• 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.

• Tunnel and Underground Space
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• v.32 no.6
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• pp.491-501
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• 2022

Bentonite has been proposed as a buffer and backfill material for high-level radioactive waste repository. Under such repository environment conditions, bentonite is subjected to combined thermal, hydrological, mechanical, and chemical processes. This study evaluates the feasibility of applying X-ray CT technology on the characterization of bentonite under hydration conditions using a newly developed testing cell. The cylindrical cell is made of platic material, with a removable cap to place the sample, enabling to apply vertical pressure on the sample and to measure swelling pressure. The hydration test was carried out with a sample made of Gyeonju bentonite, with a dry density of 1.4 g/cm³, and a water content of 20%. The sample had a diameter of 27.5 mm and a height of 34 mm. During the test, water was injected at a constant pressure of 0.207 MPa, and lasted for 7 days. After one day of hydration, bentonite swelled and filled out the space inside the cell. Moreover, CT histograms showed how the hydration process induced an initial increase and later progressive decrease on the density of the sample. Detailed profiles of the mean CT value, CT standard deviation, and CT gradient provided more details on the hydration process of the sample and showed how the bottom and top regions exhibited a decrease on density while the middle region showed an increase, especially during the first two days of hydration. Later, the differences in CT values with respect to the initial state decreased, and were small at the end of testing. The formation and later reduction of cracks was also characterized through CT scanning.