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Weaning Following a 30 Minutes Spontaneous Breathing Trial (30분 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Shin, Jin;Koh, Young-Min;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1326-1331
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    • 1997
  • Background : Weaning is the process of switching a patient from mechanical ventilator to spontaneous breathing. A number of different weaning techniques can be employed. At recent study, conventional spontaneous breathing trial was superior to other techniques, such as intermittent mandatory ventilation(IMV) or pressure support ventilation(PSV). But adequate observation time of the spontaneous breathing trial was not determined. We reported the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotrachial tube. In this study, we tried to shorten the spontaneous breathing time from 60 minutes to 30 minutes. If weaning success was predicted after 30 minutes spontaneous breathing, extubation was done without reconnection with ventilator. Methodes : Subjects consisted of 42 mechanically ventilated patients from August 1994 to July 1995. The weaning trial was done when the patients recovered sufficiently from respiratory failure that originally required ventilatory assistance, the patients became alert and showed stable vital sign, and arterial $O_2$ tension was adequated($PaO_2$ > 55 mmHg) with less than 40% of inspired oxygen fraction. We conducted a careful physical examination when the patients was breathing spontaneously through the endobronchial tube for 30 minutes. We terminated the trial if a patients was any of following signs of distress; cyanosis, diaphoresis, tachypnea(above 30 breaths per minute), and extreme tachycardia. Patients who had none of this features during spontaneous breathing for 30 minutes were extubated promptly. Result : 17 weaning trials of 15 patients were done in 42 mechanically ventilated patients. Successful weaning and extubation was possible in 14 trials of total 17 trials. In this 14 patients, 8 patients were extubated after 30 minutes spontaneous breathing, 3 patients were extubated after 60 minutes spontaneous breathing, and 3 patients needed over 3 hours for extubation from weaning. We found similar overall success rate compared with weaning following a 60 minutes spontaneous breathing trial. Conclusion : From the result of present study, we believe that weaning and extubation from mechanical ventilation following a 30 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method.

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On the Observation of Sandstorms and Associated Episodes of Airborne Dustfalls in the East Asian Region in 2005 (2005년 동아시아 지역에서 발생한 모래폭풍과 먼지침전(황사)의 관측)

  • Kim, Hak-Sung;Chung, Yong-Seung
    • Journal of the Korean earth science society
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    • v.30 no.2
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    • pp.196-209
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    • 2009
  • Occurrences of sandstorms in the deserts and loess of Mongolia and northern China and associated dustfall episodes in the Korean Peninsula were monitored during the period January through December, 2005. False colour images were made by directly receiving the NOAA Advanced Very High Resolution Radiometer (AVHRR) data, and the distribution and transport of sandstorms were analyzed. The ground concentrations for PM10, PM2.5 and visibility of the dustfall episodes (PM10 concentration over $190{\mu}g\;m^{-3}$) were analyzed at Cheongwon, located midway in South Korea, and in the leeward direction of the place of origin of the sandstorms. Variations in the concentrations of $O_3,\;NO_2$, CO and $SO_2$ were also compared with dust concentrations in the dustfall episodes. Fewer occurrences of strong sandstorms in the place of origin were observed in 2005, due largely to the accumulation of snow and mild fluctuations of high and low pressure systems in the place of origin, thereby accounting for a low frequency of dustfall episodes in Korea, compared with those during the period 1997-2005. A total of 7 dustfall episodes were monitored in Korea in 2005 that lasted 11 days. In summer, sandstorms occurred less frequently in the source region in 2005 due to high humidity and milder winds, thereby causing no dustfall episodes in Korea. In case the sandstorms occurring at the place of source head directly to Korea without passing through large cities and industrial areas of China, the PM2.5 concentrations were measured at 20% or lower than the PM10 concentrations. However, when the sandstorms headed to Korea via the industrial areas of eastern China, where they pick up anthropogenic air pollutants, the PM2.5 concentrations were at least 25% higher of the PM10 concentrations. On the other hand, over 5 cases were observed and analyzed in 2005 where the PM10 concentrations of sand dust originating from the deserts were measured at $190{\mu}g\;m^{-3}$ or lower, falling short of the level of a dustfall episode.

Application of Machine Learning Algorithm and Remote-sensed Data to Estimate Forest Gross Primary Production at Multi-sites Level (산림 총일차생산량 예측의 공간적 확장을 위한 인공위성 자료와 기계학습 알고리즘의 활용)

  • Lee, Bora;Kim, Eunsook;Lim, Jong-Hwan;Kang, Minseok;Kim, Joon
    • Korean Journal of Remote Sensing
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    • v.35 no.6_2
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    • pp.1117-1132
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    • 2019
  • Forest covers 30% of the Earth's land area and plays an important role in global carbon flux through its ability to store much greater amounts of carbon than other terrestrial ecosystems. The Gross Primary Production (GPP) represents the productivity of forest ecosystems according to climate change and its effect on the phenology, health, and carbon cycle. In this study, we estimated the daily GPP for a forest ecosystem using remote-sensed data from Moderate Resolution Imaging Spectroradiometer (MODIS) and machine learning algorithms Support Vector Machine (SVM). MODIS products were employed to train the SVM model from 75% to 80% data of the total study period and validated using eddy covariance measurement (EC) data at the six flux tower sites. We also compare the GPP derived from EC and MODIS (MYD17). The MODIS products made use of two data sets: one for Processed MODIS that included calculated by combined products (e.g., Vapor Pressure Deficit), another one for Unprocessed MODIS that used MODIS products without any combined calculation. Statistical analyses, including Pearson correlation coefficient (R), mean squared error (MSE), and root mean square error (RMSE) were used to evaluate the outcomes of the model. In general, the SVM model trained by the Unprocessed MODIS (R = 0.77 - 0.94, p < 0.001) derived from the multi-sites outperformed those trained at a single-site (R = 0.75 - 0.95, p < 0.001). These results show better performance trained by the data including various events and suggest the possibility of using remote-sensed data without complex processes to estimate GPP such as non-stationary ecological processes.

Echocardiographic Follow-up after Arterial Switch Operation for Transposition of the Great Arteries (동맥전환술을 시행한 대혈관전위 환자에서 심초음파를 이용한 술후 추적)

  • 한승세;정태은;이동협;오정훈;이정철
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.754-762
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    • 2001
  • Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

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Effect of Soil Amendment Application on Yields and Effective Components of Chrysanthemum boreale M. (산국의 수량과 유효성분에 대한 토양개량제의 효과)

  • Lee, Kyung-Dong;Lee, Yong-Bok;Yang, Min-Suk;Kim, Pil-Joo
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.1
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    • pp.27-37
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    • 2002
  • With increasing the concerns of health improving foods. the demands of C. boreale M., which is a perennial flower and has been historically used for a natural medicine, become higher, recently, However, wild C. boreale M. collected in a mountatinous area is limited and not enough to cover all demands. The cultivation system and fertilization strategy are required to produce much amount of C. boreale M. with a good quality. We investigated the effects of soil amendment application on plant growth and effective components of C. boreale M. to develop efficient cultivation system. C. boreale M. was cultivated in a pot scale, and lime, fly ash, poultry manure compost and swine manure compost as an amendment applied with rate of 2, 20, 150 and $150Mg\;ha^{-1}$, respectively. Here, chemical fertilizers were applied with the same level ($N-P_2O_5-K_2O=150-80-80kg\;ha^{-1}$) in all treatments. Flower yields of C. boreale M., edible part as a natural medicine, were increased to 37 and 27% by swine and poultry manure compost application, respectively. Poultry manure compost amending (NPK+PMC) increased 3.6 times of proline content and 58% of total amino acids in the flower part more than chemical fertilization (NPK). But the contents of amino acids did not increase with amending liming materials like lime and fly ash. Cumambrin A, which is a sesquiterpene compound and has the effect of blood-pressure reduction, increased to 34 and 19% by lime and fly ash applications, respectively. Cumambrin A was significantly correlated with calcium content in the flower part of C. boreale M. Conclusively, soil amendments like compost and liming materials might contribute to increase the yields and quality of C. boreale M.

Comparative Analysis of GNSS Precipitable Water Vapor and Meteorological Factors (GNSS 가강수량과 기상인자의 상호 연관성 분석)

  • Jae Sup, Kim;Tae-Suk, Bae
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.33 no.4
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    • pp.317-324
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    • 2015
  • GNSS was firstly proposed for application in weather forecasting in the mid-1980s. It has continued to demonstrate the practical uses in GNSS meteorology, and other relevant researches are currently being conducted. Precipitable Water Vapor (PWV), calculated based on the GNSS signal delays due to the troposphere of the Earth, represents the amount of the water vapor in the atmosphere, and it is therefore widely used in the analysis of various weather phenomena such as monitoring of weather conditions and climate change detection. In this study we calculated the PWV through the meteorological information from an Automatic Weather Station (AWS) as well as GNSS data processing of a Continuously Operating Reference Station (CORS) in order to analyze the heavy snowfall of the Ulsan area in early 2014. Song’s model was adopted for the weighted mean temperature model (Tm), which is the most important parameter in the calculation of PWV. The study period is a total of 56 days (February 2013 and 2014). The average PWV of February 2014 was determined to be 11.29 mm, which is 11.34% lower than that of the heavy snowfall period. The average PWV of February 2013 was determined to be 10.34 mm, which is 8.41% lower than that of not the heavy snowfall period. In addition, certain meteorological factors obtained from AWS were compared as well, resulting in a very low correlation of 0.29 with the saturated vapor pressure calculated using the empirical formula of Magnus. The behavioral pattern of PWV has a tendency to change depending on the precipitation type, specifically, snow or rain. It was identified that the PWV showed a sudden increase and a subsequent rapid drop about 6.5 hours before precipitation. It can be concluded that the pattern analysis of GNSS PWV is an effective method to analyze the precursor phenomenon of precipitation.

Comparison of nutritional status by energy level of night snack in Korean adults: using the data from 2005 Korean National Health and Nutrition Examination Survey (한국 성인의 야식의 에너지 수준에 따른 영양상태 비교: 2005년 국민건강영양조사 자료 이용)

  • Suh, Yoonsuk;Lee, Eun-Kyoung;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.45 no.5
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    • pp.479-488
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    • 2012
  • This study aims to investigate the nutritional status of night eaters using the data from 2005 Korean National Health and Nutrition Examination Survey. A total of 3,903 subjects aged 20 and above were divided into 3 groups by using 24-hr recall data according to the night snack calorie intake: non-night snack, night snack less than 500 kcal and 500 kcal and more. Their data were analyzed to find out the difference on the socio-demographic, anthropometric, blood pressure, blood parameters and dietary characteristics. Among the subjects, non-night eaters were 66.0%, night eaters of less than 500 kcal were 28.4% and 500 kcal and above were 5.6%. Male adults, young-aged, higher educated, higher income earner, breakfast skipper and frequent dine-outer (3 times and more a day) were found more in the night eaters with 500 kcal and above. Night eaters above 500 kcal showed higher waist circumference, Glu-FBS, Glu-PP120 and also showed higher daily intake of fat and alcohol per 1,000 kcal and food groups of meat & eggs, beverages and alcohol drinks (p < 0.05), while they showed the lowest carbohydrate energy ratio of $58.3{\pm}13.7$ among the three groups. These results suggest that habitual night snack intake above 500 kcal could lead to abdominal obesity and diabetes due to higher intake of meat, fat and alcohol.

Study on the channel of bipolar plate for PEM fuel cell (고분자 전해질 연료전지용 바이폴라 플레이트의 유로 연구)

  • Ahn Bum Jong;Ko Jae-Churl;Jo Young-Do
    • Journal of the Korean Institute of Gas
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    • v.8 no.2 s.23
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    • pp.15-27
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    • 2004
  • The purpose of this paper is to improve the performance of Polymer electrolyte fuel cell(PEMFC) by studying the channel dimension of bipolar plates using commercial CFD program 'Fluent'. Simulations are done ranging from 0.5 to 3.0mm for different size in order to find the channel size which shoves the highst hydrogen consumption. The results showed that the smaller channel width, land width, channel depth, the higher hydrogen consumption in anode. When channel width is increased, the pressure drop in channel is decreased because total channel length Is decreased, and when land width is increased, the net hydrogen consumption is decreased because hydrogen is diffused under the land width. It is also found that the influence of hydrogen consumption is larger at different channel width than it at different land width. The change of hydrogen consumption with different channel depth isn't as large as it with different channel width, but channel depth has to be small as can as it does because it has influence on the volume of bipolar plates. however the hydrogen utilization among the channel sizes more than 1.0mm which can be machined in reality is the most at channel width 1.0, land width 1.0, channel depth 0.5mm and considered as optimum channel size. The fuel cell combined with 2cm${\times}$2cm diagonal or serpentine type flow field and MEA(Membrane Electrode Assembly) is tested using 100W PEMFC test station to confirm that the channel size studied in simulation. The results showed that diagonal and serpentine flow field have similarly high OCV and current density of diagonal (low field is higher($2-40mA/m^2$) than that of serpentine flow field under 0.6 voltage, but the current density of serpentine type has higher performance($5-10mA/m^2$) than that of diagonal flow field under 0.7-0.8 voltage.

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Choroidal Thickness in Thyroid-associated Ophthalmopathy between Normal Tension Glaucoma Using Optical Coherence Tomography (스펙트럼영역 빛간섭단층촬영으로 측정한 갑상선 안병증 환자와 녹내장환자의 맥락막 두께 분석)

  • Lee, Bo Young;La, Tae Yoon;Choi, Jin A
    • Journal of The Korean Ophthalmological Society
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    • v.58 no.8
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    • pp.960-967
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    • 2017
  • Purpose: To compare the macular choroidal thickness in patients with thyroid-associated ophthalmopathy (TAO) with those with normal tension glaucoma (NTG). Methods: A total of 70 normal eyes, 74 eyes with TAO and 60 eyes with NTG were enrolled in this study. All patients underwent spectral-domain optical coherence tomography (SD-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec Inc., Dublin, CA, USA). Macular choroidal thickness was assessed using enhanced depth imaging. The average macular choroidal thickness was defined as the average value of three measurements: at the fovea and at the points located 1.5 mm in the nasal and temporal directions from the fovea. Generalized estimating equations were used to uncover factors affecting the average macular choroidal thickness. Results: The average, superior and inferior quadrant retinal nerve fiber layer thicknesses were significantly thinner in the NTG group compared with the TAO and control groups (p < 0.001). The average macular choroidal thickness of the TAO group, NTG group and controls was $281.01{\pm}60.06{\mu}m$, $241.66{\pm}55.00{\mu}m$ and $252.07{\pm}55.05{\mu}m$, respectively, which were significantly different (p = 0.013). The subfoveal, nasal and temporal side choroidal thicknesses were significantly thinner in the NTG group compared with the TAO group (p = 0.014, 0.012 and 0.034, respectively). Subjects with TAO were associated with a thicker average macular choroidal thickness compared with the NTG group after adjusting for age, sex, spherical equivalent and intraocular pressure (${\beta}=32.61$, p = 0.017). Conclusions: Macular choroidal thickness was significantly thicker in patients with TAO compared with those with NTG. Further evaluation is required to determine if a thick choroid in subjects with TAO has any role in glaucomatous optic neuropathy.

Characteristics of Seepage Water and Groundwater in a Coastal LPG Storage Cavern of Jeonnam (전남 해안 LPG 저장공동 유출수와 주변 지하수의 수질특성)

  • Lee, Jin-Yong;Choi, Mi-Jung;Kim, Hyun-Jung;Cho, Byung-Wook
    • Journal of Soil and Groundwater Environment
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    • v.14 no.4
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    • pp.33-44
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    • 2009
  • Water curtain of an underground LPG storage cavern is a facility to prevent leakage of high pressure gases, for which groundwater should flow freely towards the cavern and groundwater level also must be stably maintained. In this study, in order to evaluate qualities of seepage water and surrounding groundwater of an underground LPG storage cavern in Yeosu, 4 rounds of samplings, field measurements and laboratory analyses (February, May, August, October of 2007) were conducted. According to field measurements, pH was weak acidic to neutral but it gradually increased with time. Electrical conductivity (EC) of groundwater near a salt stack showed very high values between 10.47 and 38.50 mS/cm. Dissolved oxygen (DO) showed a very wide range of 0.20~8.74 mg/L and a mean of oxidation-reduction potential (ORP) was 159 mV, which indicated an oxidized condition. Levels of $Fe^{2+}$ and $Mn^{2+}$ were mostly less than 3 mg/L. All of seepage waters showed a Na-Cl type while only groundwater near the salt stack showed a Na-Cl type with a high total dissolved solid. The other groundwaters exhibited typical $Ca-HCO_3$ types. Levels of aerobic bacteria were mostly very high (573-39,520 CFU/mL). Based on the analyses of these hydrochemistry and biological characteristics, it is concluded that there are no particular problems in groundwater and seepage water, which not causing a trouble in the cavern operation. However, both for control of bio-clogging and for sustainable operation of the water curtain system, a regular hydrochemical and microbiological monitoring is required for the seepage water and surrounding groundwater.