• Journal of Neurocritical Care
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• v.11 no.2
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• pp.63-70
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• 2018

Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

• International Journal of Stem Cells
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• v.16 no.4
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• pp.376-384
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• 2023

The Wnt 𝛽-catenin signaling pathway is a highly conserved mechanism that plays a critical role from embryonic development and adult stem cell homeostasis. However, dysregulation of the Wnt pathway has been implicated in various diseases, including cancer. Therefore, multiple layers of regulatory mechanisms tightly control the activation and suppression of the Wnt signal. The E3 ubiquitin ligases RNF43 and ZNRF3, which are known negative regulators of the Wnt pathway, are critical component of Wnt signaling regulation. These E3 ubiquitin ligases control Wnt signaling by targeting the Wnt receptor Frizzled to induce ubiquitination-mediated endo-lysosomal degradation, thus controlling the activation of the Wnt signaling pathway. We also discuss the regulatory mechanisms, interactors, and evolution of RNF43 and ZNRF3. This review article summarizes recent findings on RNF43 and ZNRF3 and their potential implications for the development of therapeutic strategies to target the Wnt signaling pathway in various diseases, including cancer.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.41-46
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• 2001

Objective : The exact position of the lesion during the pallidotomy is critical to obtain the clinical improvement of parkinson's disease without damage to surrounding structure. Ventriculogrphy, CT(computed tomograpy) or MRI(magnetic resonance imaging) have been used to determine the initial coordinates of stereotactic target for pallidotomy. The goal of this study was to determine whether microelectrode recording significantly improves the neurophysiologic localization of the target obtained from MRI. Methods : Twenty patients were studied. They underwent a unilateral pallidotomy. Leksell frame was applied and T1 axial images parallel to the AC-PC(anterior commissure-posterior commissure) plane using a 1.5 Tesla MRI with 3mm slice thickness were obtained. Anteroposterior coordinate of target was chosen at 2mm in front of the midcommissural point and lateral coordinate between 19 and 22mm from the midline. The vertical coordinate was calculated on coronal slice using a fast spin echo inversion recovery sequence(FSEIR) related to the position of the choroidal fissure and ranged over 4-5mm below the AC-PC plane. Confirmation of the anatomical target was done on axial slices using the same FSEIR sequence . Microrecording was done at the pallidum contralateral to the symptomatic side using an electrode with a tip diameter of $1{{\mu}m}$ diameter tip and 1.1-1.4 mOhm impedance at 1000Hz. Electrophysiologic localization of the target was also confirmed intraoperatively by macrostimulation. Results : Microrecording techniques were reliable to define the transition from the base of the pallidum which was characterized by the disappearance of spike activity and by the change of the audible background activity. Signals from high amplitude neurons firing at 200-400Hz were recorded in the pallidal base. X, Y and Z coordinates of target obtained from the MRI were within 1mm from the X, Y, Z coordinates obtained with microrecording in 16 patients (80%), 15 patients(75%), 10 patients(50%) respectively. The difference of Y coordinate between on MRI and on microrecording was 4mm in only one patient. Conclusion : The MRI was accurate to localize the target within 1mm of the error from microrecording target in 70% of the patients. 4mm discrepancy was observed only once. We conclude that MRI alone can be used to determine the target for pallidotomy in most patients. However, microrecording technique can still be extremely valuable in patents with aberrant anatomy or unusual MRI coordinates. We also consider physiologic confirmation of the target using macrostimulation to be mandatory in all cases.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.32 no.8B
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• pp.482-491
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• 2007

This paper proposes a k-disjoint-path routing algorithm that provides energy efficient and reliable message transmission in wireless sensor networks. The proposed algorithm sends messages through a single path without the occurrence of critical events. However, it sends through k disjoint paths(k>1) under the occurrence of critical events. The proposed algorithm detects the occurrence of critical events by monitoring changing data patterns, and calculates k from a well-defined fault model and the target-delivery ratio. Our simulations reveal that the proposed algorithm is more resilient to node failure than other routing algorithms, and it also decreases energy consumption and reduces the average delay much more than multi-path and path-repair algorithms.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.1-12
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• 2015

Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.8 no.2
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• pp.1-11
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• 1988

The flexible highway pavement is a layered structure. The safety of the pavement is a function of the load induced by traffic and the layer strength of asphaltic concrete mixture. Therefore, the probabilistic approach was applied to the pavement system to evaluate the reliability. Monte Carlo simulation technique was used for the reliability study. Data used were colleted from the field or literature. A critical tensile strength for each layer was estimated based on a target reliability from the simulation. The critical strength was evaluated by comparing the strengths with the actual surface distress. The result shows that the critical strength estimated in the probabilistic approach is valid for the current highway condition.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.7 no.1
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• pp.39-43
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• 2013

In this paper, we present a effective method of gait rehabilitation training using critical point of median frequency in muscle fatigue analysis using EMG. To target the five healthy volunteers, EMG signal were measured in the quadriceps femoris muscle and the tibialis anterior muscle in order to determine muscle fatigue. We performed a test targeting three adult male for 30 minutes on a treadmill at a speed of 6km/h same. EMG signal analysis in frequency and median frequency is calculated to quantification of muscle fatigue, and calculated the critical point which is saturated by muscle fatigue during 30 minutes. We set saturated point the threshold which muscle can withstand. The results of this paper, we are able to quantify the threshold of the muscle.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.89-95
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• 2021

Lung cancer is one of the leading causes of cancer-related deaths in Korea. Although the smoking rate has decreased over time, the prevalence of lung cancer still remains high. In this study, we reviewed recent trends on the incidence, epidemiology, screening, diagnosis, and treatment of lung cancer in Korea by analyzing data from the national lung cancer registry and recently-published studies. Although approximately 40% of patients with non-small cell lung cancer (NSCLC) were diagnosed as stage IV, the 5-year relative survival rate improved from 11.3% (1993-1995) to 30.2% (2013-2017), possibly due to advances in methods of diagnosis and therapy. In addition, the 2019 implementation of the national lung cancer screening program with low-dose computed tomography may have also contributed to these improvements in survival rates. Recently, molecular diagnosis has become more widely used in the identification of genetic mutations in tissue specimens. Target therapy and immune checkpoint inhibitors have also been successfully used, particularly in cases of advanced NSCLC. In the future, further research on the optimal management of lung cancer remains necessary.

• Proceedings of the Korea Concrete Institute Conference
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• 2001.11a
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• pp.453-458
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• 2001

This paper presents the procedure to find the hysteresis loop of RC member using a modified strut-and-tie model. The forces and displacements at critical points, that are initial yielding point, target displacement point, unloading elastic limit, and reloading point after pinching, are investigated with the strut-and-tie models. Using bond-slip relationship, the elastic behavior of tie element is determined. The plastic flow behavior after flexural yielding is expressed by changing the location of longitudinal strut. Determination of pinching effect completes the initial hysteresis loop, assuming that the behavior of the opposite direction is symmetrical form.

• Transactions on Electrical and Electronic Materials
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• v.4 no.4
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• pp.10-12
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• 2003

NBCO thin films have been fabricated by magnetron sputtering technique on heated $SrTiO_3$ substrates. The oxidation and crystallization of the films were strongly dependent on the distance between the targets and the substrate, as well as on the oxygen partial pressure. The critical temperatures were above 80K for the films prepared under the condition of a small target to substrate gap, in spite of a very low oxygen pressure of 0.2Pa. The results suggest the importance of the activated oxygen uptake into the films during sputtering.