• Title/Summary/Keyword: Risk reduction method

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Effect Assessment and Derivation of Ecological Effect Guideline on CO2-Induced Acidification for Marine Organisms (이산화탄소 증가로 인한 해수 산성화가 해양생물에 미치는 영향평가 및 생태영향기준 도출)

  • Gim, Byeong-Mo;Choi, Tae Seob;Lee, Jung-Suk;Park, Young-Gyu;Kang, Seong-Gil;Jeon, Ei-Chan
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.17 no.2
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    • pp.153-165
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    • 2014
  • Carbon dioxide capture and storage (CCS) technology is recognizing one of method responding the climate change with reduction of carbon dioxide in atmosphere. In Korea, due to its geological characteristics, sub-seabed geological $CO_2$ storage is regarded as more practical approach than on-land storage under the goal of its deployment. However, concerns on potential $CO_2$ leakage and relevant acidification issue in the marine environment can be an important subject in recently increasing sub-seabed geological $CO_2$ storage sites. In the present study effect data from literatures were collected in order to conduct an effect assessment of elevated $CO_2$ levels in marine environments using a species sensitivity distribution (SSD) various marine organisms such as microbe, crustacean, echinoderm, mollusc and fish. Results from literatures using domestic species were compared to those from foreign literatures to evaluate the reliability of the effect levels of each biological group and end-point. Ecological effect guidelines through estimating level of pH variation (${\delta}pH$) to adversely affect 5 and 50% of tested organisms, HC5 and HC50, were determined using SSD of marine organisms exposed to the $CO_2$-induced acidification. Estimated HC5 as ${\delta}pH$ of 0.137 can be used as only interim quality guideline possibly with adequate assessment factor. In the future, the current interim guideline as HC5 of ${\delta}pH$ in this study will look forward to compensate with supplement of ecotoxicological data reflecting various trophic levels and indigenous species.

Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

Does Sarcopenic Obesity Affect Physical Function and Physical Fitness of Korean Older Women? (근위축비만이 국내 여성고령자의 신체기능과 체력에 미치는 영향)

  • Hong, Seung-youn
    • 한국노년학
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    • v.30 no.3
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    • pp.831-842
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    • 2010
  • BACKGROUND: Sarcopenic obesity(SO), a condition of the reduction in muscle mass paired with an increased fat mass has been paid attention because of its association with disability in later life. A few evidence, however, has reported the association with these factors. PURPOSE: To explore the association among SO, physical function and fitness in older women. METHOD: 257 older women(age of 74) were recruited from Y city and 7 physical functions and 4 fitness tests were measured. Participants were classified into one of four groups based on their body fat and muscle mass: Normal group (GR-A), high fat(GR-B), sarcopenia(GR-C), and sarcopenic obese(GR-D). GLMand LSD-test were conducted with SPSS 12.0. RESULTS: Chair stand, arm-curl, back-scratch, 2-min steps of GR-A was higher than GR-C and GR-D(p<.05). One-leg stand of GR-A was higher than GR-D(p<.01) and of GR-C was higher than GR-D(p<.01).8ft-TUG of GR-D was lower than GR-A(p<.01). Grip strength, knee extension of GR-A was higher than that of GR-C and GR-D(p<.01) and knee flexion of GR-A was also higher than that of GR-C and GR-D(p<.01). CONCLUSION: Based on our findings, we conclude that SO is significantly associated with lower physical function and fitness in older Korean women, which alarm the risk of frailty induced by SO.

Ensemble Learning with Support Vector Machines for Bond Rating (회사채 신용등급 예측을 위한 SVM 앙상블학습)

  • Kim, Myoung-Jong
    • Journal of Intelligence and Information Systems
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    • v.18 no.2
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    • pp.29-45
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    • 2012
  • Bond rating is regarded as an important event for measuring financial risk of companies and for determining the investment returns of investors. As a result, it has been a popular research topic for researchers to predict companies' credit ratings by applying statistical and machine learning techniques. The statistical techniques, including multiple regression, multiple discriminant analysis (MDA), logistic models (LOGIT), and probit analysis, have been traditionally used in bond rating. However, one major drawback is that it should be based on strict assumptions. Such strict assumptions include linearity, normality, independence among predictor variables and pre-existing functional forms relating the criterion variablesand the predictor variables. Those strict assumptions of traditional statistics have limited their application to the real world. Machine learning techniques also used in bond rating prediction models include decision trees (DT), neural networks (NN), and Support Vector Machine (SVM). Especially, SVM is recognized as a new and promising classification and regression analysis method. SVM learns a separating hyperplane that can maximize the margin between two categories. SVM is simple enough to be analyzed mathematical, and leads to high performance in practical applications. SVM implements the structuralrisk minimization principle and searches to minimize an upper bound of the generalization error. In addition, the solution of SVM may be a global optimum and thus, overfitting is unlikely to occur with SVM. In addition, SVM does not require too many data sample for training since it builds prediction models by only using some representative sample near the boundaries called support vectors. A number of experimental researches have indicated that SVM has been successfully applied in a variety of pattern recognition fields. However, there are three major drawbacks that can be potential causes for degrading SVM's performance. First, SVM is originally proposed for solving binary-class classification problems. Methods for combining SVMs for multi-class classification such as One-Against-One, One-Against-All have been proposed, but they do not improve the performance in multi-class classification problem as much as SVM for binary-class classification. Second, approximation algorithms (e.g. decomposition methods, sequential minimal optimization algorithm) could be used for effective multi-class computation to reduce computation time, but it could deteriorate classification performance. Third, the difficulty in multi-class prediction problems is in data imbalance problem that can occur when the number of instances in one class greatly outnumbers the number of instances in the other class. Such data sets often cause a default classifier to be built due to skewed boundary and thus the reduction in the classification accuracy of such a classifier. SVM ensemble learning is one of machine learning methods to cope with the above drawbacks. Ensemble learning is a method for improving the performance of classification and prediction algorithms. AdaBoost is one of the widely used ensemble learning techniques. It constructs a composite classifier by sequentially training classifiers while increasing weight on the misclassified observations through iterations. The observations that are incorrectly predicted by previous classifiers are chosen more often than examples that are correctly predicted. Thus Boosting attempts to produce new classifiers that are better able to predict examples for which the current ensemble's performance is poor. In this way, it can reinforce the training of the misclassified observations of the minority class. This paper proposes a multiclass Geometric Mean-based Boosting (MGM-Boost) to resolve multiclass prediction problem. Since MGM-Boost introduces the notion of geometric mean into AdaBoost, it can perform learning process considering the geometric mean-based accuracy and errors of multiclass. This study applies MGM-Boost to the real-world bond rating case for Korean companies to examine the feasibility of MGM-Boost. 10-fold cross validations for threetimes with different random seeds are performed in order to ensure that the comparison among three different classifiers does not happen by chance. For each of 10-fold cross validation, the entire data set is first partitioned into tenequal-sized sets, and then each set is in turn used as the test set while the classifier trains on the other nine sets. That is, cross-validated folds have been tested independently of each algorithm. Through these steps, we have obtained the results for classifiers on each of the 30 experiments. In the comparison of arithmetic mean-based prediction accuracy between individual classifiers, MGM-Boost (52.95%) shows higher prediction accuracy than both AdaBoost (51.69%) and SVM (49.47%). MGM-Boost (28.12%) also shows the higher prediction accuracy than AdaBoost (24.65%) and SVM (15.42%)in terms of geometric mean-based prediction accuracy. T-test is used to examine whether the performance of each classifiers for 30 folds is significantly different. The results indicate that performance of MGM-Boost is significantly different from AdaBoost and SVM classifiers at 1% level. These results mean that MGM-Boost can provide robust and stable solutions to multi-classproblems such as bond rating.

Development of Conformal Radiotherapy with Respiratory Gate Device (호흡주기에 따른 방사선입체조형치료법의 개발)

  • Chu Sung Sil;Cho Kwang Hwan;Lee Chang Geol;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.41-52
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    • 2002
  • Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

The Influence Evaluation of $^{201}Tl$ Myocardial Perfusion SPECT Image According to the Elapsed Time Difference after the Whole Body Bone Scan (전신 뼈 스캔 후 경과 시간 차이에 따른 $^{201}Tl$ 심근관류 SPECT 영상의 영향 평가)

  • Kim, Dong-Seok;Yoo, Hee-Jae;Ryu, Jae-Kwang;Yoo, Jae-Sook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.67-72
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    • 2010
  • Purpose: In Asan Medical Center we perform myocardial perfusion SPECT to evaluate cardiac event risk level for non-cardiac surgery patients. In case of patients with cancer, we check tumor metastasis using whole body bone scan and whole body PET scan and then perform myocardial perfusion SPECT to reduce unnecessary exam. In case of short term in patients, we perform $^{201}Tl$ myocardial perfusion SPECT after whole body bone scan a minimum 16 hours in order to reduce hospitalization period but it is still the actual condition in which the evaluation about the affect of the crosstalk contamination due to the each other dissimilar isotope administration doesn't properly realize. So in our experiments, we try to evaluate crosstalk contamination influence on $^{201}Tl$ myocardial perfusion SPECT using anthropomorphic torso phantom and patient's data. Materials and Methods: From 2009 August to September, we analyzed 87 patients with $^{201}Tl$ myocardial perfusion SPECT. According to $^{201}Tl$ myocardial perfusion SPECT yesterday whole body bone scan possibility of carrying out, a patient was classified. The image data are obtained by using the dual energy window in $^{201}Tl$ myocardial perfusion SPECT. We analyzed $^{201}Tl$ and $^{99m}Tc$ counts ratio in each patients groups obtained image data. We utilized anthropomorphic torso phantom in our experiment and administrated $^{201}Tl$ 14.8 MBq (0.4 mCi) at myocardium and $^{99m}Tc$ 44.4 MBq (1.2 mCi) at extracardiac region. We obtained image by $^{201}Tl$ myocardial perfusion SPECT without gate method application and analyzed spatial resolution using Xeleris ver 2.0551. Results: In case of $^{201}Tl$ window and the counts rate comparison result yesterday whole body bone scan of being counted in $^{99m}Tc$ window, the difference in which a rate to 24 hours exponential-functionally notes in 1:0.114 with Ventri (GE Healthcare, Wisconsin, USA), 1:0.249 after the bone tracer injection in 12 hours in 1:0.411 with 1:0.79 with Infinia (GE healthcare, Wisconsin, USA) according to a reduction a time-out was shown (Ventri p=0.001, Infinia p=0.001). Moreover, the rate of the case in which it doesn't perform the whole body bone scan showed up as the average 1:$0.067{\pm}0.6$ of Ventri, and 1:$0.063{\pm}0.7$ of Infinia. According to the phantom after experiment spatial resolution measurement result, and an addition or no and time-out of $^{99m}Tc$ administrated, it doesn't note any change of FWHM (p=0.134). Conclusion: Through the experiments using anthropomorphic torso phantom and patients data, we found that $^{201}Tl$ myocardium perfusion SPECT image later carried out after the bone tracer injection with 16 hours this confirmed that it doesn't receive notable influence in spatial resolution by $^{99m}Tc$. But this investigation is only aimed to image quality, so it needs more investigation in patient's radiation dose and exam accuracy and precision. The exact guideline presentation about the exam interval should be made of the validation test which is exact and in which it is standardized about the affect of the crosstalk contamination according to the isotope use in which it is different later on.

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Surgery Alone and Surgery Plus Postoperative Radiation Therapy for Patients with pT3N0 Non-small Cell Lung Cancer Invading the Chest Wall (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 단독과 수술 후 방사선치료)

  • 박영제;임도훈;김관민;김진국;심영목;안용찬
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.845-855
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    • 2004
  • Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

Inflammatory Reponse of the Lung to Hypothermia and Fluid Therapy after Hemorrhagic Shock in Rats (흰쥐에서 출혈성 쇼크 후 회복 시 저체온법 및 수액 치료에 따른 폐장의 염증성 변화)

  • Jang, Won-Chae;Beom, Min-Sun;Jeong, In-Seok;Hong, Young-Ju;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.879-890
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    • 2006
  • Background: The dysfunction of multiple organs is found to be caused by reactive oxygen species as a major modulator of microvascular injury after hemorrhagic shock. Hemorrhagic shock, one of many causes inducing acute lung injury, is associated with increase in alveolocapillary permeability and characterized by edema, neutrophil infiltration, and hemorrhage in the interstitial and alveolar space. Aggressive and rapid fluid resuscitation potentially might increased the risk of pulmonary dysfunction by the interstitial edema. Therefore, in order to improve the pulmonary dysfunction induced by hemorrhagic shock, the present study was attempted to investigate how to reduce the inflammatory responses and edema in lung. Material and Method: Male Sprague-Dawley rats, weight 300 to 350 gm were anesthetized with ketamine(7 mg/kg) intramuscular Hemorrhagic Shock(HS) was induced by withdrawal of 3 mL/100 g over 10 min. through right jugular vein. Mean arterial pressure was then maintained at $35{\sim}40$ mmHg by further blood withdrawal. At 60 min. after HS, the shed blood and Ringer's solution or 5% albumin was infused to restore mean carotid arterial pressure over 80 mmHg. Rats were divided into three groups according to rectal temperature level($37^{\circ}C$[normothermia] vs $33^{\circ}C$[mild hypothermia]) and resuscitation fluid(lactate Ringer's solution vs 5% albumin solution). Group I consisted of rats with the normothermia and lactate Ringer's solution infusion. Group II consisted of rats with the systemic hypothermia and lactate Ringer's solution infusion. Group III consisted of rats with the systemic hypothermia and 5% albumin solution infusion. Hemodynamic parameters(heart rate, mean carotid arterial pressure), metabolism, and pulmonary tissue damage were observed for 4 hours. Result: In all experimental groups including 6 rats in group I, totally 26 rats were alive in 3rd stage. However, bleeding volume of group I in first stage was $3.2{\pm}0.5$ mL/100 g less than those of group II($3.9{\pm}0.8$ mL/100 g) and group III($4.1{\pm}0.7$ mL/100 g). Fluid volume infused in 2nd stage was $28.6{\pm}6.0$ mL(group I), $20.6{\pm}4.0$ mL(group II) and $14.7{\pm}2.7$ mL(group III), retrospectively in which there was statistically a significance between all groups(p<0.05). Plasma potassium level was markedly elevated in comparison with other groups(II and III), whereas glucose level was obviously reduced in 2nd stage of group I. Level of interleukine-8 in group I was obviously higher than that of group II or III(p<0.05). They were $1.834{\pm}437$ pg/mL(group I), $1,006{\pm}532$ pg/mL(group II), and $764{\pm}302$ pg/mL(group III), retrospectively. In histologic score, the score of group III($1.6{\pm}0.6$) was significantly lower than that of group I($2.8{\pm}1.2$)(p<0.05). Conclusion: In pressure-controlled hemorrhagic shock model, it is suggested that hypothermia might inhibit the direct damage of ischemic tissue through reduction of basic metabolic rate in shock state compared to normothermia. It seems that hypothermia should be benefit to recovery pulmonary function by reducing replaced fluid volume, inhibiting anti-inflammatory agent(IL-8) and leukocyte infiltration in state of ischemia-reperfusion injury. However, if is considered that other changes in pulmonary damage and inflammatory responses might induce by not only kinds of fluid solutions but also hypothermia, and that the detailed evaluation should be study.