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Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.465-473
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    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

Site Competition of Ca2+ and Cs+ Ions in the Framework of Zeolite Y (Si/Al = 1.56) and Their Crystallographic Studies (제올라이트 Y (Si/Al = 1.56) 골격 내의 Ca2+과 Cs+ 이온의 자리 경쟁 및 그들의 결정학적 연구)

  • Kim, Hu Sik;Park, Jong Sam;Lim, Woo Taik
    • Journal of the Mineralogical Society of Korea
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    • v.31 no.4
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    • pp.235-248
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    • 2018
  • The present work was performed in order to study the effect of competing cation of $Ca^{2+}$ ion on ion exchange of $Cs^+$ on zeolite Y (Si/Al = 1.56). Three single-crystals of fully dehydrated and partially $Cs^+$-exchanged zeolites Y (Si/Al = 1.56) were prepared by the flow method using mixed ion-exchange solutions. The $CsNO_3:Ca(NO_3)_2$ molar ratios of the ion exchange solution were 1 : 1 (crystal 1), 1 : 100 (crystal 2), and 1 : 250 (crystal 3) with a total concentration of 0.05 M. The single-crystals were then vacuum dehydrated at 723 K and $1{\times}10^{-4}Pa$ for 2 days. The structures of the crystals were determined by single-crystal synchrotron X-ray diffraction technique in the cubic space group $Fd{\bar{3}}m$, at 100(1) K. The unit-cell formulas of crystals 1, 2, and 3 were ${\mid}Cs_{21}Ca_{27}{\mid}[Si_{117}Al_{75}O_{384}]-FAU$, ${\mid}Cs_2Ca_{36.5}{\mid}[Si_{117}Al_{75}O_{384}]-FAU$, and ${\mid}Cs_1Ca_{37}{\mid}[Si_{117}Al_{75}O_{384}]-FAU$, respectively. In all three crystals, the $Ca^{2+}$ ions preferred to occupy site I in the D6Rs, with the remainder occupying sites I', II', and II. On the other hand, the significant differences in the fractional distribution of $Cs^+$ ions are observed depending on the intial $Cs^+$ concentrations in given ion exchange solution. In Crystal 1, $Cs^+$ ion are located at sites II', II, III, and III', and in crystal 2, at sites II, IIIa, and IIIb. In crystal 3, $Cs^+$ ions are only located at sites IIIa and IIIb. The degree of $Cs^+$ ion exchange decreased sharply from 28.0 to 2.7 to 1.3 % as the initial $Ca^{2+}$ concentration increases and the $Cs^+$ content decreases.

Effects of Local Cooling and Root Pruning on Budding and Local Heating on Heating Energy Consumption in Forcing Cultivation of Strawberry (딸기 촉성재배 시 국소 냉방 및 단근처리와 국소난방이 화방출뢰와 난방에너지소비에 미치는 영향)

  • Kwon, Jin Kyung;Kang, Suk Won;Paek, Yee;Moon, Jong Pil;Jang, Jae Kyung;Oh, Sung Sik
    • Journal of Bio-Environment Control
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    • v.28 no.1
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    • pp.46-54
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    • 2019
  • Experiments of local cooling and heating on crown and root zone of forcing cultivation of strawberry 'Seolhyang' using heat pump and root pruning before planting were conducted. During the daytime, the crown surface temperature of the crown local cooling treatment was maintained at $18{\sim}22^{\circ}C$. This is suitable for flower differentiation, while those of control and root zone local cooling treatment were above $30^{\circ}C$. Budding rate of first flower clusters and initial yields were in the order of crown local cooling, root zone local cooling and control in root pruning plantlet and non pruning plantlet, except for purchase plantlet. Those of root pruning plantlet were higher than those of non pruning plantlet. These trends were evident in the yield of the first flower cluster until February 14, 2018, and the effect of local cooling and root pruning decreased from March 9, 2018. The budding rates of the second flower cluster according to the local cooling and root pruning treatments were not noticeable compared to first flower cluster but showed the same tendency as that of first flower cluster. In the heating experiment, root zone local heating(root zone $20^{\circ}C$+inside greenhouse $5^{\circ}C$) and crown local heating(crown $20^{\circ}C$+inside greenhouse $5^{\circ}C$) saved 59% and 65% of heating fuel, respectively, compared to control(inside greenhouse $9^{\circ}C$). Considering the electric power consumption according to the heat pump operation, the heating costs were reduced by 55% and 61%, respectively.

Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.23-32
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    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

A Study on History and Archetype Technology of Goli-su in Korea (한국 고리수의 역사와 원형기술의 복원 연구)

  • Kim, Young-ran
    • Korean Journal of Heritage: History & Science
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    • v.46 no.2
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    • pp.4-25
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    • 2013
  • Goli-su is the innovative special kind of the embroidery technique, which combines twining and interlacing skill with metal technology and makes the loops woven to each other with a strand. The loops floating on the space of the ground look like floating veins of sculpture and give people the feeling of the openwork. This kind of characteristic has some similarities with the lacework craft of Western Europe in texture and technique style, but it has its own features different from that of Western Europe. It mainly represents the splendid gloss with metallic materials in the Embroidered cloth, such as gold foil or wire. In the 10th century, early days of Goryo, we can see the basic Goli-su structure form of its initial period in the boy motif embroidery purse unearthed from the first level of Octagonal Nine-storied Pagoda of Woljeong-sa. In the Middle period of Joseon, there are several pieces of Goli-su embroidered relic called "Battle Flag of Goryo", which was taken by the Japanese in 1592 and is now in the Japanese temple. This piece is now converted into altar-table covers. In 18~19th century, two pairs of embroidered pillows in Joseon palace were kept intact, whose time and source are very accurate. The frame of the pillows was embroidered with Goli-su veins, and some gold foil papers were inserted into the inside. The triangle motif with silk was embroidered on the pillow. The stitch in the Needle-Looped embroidery is divided into three kinds according to comprehensive classification: 1. Goli-su ; 2. Goli-Kamgi-su ; 3. Goli-Saegim-su. From the 10th century newly establishing stage to the 13th century, Goli-su has appeared variational stitches and employed 2~3 dimensional color schemes gradually. According to the research of this thesis, we can still see this stitch in the embroidery pillow, which proves that Goli-suwas still kept in Korea in the 19th century. And in terms of the research achievement of this thesis, Archetype technology of Goli-su was restored. Han Sang-soo, Important Intangible Cultural Heritage No. 80 and Master of Embroidery already recreated the Korean relics of Goli-su in Joseon Dynasty. The Needle-Looped embriodery is the overall technological result of ancestral outstanding Metal craft, Twining and Interlacing craft, and Embroidery art. We should inherit, create, and seek the new direction in modern multi-dimensional and international industry societyon the basis of these research results. We can inherit the long history of embroidering, weaving, fiber processing, and expand the applications of other craft industries, and develop new advanced additional values of new dress material, fashion technology, ornament craft and artistic design. Thus, other crafts assist each other and broaden the expressive field to pursue more diversified formative beauty and beautify our life abundantly together.

Review on the Implementation Process and Achievement of ICH Safeguarding System (무형문화재 보호제도의 이행과정과 그 성과에 관한 검토)

  • Lee, Jae Phil
    • Korean Journal of Heritage: History & Science
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    • v.44 no.4
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    • pp.18-41
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    • 2011
  • The Safeguarding of Intangible Cultural Heritage in Korea has begun since1962 when the Cultural Properties Protection Act was established. Korean ICH Safeguarding system is initially derived from Cultural Properties Protection Act in Japan. Japan has started Important ICH Designation System in 1954 to concede the skills and artistic talents holders, thus it could implement the multilateral system management for adopting different ICH protection systems such as Important Intangible Folklore Properties, Selection and Preservation Techniques, and Documenting Records. However, Korea has solely adopted Important ICH Designation System since Cultural Properties Protection Act was introduced. Korean ICH Safeguarding System represented by the Certification System of ICH Skill Holders is to ensure skills and artistic holders who perform the elements of Intangible Cultural Heritage, and manage the safeguarding of intangible cultural heritage in order to let the skills and artistic holders instruct inheritors. As a result, it could build up the internal foundation for the diffusion of inheritors and established the related organizations. However, the inheritor-centered protection system has caused many problems as it is being lasted for more than fifty years. Fragmented designation measures, the cultural power of skill holders, and the research and evaluation methods have pointed out the difficulties of safeguarding and preservation measures of ICH. Moreover,the legitimacy of safeguarding system related in the authenticity of transmission in ICH has emerged to review the safeguarding system of ICH with diverse viewpoints. Therefore, this paper will review the implementation process and achievement of ICH safeguarding system to examine the problem and causes of the safeguarding system. The conference records of Cultural Property Association and articles of cultural properties policies directors, Cultural Property Association members, and professional experts are being used for the initial materials of this paper, and it is examined for the contents of designation system of Important Cultural Heritage, rather than overall cases. Thus such problems the limitation of expansion in ICH lists as inheritor-centered designation system, hierarchical and exclusive transmission system, inappropriate concept of archetype as the principle of ICH transmission are derived from the root of Important ICH designation system. Thus this paper demonstrates that this system must be revised for the expansion of ICH safeguarding system in Korea and points out multilateral protection system should be established as well as Certification System of Important ICH skill holders.

Effects of Dietary Apparent Metabolizable Energy and Protein Concentrations on Growth Performance, Nutrient Digestibility, and Quality of Korean Native Ducks (사료내 에너지 및 단백질 함량이 토종오리 생산성, 영양소 이용률 및 도체 특성에 미치는 영향)

  • Kim, Chan Ho;Kang, Hwan Ku
    • Korean Journal of Poultry Science
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    • v.46 no.3
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    • pp.205-213
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    • 2019
  • The objective of this experiment was to investigate the effect of dietary apparent metabolizable energy and protein concentrations on growth performance, carcass characteristics, and nutrient digestibility of Korean native ducks. In $2{\times}2$ factorial arrangement, 1-d-old Korean native ducks were completely randomized to experimental diets with 2,800 and 2,900 kcal of AMEn/kgofdiet, respectively, from 0 to 21 d of age. From 22 to 56 d of age, experimental diets 3,000 and 3,100 kcal of, and contained 16% and 17% CP, respectively. Feed and water were provided ad libitum. And BW gain were higher during 0 to 21 d (P<0.01) in AME 2,800 kcal/kg and CP 21% diet treatment than other treatments. As AME increased from 2,800 to 2,900 kcal/kg, feed intake was decreased (P<0.05) during 0 to 21 d. From 22 to 56 d of age, the, BW gain, feed intake and were not different among the treatments. Carcass ratio, relative weight per 100 of BW (wing, back, neck, breast, and leg), nutrient digestibility, meat color and nutrient composition in breast meat the treatments. In conclusion, diets with 2,800 kcal of AME/kg and 21% CP or with 3,000 kcal of AME/kg and 17% CP at 0 to 21 d and 22 to 56 d, respectively, were more efficient.

Investigation of PWR Spent Fuels for the Design of a Deep Geological Repository (심층처분시스템 설계를 위한 경수로 사용후핵연료 현황 분석)

  • Cho, Dong-Keun;Kim, Jungwoo;Kim, In-Young;Lee, Jong-Youl
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.17 no.3
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    • pp.339-346
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    • 2019
  • Based on the $8^{th}$ Basic Plan for Electric Power Demand and Supply, an estimation has been made for inventories and characteristics of spent fuel (SF) to be generated from existing and planned nuclear power plants. The characteristics under consideration in this study are dimensions, fuel array, $^{235}U$ enrichment, discharge burnup, and cooling time for each fuel assembly. These are essentially needed for designing a disposal facility for SFs. It appears that the anticipated quantity by the end of 2082 is about 62,500 assemblies for PWR SFs. The inventories of Westinghouse-type and Korean-type SFs were revealed to be 60% and 40%, respectively as of the end of 2018. The proportion of SFs with initial $^{235}U$ enrichment below 4.5 weight percent (wt%) was shown to be approximately 90% in total as of the end of 2018. As of 2077, more than 97% of SFs generated from Westinghouse-type nuclear reactors were shown to have cooling time of over 50 years. As of 2125, more than 98% of SFs generated from Korean-type nuclear reactors were shown to have cooling time of over 45 years. Based on these results, for the efficient design of a disposal system, it is reasonable to adopt two types of reference spent fuel. SF of KSFA with $^{235}U$ enrichment of 4.5 wt%, discharge burnup of 55 GWd/tU, and cooling time of 50 years was determined as reference fuel for Westinghouse-type SFs; SF of PLUS7 with $^{235}U$ enrichment of 4.5 wt%, discharge burnup of 55 GWd/tU, and cooling time of 45 years was determined as reference fuel for Korean-type SFs.

The Vegetation Effect of under Neutralizing Layer Type on the Acid Drainage Slope (산성배수 비탈면의 중화층 종류에 따른 녹화효과)

  • Cho, Sung Rok;Kim, Jae Hwan
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.39 no.4
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    • pp.493-503
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    • 2019
  • This study is composed of nine treatments [Control : "no neutralizing layer+vegetation layer" 3 cm, Treatment 1 : "no neutralizing layer+vegetation layer" 5 cm, Treatment 2 : "no neutralizing layer+vegetation layer" 7 cm, Treatment 3 :"neutralizing layer (cement 3 %)+ vegetation layer (cement 1 %)" 3 cm, Treatment 4 : "neutralizing layer (cement 3 %)+vegetation layer (cement 1 %)" 5 cm, Treatment 5 : "neutralizing layer (cement 3 %)+vegetation layer (cement 1 %)" 7 cm, Treatment 6 : "neutralizing layer [$(Ca{\cdot}Mg)CO_3$] +vegetation layer" 3 cm, Treatment 7 : "neutralizing layer [$(Ca{\cdot}Mg)CO_3$]+vegetation layer" 5 cm, Treatment 8 : "neutralizing layer [$(Ca{\cdot}Mg)CO_3$]+vegetation layer" 7 cm] to find out the vegetation effects according to neutralizing layer types of the acid drainage slope. There were no significant differences observed in soil hardness and soil moisture content of neutralizing layer type while highly difference of moisture content was observed according to the neutralizing and vegetation layer thickness. As for soil acidity, strong acid was shown in the control, treatment 1 and treatment 2. Neutralizing effects were outstanding in treatments of 3, 4, 5 (cement treatment group), 6, 7 and 8 (limestone treatment group). Concerning plants growth characteristics, surface coverage rates, number of germinating woody plants, plant height, and plant root status, there were excellent effects observed in the experimental groups mixed with cement (treatments 3, 4 and 5) and limestone (treatments 6, 7 and 8). At the initial stage, however, plant roots were negatively affected in cement layer treatments of 3, 4 and 5. However, no difference was shown in each layer thickness on the acid drainage slope whereas 3~5 cm thickness neutralizing layer was appropriate in consideration of economic feasibility.

Effects of environmental enrichments on performance and behavior characteristics of sows during gestating period (환경보조물이 임신모돈의 생산성 및 행동특성에 미치는 영향)

  • Jeong, Yong-Dae;Kim, Doo-Wan;Min, Ye-Jin;Jung, Hyun-Jung;Cho, Eun-Seok;Kim, Young-Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.428-434
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    • 2019
  • Many countries have interested animal welfare. Similarly, domestic people have concern for the welfare from companion animals to livestock. Environmental enrichments (EE) are tool to enforce the welfare, however, research with sows is limited. Therefore, this study was investigate to effects of environmental enrichments on performance and behavior properties of gestating sows. A total of 30 pregnant sows (Landrace) were assigned into three treatments that control, T1 (plastic device) and T2 (Rice straw). Period of trial was from Mar. 03. 18. to Mary 19. 18. The EE were allotted to center of experimental pen ($11.6{\times}6.0m$). Body weight (BW), backfat thickness (BF) and cortisol were identified at experimental initial or end date. Behavior was recorded during 24 hours on days 91 of gestation, and then analyzed the patterns. BF was reduced (15.73 vs. 16.56 mm; p>0.05) in T1 than control, but Ending BW, total litter size and alive piglets did not differ. Born dead piglets showed lower tendency (1.00 and 0.63 vs. 1.50 heads; p>0.05) in T1 and T2 than control. Similarly, the enrichments declined farrowing mortality (C, 8.68%; T1, 6.86%; T2, 3.40%; p>0.05). Cortisol was not differed among treatments. In the behavior characteristics, eating showed lower (1.81 vs. 9.68 and 6.99%; p<0.05) in T2 than control and T1. Furthermore, playing or digging were only observed (0.33 and 2.10%; p<0.05) in T1 and T2, respectively, whereas rubbing (0.91%, p<0.05) only showed in the control. These results suggest that the provision of EE would be not negatively affected the performance of the gestating sows and could be led to improvement of the livestock welfare.