• The Korean Journal of Emergency Medical Services
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• v.26 no.2
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• pp.97-111
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• 2022

Purpose: Automated External Defibrillator (AED) usage in out-of-hospital cardiac arrests (OHCAs) improves the survival of patients. In Singapore, public AEDs are protected by locked boxes with a 'break glass' mechanism to deter theft. Community responders have sustained injuries while breaking glass to retrieve AEDs. This unprecedented study aimed to elucidate the factors influencing successful retrieval of an AED and to document the prevalence of injuries. Methods: A survey was created and distributed. Participants were required to have responded to an OHCA in the past 12 months. Comparison tests were performed with the Fischer-Freeman-Halton Exact test or Pearson chi square test at 5% significance levels, and with multiple logistic regression with a logit link function. Results: Eighty-eight participants were eligible. The success of retrieving an AED was found not to be impacted by occupation, age, gender or time. Participants who responded to an OHCA because of activation by the myResponder App were more likely to retrieve an AED successfully. (AOR 11.111, 95% CI: 2.141-58.824) Conclusion: Use of the myResponder mobile application is associated with the greater success of retrieving an AED. Successful retrieval of an AED is not impacted by time, gender, age, or the occupation of the responder. Community responders in Singapore remain motivated to respond to Cardiac Arrests despite risk of injury.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.332-339
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• 2023

Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.72-81
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• 2023

Objective : Ischemia and hemorrhage of pituitary adenomas (PA) caused important clinical syndrome. However, the differences on clinical characteristics and surgical outcomes between these two kinds apoplexy were less reported. Methods : A retrospective analysis was made of patients with pituitary apoplexy between January 2013 and June 2018. Baseline and clinical characteristics before surgery were reviewed. All patients underwent transsphenoidal surgery and were followed up at least 1 year. Results : Total 67 cases (5.8%) among 1147 pituitary tumor patients were enrolled, which consisted of 28 (~2.4%) ischemic PA and 39 (~3.4%) hemorrhagic PA. There were more male patients in the ischemic group compared with hemorrhagic group (78.6% vs 53.8%, p=0.043). However, the mean age, tumor size and functional tumor ratio were significant higher in the hemorrhagic group. Headache was more common in ischemic PA (82.1%) than that of hemorrhagic PA (51.3%, p=0.011). Magnetic resonance imaging findings found that mucosal thickening and enhancement of the sphenoid sinus was observed in 15 ischemic PA patients (n=27, 55.6%), but none in patients with hemorrhagic PA (n=38, p<0.0001). It was worth noting that the rate of pre-surgical hypopituitarism in ischemic PA patients were seemed higher than that in hemorrhagic PA patients, but not significant. The two groups got a total tumor resection rate at 94.1% and 92.9%, independently. No significant difference on the operative time, blood loss in operation and complications in perioperative period was observed in two groups. After operation, cranial nerve symptoms recovered to normal at 81.8% of ischemic PA patients and 82.6% of hemorrhagic PA patients. Importantly, the incidence of postoperative hypopituitarism partially decreased in both groups, among which the rate of hypothyroidism in ischemic PA patients significantly decreased from 46.4% to 18.5% (p=0.044). Conclusion : Patients with ischemic PA presented different clinical characteristics to the hemorrhagic ones. Transsphenoidal surgery should be considered for the patients with neuro-ophthalmic deficits and might benefit for pituitary function recovery of the apoplectic adenoma patients, especially pituitary thyroid axis in ischemic PA patients.

• Animal Bioscience
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• v.36 no.4
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• pp.555-569
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• 2023

Objective: The objective of this study was to investigate the effects of N⁶-Methyladenosine modification-circRNA-zinc finger protein 638 (m⁶A-circRNA-ZNF638) on the induced activation of secondary hair follicle (SHF) stem cells with its potential mechanisms in cashmere goats. Methods: The m⁶A modification of ZNF638 was analyzed using methylation immunoprecipitation with real-time quantitative polymerase chain reaction technique in SHF stem cells. The effects of circRNA-ZNF638 on the induced activation of SHF stem cells in m⁶A dependence were evaluated through the overexpression of circRNA-ZNF638/its m⁶A-deficient mutants in circRNA-ZNF638 knockdown SHF stem cells. The competitive binding of miR-361-5p to circRNA-ZNF638/Wnt5a 3'- untranslated region was analyzed through Dual-luciferase reporter assay. Results: The m⁶A-circRNA-ZNF638 had significantly higher transcription at anagen SHF bulge of cashmere goats compared with that at telogen, as well as it positively regulated the induced activation of SHF-stem cells in cashmere goats. Mechanismly, m⁶A-circRNA-ZNF638 sponged miR-361-5p to heighten the transcriptional expression of Wnt5a gene in SHF-stem cells. We further demonstrated that the internal m⁶A modification within circRNA-ZNF638 is required for mediating the miR-361-5p/Wnt5a pathway to regulate the induced activation of SHF stem cells through an introducing of m⁶A-deficient mutant of circRNA-ZNF638. Conclusion: The circRNA-ZNF638 contributes the proper induced activation of SHF-stem cells in cashmere goats in m⁶A-dependent manner through miR-361-5p/Wnt5a axis.

• Industry Promotion Research
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• v.8 no.3
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• pp.153-162
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• 2023

Shen-Xiao-Zhan's 『Zi-Ping-Zhen-Quan』, which is called a commentary on Chart-Structure in MyungLiollgy, After selecting the Chart-Structure and classifying the good luck and bad luck of the case, the Phase-usage is set up according to the principle of Shun reverse. At this time, if two or more the sky symbol hidden in the ground of Monthly intertwine to form several Structure and become Adjunct-Structure, the subject of Structure must be finally known to set up Phase-usage and succeed Structure and failure can be judged. However, in 『Zi-Ping-Zhen-Quan』, only the structure and meaning of Adjunct-Structure were explained, and the method of determining the final subject of Adjunct-Structure was not described. This researcher reviewed various literatures for a study on selecting the subject of Adjunct-Structure, and compared and analyzed various actual cases of Adjunct-Structure by dividing them into Monthly and Chart-Structure. Common results related to the type of sign of the land that met with Monthly, the energy force of the sky sign projected from the sky symbol hidden underground in Monthly and the strength and weakness of the body were drawn. and the law was organized subjectively. It is believed that the results of this study will serve as an opportunity to reduce the confusion of Adjunct-Structure.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.588-597
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• 2020

Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetization transfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction (UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). The obstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations, ¹⁸F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis was measured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at 1.2 ppm (MTR_asym(1.2ppm)) derived from CEST and maximum standard uptake value (SUV_max) and between magnetization transfer ratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of contralateral kidneys (p < 0.05). On day 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of sham-operated kidneys (p < 0.05). The MTR_asym(1.2ppm) of UUO renal medulla was fairly negatively correlated with SUV_max (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p < 0.001). Conclusion: CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosis in UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.

• Computers and Concrete
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• v.33 no.5
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• pp.605-619
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• 2024

The increase of reclaimed asphalt pavement (RAP) content in recycled asphalt concrete (RAC) is accompanied by the degradation of low-temperature cracking resistance, which has become an obstacle to the development of RAC. This paper aims to reveal the meso-scale mechanisms of the low-temperature fracture behavior of RAC and provide a theoretical basis for the economical recycling of RAP. For this purpose, micromechanical heterogeneous peridynamic model of RAC was established and validated by comparing three-point bending (TPB) test results against corresponding numerical simulation results of RAC with 50% RAP content. Furthermore, the models with different aggregate shapes (i.e., average aggregates circularity (${\bar{C_r}}=1.00$, 0.75, and 0.50) and RAP content (i.e., 0%, 15%, 30%, 50%, 75%, and 100%) were constructed to investigate the effect of aggregate shape and RAP content on the low-temperature cracking resistance. The results show that peridynamic models can accurately simulate the low-temperature fracture behavior of RAC, with only 2.9% and 13.9% differences from the TPB test in flexural strength and failure strain, respectively. On the meso-scale, the damage in the RAC is mainly controlled by horizontal tensile stress and the stress concentration appears in the interface transition zone (ITZ). Aggregate shape has a significant effect on the low-temperature fracture resistance, i.e., higher aggregate circularity leads to better low-temperature performance. The large number of microcracks generated during the damage evolution process for the peridynamic model with circular aggregates contributes to slowing down the fracture, whereas the severe stress concentration at the corners leads to the fracture of the aggregates with low circularity under lower stress levels. The effect of RAP content below 30% or above 50% is not significant, but a substantial reduction (16.9% in flexural strength and 16.4% in failure strain) is observed between the RAP content of 30% and 50%. This reduction is mainly attributed to the fact that the damage in the ITZ region transfers significantly to the aggregates, especially the RAP aggregates, when the RAP content ranges from 30% to 50%.

• Journal of Ginseng Research
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• v.48 no.1
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• pp.77-88
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• 2024

Background: Lung inflammation occurs in many lung diseases, but has limited effective therapeutics. Ginseng and its derivatives have anti-inflammatory effects, but their unstable physicochemical and metabolic properties hinder their application in the treatment. Panaxadiol (PD) is a stable saponin among ginsenosides. Inhalation administration may solve these issues, and the specific mechanism of action needs to be studied. Methods: A mouse model of lung inflammation induced by lipopolysaccharide (LPS), an in vitro macrophage inflammation model, and a coculture model of epithelial cells and macrophages were used to study the effects and mechanisms of inhalation delivery of PD. Pathology and molecular assessments were used to evaluate efficacy. Transcriptome sequencing was used to screen the mechanism and target. Finally, the efficacy and mechanism were verified in a human BALF cell model. Results: Inhaled PD reduced LPS-induced lung inflammation in mice in a dose-dependent manner, including inflammatory cell infiltration, lung tissue pathology, and inflammatory factor expression. Meanwhile, the dose of inhalation was much lower than that of intragastric administration under the same therapeutic effect, which may be related to its higher bioavailability and superior pharmacokinetic parameters. Using transcriptome analysis and verification by a coculture model of macrophage and epithelial cells, we found that PD may act by inhibiting TNFA/TNFAR and IL7/IL7R signaling to reduce macrophage inflammatory factor-induced epithelial apoptosis and promote proliferation. Conclusion: PD inhalation alleviates lung inflammation and pathology by inhibiting TNFA/TNFAR and IL7/IL7R signaling between macrophages and epithelial cells. PD may be a novel drug for the clinical treatment of lung inflammation.

• The Journal of the Acoustical Society of Korea
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• v.29 no.4
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• pp.278-285
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• 2010

The difference between training and test environments is one of the major performance degradation factors in noisy speech recognition and many silence feature normalization methods were proposed to solve this inconsistency. Conventional silence feature normalization method represents higher classification performance in higher SNR, but it has a problem of performance degradation in low SNR due to the low accuracy of speech/silence classification. On the other hand, cepstral distance represents well the characteristic distribution of speech/silence (or noise) in low SNR. In this paper, we propose a Cepstral distance and Log-energy based Silence Feature Normalization (CLSFN) method which uses both log-energy and cepstral euclidean distance to classify speech/silence for better performance. Because the proposed method reflects both the merit of log energy being less affected with noise in high SNR and the merit of cepstral distance having high discrimination accuracy for speech/silence classification in low SNR, the classification accuracy will be considered to be improved. The experimental results showed that our proposed CLSFN presented the improved recognition performances comparing with the conventional SFN-I/II and CSFN methods in all kinds of noisy environments.

• Korean Journal of Radiology
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• v.20 no.4
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• pp.621-630
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• 2019

Objective: To study the prevalence and clinical characteristics of decreased myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) in symptomatic patients without in-stent restenosis. Materials and Methods: Thirty-seven (mean age, 71.3 ± 10 years; age range, 48-88 years; 31 males, 6 females) consecutive symptomatic patients with patent coronary stents and without obstructive de novo lesions were prospectively enrolled to undergo dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used to image the complete left ventricle. A bolus of contrast media (50 mL; iopromide, 370 mg iodine/mL) was injected into the antecubital vein at a rate of 6 mL/s, followed by a 40-mL saline flush. The mean MBF value and other quantitative parameters were measured for each segment of both stented-vessel territories and reference territories. The MBF_ratio was defined as the ratio of the mean MBF value of the whole stent-vessel territory to that of the whole reference territory. An MBF_ratio of 0.85 was used as the cut-off value to distinguish hypoperfused from non-hypoperfused segments. Results: A total of 629 segments of 37 patients were ultimately included for analysis. The mean effective dose of dynamic CT-MPI was 3.1 ± 1.2 mSv (range, 1.7-6.3 mSv). The mean MBF of stent-vessel territories was decreased in 19 lesions and 81 segments. Compared to stent-vessel territories without hypoperfusion, the mean MBF and myocardial blood volume were markedly lower in hypoperfused stent-vessel territories (77.5 ± 16.6 mL/100 mL/min vs. 140.4 ± 24.1 mL/100 mL/min [p < 0.001] and 6.4 ± 3.7 mL/100 mL vs. 11.5 ± 4 mL/100 mL [p < 0.001, respectively]). Myocardial hypoperfusion in stentvessel territories was present in 48.6% (18/37) of patients. None of clinical parameters differed statistically significantly between hypoperfusion and non-hypoperfusion subgroups. Conclusion: Decreased MBF is commonly present in patients who are symptomatic after percutaneous coronary intervention, despite patent stents and can be detected by dynamic CT-MPI using a low radiation dose.