• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.30 no.2
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• pp.87-98
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• 2020

Objective: The purpose of this study was to propose a sequential procedure for the simultaneous analysis of soluble and insoluble metal compounds. Methods: Methods for sampling and analyzing metal compounds such as ISO standards, NIOSH methods, HSE methods, and OSHA methods were reviewed. Results: Some metals have different OELs depending on the solubility of the compound. Therefore, we should take into account these characteristics and perform an exposure assessment. Soluble metal compounds are first extracted from the filter, and then the filter is digested by acids to analyze residual insoluble components. The extraction of soluble compounds can be completed by agitation for about 60 minutes with a leach solution (water) in a water bath at 37℃. For the analysis of insoluble compounds, the sample filter and the filtration filter remaining after the extraction of the soluble compounds are analyzed. This allows simultaneous determination of soluble and insoluble metal compounds. For hexavalent chromium compounds, soluble hexavalent chromium can first be extracted from the filter by using sulfate buffer. The insoluble hexavalent chromium remaining in the filter can then be extracted using carbonate buffer. Conclusion: Workers are often exposed to many hazardous substances with different exposure limits at industrial sites. The OELs for compounds of the same metal can be set differently depending on solubility. This study can help evaluate a worker's exposure to metal compounds by suggesting methods for the simultaneous determination of soluble and insoluble metal compounds.

• Tuberculosis and Respiratory Diseases
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• v.73 no.2
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• pp.100-106
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• 2012

Background: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. Methods: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. Results: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). Conclusion: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.

• Food Science of Animal Resources
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• v.39 no.6
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• pp.966-979
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• 2019

Muscle-based by-products are often undervalued although commonly reported having a high amount of natural bioactive peptides. In this study, elastin was isolated from the protein of broiler hen skin while its hydrolysate was prepared using Elastase. Assessment of antioxidative properties of elastin-based hydrolysate (EBH) was based on three different assays; 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) radical, 2,2'-azinobis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical and metal chelating ability. The EBH was purified further using ultrafiltration, gel filtration and Reverse- Phase High-Performance Liquid Chromatography (RP-HPLC). The IC₅₀ of ABTS radical activities for EBH were decreased as EBH further purified using ultrafiltration (EBH III; 0.66 mg/mL)>gel filtration (EB-II; 0.42 mg/mL)>RP-HPLC (EB-II4; 0.12 mg/mL). The sequential identification of the peptide was done by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry (MALDI-TOF/ TOF-MS) of the potent fractions obtained from RP-HPLC (EB-II4). The presence of hydrophobic amino acids (Val and Pro) in the peptide sequences could potentially contribute to the high antioxidant activity of EBH. The sequences GAHTGPRKPFKPR, GMPGFDVR and ADASVLPK were identified as antioxidant peptides. In conclusion, the antioxidative potential from poultry skin specifically from elastin is evident and can be explored to be used in many applications such as health and pharmaceutical purposes.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.45-57
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• 2014

Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

• Ocean Systems Engineering
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• v.8 no.1
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• pp.41-55
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• 2018

Accidental oil and gas leak is a critical concern for the offshore industry because it can lead to severe consequences and as a result, it is imperative to evaluate the probabilities of occurrence of the consequences of the leakage in order to assess the risk. Event Tree Analysis (ETA) is a technique to identify the consequences that can result from the occurrence of a hazardous event. The probability of occurrence of the consequences is evaluated by the ETA, based on the failure probabilities of the sequential events. Conventional ETA deals with events with crisp failure probabilities. In offshore applications, it is often difficult to arrive at a single probability measure due to lack of data or imprecision in data. In such a scenario, fuzzy set theory can be applied to handle imprecision and data uncertainty. This paper presents fuzzy ETA (FETA) methodology to compute the probability of the outcomes initiated due to oil/gas leak in an actual offshore-onshore installation. Post FETA, sensitivity analysis by Fuzzy Weighted Index (FWI) method is performed to find the event that has the maximum contribution to the severe sequences. It is found that events of 'ignition', spreading of fire to 'equipment' and 'other areas' are the highest contributors to the severe consequences, followed by failure of 'leak detection' and 'fire detection' and 'fire water not being effective'. It is also found that the frequency of severe consequences that are catastrophic in nature obtained by ETA is one order less than that obtained by FETA, thereby implying that in ETA, the uncertainty does not propagate through the event tree. The ranking of severe sequences based on their probability, however, are identical in both ETA and FETA.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.402-408
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• 2009

Background: Pre-B-cell colony enhancing factor (PBEF) has been suggested as a novel biomarker in sepsis and acute lung injury. We measured the PBEF in bronchoalveolar lavage (BAL) fluid of acute critically ill patients with lung infiltrates in order to evaluate the clinical utility of measuring PBEF in BAL fluid. Methods: BAL fluid was collected by bronchoscope from 185 adult patients with lung infiltrates. An enzyme-linked immunosorbent assay was then performed on the collected fluids to measure the PBEF. Results: Mean patient age was 59.9 ${\pm}$14.5 years and 63.8% of patients were males. The mean concentration of PBEF in BAL fluid was 17.5 ${\pm}$88.3 ng/mL, and patients with more than 9 ng/mL of PBEF concentration (n=26, 14.1%) had higher Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores on the BAL exam day. However, there were no significant differences in clinical characteristics between survivors and non-survivors. In patients with leukocytosis (n=93) seen on the BAL exam day, the linear regression analysis revealed a significant, positive relationship between PBEF and APACHE II ($r^2$=0.06), SOFA score ($r^2$=0.08), Clinical Pulmonary Infection Score ($r^2$=0.05), and plateau pressure in patients on ventilators ($r^2$=0.07) (p<0.05, respectively). In addition, multivariate regression analysis with PBEF as a dependent variable showed that the plateau pressure ($r^2$=0.177, p<0.05) was correlated positively with PBEF. Conclusion: The PBEF level in the BAL fluid may be a useful, new biomarker for predicting the severity of illness and ventilator-induced lung injury in critically ill patients with lung infiltates and leukocytosis.

• Journal of Soil and Groundwater Environment
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• v.22 no.6
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• pp.1-11
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• 2017

This study was conducted to investigate the performance of four commercial chemical agents in stabilizing arsenic (As) in soil at the forest area near the former Janghang smelter site. After amending the stabilizing agents (A, B, C, and D) into As-contaminated soil samples, synthetic precipitation leaching procedure (SPLP) and solubility bioavailability research consortium (SBRC)-extractable As concentrations significantly decreased except for agent D, which is mainly composed of fly ash and calcium carbonate. Increase of SPLP and SBRC-extractable As concentrations in four soil samples (S1, S2, S3, and J2) was attributed to desorption of As adsorbed on iron oxides due to high pH generated by agent D. It is therefore necessary to consider application conditions according to soil characteristics such as pH and buffering capacity. Results of sequential extraction showed that readily extractable fractions of As in soil (i.e., sum of $SO_4-$ and $PO_4-extractable$ As in soil) were converted into non-readily extractable fractions by amending agents A, B, and C. Such changes in the As distribution in soil resulted in the decrease of SPLP and SBRC-extractable As concentration. A series of follow-up monitoring and management plan has been suggested to assess the longevity of the stabilization treatments in the site.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2917-2921
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• 2016

Background: To explore factors that influence quality of life (QOL) in patients receiving breast conserving therapy (BCT). Materials and Methods: In this sequential mixed methods study, 118 women from Songklanagarind Hospital were included. We used participants' characteristics, Body Image Scale (BIS), and Functional Assessment of Cancer Therapy with the Breast Cancer Subscale (FACT-B) for analysis. The BIS transformed into presence of body image disturbance (BID). Factors that influenced QOL were determined by stepwise multiple linear regression. Forty-one participants were selected for qualitative analysis. Our female researcher performed the semi-structured interviews with questions based on the symbolic interaction theory. Final codes were analysed using thematic analysis along with investigator triangulation methods. Results: Ninety percent had early stage breast cancer with post-completed BCT, for an average of 2.7 years. The median BIS score and FACT-B score were 2 (IQR=10) and 130 (IQR=39). In the regression analysis, an age of more than 50 years and BID were significant factors. As for the value of conserved breasts, two themes emerged: a conserved breast is an essential part of a participant's life and also the representation of her womanhood; the importance of a breast is related to age. Conclusions: Body image influenced QOL in post BCT participants. The conserved breasts also lead to positive and better impact on their body image as an essential part of their life.

• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.79-87
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• 2010

Purpose: The previous studies on $H_1$ antihistamine overdose have generally been limited to cases of acute doxylamine succinate (DS) poisoning, yet there have been some studies on diphenhydramine (DPH) overdosing. But many clinicians consider the two drugs to be very similar and to have similar ingredients. The purpose of this study was to clarify the toxicologic characteristics and clinical outcomes between DS and DPH poisoning/overdose. Methods: We reviewed the medical and intensive care records of the patients with acute DS or DPH poisoning and who admitted to our emergency department from January 2008 and April 2010. We collected patient information regarding the features of the poisoning and the clinical and demographic characteristics. The patients were assessed for the clinical outcomes, the GCS, the PSS (Poisoning Severity Score) and the SOFA (Sequential Organ Failure Assessment). Results: Fifty seven patients (45 cases of DS poisoning and 12 cases of DPH poisoning) were enrolled. Compared with the DS group, the DPH group had higher incidences of intubation, serious mental change, QTc prolongation and ECG conduction abnormality (p=0.041, <0.001, 0.014 and 0.044, respectively). The DPH group had a higher PSS and a longer ICU stay. The peak CPK time and the CPK normalization time were longer for the patients with rhabdomyolysis due to DS poisoning. Conclusion: Two common $H_1$ antihistamines, doxylamine and diphenhydramine, are in the same ethanolamine-structural class, but the toxico-clinical outcomes are different according to many aspects. Therefore, clinicians could take a careful approach for the differential diagnosis and management between DS and DPH poisoning.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.318-325
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• 2021

Background: The diagnosis and prediction of prognosis are important in patients with sepsis, and presepsin is helpful. In this study, we aimed to examine the usefulness of presepsin in predicting the prognosis of sepsis in Korea. Methods: Patients diagnosed with sepsis according to the sepsis-3 criteria were recruited into the study and classified into surviving and non-surviving groups based on in-hospital mortality. A total of 153 patients (32 and 121 patients with sepsis and septic shock, respectively) were included from July 2019 to August 2020. Results: Among the 153 patients with sepsis, 91 and 62 were in the survivor and non-survivor groups, respectively. Presepsin (p=0.004) and lactate (p=0.003) levels and the sequential organ failure assessment (SOFA) score (p<0.001) were higher in the non-survivor group. Receiver operating characteristic curve analysis revealed poor performances of presepsin and lactate in predicting the prognosis of sepsis (presepsin: area under the curve [AUC]=0.656, p=0.001; lactate: AUC=0.646, p=0.003). The SOFA score showed the best performance, with the highest AUC value (AUC=0.751, p<0.001). The prognostic cutoff point for presepsin was 1,176 pg/mL. Presepsin levels higher than 1,176 pg/mL (odds ratio [OR], 3.352; p<0.001), higher lactate levels (OR, 1.203; p=0.003), and higher SOFA score (OR, 1.249; p<0.001) were risk factors for in-hospital mortality. Conclusion: Presepsin levels were higher in non-survivors than in survivors. Thus, presepsin may be a valuable biomarker in predicting the prognosis of sepsis.