• Journal of Korean Neurosurgical Society
• /
• v.64 no.5
• /
• pp.818-826
• /
• 2021

Objective : The widely accepted treatment option of a traumatic carotid cavernous fistula (TCCF) has been detachable balloon or coils based fistula occlusion. Recently, covered stent implantation has been proving an excellent results. The purpose of this study is to investigate our experiences with first line choice of covered stent implantation for TCCF at level 1 regional trauma center. Methods : From November 2004 to February 2020, 19 covered stents were used for treatment of 19 TCCF patients. Among them, 15 cases were first line treatment using covered stents. Clinical and angiographic data were retrospectively reviewed. Results : Procedures were technically successful in all 15 cases (100%). Immediate angiographic results after procedure were total occlusion in 12 patients (80%). All patients except two expired patients had image follow-up (mean 15 months). Recurred symptomatic three patients underwent additional treatments and achieved complete occlusion. Mean clinical follow-up duration was 32 months and results were modified Rankin Scale 1-2 in five, 3-4 in five, and 5 in three patients. Conclusion : The covered stent could be considered as fist line treatment option for treating TCCF patients especially in unstable vital sign. Larger samples and expanded follow-up are required to further develop their specifications and indications.

• Animal Bioscience
• /
• v.35 no.7
• /
• pp.955-963
• /
• 2022

Objective: The aim of this study was to estimate genetic parameters for 305-day cumulative milk yield and components, growth, and reproductive traits in Guzerá cattle. Methods: The evaluated traits were 305-day first-lactation cumulative yields (kg) of milk (MY305), fat (FY305), protein (PY305), lactose (LY305), and total solids (SY305); age at first calving (AFC) in days; adjusted scrotal perimeter (cm) at the ages of 365 (SP365) and 450 (SP450) days; and adjusted body weight (kg) at the ages of 210 (W210), 365 (W365), and 450 (W450) days. The (co)variance components were estimated using the restricted maximum likelihood method for single-trait, bi-trait and tri-trait analyses. Contemporary groups and additive genetic effects were included in the general mixed model. Maternal genetic and permanent environmental effects were also included for W210. Results: The direct heritability estimates ranged from 0.16 (W210) to 0.32 (MY305). The maternal heritability estimate for W210 was 0.03. Genetic correlation estimates among milk production traits and growth traits ranged from 0.92 to 0.99 and from 0.92 to 0.99, respectively. For milk production and growth traits, the genetic correlations ranged from 0.33 to 0.56. The genetic correlations among AFC and all other traits were negative (-0.43 to -0.27). Scrotal perimeter traits and body weights showed genetic correlations ranging from 0.41 to 0.46, and scrotal perimeter and milk production traits showed genetic correlations ranging from 0.11 to 0.30. The phenotypic correlations were similar in direction (same sign) and lower than the corresponding genetic correlations. Conclusion: These results suggest the viability and potential of joint selection for dairy and beef traits in Guzerá cattle, taking into account reproductive traits.

• Journal of Korean Clinical Nursing Research
• /
• v.15 no.1
• /
• pp.5-17
• /
• 2009

Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.

• KSII Transactions on Internet and Information Systems (TIIS)
• /
• v.18 no.2
• /
• pp.456-477
• /
• 2024

With information technology's rapid development, the Internet faces serious security problems. Studies have shown that malware has become a primary means of attacking the Internet. Therefore, adversarial samples have become a vital breakthrough point for studying malware. By studying adversarial samples, we can gain insights into the behavior and characteristics of malware, evaluate the performance of existing detectors in the face of deceptive samples, and help to discover vulnerabilities and improve detection methods for better performance. However, existing adversarial sample generation methods still need help regarding escape effectiveness and mobility. For instance, researchers have attempted to incorporate perturbation methods like Fast Gradient Sign Method (FGSM), Projected Gradient Descent (PGD), and others into adversarial samples to obfuscate detectors. However, these methods are only effective in specific environments and yield limited evasion effectiveness. To solve the above problems, this paper proposes a malware adversarial sample generation method (PixGAN) based on the pixel attention mechanism, which aims to improve adversarial samples' escape effect and mobility. The method transforms malware into grey-scale images and introduces the pixel attention mechanism in the Deep Convolution Generative Adversarial Networks (DCGAN) model to weigh the critical pixels in the grey-scale map, which improves the modeling ability of the generator and discriminator, thus enhancing the escape effect and mobility of the adversarial samples. The escape rate (ASR) is used as an evaluation index of the quality of the adversarial samples. The experimental results show that the adversarial samples generated by PixGAN achieve escape rates of 97%, 94%, 35%, 39%, and 43% on the Random Forest (RF), Support Vector Machine (SVM), Convolutional Neural Network (CNN), Convolutional Neural Network and Recurrent Neural Network (CNN_RNN), and Convolutional Neural Network and Long Short Term Memory (CNN_LSTM) algorithmic detectors, respectively.

• Korean Journal of Biological Psychiatry
• /
• v.4 no.2
• /
• pp.265-271
• /
• 1997

Objective : A 4-week, single-blind, parallel group study was conducted to evaluate the efficacy and safety of tofisopam and lorazepam in 32 outpatients with anxiety disorder. Methods : Patients were randomized to receive either tofisopam(N=17) or lorazepam(N=15). The starting dose of tofisopam was 50mg t.i.d. daily, which could be increased to a maximum of 100mg t.i.d. according to the patient's clinical response and side effect. The starting dose of lorazepam was 0.75mg b.i.d. daily, which could be increased to a maximum of 1.5mg b.i.d. depending on the patient's clinical response and side effect. Efficacy evaluations at baseline, week 1, 2, and 4 used the 14-item Hamilton Rating Scale for Anxiety(HAM-A) and Clinical Global Impression(CGI). Tolerability was assessed by response to a nonleading question concerning adverse events. Laboratory parameters including vital sign, EKG, hematological, and biochemical values were measured during trial. Results : No significant differences between HAM-A total scores, two HAM-A factors(psychic, somatic) and CGI severity scores were recorded at any point during tofisopam and lorazepam treatments. However, in each group there was a significant decrease in HAM-A total scores, two HAM-A factor s(psychic, somatic), CGI severity scores over time. The pecentages of patients with tofisopam who at least minimally improved increased from 64.7% at week 1 to 94.1% at week 4. The pecentages of patients with lorazepam who at least minimally improved increased from 40.0% at week 1 to 66.7% at week 4. The pecentages of patients with tofisopam who had not any adverse event increased from 58.8% at week 1 to 87.9% at week 4. The pecentages of patients with lorazepam who had not any adverse event were not changed from 46.7% at week 1 to 46.7% at week 4. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial in both groups. Conclusion : These data suggest that tofisopam may be effective in reducing anxiety and is a anti-anxiety drug of identical potency with lorazepam. Tolerability of tofisopam was superior to lorazepam. These findings should be confirmed by using double-blind crossover study with a large member of patients.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.14 no.2
• /
• pp.91-97
• /
• 2007

Purpose: This thesis focuses on researching the burden of the Home Health Care that the Family Care-givers have. Method: This study had been conducted for the duration of 3 consecutive months from January 2006 to March 2006 and had investigated 120 person registered as the Home Health Care Clients to a University Hospital located in Incheon City. The thesis adopted the 'feeling of burden' measuring method jointly developed by Seo, Mi-Hye and Oh, Ga-Sil(1993), and FACES-III(Family Adaptability Cohesion Evaluation) developed by Olson(1985) etc. translated by Kim, Yun-Hee(1989) as the measuring method for Family Function. Result: The overall Health Status of the Home Health Care Clients was 2.18 point of average out of 3 point, where as 1.83 for Activities of Daily living and 1.98 for Vital sign, which are below the average. In the mean time, the Competence for Modified Barthel Index marked 30.88 point out of the full mark. The analyzed result of the burden that the family members have was 3.43 point of average out of 5 point which shows that the interviewee feel that they are considerable burden to their families. When it comes to 'the Burden to the family members' and 'the Function of the family' according to the characteristics of the patient, the result shows statistically significant differences, which are varied according to gender, the relationship between the care-givers and the patients. When it comes to the Family Cohesion, the difference was examined as 'statistically significant' according to the Academic background of the patients and the relationship between the patients and the interviewee.(p<0.05). The result also suggests that there exists 'Negative correlation' among the level of patients' health status, the Family Cohesion and the Family Burden. Conclusion: From the result of this study stated above, this thesis is strongly insisting that there is an urgent need for us to develop a health care mediation program, which could eventually reduce the burden of home health care that the patients' family have. At the same time, a follow-up research to prove the effect of the program is imminent.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.11
• /
• pp.5238-5246
• /
• 2012

This study was done to identify the evaluation of CPSCS for neurocritical patients and provide effective nursing interventions for these patients. Data were collected from medical records of 203 neurocritical patients over 18 years of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009 and from October 2011 to December 2011. Collected data were analyzed through t-test, ANOVA test, Person's correlation analysis, trend analysis, stepwise multiple regression. The average CPSCS score was $112.09{\pm}18.91$ and there was a significant trendency for higher severity to lead to higher CPSCS's scores(survival: J-T:9.795, die: J-T:5.415, p=<.001). The scores of the respective areas follows measurement of vital sign($3.74{\pm}2.15$), monitoring($28.97{\pm}4.31$), activity daily living ($34.99{\pm}3.66$), feeding($.19{\pm}.98$), intravenous infusion ($18.20{\pm}8.27$), treatment/procedure ($16.93{\pm}4.90$), respiratory therapy($8.61{\pm}7.07$). By means of stepwise multiple regression analysis, the intravenous therapy & medication, respiratory therapy, activities of daily living, and monitoring area that contains the model showed a significant (F=2073.963, p<.001), and they explained 98.1% of CPSCS. These findings provide information that is relevant in designing interventions to enhance CPSCS among neurocritical patients in hospital.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.139-145
• /
• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.204-208
• /
• 2016

For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

• Journal of Korean Academy of Nursing Administration
• /
• v.12 no.1
• /
• pp.63-75
• /
• 2006

Purpose: This study was aimed to specify roles of nurses from the anesthesia and recovery room by analyzing nursing activities as well as anesthesia nursing during surgery. Method: The objects were 12 RNs working in the recovery room of a university hospital located in Incheon. Self-report was performed by measuring stop-watch for five days from May 17th to May 21st in 2004. Research method was designed to record the time and frequency of the nursing activity from anesthesia and recovery room based on nurses' statement and other references for five days. The data were analyzed with descriptive statistics, ANOVA, and t-test via SPSS Win 10.0 program. Result: Nursing activities in anesthesia recovery room were classified into two different characteristics such as direct and indirect nursing activity. The activities consisted of 11 direct nursing areas and 39 nursing activities in anesthesia preparation room. The indirect nursing was classified into 8 nursing areas and 32 nursing activities. The direct nursing was classified into 12 nursing areas and 55 nursing activity. Also, the indirect nursing was classified into 7 nursing areas and 21 nursing activities in recovery room. In terms of prevalence of nursing activities in the anesthesia preparation room, observation and cooperation of anesthesia was the most prevalent activity, drug and eqipment management the second prevalent, and drug administration the third. On the other hand, in the recovery room, the most prevalent activity was vital sign checking and observation, the second most prevalent activity informative activity, and the third body temperature control. Nursing activity time was recorded according to the nursing characteristics. In the anesthesia preparation room, the direct nursing spent for 8092.20 minutes was larger than the indirect nursing spent for 7198.50 minutes. Also, in the recovery room, the direct nursing spent for 2361.16 minutes was larger than the indirect nursing spent for 1134.13 minutes. 4. Nursing activity time was compared to duty shifts. In the anesthesia preparation room, the direct nursing was more prevalent on day shift and the indirect nursing was prevalent on evening shift. However, in the recovery room, both direct and indirect nursing activities were prevalent on day shift. Conclusion: The role of anesthesia and recovery room nurses was analysed according to the time, frequency, and its characteristics.