• Title/Summary/Keyword: life saving

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Risk Factor, Mortality and Infection Rate of Mediastinum After Delayed Sternal Closure in Congenital Heart Surgery Patients (선천성 심장수술 후 지연 흉골 봉합시 사망률 및 종격동 감염률 그리고 위험인자)

  • 이진구;박한기;홍유선;박영환;조범구
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.517-522
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    • 2002
  • Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.

Clinical Outcome of Emergency Coronary Artery Bypass Grafting after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 실패에 의해 발생한 응급환자의 임상경과)

  • Kim, Do-Kyun;Yoo, Kyung-Jong;Youn, Young-Nam;Yi, Gi-Jong;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.209-214
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    • 2007
  • Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

Actual State of Structures and Environmental Control Facilities for Tomato Greenhouses in Chungnam Region (충남지역 토마토 재배온실의 구조와 환경조절설비 실태분석)

  • Nam, Sang-Woon;Kim, Young-Shik
    • Korean Journal of Agricultural Science
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    • v.36 no.1
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    • pp.73-85
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    • 2009
  • An investigation was conducted to get the basic data for establishing structural safety and environmental management of tomato greenhouses in Chungnam region. The contents of the investigation consisted of actual state of greenhouse structures and environmental control facilities. Most of greenhouses were arch type single-span plastic houses and they had too low height for growing tomatoes. Frameworks of multi-span greenhouses were suitable, but those of single-span were mostly insufficient. Every greenhouse had thermal curtain movable or covering fixed inside the greenhouse for energy saving, and heating facilities were mostly warm air heater. Irrigation facilities were mostly drip tube and controlled by manual operation or timer. Almost all of the greenhouses didn't install high level of environmental control facilities such as ventilator, air circulation fan, $CO_2$ fertilizer, insect screen, supplemental light, and cooling device.

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Effects of Planting Density on Growth and Yield in Cassia obtusifolia. L. (결명자(決明子)의 재식밀도(栽植密度)가 생육(生育) 및 수량(收量)에 미치는 영향(影響))

  • Kim, Young-Guk;Bang, Jin-Ki;Yu, Hong-Seob;Lee, Seoung-Tack;Park, Jong-Sun
    • Korean Journal of Medicinal Crop Science
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    • v.5 no.2
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    • pp.95-101
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    • 1997
  • This study was conducted to investigate how a labor saving for conventional hand sowing and respond to major agronomic traits under different planting density in 1993 and 1994. Each trial was a randomized block split plot with row spacing as the main plots and hill spacing as subplots. Sowing rate appeared lower in 20 or 25cm hill spacing using machine seeder than in hand sowing. Sowing time required reduced more 121 hours per hectare in 60cm row, 20cm hill spacings using machine seeder than in hand sowing. Increasing row and hill spacings reduced number of seedling stand per unit $area(m^2)$. Both number of pods per plant and grain weight per plant and showed highly increase in wide planting. Best yield obtained in 60cm row, 20cm hill spacing using machine seeder. Accumulative mean air temperature was positively correlated with stem height, number of pods per plant and yield, otherwise accumulative rainfall was negatively correlated with ones. A highly significant negative correlation was showed between number of seedling stand per unit $area(m^2)$ and number of branches, number of pods per plant, grain weight per plant and yield. Yield was positively correlated with number of branches, number of pods per plant and grain weight per plant.

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A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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A Newborn Case of Maple Syrup Urine Disease Type 1B Presenting with Lethargy and Central Apnea (기면과 중추성 무호흡으로 나타난 단풍시럽뇨병 Type 1B 신생아 1례)

  • Kang, Youngtae;Choi, Sung Hwan;Ko, Jung Min;Shin, Seung Han;Kim, Ee-Kyung;Kim, Han-Suk
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.2
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    • pp.43-49
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    • 2018
  • Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain ${\alpha}$-ketoacid dehydrogenase (BCKDH) genes. It prevents the normal breakdown of branched-chain amino acids (BCAAs), such as leucine, isoleucine, and valine, and leads to poor feeding, lethargy, abnormal movements, seizure, and death if untreated. Here, we report the case of a Korean newborn of biochemically- and genetically-confirmed MSUD manifesting lethargy and central apnea, the acute state of which was successfully treated. The molecular genetic investigation revealed two novel heterozygous mutations (p.Ala32Phefs*48 and p.Val 130Phe) in BCKDHB, and both parents were confirmed as carriers. We emphasize the importance of early diagnosis and prompt introduction of specific treatment for MSUD in life saving and prognosis.

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Psychological Characteristics of Living Liver Transplantation Donors using MMPI-2 Profiles (MMPI-2를 이용한 생체 간 공여자들의 심리적 특성에 대한 연구)

  • Lee, Jin Hyeok;Choi, Tae Young;Yoon, Seoyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.42-49
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    • 2019
  • Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

Analyzing Different Contexts for Energy Terms through Text Mining of Online Science News Articles (온라인 과학 기사 텍스트 마이닝을 통해 분석한 에너지 용어 사용의 맥락)

  • Oh, Chi Yeong;Kang, Nam-Hwa
    • Journal of Science Education
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    • v.45 no.3
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    • pp.292-303
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    • 2021
  • This study identifies the terms frequently used together with energy in online science news articles and topics of the news reports to find out how the term energy is used in everyday life and to draw implications for science curriculum and instruction about energy. A total of 2,171 online news articles in science category published by 11 major newspaper companies in Korea for one year from March 1, 2018 were selected by using energy as a search term. As a result of natural language processing, a total of 51,224 sentences consisting of 507,901 words were compiled for analysis. Using the R program, term frequency analysis, semantic network analysis, and structural topic modeling were performed. The results show that the terms with exceptionally high frequencies were technology, research, and development, which reflected the characteristics of news articles that report new findings. On the other hand, terms used more than once per two articles were industry-related terms (industry, product, system, production, market) and terms that were sufficiently expected as energy-related terms such as 'electricity' and 'environment.' Meanwhile, 'sun', 'heat', 'temperature', and 'power generation', which are frequently used in energy-related science classes, also appeared as terms belonging to the highest frequency. From a network analysis, two clusters were found including terms related to industry and technology and terms related to basic science and research. From the analysis of terms paired with energy, it was also found that terms related to the use of energy such as 'energy efficiency,' 'energy saving,' and 'energy consumption' were the most frequently used. Out of 16 topics found, four contexts of energy were drawn including 'high-tech industry,' 'industry,' 'basic science,' and 'environment and health.' The results suggest that the introduction of the concept of energy degradation as a starting point for energy classes can be effective. It also shows the need to introduce high-tech industries or the context of environment and health into energy learning.

Indian Culture Code and Glocal Cultural Contents (인도의 문화코드와 글로컬문화콘텐츠)

  • Kim, Yunhui;Park, Tchi-Wan
    • Journal of International Area Studies (JIAS)
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    • v.14 no.4
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    • pp.79-106
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    • 2011
  • The cultural contents industries have moved closer to the centre of the economic action in many countries and across much of the world. For this reason, the concern with the development of glocal cultural contents has also been growing. According to Goldman Sock's BRICs report, Indian economy will be the engine of global economy with China. In addition, India will be a new blue chip country for large consumer market of cultual contents. The most important point for the development of glocal cultural contents is a systematic and in-depth analysis of other culture. India is a complex and multicultural country compared with Korea which is a nation-state. Therefore, this paper is intended as an understanding about India appropriately and suggestion for a strategy to enter cultural industry in India. As the purpose of this paper is concerned, we will take a close look at 9 Indian culture codes which can be classified into three main groups: 1) political, social and cultural codes 2) economic codes 3) cultural contents codes. Firstly, political, social and cultural codes are i) consistent democracy and saving common people, ii) authoritarianism which appears an innate respect for authority of India, iii) Collective-individualism which represents collectivist and individualistic tendency, iv) life-religion, v) carpe diem. Secondly, economic culture codes are vi) 1.2billion Indian people's God which represents money and vii) practical purchase which stands for a reasonable choice of buying products. Lastly, viii) Masala movie and ix) happy ending that is the most popular theme of Masala movies are explained in the context of cultural content codes. In conclusion, 3 interesting cases , , will be examined in detail. From what has been discussed above, we suggest oversea expansion strategy based on these case studies. Eventually, what is important is to understand what Indian society is, how Indian society works and what contents Indian prefers.

Analysis on Statistical Characteristics of Household Water End-uses (가정용수 용도별 사용량의 통계적 특성 분석)

  • Kim, Hwa Soo;Lee, Doo Jin;Park, No Suk;Jung, Kwan Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.5B
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    • pp.603-614
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    • 2008
  • End-uses of household water have been changed by a life style, housing type, weather, water rate and water supply facilities etc. and those variables can be considered as an internal and exogenous factors to estimate long-term demand forecasts. Analysis of influential factors on water consumption in households would give an explanation to cause on the change of trend and would help predicting the water demand of end-use in household. The purpose of this study is to analyze the demand trends and patterns of household water uses by metering and questionnaire such as occupation, revenue, numbers of family member, housing types, age, floor area and installation of water saving device, etc. The peak water uses were shown at Saturday among weekdays and July in a year based on the analysis results of water use pattern. A steep increase of total water volume can be found in the analysis of water demand trend according to temperature from $-14^{\circ}C$ to $0^{\circ}C$, while there are no significant variations in the phase of more than $0^{\circ}C$, with an almost stable demand. Washbowl water shows the highest and toilet water shows the lowest relation with temperature in correlation analysis results. In the results of ANOVA to find the significant difference in each unit water use by exogenous factors such as housing type, occupation, number of generation, residential area and income et al., difference was shown in bathtub water by housing type and shown in kitchen, toilet and miscellaneous water by numbers of resident. Especially, definite differences in components except washbowl and bathtub water, could be found by numbers of resident. Based on the result, average residents in a house should be carefully considered and the results can be applied as reference information, in decision making process for predicting water demand and establishing water conservation policy. It is expected that these can be used as design factors in planning stage for water and wastewater facilities.