Concrete tunnel lining must be designed to having the fireproof performance because the lining are sometimes exposed to very high temperature due to traffic accident. Such fire temperature may cause explosion of concrete, or collapse of tunnel structure. The purpose of this study is to obtain the fundamental fireproof behavior of fire resistance-engineered cementitious composites(FR-ECC) under fire temperature in order to use the fire protection material in tunnel lining system. The present study conducted the experiment to simulate fire temperature by employing 2 types of FR-ECC and investigated experimentally the explosion and cracks in heated surface of these FR-ECC. Employed temperature curve were hydro carbon(HC, ECl) criterion, which are severe in various criterion of fire temperature. The numerical analysis is carried out the nonlinear transient heat flow analysis and verified against the experimental data. The complex features of behavior in fire conditions, such as thermal expansion, plasticity, cracking or crushing, and material properties changing with temperature are considered. By the use of analytical model, the concrete tunnel subjected to fire loads were analyzed and discussed. With comparison of current concrete materials and FR-ECC, the experimental and analytical results of FR-ECC shows the better fire resistance performance than the other.
A research projects is currently being conducted to develop a nonlinear finite element analysis methods for predicting the structural behavior of reinforced concrete frame structures, exposed to fire. As part of this, reinforced concrete frames subjected to fire loads were analyzed using the nonlinear finite-element program DIANA. Two numerical steps are incorporated in this program. The first step carries out the nonlinear transient heat flow analysis associated with fire and the second step predicts the structural behavior of reinforced concrete frames subjected to the thermal histories predicted by first step. The complex features of structural behavior in fire conditions, such as thermal expansion, plasticity, cracking or crushing, and material properties changing with temperature are considered. A concrete material model based on nonlinear fracture mechanics to take cracking into account and plasticity models for concrete in compression and reinforcement steel were used. The material and analytical models developed in this paper are verified against the experimental data on simple reinforced concrete beams. The changes in thermal parameters are discussed from the point of view of changes of structure and chemical composition due to the high temperature exposure. Although, this study considers codes standard fire for reinforced concrete frame, any other time-temperature relationship can be easily incorporated.
This study is to evaluate contamination of the 3-way stopcocks connected to infusion set, which is used to the patients admitted to emergency room in a general hospital in D city. The data were collected from Oct. 1, 2001 to Feb. 25, 2002. First of all, in order to select microorganisms, From the 50 patients were randomized, Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus, Pseudomonas aeruginosa, Acinetobacter detected. Coagulase Negative Staphylococcus, Staphylococcus aureus, micrococcus were determined to be evaluated in this study. As a result, 8 of the patients were Coagulase Negative Staphylococcus positive(>15 colonies), 4 were Staphylococcus aureus positive(>15 colonies). 1 was micrococcus positive(>15 colonies). Among the patients who were Coagulase Negative Staphylococcus positive 112(average) colonies were detected on the first day, 429 were on the second day, and 563 were on the third day. In case of patients of Staphylococcus aureus positive, 85(average) colonies were detected on the first day, 151 were on the second day, and the 203 were on the third day. CNS was cultured using API kit for the 8 patients who were in CNS positive. One case was detected Staphylococcus capitis, another one case was Staphylococcus chromogenes. Two cases were Staphylococcus xylosus, another two were Staphylococcus hominis, and the remainer were Staphylococcus epidermidis. As a result, the API codes of two Staphylococcus epidermidis had shown the same pattern, and the resistance patterns of the them were the same, too. As a result of resistance test among 5 patients who have shown that the same resistance pattern in 02SAK1, 02SAK5, 02SAK2, 02SAK4. As a result of this study, aseptic technique of 3-way stopcock intravenous therapy can protect infections, and it is needed the sterilization of the 3-way stopcock just before injection using disinfectants. It needs to improve the 3 way stopcock change intervals from 48 hours.
The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.
The present study was retrospectively designed to define whether preoperative levels of leukocytes and D-dimer are potentially useful factors in predicting perioperative outcomes of coronary heart disease (CHD). There was no relationship between preoperative leukocyte counts (Pre-OP leukocyte) and preoperative D-dimer levels (Pre-OP D-dimer). Pre-OP leukocyte counts each had positive correlation with cardiac troponin-I, creatine kinase-MB or C-reactive protein (cardiac markers) levels at preoperative and postoperative periods. Pre-OP D-dimer levels were positively associated with each cardiac marker at the same periods. Pre-OP leukocyte counts positively related with aspartate aminotransferase and alanine aminotransferase (liver markers), whereas Pre-OP D-dimer level positively or negatively correlated with bilirubin (liver marker), creatinine (renal marker) or glucose levels at preoperative and/or postoperative periods. Pre-OP leukocyte and Pre-OP D-dimer were inversely associated with Pre-OP high density lipoprotein cholesterol levels or left ventricular ejection fraction. Pre-OP leukocyte counts each had positive correlation operation duration and postoperative mechanical ventilation-time (PMVT), whereas Pre-OP D-dimer levels had positive relationship with PMVT, intensive care unit-staying period and hospitalization. The retrospective data suggest that Pre-OP leukocyte and Pre-OP D-dimer levels may be clinically useful factors for predicting perioperative outcomes in patients with CHD.
Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.
Journal of the Institute of Electronics Engineers of Korea SC
/
v.44
no.5
/
pp.45-54
/
2007
Time/frequency analysis has been extensively used in biomedical signal processing. By extracting some essential features from the electro-physiological signals, these methods are able to determine the clinical pathology mechanisms of some diseases. However, this method assumes that the signal should be stationary, which limits its application in non-stationary system. In this paper, we develop a new signal processing method using Hilbert-Huang Transform to perform analysis of the nonlinear and non-stationary ventricular fibrillation(VF). Hilbert-Huang Transform combines two major analytical theories: Empirical Mode Decomposition(EMD) and the Hilbert Transform. Hilbert-Huang Transform can be used to decompose natural data into independent Intrinsic Mode Functions using the theories of EMD. Furthermore, Hilbert-Huang Transform employs Hilbert Transform to determine instantaneous frequency and amplitude, and therefore can be used to accurately describe the local behavior of signals. This paper studied for Return Of Spontaneous Circulation(ROSC) and non-ROSC prediction performance by Support Vector Machine and three parameters(EMD-IF, EMD-FFT) extracted from ventricular fibrillation ECG waveform using Hilbert-Huang transform. On the average results of sensitivity and specificity were 87.35% and 76.88% respectively. Hilbert-Huang Transform shows that it enables us to predict the ROSC of VF more precisely.
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.
Background : Computer- and web-based simulation methods help students develop problem solving and decision making skills. In addition, they provide reality based learning to the student clinical experience with immediate medical feedback as well as repetitive training, on-site reviews and case closure. Materials and Methods : Seventy-five third-year medical students participated in a two-week simulation program. The students selected four modules from eight modules as follows: airway and breathing 1, cardiac arrest 1, cardiac arrhythmia 1, and chest pain 1, and then selected the first case within each of the modules. After 2 weeks, a pass score was obtained and the data analyzed. The average pass score of over 70% was considered a passing grade for each module. If the student did not pass each module, there was no score (i.e., pass score was zero). In addition, when at least one of the four modules was zero, the student was not included in this study. Results : Seventy-five students participated in the simulation program. Nineteen students were excluded based on their performance. The final number of students studied was 56 students (74.7%). The average scores for each module 1 to 4 were 86.7%, 85.3%, 84.0%, and 84.0%, and the average obtained pass score was 88.6 for the four modules in all 56 students. Conclusion : Medical simulation enabled students to experience realistic patient situations as part of medical learning. However, it has not been incorporated into traditional educational methodology. Here we describe the introduction and the development of various simulation modules and technologies for medical education.
Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.
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