• Title/Summary/Keyword: critical duration

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Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

A Study on Repetition and Multiplicite of Superhero Comics (슈퍼히어로 코믹의 반복과 다양체적 형식에 관한 연구)

  • Park, Seh-Hyuck
    • Cartoon and Animation Studies
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    • s.28
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    • pp.27-53
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    • 2012
  • American superhero comics are being produced in numerous different forms for multiple, and cross-platform media. In cinema, films based on superhero comics top the list of all time box office records. The same phenomenon of the 'Invasion of Superhero' is duplicated in Korean box office 2012, however, the korean fans are not familiar with the superheroes from the publication which provides the original source of characters and stories for other superhero related media products. Based on observing the multiple and vastness of world building characteristics of superhero comic, this paper attempts to associate the continuous creative nature and the infinite repetition of superheroes and comic texts with the identity of superhero on ontological level. First, chapter 2 examines how one superhero exists in multiple and different worlds individually by utilizing the concept of 'multi-universe' or 'multiverse' in comic texts. Initially, duplicating a superhero on multiple settings and series destroyed continuity and allowed contradiction and paradox confused narrative as a whole, but it also gave chances for comics to be more vibrant and experimental with their stories and characters. Chapter 3 analyzes the superhero comic texts in the light of repetition, concept developed by french philosopher Gilles Deleuze, and make the argument that the superheroes and texts are not repeated to generate surplus of source for economic utilitarian purposes, but it is, first and foremost, a repetition of creativeness and capability. Many concepts introduced by Deleuze in his early masterpiece, $\acute{e}$rence et R$\acute{e}$p$\acute{e}$tition> are taken to support this argument. Mainly, his critical views on generality of the identity and his effort to replace the Plato's system of representation with vibrant creative, and renewal energy of r$\acute{e}$p$\acute{e}$tition. According to Deleuze, repetition is similar concept, if not identical, to what Nietzsche called the 'eternal return' which allows the return of the Overhuman or the Superhuman, and he extends his idea that the returning Overhuman is the singular simulacre which opposes the generalization of identity, in the likes of Plato's Idea. Thus, the superhero's identity is ever changing, ever returning, and ever renewing Overhuman. The superhero must be repeated to fully actualize his/her existence. Also, based on Deleuze's reading of Bergson's texts on the Virtual, the superhero, for example Superman, is actualization of his/her multiplisit$\acute{e}$, the internally multiple, and differentiated variations from itself. These every Supermans' multiplisit$\acute{e}$ shares common memory, past, and duration, thus the Virtual of Superman. Superman becomes himself only by actualizing the movement and differentiation from these multiplisit$\acute{e}$ in his virtual on the surface of reality. On chapter 4, a popular Korean comic book character Oh, Hae-Sung's r$\acute{e}$p$\acute{e}$tition and multiplist$\acute{e}$ are analyzed, and makes comparison to that of Superman to distinguish the repetition from r$\acute{e}$p$\acute{e}$tition, and multiplicit$\acute{e}$ from diversity.

Usefulness and Limitations of Fine Needle Aspiration Cytology in Adult Cervical Lymph Node Enlargement Patients: An analysis of 342 cases (성인 경부 림프절 비대 환자들에서 미세침 흡인 세포검사법의 유용성과 문제점: 342 증례의 분석)

  • Lee, Jaeho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.18-28
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    • 2004
  • Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.

An Analysis of Changes in Rice Growth and Growth Period Using Climatic Tables of 1960s (1931~1960) and 2000s (1971~2000) (우리나라 1960년대 (1931~'60)와 2000년대 (1971~2000) 기후표를 이용한 벼 생육 및 재배기간 변화 분석)

  • Lee, Jeong-Taek;Shim, Kyo-Moon;Bang, Hea-Son;Kim, Myung-Hyun;Kang, Kee-Kyung;Na, Young-Eun;Han, Min-Su;Lee, Deog-Bae
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.6
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    • pp.1018-1023
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    • 2010
  • Climatic change was observed and analyzed in view of impacts on agricultural ecosystem, inter alia on rice cropping. The changed climate gave rise to earlier transplanting of rice seedling and later harvest after 40 years. Also phenological change and prolonged growth duration was observed. The meteorological data was selected from the standardized climatological data of 30 year normals of 1960s and 2000s, which were published by Korea Meteorological Administration. Development stages and growing periods of rice crop were compared by analyzing critical and optimum temperatures of each growth stage during these two periods. The first appearance date of $15^{\circ}C$ was ranged from Apr. 29 to May 23 in the year-normals of 1960s and it varied from Apr. 24 to May 16 in the normals of 2000s. The difference of the first appearance date of $15^{\circ}C$ was 0~10 days earlier in the year-normals of 2000s than the 1960s. The last harvesting date was determined to be the last appearance date of mean air temperature $15^{\circ}C$. The difference in the last appearance date of $15^{\circ}C$ was 1 to 13 days later in the year-normals of 2000s than in 1960s. The plant height of a rice variety, Hwayoung-byeo was 101~109 cm in 4 local areas, Seoul, Kangneung, Kwangju and Daegu. The plant height became 1~4 cm taller under warm condition. Rice grain yields estimated with daily weather data for the year-normals of 1960s and 2000s were 453~580 kg $10a^{-1}$ and 409~484 kg $10a^{-1}$ respectively. Rice grain yield of the former period was 50~100 kg $10a^{-1}$ higher than that hat in the later period.

Assessment of Productivity and Vulnerability of Climate Impacts of Forage Corn (Kwangpyeongok) Due to Climate Change in Central Korea (국내 중부지역에 있어서 기후변화에 따른 사료용 옥수수의 생산성 및 기후영향취약성 평가)

  • Chung, Sang Uk;Sung, Si Heung;Zhang, Qi-Man;Jung, Jeong Sung;Oh, Mirae;Yun, Yeong Sik;Seong, Hye Jin;Moon, Sang Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.39 no.2
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    • pp.105-113
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    • 2019
  • A two-year study was conducted from 2017 to 2018 by the establishment of a test field at Chungju-si and Cheongyang-gun. Plant height, number of leaves, insects and diseases, and fresh and dry matter yields for corn hybrid('Kwangpyeongok') were investigated. Daily average, maximum, and minimum temperature, monthly average temperature, daily precipitation, and sunshine duration during the growing season were investigated. We selected climate-critical factors to corn productivity and conducted an evaluation of vulnerability to climate change from 1999 to 2018 for both regions. In 2018, the dry matter yield of forage corn was 6,475 and 7,511 kg/ha in Chungju and Cheongyang, respectively, which was half of that in 2017. The high temperature and drought phenomenon in the 2018 summer caused the corn yield to be low. As well as temperature, precipitation is an important climatic factor in corn production. As a result of climate impact vulnerability assessment, the vulnerability has increased recently compared to the past. It is anticipated that if the high temperature phenomenon and drought caused by climate change continues, a damage in corn production will occur.

Acute Exacerbation of Idiopathic Pulmonary Fibrosis with Lung Cancer: A Comparative Analysis of the Incidence, Survival Rate, and CT Findings with the Patients without Lung Cancer (폐암을 동반한 특발성 폐섬유증 환자에서 폐섬유증의 급성 악화: 폐암 비동반군과의 발병률, 생존율 및 전산화단층촬영 소견의 비교)

  • Bumsang Cho;Hee Kang;Je Hun Kim;Jung Gu Park;Sekyoung Park;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.688-700
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    • 2020
  • Purpose To compare the incidence, survival rate, and CT findings of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) between patients with and without lung cancer. Materials and Methods From June 2004 to July 2018, 89 consecutive patients diagnosed with IPF were included. Among them, 26 patients had IPF with lung cancer (IPF-LCA), and 63 patients had IPF alone. The clinical characteristics and CT findings associated with IPF, lung cancer, and AE were reviewed. Surgery and chemotherapy were performed for 6 and 23 cases of lung cancer, respectively, as the first- or second-line anticancer treatment. The overall survival, CT findings, disease-free period before AE, and duration from the onset of AE to death were compared. Results The incidence of AE was 61.5% in the IPF-LCA group and 58.7% in the IPF group (p = 0.806). The mean overall survival in the IPF-LCA and IPF groups were 16.8 and 83.0 months, respectively (p < 0.001). The mean durations from the start of the lung cancer treatment to the onset of AE were 16.0 and 4.6 months in cases of surgical treatment and chemotherapy, respectively. In comparison of death from AE, the survival rate was significantly lower in the IPF-LCA group than in the IPF group (p = 0.008). In the CT findings associated with AE, the IPF-LCA group tended to have a peribronchial (p < 0.001) or asymmetric distribution (p = 0.016). Conclusion In patients with IPF who develop lung cancer, the rate of death from AE is higher than that in patients with IPF alone. They tend to have unusual CT patterns associated with AE, such as a peribronchial or asymmetric distribution.

The National Survey of Open Lung Biopsy and Thoracoscopic Lung Biopsy in Korea (개흉 및 흉강경항폐생검의 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.5-19
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    • 1998
  • Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

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