Separating the patient from hypothermic cardiopulmonary bypass(CPB) before achieving adequate rewarming often results in afterdrop, which can predispose to electrolyte disturbances, arrhythmia, hemodynamic alterations, and shivering-induced increase of oxygen consumption. In an attempt to find an adequate end point temperature of rewarming after hypothermic CPB, 50 pediatric cardiac surgical patients were r ndomly assigned for end point temperature of rewarming of 35.5$^{\circ}C$ (Group 1) or 37t (Group 2), rectal temperature. Thereafter the rectal temperature was measured half, one, four, eight, and 16 hour after arrival to the intensive care unit(ICU), with heart rate and blood pressure. Additionally the rectal temperature was compared with esophageal temperature during CPB, and axillary temperature luring stay in the ICU. Nonpulsatile perfusion with a roller pump was used in all patients and a membrane or bubble oxygenator was used for oxygenation. Both groups were comparable with respect to age, sex, body surface area, total bypass time, and rewarming time. There was no afterdrop in both groups, and there were no statistical differences in the rectal temperatures between two groups. There were also no statistical dilyerences with respect to the heart rate and blood pressure between two groups. At the end of rewarming the esophageal temperature was higher than the rectal temperature. The axil ary temperature measured in ICU was always lower than the rectal temperature. No shivering was noted in all patients. In conclusion, with restoration of rectal temperature above 35.5$^{\circ}C$ at the end of CPB in pediatric patients, we did not observe an afterdrop.
Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.
Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.
The webtoon market has been consisently developing in the digital market. Under such circumstances, The Korea webtoon market is rapidly growing and leading of them. This is the time to prepare the base of a stable environment for the webtoon market which shows a swift rise. The Korean webtoon is surely aiming at the global market as well as the domestic one. As the Korean webtoon companies spread out to the world briskly, The leading publication cartoon market, Japan tries to break into the Korean digital market. The domestic market that has the good-quality cartoons through exportation and importation to make people of all ages enjoy them. and also the Korean webtoon is in the center of the global webtoon markert. The early model of Korean webtoon, line-webtoon is translated in English, Chinese, Thai language and Indonesian language to use on the mobile applications and web. Nevertheless, It is just the stating point. With Eradicating of the Achilles heel of the digital contents, illegal distribution and finding materials for cultural discount rate minimized cartoon, The Korean webtoon can become the highest in the global market and hold it. Moreover, not only webtoon but also published cartoons are existing together to have a long run. Beyond the existing cartoon books printed on paper, we should reach toward the digital books with portability and economic feasibility to make the contents stay out longer.
The Journal of Korean Association of Computer Education
/
v.5
no.4
/
pp.134-145
/
2002
The purpose of this study is to present the functional and technical solutions for text learning of web-based textbook in which each letter has its own focal point. The solutions help learners not to lose the main focus when eye moves to the next letter or line. The text screen of the electronic textbook automatically scrolls the text to up and down or left and right directions which are preassigned by learner. It doesn't need the operation of mouse or keyboard. And learner can change scroll speed and types anytime during scrolling. Automatic text scroll function is a solution for controlling data and screen to reflect the personal favor and ability. It contains the content structure of the text(characteristics, categorizations etc.), the appearance of the text(density, size, font etc.), scroll options(scroll, speed etc.), program control type(ram resident program etc.), and the application of the screen design principles(legibility etc.). To resolve these functional problems, technical 8 phases are provided, which are environment setting, scroll option setting, copy, data analysis, scroll coding, centered focus coding, left and right focus coding, implementation. The learner can focus on text without dispersion because the text focal points stay in the fixed area of screen. 1bey read the text following their preferences for fonts, sizes, line spacing and so on.
Ancient Greece was a patriarchal society that distinguished gender roles between men and women. Although their costumes were composed of simple rectangular fabric without any technical complications in itself, the Greeks did try to express gender differences in their clothing. The final look of the Greek costume was dependent on the way the cloth draped onto its wearer as well as the wearer's identity. Greeks costume could just be seen as a rectangular fabric when it was not draped on a person's body. The purpose of this study is to examine how the gender differences were expressed in the ancient Greek drapery costume, which was made by using a completely different technical process, compared with the modern tailored costume. There are four elements of the costume that give the costume its formative shape, which are the wearer's body, the rectangular fabric (material as the first formative costume), the way the fabric is draped, and the final appearance as the second formative costume (the relationship between the wearer's body and the costume) and this study analyzes these elements individually. It is intended to analyze the gender characteristics and how each element appears in a different way from the perspective of Structuralism, an analytical method that considers a phenomenon as a total sum of the elements. Literature research was conducted and representative sculpture, painting and pottery, were used between the Archaic Period (B.C. 800~500) and the Classical Period (B.C. 500~323). The results show that the gender differences appear in each formative element of costume: First, the body was distinguished by the ancient Greek custom. The man's nudity was accepted while the woman's body was concealed. Second, in regards to the first formative costume, which was the rectangular fabric, men's were made with thick high quality wool because their involvement in outdoor activities meant that they needed clothes to stay warm, while the women wore clothes made of thin wool or hemp cloth, because their most of their activities were at home. Third, the way to drape the fabric shows the gender differences by changing the length of the clothing and its design ; men's short khiton was practical for big movement and at the same time the clothing exposed the man's body. The woman's doric khiton diversified its decoration by the size of the apotigma and by using the belt. Finally the second formative costume reflected the Greeks' social distinction between a man's body and a woman's body. The man's costume naturally exposed the man's body. On the other hand, the woman's long costume has a variety of shapes on the ground, that concealed her lower body, while the ornamental function was more accentuated than the man's costume. The gender differences expressed in Greek costume fundamentally reflected the point of view of the male and female body and their social roles in society.
Dong, Wen;Liu, Xiguang;Zhu, Shunfang;Lu, Di;Cai, Kaican;Cai, Ruijun;Li, Qing;Zeng, Jingjing;Li, Mei
Nutrition Research and Practice
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v.14
no.1
/
pp.20-24
/
2020
BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.
Purpose: In this study, a comparison was done of the extent of health-related quality of life (HRQoL) for preterm and fullterm children during early childhood, and factors affecting HRQoL in the early childhood of premature children were analyzed. Methods: Eighty mothers of children born prematurely and 83 mothers of children born at fullterm listed on two Internet cafes were sampled for this study. The major instrument used for the study was the TNO-AZL Preschool Quality Of Life (TAPQOL) questionnaire. Results: Total score for HRQoL in the premature group was 80.5 (${\pm}9.9$) and for the full term group, 85.0 (${\pm}8.3$), on a 100-point scale. A comparison of the premature group and full term group showed that the domains which scored relatively lower with respect to HRQoL included the stomach, motor function, anxiety, liveliness and communication. Among the factors that have an impact on HRQoL were 'length of stay in neonatal intensive care unit (${\geq}7$ days)' and 'birth weight (<1,000 gm)'. The explanation power of the model was 17%, which was statistically significant. Conclusion: These findings indicate that a differentiated premature infant follow-up program for children who are hospitalized over 7 days in NICU or weighed under 1,000g at birth is urgently needed.
Journal of The Korean Society of Grassland and Forage Science
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v.4
no.2
/
pp.147-151
/
1983
In order to know the effect of planting date and cutting management on Jerusalem Artichoke (Helianthus truberosus L.) as a new forage or energy crop, JA tubes were planted from April 7 to June 27 with 20 day interval. Growth and yield could stay high as normal planting if tuber planting had been done until late May. The delayed planting after June caused deterioration of seed tuber, produced poor emergence and retarded growth. Previous harvested field did not need additional planting every spring because there were enough leftover tubers usually small size, less than 3gr., to provide a dense seedling establishment. This plot had too dense in population to adjust its spacing by thinning some of seedlings. One or two times cutting for forage or silage production reduced tuber yield very significantly. Therefore, it was not a good management to harvest for both forage and tuber production. Topping at 20cm from growing point in early July prevented from lodging and assured tuber yield.
This thesis examines the reality of Hwaseo's view of scholarship established through the various academic roots, and explains the writing techniques in his poetic world. The results are as follows; With the roots including the Five Books of Confucianism, Five Classics, the books of Zhuxi and Songjadaejeon, Hwaseo established his own scholarship based on the principle of 'keeping of piety and acting with prudence(持敬致愼)'. And he pursued a practical discipline in parallel with 'understanding the utmost principle and extension of knowledge(致知)' and 'diligent self-cultivation(力行)'. The characteristics of his poetic techniques are the use of quotation and interweaving narrative with discussion. He did not stay in just borrowing or variations on the quotation, but gave new meanings beyond the acceptation, and even reached the point of creating newly coined words. He made pithy narratives according to historical events and character's activities, put forward some discussions, and then expressed his emotion. In particular, there were the poems described by interweaving narrative with discussion based on Mencius's historical viewpoint of 'repetition of peaceful times and troublous times one by one(一治一亂)', which could be regarded as the most representative works of his literary value as well as the essence of his scholarship and ideas.
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