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Using Continuous Flow Data to Predict the Course of Air Leaks After Lung Lobectomy

  • Jaeshin Yoon;Kwanyong Hyun;Sook Whan Sung
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.179-185
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    • 2023
  • Background: Assessments of air leaks are usually performed subjectively, precluding the use of air leaks as an evaluation factor. We aimed to identify objective parameters as predictive factors for prolonged air leak (PAL) and air leak cessation (ALC) from air flow data produced by a digital drainage system. Methods: Flow data records of 352 patients who underwent lung lobectomy were reviewed, and flow data at designated intervals (1, 2, and 3 hours postoperatively [POH] and 3 times a day thereafter [06:00, 13:00, 19:00]) were extracted. ALC was defined by flow less than 20 mL/min over 12 hours, and PAL was defined as ALC after 5 days. Cumulative incidence curves were obtained using Kaplan-Meier estimates of time to ALC. Cox regression analysis was performed to determine the effects of variables on the rate of ALC. Results: The incidence of PAL was 18.2% (64/352). Receiver operating characteristic curve analysis showed cut-off values of 180 mL/min for the flow at 3 POH and 73.3 mL/min for the flow on postoperative day 1; the sensitivity and specificity of these values were 88.9% and 82.5%, respectively. The rates of ALC by Kaplan-Meier analysis were 56.8% at 48 POH and 65.6% at 72 POH. Multivariate Cox regression analysis revealed that the flow at 3 POH (≤80 mL/min), operation time (≤220 minutes), and right middle lobectomy independently predicted ALC. Conclusion: Air flow measured by a digital drainage system is a useful predictor of PAL and ALC and may help optimize the hospital course.

Implementation and evaluation of reliable multicast protocol with the ALC and LDPC FEC over wireless LAN environment (무선 LAN 환경에서 ALC와 LDPC FEC를 이용한 신뢰적인 멀티 캐스트 전송 프로토콜의 구현 및 성능 평가)

  • Paik Il-Woo;Seong Baek-Dong;Hong Jin-Pyo
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.06d
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    • pp.250-252
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    • 2006
  • ALC(Asyncronous Layered Coding)는 LCT(Layered Coding Transport)기반의 폭넓은 확장성과 다양한 전송속도로 신뢰성 있는 멀티캐스트 전송을 주 목적으로 한다. ALC는 다른 RMT 프로토콜과는 달리 재전송을 하지 않고 receiver-driven 형태의 혼잡제어를 하기 때문에 신뢰성을 제공하기 위해 FEC(Forward Error Correction) 스킴를 이용한다. 본 논문은 신뢰적인 멀티캐스트 전송 프로토콜을 위해 ALC와 FEC 스킴 중 하나인 LDPC 코드를 이용하여 구현한다. 인코딩 비율(Encoding ratio)에 따라 일정 수준 이상의 복구 성공 확율에 대해 최대 허용 가능한 패킷 손실률을 측정하여 신뢰치를 측정한다. 마지막으로 일대다의 파일 전송 시, TCP와 비교하여 본 구현물의 유연성과 효율성에 대해 분석 및 평가한다.

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An Experimental Study on the Strength Characteristic Improvement of the Autoclaved Lightweight Concrete(ALC) containing Quicklime and Silica Fume (생석회와 실리카퓸을 활용한 경량기포콘크리트(ALC)의 강도특성 개선을 위한 실험적 연구)

  • Kim, Young-Ho;Song, Hun
    • Journal of The Korean Digital Architecture Interior Association
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    • v.11 no.4
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    • pp.21-27
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    • 2011
  • These materials in architecturally glass or metal have weaknesses such as inadequate insulating quality, combustibility and toxic gases in fires substance. However, Autoclaved Lightweight Concrete(ALC) has excellent thermal insulation properties and seem to possess the superb insulating quality as substitute of existing exterior materials. This research is to compare experimentally to the kind of the strength properties of ALC materials which mixed with blast furnace slag pounder and silica fume. For the purpose of increasing the strength, the plastic states of ALC evaluate the physical characteristics as microstructure and strength according to various specific gravity. According to the quicklime quantity the compressive strength is proportionate depend on the absolute dried specific gravity. When not putting in 10% quicklime, the compressive strength appeared most lowly with 14.0MPa. When putting in the quicklime, the strength appeared higher with 15.1MPa. And strength of specimen containing 2.25% silica fume is 15.6MPa increased 10.3% than reference specimen 14.0MPa.

Composting of Swine Manure Using Autoclaved Lightweight Concrete as a Bulking Agent (규산질다공체를 이용한 돈분 퇴비화에 관한 연구)

  • 전병수;곽정훈;박치호;평봉삼;김태일;유용희;김형호;한정대;최롱
    • Journal of Animal Environmental Science
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    • v.4 no.1
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    • pp.29-36
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    • 1998
  • Sawdust is commonly used as a bulking agent for livestock manure composting. Nowadays, demand of sawdust for composting is increasing, so its price is very high and not easy to obtain. In this study in order to examine the effect of autoclaved lightweight concrete (ALC, one of the industrial wastes) on composting of swine manure, ALC (each size of 2, 4, an 8mm) was used as a bulking agent. Swine manure was mixed with each of sawdust and 8mm of ALC in a 1:1 ratio by volume and 2, 4mm of ALC was mixed in a 2:1 ratio by volume. The total period lasted 50 days and was divided into two periods. After mixing bulking agent with swine manure, they were left undisturbed to compost with aeration for an initial period of 20 days. At the end of this period, they were decomposed and mixed to effect a homogenization and then a second period of composting (without aeration) was conducted for 30 days. Temperature during the initial period of swine manure composting were above 70$^{\circ}C$ in all piles and maintained above 55$^{\circ}C$ for 5 days. Temperatures during the second period were relatively lower than the initial period. pH of the compost was increased during the initial period and after 50 days it reached 9.08 in sawdust pile and 9.03 in ALC pile ( 2mm). In nitrogen content of final compost, sawdust pile was higher than ALC piles by 21∼29%.

Biochemical Evaluation of Nutritional Status of Vitamins and Minerals in Patients with Alcoholic Liver Disease (생화학적 지표로 본 알코올성 간질환 환자의 비타민 및 무기질 영양상태)

  • 구보경;정준모;이혜성
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.27 no.6
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    • pp.1244-1252
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    • 1998
  • The purpose of this study is to evaluate the nutritional status of vitamin and minerals in the patients with alcoholic liver disease and to obtain the materials for nutritional education for alcoholics. The subjects consist of 80 patients with alcoholic liver cirrhosis(ALC) and 12 patients with alcoholic fatty liver(AFL). The control group included 57 alcoholics without liver disease(A), 32 patients with viral liver cirrhosis(VLC) and 194 normal men(NL). Biochemical evaluation of nutritional status was investigated by the analysis of blood samples. The frequency of vitamin B1 deficiency in the ALC, AFL and A groups as indicated by the erythrocyte transketolase activity coefficient were 46.0%, 66.7% and 57.9% respectively. The frequency of vitamin B2 deficiency in the ALC, AFL and A groups as indicated by the erythrocyte glutathione reductase activity coefficient were 9.8%, 8.3% and 38.6% respectively. Vitamin A deficiency was not detected in the alcoholic subjects. The frequency of vi tamin E deficiency in ALC, AFL and A were 96.3%, 66.7% and 86.0% respectively. The levels of plasma lipid peroxidation products were significantly higher in the alcoholic subjects than in the normal subjects. The frequency of subjects below normal range of hemoglobin were 85.0% in ALC, 50.0% in AFL and 31.6% in A. The frequency of copper deficiency in the ALC, AFL and A groups were 48.4%, 16.7% and 17.5% respectively. The frequency of zinc deficiency in the ALC, AFL and A groups were 83.8%, 41.7% and 66.7% respectively. Overall, the vitamin and minerals status of the alcoholic subjects in this study was evaluated to be very poor on the basis of biochemical assessments. The results suggest that alcohol abuse and poor dietary intake could cause malnutrition and may be important risk factors in causing alcoholic liver disease in alcoholics. In addition, vitamin B1, vitamin B2, Cu, Fe and antioxidant supplementation may be effective in nutritional therapy for chronic alcoholics.

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Comparison between Traditional Classrooms and Active Learning Classrooms: The Impact of Learning Spaces on Student Perceptions (전통 교실과 Active Learning Classroom 간 비교 연구: 학습 공간이 대학생들의 인식에 미치는 영향을 중심으로)

  • Choi, Koun;Shin, Won-Sug;Kim, Myunglang
    • Journal of Convergence for Information Technology
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    • v.10 no.8
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    • pp.161-172
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    • 2020
  • The purpose of this study is to compare students' perception shaped by two different university classrooms: Traditional Classroom and ALC(Active learning classroom). We conducted survey of 71 university students who were taught by an identical instructor using same pedagogy. The survey questionnaires asked respondents about their perceptions on teaching and learning and physical environments relations, teaching proficiency, social context, student satisfaction and immersion. The data was analyzed using Student's T-test. The results showed that ALC group, compared to the traditional classroom group, demonstrated statistically higher awareness on teaching and learning and physical environments relations, teaching proficiency, and instructor-student unofficial relations. Based on these findings, implications and limitations of this study were discussed.

Altered Frequency, Activation, and Clinical Relevance of Circulating Innate and Innate-Like Lymphocytes in Patients With Alcoholic Liver Cirrhosis

  • Ki-Jeong Park;Hye-Mi Jin;Young-Nan Cho;Jae Hyun Yoon;Seung-Jung Kee;Hyo-Sin Kim;Yong-Wook Park
    • IMMUNE NETWORK
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    • v.23 no.3
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    • pp.22.1-22.15
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    • 2023
  • Alcoholic liver cirrhosis (ALC) is caused by chronic alcohol overconsumption and might be linked to dysregulated immune responses in the gut-liver axis. However, there is a lack of comprehensive research on levels and functions of innate lymphocytes including mucosal-associated invariant T (MAIT) cells, NKT cells, and NK (NK) cells in ALC patients. Thus, the aim of this study was to examine the levels and function of these cells, evaluate their clinical relevance, and explore their immunologic roles in the pathogenesis of ALC. Peripheral blood samples from ALC patients (n = 31) and healthy controls (HCs, n = 31) were collected. MAIT cells, NKT cells, NK cells, cytokines, CD69, PD-1, and lymphocyte-activation gene 3 (LAG-3) levels were measured by flow cytometry. Percentages and numbers of circulating MAIT cells, NKT cells, and NK cells were significantly reduced in ALC patients than in HCs. MAIT cell exhibited increased production of IL-17 and expression levels of CD69, PD-1, and LAG-3. NKT cells displayed decreased production of IFN-γ and IL-4. NK cells showed elevated CD69 expression. Absolute MAIT cell levels were positively correlated with lymphocyte count but negatively correlated with C-reactive protein. In addition, NKT cell levels were negatively correlated with hemoglobin levels. Furthermore, log-transformed absolute MAIT cell levels were negatively correlated with the Age, Bilirubin, INR, and Creatinine score. This study demonstrates that circulating MAIT cells, NKT cells, and NK cells are numerically deficient in ALC patients, and the degree of cytokine production and activation status also changed. Besides, some of their deficiencies are related to several clinical parameters. These findings provide important information about immune responses of ALC patients.

The Effects of Alismatis Rhizoma Extract on Allergic Inflammation in RBL-2H3 Mast Cells and OVA/alum-Sensitized Mice (택사 (澤瀉, Alismatis Rhizoma) 추출물이 RBL-2H3 비만세포와 OVA/alum 감작 생쥐의 알레르기 염증 반응에 미치는 영향)

  • Song, Ji Hyun;Lee, Jin Hwa;Kim, Eun Jin;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.3
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    • pp.1-15
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    • 2018
  • Objectives Alismatis Rhizoma has been known to suppress inflammation and allergic reaction. However, the cellular target of Alismatis Rhizoma and its mechanism of action remain unclear. This study was designed to examine the effect of Alismatis Rhizoma extract (ALC) on the RBL-2H3 mast cells in vitro and on the OVA/alum sensitized mice ex vivo. Methods In the study, RBL-2H3 mast cells were cultured in minimal essential medium (MEM) for 24 hours, and treated separately with cyclosporin A and varying doses of ALC, and then stimulated with Phorbol 12-myristate 13-acetate (PMA) (50 ng/ml) and Ionomycin ($0.5{\mu}M$). The levels of IL-13, IL-4 were measured by ELISA analysis. The mRNA levels of IL-4, IL-5, IL-6, IL-13, GM-CSF, $TNF-{\alpha}$ were analyzed with Real-time PCR. Also, manifestations of MAPKs transcription factors and $NF-{\kappa}B$ p65 translocation were analyzed by western blotting in vitro. Subsequently, for ex vivo experiment, we induced allergic inflammation on Balb/c mice by OVA/alum and administered ALC orally. And we measured serum OVA-specific IgE level and IL-4, IL-13 in the splenocyte culture supernatant by ELISA analysis. Results ALC was shown to suppress mRNA expression of IL-4, IL-5, IL-6, IL-13, GM-CSF, $TNF-{\alpha}$, and to inhibit the IL-13, IL-4 production. Also ALC reduced an activation of mast cells specific signal MAPKs transcription factors and $NF-{\kappa}B$ p65 from the western blot analysis in in vitro experiment. In ex vivo, ALC oral adminstration decreased the level of OVA-specific IgE in serum, and IL-4, IL-13 in the splenocyte culture supernatant. Conclusions ALC is shown to reduce inflammation and allergic response by suppressing Th2 cytokines through the regulation of transcription factors MAPKs and $NF-{\kappa}B$ p65 in mast cells. Administration of ALC suppressed OVA-specific IgE in ovalbumin allergy model through the inhibition of Th2 cytokine. In conclusion, ALC can be considered as an effective treatment for allergic diseases such as atopic dermatitis.

Bioequivalence of L-Cartin Tablet to Nicetile Tablet (Acetyl-L-Carnitine 500 mg) (니세털 정(아세틸-엘-카르니틴 500 mg)에 대한 엘카틴 정의 생물학적 동등성)

  • Cho, Hea-Young;Yun, Ji-Hun;Oh, Injoon;Moon, Jai-Dong;Lee, Yong-Bok
    • Korean Journal of Clinical Pharmacy
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    • v.11 no.2
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    • pp.49-56
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    • 2001
  • Acetyl-L-carnitine (ALC), an endogenous component of the L-carnitine family, is a naturally existing molecule synthesized from L-carnitine (LC) by carnitine acetyl transferase. ALC has been shown to improve the cognitive performance of patients suffering from dementia of the Alzheimer's type and proposed for treating Alzheimer's disease in pharmacological doses. The purpose of the present study was to evaluate the bioefuivalence of two ALC tablets, $Nicetile^{TM} (Dong-A Pharmaceutical Co.) and $L-Cartin^{TM}$ (Kuhn Il Pharmaceutical Co.), according to the guidelines of Korea Food and Drug Administration (KFDA). The ALC release from the two ALC tablets in vitro was tested using KP VII Apparatus II method in various dissolution media (pH 1.2, 6.0 and 6.8). Twenty six normal male volunteers, $24.46\pm3.67$ years in age and $64.45\pm5.54$ kg in body weight, were divided into two groups and a randomized $2\times2$cross-over study was employed. After one tablet containing 500 mg of ALC was orally administered, blood was taken at predetermined time intervals and the concentrations of ALC in serum were determined using HPLC with fluorescence detector. Because of the presence of endogenous ALC, the calibration was performed using dialyzed serum. The dissolution profiles of the two ALC tablets were similar in all the dissolution media. The pharmacokinetic parameters such as $AUC_t,\;C_{max}\;and\;T_{max}$ were calculated and ANOVA was utilized for the statistical analysis of the parameters. The results showed that the differences in $AUC_t,\;C_{max}\;and\;T_{max}$ between two tablets were $0.35\%,\;0.93\%\;and\;2.34\%$ respectively, when calculated against the $Nicetile^{TM} tablet. The powers $(1-\beta)\;for\;AUC_t$ , and Cmax were $98.72\%\;and\;85.48\%$, respectively. Minimum detectable differences $(\Delta)\;at\;\alpha=0.05\;and\;1-\beta=0.8$ were less than $20\%,\;(e.g.,\;13.21\%\;and\;18.42\%\;for\;AUC_t,\;and\;C_{max}$ respectively). The $90\%$ confidence intervals were within $\pm20\%\;(e.g.,\;-7.38\sim8.09\;and\;-9.86\sim11.72\;for\;AUC_t,\;and\;C_{max}$, respectively). These two parameters met the criteria of KFDA for bioequivalence, indicating that $L-Cartin^{TM}$ tablet is bioequivalent to $Nicetile^{TM} tablet.

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