remodeling in a rat model of chronic heart failure following coronary artery ligation. These results suggest that potent GRK5 inhibitor could effectively attenuate both cardiac hypertrophy and dysfunction in experimental heart failure, and KR-39038 may be useful as an effective GRK5 inhibitor for pharmaceutical applications.

The effect of 5 different personalities on job stress in physical therapists

  • Kim, Eun Hyeong;Jang, Ho Young;Lee, Suk Min
    • Physical Therapy Rehabilitation Science
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    • v.7 no.4
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    • pp.191-196
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    • 2018
  • Objective: The purpose of this study was to investigate the effects of 5 different personalities on job stress in physical therapists. Design: Descriptive cross-sectional study. Methods: Structured self-report questionnaires consisted of demographic items, 5 types of personalities, and occupational stress. A questionnaire was distributed to 420 physical therapists working in Seoul and Incheon who had voluntarily agreed to participate in the study after the purpose of the study was explained. Of the 420 questionnaires, 405 questionnaires were collected and showed a recovery rate of 96.4%, of which 28 cases were excluded, leaving a total of 377 questionnaires being used for analyses. Pearson correlation analysis was performed to investigate the correlation of job stress and five personalities types. In addition, multiple regression analysis was performed to investigate the effect of general and occupational characteristics of physical therapist on job stress and the effect of personality type on occupational stress. All statistical significance levels were set at p<0.05. Results: The highest number of subjects, which were the physical therapists, showed the tendency to have a sincere personality, followed by affinity, openness, extroversion, and neuroticism. Physical therapists reported to be the most stressed in the order of professional role conflict, overload of work, work relation with a physician and supervisor, interpersonal relationship with patient and caregiver. The higher the level of affinity and sincerity, the lower the amount of stress received by the therapist from the interpersonal relationships between the patient and caregivers. On the other hand, the greater the level of openness and sincerity, the lower the stress levels related to professional role conflict. Conclusions: This study showed that the personality type and job stress of physiotherapists had a statistically significant effect. It is very important for physiotherapists to find their own way of coping with stress, which is satisfactory and appropriate for their job, because it is related not only to individual problems but also to the quality of patient care and medical services. Therefore, it is necessary to continue conducting research on how to relieve the stress levels of physical therapists according to their personality characteristics.

Ultrasound and clinical findings in the metacarpophalangeal joint assessment of show jumping horses in training

  • Yamada, Ana Lucia M.;Pinheiro, Marcelo;Marsiglia, Marilia F.;Hagen, Stefano Carlo F.;Baccarin, Raquel Yvonne A.;da Silva, Luis Claudio L.C.
    • Journal of Veterinary Science
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    • v.21 no.3
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    • pp.21.1-21.14
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    • 2020
  • Background: Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives: The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods: A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results: The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions: The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.

Influence of Implant Fixture-Abutment Connection and Abutment Design on Mechanical Strength (임플란트 고정체-지대주 연결부 및 지대주 디자인이 기계적 강도에 미치는 영향)

  • Chun, Mi-Hyun;Jeong, Chang-Mo;Jeon, Young-Chan;Eom, Tae-Gwan;Yoon, Ji-Hoon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.3
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    • pp.269-281
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    • 2008
  • Fatigue or overload can result in mechanical problems of implant components. The mechanical strength in the implant system is dependent on several factors, such as screw and fixture diameters, material, and design of the fixture-abutment connection and abutment. In these factors, the last rules the strength and stability of the fixture-abutment assembly. There have been some previous reports on the mechanical strength of the fixture-abutment assembly with the compressive bending test or short-term cyclic loading test. However, it is restrictive to predict the long-term stability of the implant system with them. The purpose of this study was to evaluate the influence of the design of the fixture-abutment connection and abutment on the mechanical strength and failure mode by conducting the endurance limit test as well as the compressive bending strength test. Tests were performed according to a specified test(ISO/FDIS 14801) in 4 fixture-abutment assemblies of the Osstem implant system: an external butt joint with Cemented abutment (group BJT), an external butt joint with Safe abutment (group BJS), an internal conical joint with Solid abutment (group CJO), and an internal conical joint with ComOcta abutment (group CJT). The following conclusions were drawn within the limitation of this study. Compressive bending strengths were decreased in order of group BJS(1392.0N), group CJO(1261.8N), group BJT(1153.2N), and group CJT(1110.2N). There were no significant differences in compressive bending strengths between group BJT and group CJT(P>.05). Endurance limits were decreased in order of group CJO(600N), group CJT(453N), group BJS(360N), and group BJT(300N). 3. Compressive bending strengths were influenced by the connection and abutment design of the implant system, however endurance limits were affected more considerably by the connection design.

The Development of a Cryotherapy System (한냉물리치료기의 개발)

  • Kim, Yeong-Ho;Yang, Gil-Tae;Jang, Yun-Hui;Park, Si-Bok;Ryu, Jin-Sang
    • Journal of Biomedical Engineering Research
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    • v.19 no.6
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    • pp.617-622
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    • 1998
  • A cryotherapy system using cold air was developed. The developed system had superior low-temperature characteristics with various flow rates and nozzle sizes, and used R-404A, as a coolant, which has no destructive effects of Ozone layers. Flow rates and the treatment time can be easily altered during the operation. In addition, and alarm system was designed for the overload, overheat, and over-charge of the machine. For clinical applications, skin temperatures, intra-articular temperatures of the knee joint and intra-muscluar temperatures of the gluteal muscles were measured during and after the cryotherapy. After a 5-minute therapy, skin and intra-articular temperatures decreased by $23.3{\pm}4.7 and 4.1 {\pm}1.0^{circ}C$, respectively. A 5-minute cryotherapy was good enough to maintain low intra-articular temperatures for 2-3 hours. Resting intra-muscular temperatures in 2, 4, and 6cm deep in the gluteal muscle were $36.5{\pm}1.2, 36.9{\pm}0.2, 37.1{\pm}0.2^{circ}C$, respectively (p<0.05). Lowest temperatures in 2, 4, and 6cm depth were $35.1{\pm}0.7, 36.2{\pm}0.4, 36.9{\pm}0.3^{circ}C$, respectively (p<0.05). Temperatures after a 2-hour cold air application on the skin and in the muscle in dept도 of 2, 4, and 6cm were $32.2{\pm}1.1, 36.2{\pm}0.5, 36.6{\pm}0.3, 36.9{\pm}0.3^{circ}C$respectively (p<0.05). Temperatures on the skin and in the muscle significantly decreased after 2 hours, compared with before cold air application (p<0.05). The intra-muscular temperature was changed more slowly than the skin temperature, and the deeper the muscle, the lesser temperature changes. The effect of a 5-minute cold air application lasts up to 2 hours, and it seems that the rebound-rise of the temperature dut to the reactive vasodilatation does not occur in the gluteal muscle.

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The Endotoxin Assay of Contaminated Titanium Implants following Various Techniques of Detoxification (오염된 임프란트 표면의 해독 방법에 따른 내독소 제거 효과에 관한 연구)

  • Park, Joong-Hee;Lim, Sung-Bin
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.71-81
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    • 2004
  • Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.