• Journal of Chest Surgery
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• 제24권9호
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• pp.843-852
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• 1991

We prospectively studied postoperative cardiac arrhythmia after open heart surgery to analyze the types and incidence of cardiac arrhythmia and to predict preoperative risk factors. And also we evaluated the effectiveness of atrial and ventricular epicardial electrodes which were placed during operation Between March 1990 and August 1990, We had operated on in 211 patients and we studied 201 consecutive patients excluding 10 patients. The study group included 99 males and 102 female patients, ages 1 month to 75 years[Mean$\pm$SD=28.0$\pm$21.7 years]. Postoperatively, all patients were regularly seen by the cardiac surgeon and cardiologist, They had continuous electrocardiographic monitoring for the first 3 days, initially in the intensive care unit and were checked routine electrocardiography on the postoperative 7 days, The postoperative cardiac arrhythmia were analyzed and possible associations of this arrhythmia with various pre, intra, and postoperative factors were studied by univariate and multivariate discriminant analysis, The overall incidence of postoperative cardiac arrhythmia except relative sinus bradycardia was 36.8%;[74/201], The incidence of postoperative cardiac arrhythmia in acyanotic congenital heart disease: 19.4%, cyanotic congenital heart disease: 20.8%, cardiac arrhythmia surgery: 33.3%, acquired valvular heart disease: 60.9% and coronary artery occlusive disease: 38.9%. Both univariate and multivariate studies indicated the pre operative symptom duration[p = 0013], the duration of medication[p=0.003], presence of preoperative arrhythmia[p<0.001] and pre-operative left atrial dimension in echocardiography to be the factor promoting postoperative cardiac arrhythmia. Multivariate discriminant analysis showed that the presence of preoperative cardiac arrhythmia, bypass time and the duration of preoperative symptom duration conveyed considerable risk factor on post-operative arrhythmia. The atrial wire electrodes were used diagnostically in 36 and were used therapeutically in 89 among 201 patients. Atrial pacing were used to treat relative sinus bradycardia, accelerated junctional tachycardia or premature atrial or ventricular contractions in 51 patients. Atrioventricular sequential pacing were used in 16 patients and ventricular pacing were used in 20 patients. Hemodynamics were evaluated in 2 patients of relative sinus bradycardia before and after atrial pacing. The atrial pacing increased the amount of cardiac output to 15% more. Because of their great utility in the diagnosis and treatment of arrhythmias, we conclude that routine placement of atrial and ventricular electrodes at the time of operation is indicated regardless of the nature of the open-heart procedure.

• Tuberculosis and Respiratory Diseases
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• 제72권6호
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• pp.481-485
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• 2012

Background: Tracheostomy is a common procedure for patients requiring prolonged mechanical ventilation. However, the timing of tracheostomy is quite variable. This study was performed to find out the factors determining the timing of tracheostomy in medical intensive care unit (ICU). Methods: Patients who were underwent tracheostomy between January 2008 and December 2009 in the medical ICU of Seoul National University Hospital were included in this retrospective study. Results: Among the 59 patients, 36 (61.0%) were male. Median Acute Physiology And Chronic Health Evaluation (APACHE) II scores and Sequential Organ Failure Assessment scores on the admission day were 28 and 7, respectively. The decision of tracheostomy was made on 13 days, and tracheostomy was performed on 15 days after endotracheal intubation. Of the 59 patients, 21 patients received tracheostomy before 2 weeks (group I) and 38 were underwent after 2 weeks (group II). In univariate analysis, days until the decision to perform tracheostomy (8 vs. 14.5, p<0.001), days before tracheostomy (10 vs. 18, p<0.001), time delay for tracheostomy (2.1 vs. 3.0, p<0.001), cardiopulmonary resuscitation (19.0% vs. 2.6%, p=0.049), existence of neurologic problem (38.1% vs. 7.9%, p=0.042), APACHE II scores (24 vs. 30, p=0.002), and $PaO_2/FiO_2$ <300 mm Hg (61.9% vs. 91.1%, p=0.011) were different between the two groups. In multivariate analysis, APACHE II scores${\geq}20$ (odds ratio [OR], 12.44; 95% confidence interval [CI], 1.14~136.19; p=0.039) and time delay for tracheostomy (OR, 1.97; 95% CI, 1.11~3.55; p=0.020) were significantly associated with tracheostomy after 2 weeks. Conclusion: APACHE II scores${\geq}20$ and time delay for tracheostomy were associated with tracheostomy after 2 weeks.

• Biomolecules & Therapeutics
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• 제1권2호
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• pp.188-195
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• 1993

In order to understand the machanism of action and regulation of ${\beta}$-adrenergic receptor in terms of molecular level, the purification of receptor protein has a fundamental importance. Moreover, species differences among avian, amphibian and mammalian ${\beta}$-adrenergic receptors make it more important to purify mammalian ${\beta}$-adrenergic receptor. Because ${\beta}$-adrenergic receptor is an integral membrane protein, it must be solubilized from the membrane for the purification. The purpose of the present study was to solubilize and characterize the mammalian $\beta$-adrenergic receptor from guinea pig lung in quantities by more efficient and practical method eventually to purify receptor. Guinea pig lung membrane preparation was solubilized by sequential treatment of buffers containing low and high concentration of digitonin which are 0.2 and 1.2% respectively. About 50% of the total receptor pool was released by this double extraction procedure. The $\beta$-adrenoceptors in the digitonin extract were identified using the ${\beta}$-adrenergic antagonist, (-)-[$^3H$]-dihydroalprenolol ([$^3H$]DHA). The solubilized receptor retained all of the essential characteristics of membrane-bound receptor, namely saturability; stereoselectivity; high affinity to ${\beta}$-adrenergic drugs. For the measurement of soluble receptor activity, Sephadex G-50 chromatography method has been widely used. Inspite of its accuracy and wide acceptance, this technique employed troublesome column work which required long time to assay the activity of receptor. We employed another methods to measure receptor activity. When using 0.5% polyethylenimine pretreated GF/B glass fiber filter, filtration technique could be used to measure soluble receptor activity. This technique enabled us to reduce the total amount of time to assay by a factor of 4 as well as to detect soluble receptor. In the present study, we could establish more efficient and practical solubilization method of mammalian $\beta$-adrenergic receptor. The rapidity and high yield of this solubilization scheme, together with the favorable recovery of the receptor activity, are significant steps toward the ultimate purification of the mammalian $\beta$-adrenergic receptor. The result of this study together with more convenient purification method could provide large amount of purified receptor with ease for various research purposes.

• 한국토양비료학회지
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• 제24권3호
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• pp.183-191
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• 1991

본 연구는 아연광산(亞鉛鑛山) 주변의 논토양에 존재하는 Cd, Pb, Cu 및 Zn의 형태별 함량을 조사하여 중금속간의 분포(分布) 특성(特性)을 검토하였으며, 토양 화학적 성질이 이들의 형태별 함량 분포에 미치는 영향을 밝히기 위하여 수행되었다. 그 결과를 요약하면 다음과 같다. 1. 공시토양에 존재하는 Cd, Pb, Cu 및 Zn은 주로 해화물-잔류태(殘留態)로 존재하였으며, Cd와 Pb의 산화물(酸化物)-탄산염태(炭酸鹽態)와 Cu의 유기복합태(有機複合態)의 함량도 높은 편이었다. Pb와 Cu의 치환태는 소량 존재하였으며, 수용태는 Zn만 검출되었다. 2. 치환태의 분포비가 높은 토양일수록 산화물-탄산염태 및 황화물-잔류태의 분포비가 낮았다. 3. 토심이 깊어질수록 치환태 Cd 및 Zn의 분포비(分布比)는 낮아지고 항화물-잔류태의 분포비가 높아졌으며, Pb는 산화물-탄산염태의 분포비가 낮아지고 황화물-잔류태의 분포비가 높아졌다. 4. Cu는 유기물이 많은 토양일수록 Cu의 유기복합태 함량이 많았으며, Cd, Pb 및 Zn의 유기복합태는 유기물함량과 관계가 없었다. 치환태 Cd, Pb 및 Zn의 분포비는 pH가 높은 토양일수록 낮았으나, 이들의 산화물-탄산염태과 황화물-잔류태의 분포비의 합은 높았다. Pb의 산화물-탄산염태 및 황화물-잔류태의 분포비는 공시토양의 pH 전범위에서 Cd 및 Zn에 비하여 높았다.

• Clinical and Experimental Pediatrics
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• 제54권11호
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• pp.463-469
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• 2011

Purpose: To validate the Dinamap ProCare 200 blood pressure (BP) monitor against a mercury sphygmomanometer in children 7 to 18 years old in accordance with the 2010 International Protocol of European Society of Hypertension (ESH-IP2) and the British Hypertension Society (BHS) protocol. Methods: Forty-five children were recruited for the study. A validation procedure was performed following the protocol based on the ESH-IP2 and BHS protocols for children and adolescents. Each subject underwent 7 sequential BP measurements alternatively with a mercury sphygmomanometer and the test device by trained nurses. The results were analyzed according to the validation criteria of ESH-IP2. Results: The mean (${\pm}SD$) difference in the absolute BP values between test device and mercury sphygmomanometer readings was $1.85{\pm}1.65$ mmHg for systolic BP (SBP) and $4.41{\pm}3.53$ mmHg for diastolic BP (DBP). These results fulfilled the Association for the Advancement of Medical Instrumentation criterion of a mean${\pm}$SD below $5{\pm}8$ mmHg for both SBP and DBP. The percentages of test device-observer mercury sphygmomanometer BP differences within 5, 10, and 15 mmHg were 96%, 100%, and 100% for SBP, and 69%, 92%, and 100% for DBP, respectively, in the part 1 analysis; both SBP and DBP passed the part 1 criteria. In the part 2 analysis, SBP passed the criteria but DBP failed. Conclusion: Although the Dinamap ProCare 200 BP monitor failed an adapted ESH-IP2, SBP passed. When comparing BP readings measured by oscillometers and mercury sphygmomanometers, one has to consider the differences between them, particularly in DBP, because DBP can be underestimated.

• 대한환경공학회지
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• 제27권10호
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• pp.1072-1080
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• 2005

과거 납제련소 부지의 중금속으로 오염된 토양을 EDTA, citrate, HCl의 세가지 용매를 이용하여 토양세척법으로 처리한 경우 중금속의 추출특성에 대하여 중금속의 추출율과 화학적 결합형태별 변화를 중심으로 살펴보았다. EDTA를 이용한 토양세척실험에서 중금속의 추출은 Pb에 특히 효과적이었다. EDTA/HM의 물비가 증가할수록 Pb의 제거율도 증가하였고 EDTA/HM의 몰비 6.5에서 효율적인 제거가 가능하였다. Citrate를 이용한 토양세척실험에서 중금속의 추출은 다른 중금속들 보다 Zn의 추출에 효과적이었다. HCl은 모든 중금속에 대하여 전반적으로 높은 추출율을 나타내었으며 0.3N 농도에서 가장 효율적인 추출이 가능하였다. EDTA로 토양세척법 처리 전후 중금속의 결합형태별 변화는 교환성과 탄산염 형태와 같이 결합력이 약한 형태로 존재하는 중금속이 대부분 추출되었다. Citrate와 HCl 처리 후 중금속의 결합형태별 변화는 네가지 중금속 모두 유사한 경향을 보였으며 Pb은 처리 전보다 처리 후에 교환가능성 형태가 증가하는 현상이 관찰되었다. Citrate 처리시 중금속 추출효율은 비결정성 형태의 함량과 거의 일치하는 결과를 나타내었다. EDTA와 HCl을 이용한 경우는 중금속 추출효율과 중금속의 결합형태의 비교결과 Zn을 제외한 나머지 중금속의 경우 비잔류성 형태의 대부분을 제거할 수 있었다. 처리 후 토양의 TCLP 결과는 EDTA로 처리한 경우에 Pb의 USEPA 기준인 5 mg/L를 만족시켰다.

• 대한환경공학회지
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• 제22권7호
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• pp.1357-1364
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• 2000

본 연구는 소각 비산재의 물리 화학적 특성이 중금속의 용출 거동에 미치는 영향을 알아보고자 수행되었다. 영향인자로는 비산재의 pH, CEC, 입자크기, 연속추출방법에 의해 분류된 중금속의 존재형태 중에서 exchangeable fraction을 고려하였다. KSLT법에 의한 중금속의 용출율은 pH에 크게 의존적이고 원소에 따라 차이를 보였다. 카드뮴과 구리의 용출율은 pH가 증가함에 따라 감소한 반면, 납과 아연은 중성 또는 강알칼리성 조건에서 증가하는 것으로 나타났는데, 중금속의 용출 거동이 용해도에 의해 제한됨을 나타내 준다. CEC가 중금속의 용출율에 미치는 영향은 pH와 비슷한 것으로 나타났다. 비산재의 입자크기 중에서 $D_{10}$은 KSLT법에 의한 중금속의 용출량과 음의 상관성을 나타내었다. Exchangeable fraction의 경우는 비산재의 CEC 값이 40 meq/100g 미만인 시료는 선형관계에 있지만, 그 외의 CEC 값에서는 비선형관계를 보여주었다.

• 대한방사선기술학회지:방사선기술과학
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• 제32권1호
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• pp.61-67
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• 2009

연구목적 : poly-L-guluronic alginate(PGA) 겔이 혈관색전술에 적용가능한지 시뮬레이션을 통해 확인하고, PGA 겔이 혈관 내에서도 유용한지 혈관조영술을 통해 알아보고자 하였다. 연구방법 : 겔을 형성하는 PGA는 다시마에서 추출하여 생물학적 적합성 시험을 거쳤고, 단백질 불순물을 완전히 정제한 후 실험에 이용하였다. 유리 동맥류 모형을 이용하여 PGA가 겔을 형성하여 색전을 일으키는지 확인하였고, 가토의 신장 혈관에서도 PGA가 색전을 일으키는지 혈관조영술을 통해 확인하였다. 결 과 : 유리 동맥류 모형에서 PGA는 자동 주입기를 이용하여 카테타를 통해 주입한 후 염화칼슘($CaCl_2$)을 주입하니 유리 동맥류 모형 내에서 겔을 형성하며 색전을 일으켰다. 가토 실험에서는 우신 동맥과 대동맥을 결찰한 후 혈관조영술을 통해 좌신의 혈류를 확인하였다. 좌신동맥으로 PGA와 염화칼슘($CaCl_2$)을 동일한 카테터를 통해 순서대로 주입한 후 우신동맥과 대동맥의 결찰을 제거하였다. 혈관조영술을 다시 실시하여 좌신동맥의 혈류를 확인하니 좌신동맥이 보이지 않았다. 이는 좌신 혈관 내에세 PGA가 겔을 형성하여 혈류를 완전히 차단하였기 때문이었다. 결 론 : PGA는 혈관 내에서 혈관을 완전히 차단하고 색전을 일으킴을 확인하였다. 그러므로 PGA는 혈관 색전물질로 유용할 것이고, 혈관색전술과 조영술 적용에 상당히 효과적일 것이다.

• Journal of Chest Surgery
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• 제33권1호
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• pp.38-44
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• 2000

Background: We analyzed the result of the "Off-Pump" Coronary Artery Bypass grafting (OPCAB) performed to minimize inflammatory responses to cardiopulmonary bypass and myocardial ischemia during the aortic cross-clamp period. Material and Method : The preoperative diagnosis operative procedure mortality complication and postoperative course of the 50 patients who underwent OPCAB between January 1998 and September 1998 were analyzed. There were 34 males and 16 females with mean age of 60$\pm$9 years. Preoperative clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and postinfarction angina in 3(6%) patients. Preoperative angiographic diagnoses were three-vessel disease in 25(50%) two-vessel disease in 5(10%) one-vessel disease in 7(14%) and left main disease in 13(26%) patients. There were elective operation in 37 cases and urgent operation in 13 cases. Result: The mean number of grafts was 3.2$\pm$1.2 per patient. Grafts used were unilateral internal thoracic artery in 43 greater saphenous vein in 37 radial artery in 7 bilateral internal thoracic arteries in 4 and right gastroepiploic artery in 2 cases Forty sequential anastomoses were performed in 18 cases. Vessels accessed were left anterior descending artery in 48 diagonal branch in 41 obtuse marginal branch in 30 right coronary artery in 24 posterior descending artery in 9 ramus intermedius in 5 and posterolateral branch in 5 anastomoses. Predischarge coronary angiography performed in 44 patients demonstrated the patency rate of 89.5%(128/143) Operative mortality was 2%(1/150) Postoperative complications were arrhythmia in 5 graft occlusion that needed reoperation in 4. perioperative myocardial infarction in 2 femoral artery thromboembolism developed after the application of IABP in 1 postoperative transient delirium in 1 peripheral compression neuropathy in 1 case. Sixteen patients(32%) were extubated at the operating room and the other patients were extubated at the mean 13$\pm$20 hours after the operation. Mean duration of stay in intensive care unit was 49$\pm$46 hours. Thirteen patients(26%) required blood transfusions perioperatively and the amount of perioperative blood transfusion was mean 0.70$\pm$1.36 pack/patient. Conclusion: OPCAB is suggested to be the ideal technique with less postoperative complication less hospitalization time and less cost.less cost.

• 한국콘텐츠학회논문지
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• 제11권8호
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• pp.475-487
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• 2011

본 논문에서는 고차원펄스의 스펙트럼을 유도하는 체계적인 방법을 제시하고, 이를 학습내용으로 하는 효율적인 이러닝 시스템을 설계한다. 고차원펄스의 스펙트럼은 연속미분법이나 콘볼루션법 등 기존의 방법에 의하여 유도될 수 있으나, 그 차수가 증가함에 따라 현저하게 높아지는 복잡도 때문에 사용할 수 없다. 우리는 고차원펄스의 차수에 따라 순환적으로 적용되는 알고리듬을 제시하고, 이를 찾아보기표에 의하여 함수적으로 차수에 연관된 스펙트럼의 식을 유도한다. 또한, 이를 이용하여 고차원펄스의 스펙트럼을 분석하는 과정을 학습하는 이러닝 콘텐츠를 설계한다. 여기에는 기존의 순차적 재생을 기본으로 하여 이른바 개념단위 오브젝트별 분기방식을 적용하는 콘텐츠 처리방식이 사용된다. 모델링, 임펄스응답과 전달함수, 파라미터, 찾아보기표 등 전체를 네 개의 개념단위로 분할한 콘텐츠페이지를 설계하고, 이들로부터 하향식으로 분화된 개념단위들을 모듈과 서브모듈로 설정한다. 이들은 개념단위 오브젝트별 분기방식에 의하여 학습자에게 다양한 학습순서와 반복학습 등을 제공하여 상호작용을 증대하고, 저작된 이러닝 콘텐츠에 의한 학습효과를 현저히 향상시킨다. 또한, 콘텐츠 자체의 효율성 측면에서도 현저한 향상을 이룬다.