Boprosthetic cardiac valves fail from biological and metabolic as well as mechanical reasons, and the limited durability is the main factor of marked withdrawal in their clinical use. Starting the use of bioprosthetic valves in 1976, up to the end of 1992, the consecutive 178 patients have undergone re-replacement of glutaraldehyde-treated xenograft valves for primary tissue failure [PTF]among the patients who had initial valve replacement at Seoul national University Hospital. The explanted valves were 69 porcine aortic [51 Hancock, 12 Angell-Shiley and 6 Carentier-Edwards] and 141 bovine pericardial [129 standard-profile and 12 low-profile ionescu-Shiley] valwes, with an overall incidence of PTF of 15.2%. The operative mortality rate of re-replacement was 5.1%. Calcific degeneration and tissue damage in relation to calcification were the most frequent modes of PTF on gross examinatin of the explanted valves resulting hemodynamically in valvular regurgitation. The number of Hancocg porcine and the standard-profile Ionescu-Shiley valves in valves in mitral position failed more often from tissue damage [tears, holes, and loss or destruction of cuspal tissue] than calcification [68.3% vs. 39.0%, p<0.01] with resultant regurgitation in 61%, the Ionescu-Shiley valves in the same position in 53%. The tendency of more calcification than tissue damage[71.3% vs. 33.3%, p<0.001]with stenosis in 53%. The tendency of more calcification and immobility of cusps in the latter group was partly explainable by the inclusion of patients of pediatric age. Observation made in this study suggest : many of bioprosthetic valves would fail from calcification and tissue damage : some fail prematurely because of mechanical stress probably owing to the valve design in construction ; andeven those valves escaped early damage would be subject to calcify in the prolonged follow-up period. In conclusion, at the present time, the clinical use of bioprostheticxenograft valves seems to be quite limited until further improvement in biocompatibility and refinement in valve design in manufacture are achieved.
The purpose of this study is to assess the accurate state of the following: total welding fumes versus welding fumes in the air, respirable particulate mass, and exposure of dockyard welders to heavy metals. In addition, this study provides basic data for proposing improvements to create efficient and appropriate welding environments and to prevent occupational diseases. The subjects of this study were 94 laborers who worked at the block construction sites of large-scale dockyards located in Gyeongnam Province from March 2005 to June 2005. In order to collect samples on total welding fumes in the air and respirable particulate mass from the welders, Methods 0500 and 0600, established by the National Institute for Occupational Safety and Health (NIOSH), were used. The metals within the welding fumes were also analyzed using Inductively Coupled Plasma (ICP) under Method 7300 from NIOSH. The results of this research are summarized below. The geometric mean concentration of total welding fumes and that of respirable particulate mass were $4.11\;mg/m^3\;and\;3.53\;mg/m^3$, respectively. As a result of comparing the two measurement methods, there were significant differences (p<0.05) between the two groups for Ca, Cu, Cr, and Ni; however, there were no differences in Fe, Mg, Zn, Mg, Pb, and Cd. As a result of the analysis, the correlation between Mn and the concentration of heavy metals in the total welding fumes and respirable particulate mass was found to be -0.29, a significant negative correlation. The correlation between other heavy metals, however, was low. Finally, in the same total welding fumes, the correlation of Fe and Mg was high.
The retinoid-related orphan nuclear receptor gamma ($ROR{\gamma}$) plays critical roles in regulation of development, immunity and metabolism. As transcription factor usually forms a protein complex to function, thus capturing and dissecting of the $ROR{\gamma}$ protein complex will be helpful for exploring the mechanisms underlying those functions. After construction of the recombinant tandem affinity purification (TAP) plasmid, pMSCVpuro $ROR{\gamma}$-CTAP(SG), the nuclear localization of $ROR{\gamma}$-CTAP(SG) fusion protein was verified. Following isolation of $ROR{\gamma}$ protein complex by TAP strategy, seven candidate interacting proteins were identified. Finally, the heat shock protein 90 (HSP90) and receptor-interacting protein 140 (RIP140) were confirmed to interplay with $ROR{\gamma}$ by co-immunoprecipitation. Interference of HSP90 or/and RIP140 genes resulted in dramatically decreased expression of CYP2C8 gene, the $ROR{\gamma}$ target gene. Data from this study demonstrate that HSP90 and RIP140 proteins interact with $ROR{\gamma}$ protein in a complex format and function as co-activators in the $ROR{\gamma}$-mediated regulatory processes of HepG2 cells.
If remodeling is defined as activities that restore the overall function of a building up to the standards currently demanded rather than as a simple replacement or repair of old facilities and equipment, the main task of remodeling should be the reduction in differences between areas, establishment of a functional linkage between departments and setup of a smooth circulation system. Therefore, this study is an analysis of remodeling strategies and construction processes to resolve major tasks of remodeling. Through this research we acquire concluding remarks. 1) The remodeling strategies of equipment-intensive areas can be divided into two measures: utilizing the existing buildings (the main buildings) the most, and of concentrated relocation in the new buildings. The former method is advantageous in that the main building serves as a center in hospital layouts because concentrated placement of the diagnosis/ treatment area and the supply area benefit the overall operation in terms of functions. However, the measure has limits in that it is difficult to install the facilities and equipment of the new demands due to the low ceilings, which serve as a potential challenge in future growth and changes. 2) The latter measure is the one in which equipment-intensive areas and the areas that are absolutely short of space are first placed in the new buildings while other areas (the outpatient area, the administration area and the miscellaneous areas) are in the existing building (main building). Given the possibility of development In the future, concentrated placement in the new buildings can be said to be more effective order to actively address future growth and changes.
Park, Jeong-Eun;Chung, Kwi-Ae;Cho, Hune;Kim, Hwa Sun
Women's Health Nursing
/
v.19
no.1
/
pp.1-12
/
2013
Purpose: This study was performed to propose an ontology methodology based on standardized nursing process as framework in obstetric and gynecologic nursing practice. Methods: The instrument used in this study was based on the nursing diagnosis classification established by North American Nursing Diagnosis Association (NANDA) (2009-2011), fifth edition of the Nursing Interventions Classification (NIC) (2008), forth edition of the Nursing Outcomes Classification (NOC) (2008) developed by Iowa State University and systematized nomenclature of medicine clinical terms (SNOMED CT). The nursing records data were collected from electronic medical records of one hospital from August to October 2010. Results: One hundred and forty-one nursing diagnosis statements used in obstetric and gynecologic nursing unit were linked standardized nursing classifications and constructed nursing diagnosis ontology including interoperability. Conclusion: Not only will this result be helpful to complete nurse's lack of knowledge and experience, it will also help to determine nursing diagnosis logically by using standardized nursing process. It will be utilized as the method to construct ontology including interoperability in other nursing units. It will be presented nursing interventions according to nursing diagnosis and thus will be easier to establish nursing planning. This can provide immediate feedback of the nursing process application.
Total quality management has been a focus of concern in recent years since some dissatisfaction with the results from implementation of quality assurance programs in the U.S. Many managerial methodologies and innovation guidelines from academic disciplines have been applied to promote TQM programs in the health field. This paper consists of two folds of aspects: firstly to examine TQM's managerial philosophy by comparing with the newly introduced managerial concepts in Business Reengineering; and then to introduce a method for an integrative way of process analysis, Entity Life-Cycle Diagram (ELCD) modeling. The analysis method was compared with Process Map, which is a well-known method for BR applications. To show effectiveness of ELCD modeling, a case of application was introduced using 'drug' as a target entity. With having TQM issues in mind, the result was reflected in designing Entity Relation Diagrams. The results of ELCD modeling turn out to be helpful in designing database related to quality monitoring, in that many monitoring check points can be identified in a systematic way and that queries cross-sectional over organizational boundaries can be generated with a consistent view focusing on the drug use as a single process. Full evaluation of the analysis method remains to be studied until the completion of the information system under construction. But as long as TQM is based on a process-oriented view and needs supports from information system, ELCD can be one of the appropriate choice as a tool for the process analysis.
The purpose of this study was to examne the relationship between sex-role-identity and life adjustment which adult patients perceive by means of the analysis of the relationship between the sex-role-identity and life adjustment which are perceived by adult patients who are hospitalized. The primary purpose of this study is to investigate how the adult patients describe their own Sex role-identity. Sceondary purpose is to find out whether their Sex role-identity is related to life adjustment and which life circumstances. If any are associated with Sex role identity. 207 adult patients who were older than 30 years living under 65 years were admitted to the hospital in Seoul. Were interviewed with measures including the Bem Sex Role Inventory short Form. Life adjustment and current life situation. For data analysis, X$^2$-test, ANOVA, and Scheffe test were used. The results are summarized as follows ; (1) Most adult patients described androgynous Sex role-identity. (2) Sex role-identity differentiated significantly life adjustment. (3) Perceived Sex role identity was related to the Several dimension of life sityation such as marital status family construction activity. By the result of this study, the present writer is to suggest as follows ; Firstly, in the aspect of the study of nursing the many -sided and desirable study on the relation between the sex-role-identity life ajustment, and the study which a nurse can control and prevent the anxiety of adult patients by means of examining the measure and the cause of the emotional support on a patient must be accomplished. Secondly, in the aspect of the aspect of the practical affairs of nursing the practical effort which puts emphasis on the whole personal nursing in the performance of the duty, and the institutional support in the nursing administration must be planned in order to increase the efficiency of the nursing service by promoting the whole -personal nursing role of a nurse.
The purpose of this study was to investigate Rn concentration and annual radiation exposure level in the basement and first floor. The Rn Cup monitors were placed in different environments such as shopping stage, office building, Apartment, Hospital, house in Seoul from Match 1996 to April 1997 and CR-39 films were collected every two months. The mean radon concentration in the basement of house($88.6\;Bq/m^3$) showed the highest level among the areas, while radon concentration on the first floor of house($50.5\;Bq/m^3$) showed the higher than other areas. The annual radiation exposure dose that person on the floor / in the basement of differential place in the seoul can be exposed during living was estimated from 24.11 to 87.64 mRem/yr. This radiation dose is significantly lower than 130mRem maximum radiation dosage from the radon nuclide prescribed by the ICRP, with respect to the overall average exposure of the working adult. this study indicated that possible radon sources on the first floor / in the basement areas are radon intrusion from soil gas, construction materials, or ground water leaking. Further study is needed to quantitatively assess major contributions of radon-222 and health effect to radon exposure.
This paper describes the construction of knowledge data retrieval management system based on medical image CT. The developed system is aimed to improve the efficiency of the hospital by reading the medical images using the intelligent retrieval technology and diagnosing the patient 's disease name. In this study, the medical image DICOM file of PACS is read, the image is processed, and feature values are extracted and stored in the database. We have implemented a system that retrieves similarity by comparing new CT images required for medical treatment with the feature values of other CTs stored in the database. After converting 100 CT dicom provided for academic research into JPEG files, Code Book Library was constructed using SIFT, CS-LBP and K-Mean Clustering algorithms. Through the database optimization, the similarity of the new CT image to the existing data is searched and the result is confirmed, so that it can be utilized for the diagnosis and diagnosis of the patient.
Purpose: This study aimed to derive the elements for effectively improving the management of emerging infectious diseases in the emergency room in large general hospitals. Methods: This research involved an analytic hierarchy process analysis of 10 experienced nurses working in a large general hospital located in the Seoul metropolitan area. The weighted values of the criteria for evaluating the importance of the management elements of patients with emerging infectious diseases in the emergency room of large general hospitals were derived using an analytic hierarchy process survey. Results: The results of the analytic hierarchy process analysis showed that experts considers responsiveness (0.291) as most important with respect to the criteria for the policy for isolation and control of infectious patients. The order of importance of the criteria for the policy for isolation and control of infectious patients were as follows: responsiveness (0.291), economical efficiency (0.257), feasibility (0.242), and sustainability (0.209). Subsequently, the weighted values of the management of the policy elements were determined based on the derived importance of the criteria mentioned above. These were, in order of priority, the construction of communication channels with the government authorities when dealing with emerging infectious diseases (15.9%), the equipment and provision of personal protective equipment to protect nurses from infection and dissemination of material (14.6%), and the operation of the isolation room and patient separation systems (14.1%). Conclusion: This study suggests critical strategies for infection control during a pandemic of emerging infectious disease.
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