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Hematologic Changes and Factors Related to Postoperative Hemorrhage Following Cardiopulmonary Bypass (체외순환에 따른 혈액학적 변화와 술후 출혈에 관계하는 인자에 관한 연구)

  • 김하늘루;황윤호;최석철;최국렬;김승우;조광현
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.952-963
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    • 1998
  • Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

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Biological Control of the Mushroom Fly, Lycoriella mali, Using Bacillus thuringiensis subsp. israelensis (Bacillus thuringiensis subsp. israelensis를 이용한 느타리 재배에서 버섯파리의 생물학적 방제)

  • Moon, Byung-Ju;Lee, Su-Hee;Lim, Eun-Kyung;Kim, Tae-Sung;Kim, Hyun-Ju;Song, Ju-Hee;Kim, Ik-Soo
    • The Korean Journal of Mycology
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    • v.30 no.1
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    • pp.50-55
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    • 2002
  • Biological control against mushroom fly, Lycoriella mali, was performed by using Bacillus thuringiensis subsp. israelensis Bti-D and Bti-U, isolated from dead mushroom fly in oyster mushroom houses. Control values of the bacterial strains Bti-D and Bti-U against L. mali in bottle culture of oyster mushroom were 74.4% and 64.2%, respectively, and the value in small tray culture were 75.8% and 56.8%, respectively. In the experiment to develop the mass, cheap media for Bti-D and Bti-U isolates, the Biji broth (bean curd residue, called Biji in Korean language) was selected as a culture medium for an inexpensive and mass cultivation by the measurement of optical density of the two bacteria grown in the different media tested. Insecticidal effect of the formulation contained different ingredients that were prepared by using the Bti-D strain cultured in the Biji broth was tested in tray and bottle culture of oyster mushroom. The WCS formulation that contained corn starch as bio-gel (86.4%) was more effective to control the mushroom fly than living cells (69.1%) in bottle culture of oyster mushroom. Moreover, insecticidal effect of the WCS formulation was improved when water of pH 8 was used for dilution of the formulation. Effect of the WCS formulation using water of pH 8 and chemicals, Zuron (dimillin) W.P. on the control of mushroom fly and the productivity of oyster mushroom was investigated in tray culture of oyster mushroom. The Zuron W.P. was more effective to control the mushroom fly than the WCS formulation. However, compared with no treatment, the productivity of the mushroom treated with the WCS formulation was improved than that of the mushroom with Zuron W.P.

Consideration About the Bacterial Endotoxin Test Showing False Positive Test Result When Performing LAL Test (LAL Test에서 위양성을 나타내는 원인들에 대한 고찰)

  • Hwang, Ki-Young;Cho, Yong-Hyun;Lee, Yong-Suk;Kim, Hyung-Woo;Lee, Hong-Jae;Kim, Hyun-Ju
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.156-158
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    • 2009
  • Purpose: Since radiopharmaceuticals are intended for human administration, it is imperative that we should undergo quality control very strictly. Now almost all the PET laboratories have adopted Bacterial Endotoxin Test as the stand quality control method to monitor whether pyrogen is free or not in the product vial containing crude solution. The aim of this study is to find out the reason why false positive result is observed when using commercially available test vial. Materials and Methods: For this experiment, we used commercially available single test kit (Associates of Cape Code. Inc. USA) and we made pH samples by mixing each buffer whose pH ranges are 1.0 to 12.0. Otherwise we made Ethanol samples diluted with distilled water. After making test samples, it added 0.2 mL to the test vial. Assay mixture in the test vial was incubated in a water bath (Chang Shin Co. KOR) for 60 min at $35{\pm}2^{\circ}C$. Results: After incubation period ($60{\pm}1^{\circ}C$), we inverted the test vial about $180^{\circ}$ To know what pH and how many percentage of Ethanol (Fisher Scientific Korea. Ltd) will affect the reaction. With pH buffer, false positive result was observed at pH 1.0 to 5.0 and 7.7 to 12.6 but at pH 5.2 to.7.5, the test results show negative. It's very strange that we couldn't observe negative test result with Tris buffer at pH 8.4, 8.6, 8.8, 9.0. in other case Ethanol, the test result was seen with 5 to 10% Ethanol. But to my surprise we could see very thick gel formation with 100% Ethanol. Conclusions: In this study, we could notice that pH which is too much acidic or alkalic or high concentrated Ethanol would affect Bacterial Endotoxin Test result. As you know, LAL test is sensitive and very reliable method. Therefore, we are needed to elicit the accurate test result as possible as we can.

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Effects of Health Education with Printed Media for Smoking Cessation, Pap Smear and Breast Self-examination (금연, 자궁암 검진 및 유방암 자가검진에 대한 인쇄매체를 이용한 보건교육의 효과)

  • 김인숙;김석범;강복수
    • Korean Journal of Health Education and Promotion
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    • v.15 no.2
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    • pp.163-183
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    • 1998
  • To evaluate the impacts of the health education programs including smoking cessation, pap smear and breast self-examination(BSE), a community trial was conducted during one year from December 1996 to December 1997 in Kyongju City. Before health education, a base-line survey was implemented and the target population was allocated randomly to case and control groups. The case and control groups were divided into three categories which were smoking cessation, pap smear and BSE. The series of health education leaflets about anti-smoking, pap smear and BSE were mailed to case group and the evaluation survey was conducted at the end of this trial to compare the change of health related behaviours of case and control groups. Smoking prevalence of case group did not decline significantly after anti-smoking education but the cessation rates of the elderly and low educated were higher than others. The knowledge level of case group on the health risk associated with smoking was higher than that of control group and the willingness of case group to quit smoking was higher than the control group. The case group's compliance with pap smear for cervical cancer was more increased compared to control group after health education. Of the case group, the younger and lower educated women were screened at a higher rate than others. The knowledge level of case group on the risk factors of cervical cancer and how to prevent it was higher than that of control group. Nearly 60 percent of case group reported that the health education leaflet influenced them to have the pap smear. The unscreened cases were highly motivated to get the pap smear test in the future.

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Identification of Differentially Expressed Genes Between Somatic Cell Nuclear Transfer and Normal Placenta in Cattle (소의 체세포핵이식태반과 정상태반간의 차등 발현 유전자 분석)

  • Yu, Seong-Lan;Jeong, Hang-Jin;Sang, Byung-Chan;Ryoo, Seung-Heui;Jung, Kie-Chul;Yoon, Jong-Taek;Seong, Hwan-Hoo;Jin, Dong-Il;Lee, Jun-Heon
    • Journal of Animal Science and Technology
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    • v.50 no.5
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    • pp.641-648
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    • 2008
  • There has been great success for making transgenic animals using somatic cell nuclear transfer(SCNT) up to this time. However, the success rates of the production of live transgenic animals are still very low. The current research has been carried out for delineation of differentially expressed genes between SCNT and normal placenta in cattle. In the present observations, high expression has been observed for CTSZ, LOC509426 and ELF1 genes in normal placenta. On the other hand, TIMP2, PAG1B, PAG-21, LOC782894, SERPINB6 and mKIAA2025 protein were highly expressed in SCNT placenta. Five genes, which were highly expressed in SCNT placenta, have been further investigated using semi-quantitative real-time PCR. The results were similar to that we observed using ACP. In the future, all genes affecting the SCNT and normal placenta have to be discovered and their networks will be fully investigated. The genes were identified in this study would be great help for identifying differential gene expressions in SCNT placenta.

Relationships Among Cow Daily Milk Yield, Calf Body Weight at Birth and 3 Month of Age and Preweaning Daily Gain in Hanwoo (한우 어미 소의 일일 산유량과 송아지의 생시체중, 3개월령 체중 및 포유기 일당증체량에 관한 상관 분석)

  • Hwang, Jeong-Mi;Kim, Si-Dong;Choi, Jae-Gwan;Lee, Chae-Young;Kim, Byung-Wan;Kim, Jong-Bok
    • Journal of Animal Science and Technology
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    • v.50 no.5
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    • pp.591-600
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    • 2008
  • This study was conducted to investigate relationships among cow daily milk yield, calf body weight at birth and 3 month of age and calf preweaning daily gain. Cow daily milk yield(DMILK) of 90 days after postpartum measured by weigh-suckle-weight method, calf birth weight(BW), calf body weight at 3 month of age(WT3), and calf preweaning daily gain from birth to 3 month of age(PDG) were collected from June to November on 2002 and April to November on 2003. All traits studied were considered as cow traits and analysed by WOMBAT packages to obtain A-I REML(average information restricted maximum likelihood) estimates. Heritability estimate of daily milk yield uncorrected for cow-calf separation time(DMILK) was 0.39, which was not differ from 0.36 of heritability estimate corrected on the basis of 24 hour cow-calf separation time(CMILK). Heritability estimates for maternal genetic effects of BW, WT3 and PDG were respectively 0.28, 0.17 and 0.18. Genetic correlations between DMILK and maternal effect of BW, WT3 and PDG were respectively 0.59, 0.79 and 0.68. High genetic correlation coefficients of DMILK with WT3 and PDG indicate that selections for maternal breeding value for WT3 or PDG may be effective to enhance the cow’s milk production ability in Hanwoo.

Determination of shear wave velocity profiles in soil deposit from seismic piezo-cone penetration test (탄성파 피에조콘 관입 시험을 통한 국내 퇴적 지반의 전단파 속도 결정)

  • Sun Chung Guk;Jung Gyungja;Jung Jong Hong;Kim Hong-Jong;Cho Sung-Min
    • 한국지구물리탐사학회:학술대회논문집
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    • 2005.09a
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    • pp.125-153
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    • 2005
  • It has been widely known that the seismic piezo-cone penetration test (SCPTU) is one of the most useful techniques for investigating the geotechnical characteristics including dynamic soil properties. As the practical applications in Korea, SCPTU was carried out at two sites in Busan and four sites in Incheon, which are mainly composed of alluvial or marine soil deposits. From the SCPTU waveform data obtained from the testing sites, the first arrival times of shear waves were and the corresponding time differences with depth were determined using the cross-over method, and the shear wave velocity profiles (VS) were derived based on the refracted ray path method based on Snell's law and similar to the trend of cone tip resistance (qt) profiles. In Incheon area, the testing depths of SCPTU were deeper than those of conventional down-hole seismic tests. Moreover, for the application of the conventional CPTU to earthquake engineering practices, the correlations between VS and CPTU data were deduced based on the SCPTU results. For the empirical evaluation of VS for all soils together with clays and sands which are classified unambiguously in this study by the soil behavior type classification Index (IC), the authors suggested the VS-CPTU data correlations expressed as a function of four parameters, qt, fs, $\sigma$, v0 and Bq, determined by multiple statistical regression modeling. Despite the incompatible strain levels of the down-hole seismic test during SCPTU and the conventional CPTU, it is shown that the VS-CPTU data correlations for all soils clays and sands suggested in this study is applicable to the preliminary estimation of VS for the Korean deposits and is more reliable than the previous correlations proposed by other researchers.

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A Study on Relationships Between Environment, Organizational Structure, and Organizational Effectiveness of Public Health Centers in Korea (보건소의 환경, 조직구조와 조직유효성과의 관계)

  • Yun, Soon-Nyoung
    • Research in Community and Public Health Nursing
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    • v.6 no.1
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    • pp.5-33
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    • 1995
  • The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069), 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

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A Study of School Nursing Activity Performed by School Nurses and Teachers Holding Additional School Health (부산지역 중등학교 양호교사 및 양호겸직교사의 학교보건업무 활동 양상)

  • Park Jung Za;Jung Moon Sook
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.17-32
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    • 1995
  • The purpose of this study was to improve upon school health by understanding the present status of school health and escpecially to investigate the performance rate of regular health instruction. 261 schools, including middle and high schools enrolled in the Busan Educational Association, were sent Questionnaires. Data was collected from the 25th of January to the 10th of April, 1994. 229 subjects who responded to the Questionnaires were finally analyzed as samples. Among them, 127 were school nurses and 102 were teachers acting in a school health capacity. The results of this study are summerized as follows: Of the teachers holding additional school health responsibilities, $85.6\%$ worked in private schools. Many of them $(74.5\%)$ were formally dissatisfied with their ability to provide care because $85.3\%$ of them had never studied any school health. Some of them$(30.4\%)$ didn't know about the annual school nursing budget and $23.5\%$ of them hadn't taught any health education to students. In spite of this fact, they were placed in charge of a school health activity against their own will. There were statistically significant differences in the performance of school health affairs between nurses and teachers holding additional school health (p<0.001) as follows: annual school nursing budget, Health Program Planning and Evaluation, annual purchase price for medicines, average students cared for per day, average students who held at least one consultation per month and extra. Surely, the self-confidence of school nurses was higher than that of teachers with school health as an assigned responsibility. This was demonstrated by a significant statistical difference (p<0.01) in the responses by the two groups. $88.2\%$ of the school nurses and $73.5\%$ of teachers for school health thought that regular health instruction was necessary. But regular health education had been performed only by $32.8\%$ of respondents. Among them, 84% were school nurses and $16\%$ were teachers holding additional school health. Of the persons who performed regular health education, $69.3\%$ used less than $60\%$ of the health content of the athletic textbook. And $64\%$ of them said teaching materials were insufficient. Most of them $(69.4\%)$used home made lesson plans. which they compiled from various sources. There was a significant difference in the formality of the health lesson according to the concern of the school principal (p<0.01) and there was a significant difference in performing health education between school nurses and teachers holding additional school health (p<0.001) It appears that there are a lot of problems with providing school health care using people who are untrained. In a word, school health nurses with professional training are needed in order to perform the qualitative management for the health of the students. These days, regular health education is an indispensable part in making students improve their self-care abilities. Therefore a more effective and better defined program should be prepared for regular systematic health education. To resolve these problems, present laws and regulations related to school health should be revised considering the specialist's request for the improvement of school health. In addition, the concern and financial support of the government are essential.

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Verification and Estimation of the Contributed Concentration of CH4 Emissions Using the WRF-CMAQ Model in Korea (WRF-CMAQ 모델을 이용한 한반도 CH4 배출의 기여농도 추정 및 검증)

  • Moon, Yun-Seob;Lim, Yun-Kyu;Hong, Sungwook;Chang, Eunmi
    • Journal of the Korean earth science society
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    • v.34 no.3
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    • pp.209-223
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    • 2013
  • The purpose of this study was to estimate the contributed concentration of each emission source to $CH_4$ by verifying the simulated concentration of $CH_4$ in the Korean peninsula, and then to compare the $CH_4$ emission used to the $CH_4$ simulation with that of a box model. We simulated the Weather Research Forecasting-Community Multiscale Air Quality (WRF-CMAQ) model to estimate the mean concentration of $CH_4$ during the period of April 1 to 22 August 2010 in the Korean peninsula. The $CH_4$ emissions within the model were adopted by the anthropogenic emission inventory of both the EDGAR of the global emissions and the GHG-CAPSS of the green house gases in Korea, and by the global biogenic emission inventory of the MEGAN. These $CH_4$ emission data were validated by comparing the $CH_4$ modeling data with the concentration data measured at two different location, Ulnungdo and Anmyeondo in Korea. The contributed concentration of $CH_4$ estimated from the domestic emission sources in verification of the $CH_4$ modeling at Ulnungdo was represented in about 20%, which originated from $CH_4$ sources such as stock farm products (8%), energy contribution and industrial processes (6%), wastes (5%), and biogenesis and landuse (1%) in the Korean peninsula. In addition, one that transported from China was about 9%, and the background concentration of $CH_4$ was shown in about 70%. Furthermore, the $CH_4$ emission estimated from a box model was similar to that of the WRF-CMAQ model.