• Title/Summary/Keyword: effective clearance

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A Case of Pulmonary Alveolar Proteinosis Associated with Pulmonary Tuberculosis (폐결핵과 병발된 폐포단백증 1예)

  • Park, Min Sik;Jung, Sung Chang;Jin, Myoung In;Lee, Jin Bae;Lim, Sang Hyuk;Park, Sung Hun;Chung, Seung Hie;Shin, Tae Rim;Hyun, Dae Sung;Lee, Sang Chae;Yun, Kil Suk;Kwon, Kun Young
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.411-418
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    • 2002
  • Pulmonary alveolar proteinosis(PAP) is a disorder in which an insoluble, proteinaceous material, rich in phospholipids, is deposited in the alveoli and bronchioles. The deficiency in the clearance and degradation of the intra-alveolar phospholipoproteinaceous material in PAP most likely represents a dysfunction of the type II pneumocytes. Although the pathogenesis and causative treatment of PAP is unclear a whole lung bronchopulmonary lavage is a relatively safe and effective treatment. Here we experienced a case of pulmonary alveolar proteinosis in a 62 year old female patient who had pulmonary tuberculosis approximately 20 years ago. She complained of aggravated dyspnea and chronic cough, and presented fine inspiratory crackles at both lung fields, diffuse ground glass opacity with some area of consolidation and smooth interlobular septal thickenings in both upper, right middled lobes, and a portion of right lower lobe. Optical microscopy of the lung tissue obtained by and open lung biopsy revealed many granulomas containing acid-fast smear positive bacilli and diffuse homogeneous PAS-positive fluid in the alveolar space. Immunohistochemical stain showed surfactant. A in the alveolar space. Antituberculosis drugs with bronchoalveolar lavage were used to treat the disease. Thereafter she showed improvement in her symptoms and a partial improvement in the chest X-ray and HRCT findings. We present a case of PAP associated with pulmonary tuberculosis.

Effects of a Home Respiratory Management Program on Unmet Healthcare need and Healthcare resource utilizations for Patients applying Home Mechanical Ventilator with Amyotrophic Lateral Sclerosis (가정형 인공호흡기 사용 중인 재가 근위축성 측삭증후군 환자의 가정간호기반 호흡관리 프로그램이 미충족의료와 의료자원이용에 미치는 효과)

  • Hwang, Moon Sook;Park, Jin-Hee
    • Journal of Industrial Convergence
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    • v.17 no.4
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    • pp.77-86
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    • 2019
  • The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.

A Study on the Experiment of Represtressed Preflexional Composite Beams (RPF 합성보의 실험 연구)

  • Chang, Dong Il;Hwang, Yoon Kook;Kim, Jung Ho;Cho, Tae Jun
    • Journal of Korean Society of Steel Construction
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    • v.9 no.4 s.33
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    • pp.697-705
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    • 1997
  • The conventional preflex beams are designed by the method of paritial prestressing and allow the tensile stresses at the lower concrete of beams. As a consequence, most of preflex beams experience the tensile cracks under the service loads. This study was conducted to develop the most effective preflex beams, which do not allow tensile stress under the service load, by introducing additional prestressing called 'represtressing' at the lower concrete of beams. The objective of the study was accomplished by developing a computer analysis and design program and conducting experiments. Using the developed computer program, standard sections of the represtressed preflex beams were determined by computer modeling. In the experiment, two actual size of represtressed beams were tested under the imitated service loads. The results of test have shown that the performance of the represtressed preflex beams is generally excellent. A remarkable improvement was made in the design of preflex composite beams. Since the represtressed preflex beams(RPF) do not experience the tensile cracks under the service loads, the use of this beam for the bridge structures will lead to easy bridge maintenance and management. Furthermore, due to the low beam depth, high clearance and economical design can be realized in the bridge design using RPF.

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Effect of low-dose Aprotinin on Postoperative Bleeding and Renal Function after Cardiopulmonary Bypass (체외순환후 출혈감소와 신기능에 미치는 저용량 aprotinin효과)

  • 박철현;현성열;이현재;박국양;김주이;임창영
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.32-39
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    • 1998
  • High-dose aprotinin(Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243$\pm$ 123 ml versus 406$\pm$303 ml(P=0.037) during 6 hours immediate-postoperatively, 494$\pm$358 ml versus 869$\pm$570 ml(P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference(55$\pm$23 versus 24$\pm$10 in the alpha-1-microglobulin/creatinine, 56$\pm$19 versus 38$\pm$25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.

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The prediction Models for Clearance Times for the unexpected Incidences According to Traffic Accident Classifications in Highway (고속도로 사고등급별 돌발상황 처리시간 예측모형 및 의사결정나무 개발)

  • Ha, Oh-Keun;Park, Dong-Joo;Won, Jai-Mu;Jung, Chul-Ho
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.9 no.1
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    • pp.101-110
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    • 2010
  • In this study, a prediction model for incident reaction time was developed so that we can cope with the increasing demand for information related to the accident reaction time. For this, the time for dealing with accidents and dependent variables were classified into incident grade, A, B, and C. Then, fifteen independent variables including traffic volume, number of accident-related vehicles and the accidents time zone were utilized. As a result, traffic volume, possibility of including heavy vehicles, and an accident time zone were found as important variables. The results showed that the model has some degree of explanatory power. In addition, when the CHAID Technique was applied, the Answer Tree was constructed based on the variables included in the prediction model for incident reaction time. Using the developed Answer Tree model, accidents firstly were classified into grades A, B, and C. In the secondary classification, they were grouped according to the traffic volume. This study is expected to make a contribution to provide expressway users with quicker and more effective traffic information through the prediction model for incident reaction time and the Answer Tree, when incidents happen on expressway

Clinical Pharmacokinetics of Vancomycin in Ovarian Cancer Patients (난소암 환자에서 반코마이신의 임상약물동태)

  • Kim, Yang Woo;Choi, Jun Shik;Lee, Jin Hwan;Park, Jae Young;Choi, Byong Chul;Burm, Jin Pil
    • Korean Journal of Clinical Pharmacy
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    • v.8 no.1
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    • pp.13-18
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    • 1998
  • The purpose of this study was to determine pharmacokinetic parameters of vancomycin using the compartment model dependent and compartment model independent analysis in 6 Korean normal volunteers and 8 ovarian cancer patients. Vancomycin was administered 1.0 g bolus by IV infusion over 60 minutes. The elimination rate constant ($\beta$), volume of distribution (Vd), total body clearance (CLt), and area under the plasma level-time curve (AUC) of vancomycin in normal volunteers using the compartment model dependent analysis were $0.150\pm0.030\;hr^{-1},\;32.9\pm2.81\;L/kg,\;5.36\pm0.63\;L/hr,\;and\;186.5\pm20.5\;{\mu}g/ml{\cdot}hr$, respectively. The $\beta$, Vd, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model dependent analysis were $0.109\;0.008\;hr^{-1},\;41.5\pm3.01\;L/kg,\;4.58\pm0.57\;L/hr\;and\;218.3\pm22.9\;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05,\;p<0.01) in $\beta$, Vd, CLt, and AUC between normal volunteers and ovarian cancer patients. The elimination rate constant (Kel), CLt, and AUC of vancomycin in normal volunteers using the compartment model independent analysis were $0.152\pm0.022\;hr^{-1},\;5.77\pm0.75\;L/hr,\;and\;173.2\pm22.5;{\mu}g/ml{\cdot}hr$, respectively. The Kel, CLt, and AUC of vancomycin in ovarian cancer patients using the compartment model independent analysis were $0.126\pm0.012\;hr^{-1},\;4.96\pm0.55\;L/hr,\;and\;201.7\pm25.6;{\mu}g/ml{\cdot}hr$, respectively. There were significant differences (p<0.05, p<0.01) in Kel, CLt, and AUC between normal volunteers and ovarian cancer patients. And also, there was significant difference (p<0.05) in Kel of vancomycin in ovarian cancer patients between the compartment model dependent and independen analysis. It is necessary for effective dosage regimen of vancomycin in ovarian cancer patient to use these population parameters.

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A Preliminary Study for Effect of High Flow Oxygen through Nasal Cannula Therapy in Carbon Monoxide Poisoning (일산화탄소 중독 환자에서 고유속 비강 캐뉼라 산소치료 효과에 대한 예비 연구)

  • Kim, Young-Min;Kim, Sang-Chul;Park, Kwan-Jin;Lee, Seok-Woo;Lee, Ji-Han;Kim, Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.102-107
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    • 2019
  • Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

Therapeutic Efficacy of Prednisolone Withdrawal Followed by Recombinant ${\alpha}$ Interferon in Children with Chronic Hepatitis B (소아 만성 B형 간염 환자에서 스테로이드 이탈 요법 후 인터페론 병용 투여의 치료 효과)

  • Ryu, Na-Eun;Kim, Byung-Ju;Ma, Jae-Sook;Hwang, Tai-Ju
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.169-177
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    • 1999
  • Purpose: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. Methods: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT ${\geq}$ 100 IU/L and HBV DNA ${\leq}$ 100 pg/$300\;{\mu}L$) received interferon alpha 2a 5 $MU/m^2$ of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/$300\;{\mu}L$) received prednisolone in decreasing daily doses of 60 mg/$m^2$, 40 mg/$m^2$, and 20 mg/$m^2$, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. Results: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. Conclusion: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.

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A Feasibility Study of the K-LandBridge through a Linear Programming Model of Minimum Transport Costs (최소운송비용의 선형계획모형을 통한 K-LandBridge의 타당성 연구)

  • Koh, Yong Ki;Seo, Su Wan;Na, Jung Ho
    • Journal of Korea Port Economic Association
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    • v.32 no.3
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    • pp.95-108
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    • 2016
  • China has recently advocated a national strategy called "One Belt One Road" and transferred to execution to refine it into detailed action plans and has continued to fix the complement. However, the Korean Peninsula, including the North Korea remains could not be included at all in the Chinese development policy and framework in terms of the International Logistics. Currently it is raised between Korea-China rail ferry system again and that is when we need to make effective policy development on international multimodal transport system in Northeast Asia. This paper introduces the K-LB (Korea LandBridge) as its execution plan and conducted a feasibility study on this. K-LB consists of a Korea-Russian train ferry system based in Pohang Yeongil New Port(light-wing) and a Korea-China train ferry system based in Saemangeum New Port(left-wing). These two wings are linked to the existing rail system in Korea. This study is convinced that the K-LB is an effective international logistics system in the current terms and conditions and also demonstrated that it is feasible to introduce th K-LB on the peninsula. More strictly speaking, through a linear programming under objective function that minimize the transport cost quantified prior to demonstrate the feasibility, the available ranges and conditions for the transportation costs that are ensured the effectiveness of the K-LB are presented as results. According to the results, if the transport cost of K-LB is cheaper about 34.5% than that of sea transport such as container transport, the object goods may be transported by K-LB on this route. It means that the K-LB system has a competitive advantage due to more rapid customs clearance as well as omitted loading and unloading procedures over container transportation system. It also noted that the threshold level may not be large. Therefore, K-LB has competitive enough to prove its introduction in the Northeast Asian logistics system.

A STUDY ON THE CHANGE OF SALIVARY FLUORIDE CONCENTRATION WITH TIME AFTER VARIOUS TOPICAL FLUORIDE TREATMENTS (각종 불소처치 이후 시간변화에 따른 타액내 불소농도 변화에 관한 연구)

  • Park, Soo-Jin;Kim, Hyung-Doo;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.262-274
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    • 1999
  • Several alternatives for increasing the fluoride concentration in the mouth, such as water fluoridation, ingestion of fluoride supplements, fluoride paste, fluoride mouthrinse, application of fluoride gel are available. There is an impressive body of evidence that the topically deliverd fluorides are clinically effective in inhibiting the progression of dental caries. Recent studies on the cariostatic action of fluoride have indicated the importance of fluoride in the fluid environment of the teeth. The fluoride levels in unstimulated whole saliva can be considered indicative of F in the aqueous phase available for interaction with the tooth surface at a given time. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The aim of this study was to determine the elevation and clearance of fluoride in whole saliv after the following topical flouride treatments using HMDS-diffusion technique and fluoride ion electrode. The obtained results were as follow: 1. Average salivary fluoride concentration in the unstimulated whole saliva was $0.0152ppm{\pm}0.0091ppm$. Unstimulated salivary flow rate was between 0.34-0.36ml/min and there was no statistically significant difference among the groups(p>0.05). 2. Except for the immediate time after treatment, fluoride levels followed as APF gel>neutral gel>F-rinse>F-paste. There was no statistical difference between the salivary F concentration of F-paste group and that of control group after 2 hours. In case of F-rinse group, after 3 hours the concentration had dropped to baseline value. But there was statistically significant difference among the F concentraion of F gel groups and that of control group(p<0.05). 3. The mean $AUC_{0-120min}$ values were followed as neutral gel>APF gel>F-rinse>F-paste, and the values of the two former groups were significantly higher than those of the two latter groups(p<0.05).

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