Background: When we define the pressure of pulmonary vasculature in which a recruitment of blood flow occurs as $P_I$ and the proportion of change in pulmonary artery to that in cardiac output as IR and then we compare PI and IR with pulmonary vascular resistance, we would find some problems in pulmonary vascular resistance. In other words, it is the theory that, IR should be increased mainly in pulmonary embolism in which decreases the cross sectional area of pulmonary vasculature. But there are many contradictory reports resulted from various researches and the fact is known widely that any difference exists between PVR and PI, IR. For this reason, the purpose of this study is to observe how PI and IR change at the time of the outbreak and during treatment of the pulmonary embolism, and to find out the meaning of these new indicators and the difference from the pulmonary vascular resistance used generally when we subdivide the pulmonary vascular resistance into PI and IR. Method: After making AV fistula in experimental dog, we controlled cardiac output at the intervals of 15 minute in case of three kinds(all AV fistula are obstructed, only one of fistula is open and all of fistula is open), and after evoking massive pulmonary embolism with radioactive autologous blood clots, we measured the mean pulmonary artery pressure, and calculated PI and IR. We observed the pattern of change in PI and IR, without giving the control group any specific treatment and with injecting intravenously rtPA in the Group 1 and Group 2 at the dose of 1mg per kg, for 15 minutes fot the former and 3 hours for the latter. Result: 1) Pulmonary vascular resistance showed a change similar to that of pulmonary artery pressure and in all three group, PVR increased significantly, but group 1 and group 2 showed tendency that PVR keeps on decreasing after treatment, and the rate of decrease in group 1 is more rapid than group 2 significantly. 2) Both intersection(PI) and degree(IR) are proved statistically significant, in view of the straight line relationship between cardiac output and pulmonary artery pressure, calculated by minimal regression method. 3) PI changed similarly to pulmonary vascular resistance, while in the IR which is theoretically more similar to PVR, there was no significant difference or change after rtPA infusion. Conclusion: In the pulmonary embolism, Both change in IR which means real resistance of pulmonary vasculature and PI which was developed due to secondary vasoconstriction by pulmonary embolism are reflected same time.
Park, Seung-Kyu;Choi, In-Hwan;Kim, Cheon-Tae;Song, Sun-Dae
Tuberculosis and Respiratory Diseases
/
v.44
no.6
/
pp.1234-1244
/
1997
Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.
Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.
Kim, Joung-Ryul;Park, Jong-Sung;Choi, Young-Youn;Song, Oh-Sung
Journal of the Korean Vacuum Society
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v.17
no.6
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pp.528-537
/
2008
60 nm and 20 nm thick hydrogenated amorphous silicon(a-Si:H) layers were deposited on 200 nm $SiO_2$/single-Si substrates by inductively coupled plasma chemical vapor deposition(ICP-CVD). Subsequently, 30 nm-Ni layers were deposited by an e-beam evaporator. Finally, 30 nm-Ni/(60 nm and 20 nm) a-Si:H/200 nm-$SiO_2$/single-Si structures were prepared. The prepared samples were annealed by rapid thermal annealing(RTA) from $200^{\circ}C$ to $500^{\circ}C$ in $50^{\circ}C$ increments for 40 sec. A four-point tester, high resolution X-ray diffraction(HRXRD), field emission scanning electron microscopy(FE-SEM), transmission electron microscopy(TEM), and scanning probe microscopy(SPM) were used to examine the sheet resistance, phase transformation, in-plane microstructure, cross-sectional microstructure, and surface roughness, respectively. The nickel silicide from the 60 nm a-Si:H substrate showed low sheet resistance from $400^{\circ}C$ which is compatible for low temperature processing. The nickel silicide from 20 nm a-Si:H substrate showed low resistance from $300^{\circ}C$. Through HRXRD analysis, the phase transformation occurred with silicidation temperature without a-Si:H layer thickness dependence. With the result of FE-SEM and TEM, the nickel silicides from 60 nm a-Si:H substrate showed the microstructure of 60 nm-thick silicide layers with the residual silicon regime, while the ones from 20 nm a-Si:H formed 20 nm-thick uniform silicide layers. In case of SPM, the RMS value of nickel silicide layers increased as the silicidation temperature increased. Especially, the nickel silicide from 20 nm a-Si:H substrate showed the lowest RMS value of 0.75 at $300^{\circ}C$.
Purpose : The aim of this study was to evaluate the difference of bone mineral density according to distal radius rotation and to develop the supporting tool to measure rotation angles. Materials and Methods : CT scanning and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 20 males. Twenty healthy volunteers without any history of operations, anomalies, or trauma were enrolled. The CT scan was used to evaluate the cross sectional structure and the rotation angle on the horizontal plane of the distal radius. The rotational angle was measured by the m-view program on the PACS monitor. The DXA was used in 20 dried radii of cadaveric specimens in pronation and supination with five and ten degrees, respectively, including a neutral position (zero degrees) to evaluate the changes of BMD according to the rotation. Results : The mean rotation angle of the distal radius on CT was 7.4 degrees of supination in 16 cases (80%), 3.3 degrees of pronation in three cases (15%), and zero degree of neutral in one case (9%), respectively. The total average rotation angle in 20 people was 5.4 degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained at 3.3 degrees of supination. Conclusion : In the case of the measurement of BMD in the distal radius with a neutral position, the rotational angle of the distal radius is close to supination. Pronation is needed for the constant measurement of BMD in the distal radius with the rotation angle measuring at the lowest BMD and about five degrees of pronation of the distal radius is recommended.
Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
Journal of the Korea institute for structural maintenance and inspection
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v.15
no.6
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pp.135-146
/
2011
Steel structures have been generally painted to prevent corrosion damage. However, the painted film is deteriorated with increase in service life, and then corrosion damage resulting in cross sectional area occurs on steel surface. As a result, the buckling strength of steel structures can be decreased due to the corrosion damages. The evaluation method of the axial buckling strength of columns about a variety of section shapes and supporting conditions have been presented, but evaluation method of buckling strength about irregular nonprismatic columns is not established. In this study, the axial buckling strength of corroded steels was evaluated based on the buckling test results of corroded steel specimens that were cut off at a temporary steel structure. The corroded specimens were picked up total 10 specimens according to various slenderness ratio from the web of a temporary structure's main beam. The length of specimens is 200, 300, 400, 500 and 600mm respectively. The rust productions were removed by the chemical treatment. Then, the surface geometry was measured at intervals of $1{\times}1mm$ by using the optical 3D digitizing system, and the residual thickness of the specimens was calculated. The axial buckling test was performed on 10 corroded specimens and 12 non-corroded specimens under the fixed-fixed support condition. From the test results, the effect of corrosion damages on axial buckling load was investigated. Regardless of corrosion damage degree, the axial buckling strength of corroded specimens and non-corroded specimens was evaluated identically by using minimum average residual thickness or average residual thickness to minus its standard deviation. Reasonable measuring intervals of residual thickness was proposed by using the results to apply for practical works.
Um, Mi Hyang;Park, Yoo Kyoung;Song, Yoon Mi;Lee, Song Mi;Lyu, Eun Soon
Journal of Nutrition and Health
/
v.50
no.5
/
pp.519-529
/
2017
Purpose: The purpose of this study was to explore whether or not there is a relationship between doctor's awareness of clinical nutrition service and needs for a clinical dietitian. Methods: A cross-sectional survey design was used. The research was carried out by using questionnaires that had been specifically designed for the study. The research was conducted from September to October, 2013 for 311 doctors at 43 hospitals (with over 400 beds). Frequency analysis, factor analysis, reliability analysis, confirmatory factor analysis, and bootstrapping analysis were conducted using SPSS 21.0. Results: 'Implementation of clinical nutritional service' (p < 0.001) and 'usefulness on clinical nutrition service' (p < 0.001) were found to be correlated with 'importance of clinical nutrition service' as an independent variable. The correlation between 'importance of clinical nutrition service' as a mediating variable and 'needs for clinical dietitian' as a dependent variable was also confirmed (p < 0.001). The results of the bootstrapping test showed that the mediating effect of 'importance of clinical nutrition service' was significant. The indirect effect value between 'implementation of clinical nutrition service' and 'needs for clinical dietitian' was 0.040, indirect effect value between 'usefulness on clinical nutrition service' and 'needs for clinical dietitian' was 0.095. Conclusion: The frequency of providing clinical nutritional services, the quality of clinical nutritional services, and the degree of implementation of clinical nutritional services were found to be important for positive perception of clinical nutrition services by doctors. Therefore, proper provision of clinical nutrition services and effective therapeutic effects will be continuously highlighted, which will increase the awareness of the physician and ultimately increase the demand for clinical nutrition service.
Purpose: The purpose of this cross-sectional study was to investigate intake-related factors of energy drinks and educational needs regarding energy drinks in female high school students. Methods: Subjects were 340 female high school students in Incheon, and data were collected using self-administered questionnaires. Statistical analysis was performed using the SPSS 20.0 program. Results: Subjects who had drunk energy drinks were 74.3% (249 subjects) of all subjects. The first time they drank an energy drink was significantly associated with grade (p < 0.05). In 75.1% of 249 subjects who had drunk energy drinks, the places for buying energy drinks were supermarkets and convenience stores near their homes. For the effects of energy drink intake, sleeplessness (44.6%) and no effect (41.7%) were cited, and 24.5% experienced side effects such as palpitation, tremors, etc. The scores for self-diagnosis of caffeine addiction were significantly higher in the low weight group compared to the overweight group (p < 0.05). The degree of caffeine addiction was significantly associated with effects of energy drink intake (p < 0.001) and type of side effects (p < 0.001). Willingness to stop consuming energy drinks (p < 0.001) and necessity of nutrition education about energy drinks (p < 0.05) were significantly lower in the caffeine addiction group compared to the general group. About 75.0% of subjects wanted to be educated about the side effects of energy drinks and caffeine. Conclusion: This study shows that female high school students need proper education about the effects of intake of energy drinks. Therefore, guidelines and a nutrition education program right intake of energy drinks should be provided as well as campaigns concerning the side effects of energy drinks and caffeine in female high school students.
This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.
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