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The Therapeutic Efficacy and the Bleeding Complications of Urokinase and Alteplase in Patients with Massive Pulmonary Thromboembolism (중증 폐혈전색전증 환자에서 Urokinase와 Alteplase의 효과 및 출혈 합병증 비교)

  • Yoo, Jung-Wan;Kim, Wongyoung;Choi, Chang Min;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.6-12
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    • 2009
  • Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.

A Study on the Utilization of Diagnostic Equipments and Patient Dose for Diagnostic Radiological Procedures in Korea (진단방사선영역에서 방사선장치의 이용실태 및 환자피폭선량에 관한 조사연구)

  • Kim Youhyun;Choi Jonghak;Kim Sungsoo;Lee Chanhyeup;Cho Pyongkon;Lee Youngbae;Kim Chelmin
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.10-15
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    • 2005
  • IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

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A Study on Comparison of Outdoor Wind Pressure Performance According to Outdoor Exposure and Acceleration Deterioration Methods of Structural Sealants Applied to Curtain Wall (커튼월에 적용된 구조용 실링재의 옥외폭로와 실내복합열화 처리방법에 따른 내풍압성능 비교연구)

  • Jang, Pil Sung;Hong, Soon Gu;Kim, Sung Rae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.279-287
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    • 2018
  • Sealants are an important element of modern architecture and serve as a building protection against weathering by providing barriers against ingress of moisture, air, and other materials. Exposure to a variety of environments often reduces lifespan due to changes in physical, chemical and mechanical characteristics, and UV, humidity, and temperature expansion are important issues that are directly related to durability. In this study, a combined deterioration test chamber was developed to simulate the environment of the open air as an instrument for verifying the durability of structural sealing materials indoors. In order to replicate special weather conditions, such as yellow dust, acid rain, and contamination by microorganisms, it was deemed impossible to replicate the outdoor environment by 100 %, and the results of the results of the results of the external exposure test of the structural sealant and the combined deterioration testing device. As a result of the displacement test of the outdoor exposure test, it was determined that the sealant was breaking apart and that it would be smooth, and the displacement would be up to three times greater than the initial material value of 1 year. The displacement test results of the combined deterioration test device show the tendency to deteriorate, decreasing the elasticity and tensile characteristics. In the case of denatured silicon, the current 400 cycles have been completed to confirm 12 months of degradation of the external exposure. The deformation of the test specimen cannot be verified with the naked eye, so it is considered that the conditions of the specimen are more stable than the silicon sealant. As a result of the outdoor exposure test, if the combined deterioration test device is structured and proposed in the relevant guidance or specification, the anticipated lifespan of 12 months in the actual use environment can be verified indoors and below 3 months later, economically.

The Nopsae;a Foehn type wind over the Young Suh region of central Korea (영서지방의 푄현상)

  • ;Lee, Hyon-Young
    • Journal of the Korean Geographical Society
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    • v.29 no.3
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    • pp.266-280
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    • 1994
  • Upper-air synoptic data and surface weather elements such as temperature, relative humidity, wind speed, cloud and precipitation were analyzed in some detail to determine the characteristics of Nopsae, a foehn-like surface wind over the Youngsuh region of Central Korea. NOAA AVHRR and GMS images are also referenced to identify the distribution of clouds and precipitation to classify the tpyes of foehn over the study area. The data period examined is from 1982 until 1993 of spring and summer months from March through August. Results of the anaylsis are as follows. Warm and dry air penetration over the Younesuh region has experienced on foehn days occured between March 21 and August 10 during study perion. The mean annual number of foehn the days were 28. Foehn phenomena were prominent during March 21-25, April 5-15, May 25-June 10, and June 26-30 pentads. The intensity of the phenomena can be evaluated as the difference of daily maximum temperature and relative humidity between windward sites and leeward sites. The intensity of daily maximum temperature reached 14.5$^{\circ}C$, but most values were in the range of 5.0-7.5$^{\circ}C$ (61%). Although strong intensity of foehns usually develop in June, it is common that farmers in the region experince more aridity during the foehnday of April and May due to the transplantation of rice seedlings. Long-run foehn are not common phenomena and 55% of foehn terminate in one day, but there is a record that Nopsae persisted up to 9 days continuously. The author identified using the cloud and precipitation data out of NOAA-11, AVHRR and GMS images is that one of them has no precipitation over windward side. The available data and the results of the analysis are somewhat inadequate. Since the results imply that wave phenomenon is potentially important in terms of local surface weather and vertical momentum transport, more detailed theoretical and observational studies are necessary to clarify the mechanism and the impacts of Nopsae.

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Assessment of Emission Data for Improvement of Air Quality Simulation in Ulsan (울산 지역 대기질 모의능력 개선을 위한 배출량자료 평가)

  • Jo, Yu-Jin;Kim, Cheol-Hee
    • Journal of Environmental Impact Assessment
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    • v.24 no.5
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    • pp.456-471
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    • 2015
  • Emission source term is one of the strong controlling factors for the air quality simulation capability, particularly over the urban area. Ulsan is an industrial area and frequently required to simulate for environmental assessment. In this study, two CAPSS (Clean Air Policy Support System) emission data; CAPSS-2003 and CAPSS-2010 in Ulsan, were employed as an input data for WRF-CMAQ air quality model for emission assessment. The simulated results were compared with observations for the local emission dominant synoptic conditions which had negative vorticities and lower geostrophic wind speed at 850hPa weather maps. The measurements of CO, $NO_2$, $SO_2$ and $PM_{10}$ concentrations were compared with simulations and the 'scaling factors' of emissions for CO, $NO_2$, $SO_2$, and $PM_{10}$ were suggested in in aggregative and quantitative manner. The results showed that CAPSS-2003 showed no critical discrepancies of CO and $NO_2$ observations with simulations, while $SO_2$ was overestimated by a factor of more than 12, while $PM_{10}$ was underestimated by a factor of more than 20 times. However, CAPSS-2010 case showed that $SO_2$ and $PM_{10}$ emission were much more improved than CAPSS-2003. However, $SO_2$ was still overestimated by a factor of more than 2, and $PM_{10}$ underestimated by a factor of 5, while there was no significant improvement for CO and $NO_2$ emission. The estimated factors identified in this study can be used as'scaling factors'for optimizing the emissions of air pollutants, particularly $SO_2$ and $PM_{10}$ for the realistic air quality simulation in Ulsan.

Objective Analysis of the Set-up Error and Tumor Movement in Lung Cancer Patients using Electronic Portal Imaging Device (폐암 환자에서 Electronic Portal Imaging Device를 이용한 자세 오차 및 종양 이동 거리의 객관적 측정)

  • Kim, Woo-Cheol;Chung, Eun-Ji;Lee, Chang-Geol;Chu, Sung-Sil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.69-76
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    • 1996
  • Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.

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Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery (흉골절개술을 이용한 개심술 후 발생한 흉골 감염 및 종격동염의 위험인자 분석)

  • Chang, Won-Ho;Park, Han-Gyu;Kim, Hyun-Jo;Youm, Wook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.583-589
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    • 2003
  • With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. Material and Method: From March 200f to March 2003 at the depart-ment of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, post-operative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. Result: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardio-pulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p< 0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p< 0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). Conclusion: Contamination of pa-tients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.

Comparison of the Low Potassium Dextran Solution and ET-Kyoto Solution in Rabbit Lung (토끼 폐장 분리관류 모형을 이용한 LPD 폐보존액과 ET-Kyoto 폐보존액의 비교)

  • Lim, Cheong;Kim, Kyung-Hwan;Kim, Young-Tae;Sung, Sook-Whan;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1159-1166
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    • 1997
  • For Improvement of lung preservation, many tripes of preservation solution were developed and tested. The aim of this study was to compare the effect of the most frequently used extracellular type pieservation solution (Low Potassium Dextran, LPD) with a newly developed trehalose containing extracellular type preservation solution(ET-Kyoto, ETK) on postischemic lung function. Twelve New-Zealand white rabbit lungs were harvested and studied on an isolated, blood-perfused model of lung function after 4 hours of cold ischemia at $10^{\circ}C$ In group I (n=6), lungs were preserved with 100 mL/kg of LPD solution; in group II(n=6), lungs were preserved with 100 mL/kg of ETK solution. A few minutes before flushing with preservation solutions, 20$\mu\textrm{g}$ of PGEI were injected into main pulmonary artery. Functions of the preserved lung were compared with PO2, PA pressure, t acheal air pressure, and drylwet ratio. The pulmonary efferent blood oxygen tension at the end of the 60-minute reperfusion period was higher in group II compacted with group I(486.5 $\pm$ 80.3 mmHg versus $432.5\pm82.9$ mmHg at FiO2 1.0, p-value = NS). The mean pulmonary arterial pressure was similar in both $groups.(33.7\pm2.2$ mmHg versus $35.5\pm2.0$ mmHg, p-value : NS). The peak inspiratory airway pressure was significantly lower in group 11(8.010.6 mmHg versus 11.8 $\pm$ 1.4 mmHg, p-value=0.02) The water content of the lung was lower in group II $(70.2\pm6.9%$ versus 78.5 $\pm6.1%),$ but not significant. These data demonstrate that a newly-developed trehalose-containing ET-Kyoto solution yield equal or slightly superior lung function after reperfusion compared with LPD solution.

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Development and Validation of an Analytical Method for Ametoctradin Residue Determination in Domestic Agricultural Commodities by HPLC-PDA (HPLC-PDA를 이용한 국내 유통 농산물 중 ametoctradin 잔류량 분석법 개발 및 검증)

  • Do, Jung-Ah;Kwon, Ji-Eun;Lee, Eun-Mi;Kim, Mi-Ra;Kuk, Ju-Hee;Cho, Yoon-Jae;Kang, Il-Hyun;Kim, Hyung-Su;Kwon, Kisung;Oh, Jae-Ho
    • Korean Journal of Food Science and Technology
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    • v.45 no.3
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    • pp.285-292
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    • 2013
  • This study was carried out to validate the safety of ametoctradin residues in agricultural commodities by developing an official analysis method. An analytical method was developed and validated using HPLC-PDA detectors. The samples were extracted with methanol, subsequently partitioned with dichloromethane and purified with florisil column chromatograph using acetone/hexane (30/70, v/v) as solvent. The method was validated by using grape, hulled rice, mandarin, and potato spiked with ametoctradin at 0.05 and 5.0 mg/kg, and pepper at 0.05 and 2.0 mg/kg. Average recoveries were 76-114.8% with relative standard deviation less than 10%, and the limit of detection and limit of quantification were 0.0125 and 0.05 mg/kg, respectively. The result of recoveries and overall coefficient of variation of the laboratory results from Gwangju regional Food and Drug Administration (FDA) and Daejeon regional FDA was accorded with Codex Alimentarius Commission Guideline (CAC/GL 40). Based on these results, this method was found to be appropriate for ametoctradin residue determination and can be used as the official method of analysis.

Physicochemical and Textural Properties, and Antimicrobial Effects of Low-fat Comminuted Sausages Manufactured with Grapefruit Seed Extract (자몽 종자 추출물을 첨가한 저지방 세절 소시지의 이화학적, 조직적 특성 및 향균 효과)

  • Chin Koo B.;Kim Wha Y.;Kim Kwang H.
    • Food Science of Animal Resources
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    • v.25 no.2
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    • pp.141-148
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    • 2005
  • This study was conducted to evaluate physicochemical and textural properties, and antimicrobial effects of low-fat comminuted sausages manufactured with sodium lactate $(3.3\%,\;SL)$ and various levels $(0.1\~0.3\%)$ of grapefruit seed extract (GSE, DF-100) during refrigerated storage for 10 weeks. Low-fat comminuted sausages (LFCS) has pH ranges of $6.09\~6.26,\;74\~76\%$ moisture, $<3\%\;fat,\;16\~17\%$ protein. The addition of SL $(3.3\%)$ and GSE with various levels $(0.1\~0.3\%)$ didn't impair water holding capacity (WHC), vacuum purge (VP) and Hunter color values (L, a, b). LFCS containing SL $(3.3\%)$ increased hardness and chewiness, whereas most TPA values were not affected by the addition of various levels $(0.1\~0.3\%)$ of GSE. LFCS containing $0.2\%\;or\;0.3\%$ GSE retarded the microbial growth of Listeria monocytogenes(LM). The addition of $0.3\%$ GSE in LFCS showed similar antimicrobial effect to $3.3\%$ SL, which kept $10^3 CFU/g$ until 10 weeks of refrigerated storage. Yellowness, VP and cohesiveness tended to be increased with increased storage time. These results indicated that the addition of $0.3\%$ GSE as a replacer for synthetic particularly paI1icuiarly inhibited the microbial growth of LM, resulting in antimicrobial effect similar to those of $3.3\%$ SL treatment without quality defects.