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Conversion to Veno-arteriovenous Extracorporeal Membrane Oxygenation for Differential Hypoxia

  • Ho Jeong Cha;Jong Woo Kim;Dong Hoon Kang;Seong Ho Moon;Sung Hwan Kim;Jae Jun Jung;Jun Ho Yang;Joung Hun Byun
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.274-281
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    • 2023
  • Background: Patients who require initial venoarterial extracorporeal membrane oxygenation (VA ECMO) support may need to undergo veno-arteriovenous ECMO (VAV ECMO) conversion. However, there are no definitive criteria for conversion to VAV ECMO. We report 9 cases of VAV ECMO at Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine. Methods: Of 158 patients who received ECMO support between January 2017 and June 2019, 82 were supported by initial VA ECMO. We retrospectively reviewed the medical records of 9 patients (7 men and 2 women; age, 53.1±19.4 years) who had differential hypoxia and required VAV ECMO support. Percutaneous transaortic catheter venting was used to detect the differential hypoxia. Results: Among the 82 patients who received VA ECMO support, 9 (10.9%) had differential hypoxia and required conversion to VAV ECMO support. The mean time from VA ECMO support to VAV ECMO support and the mean duration of the VAV support were 2.1±2.2 days and 1.9±1.5 days, respectively. The average peak inspiratory pressure before and after VAV ECMO application was 23.89±3.95 cmH2O and 20.67±5.72 cmH2O, respectively, decreasing by an average of 3.2±3.5 cmH2O (p=0.040). The PaO2/FiO2 ratio was kept below 100 mm Hg in survivors and non-survivors for 116±65.4 and 250±124.9 minutes, respectively (p=0.016). Six patients underwent extracorporeal cardiopulmonary resuscitation, of whom 4 survived (67%). The overall survival rate of patients who underwent conversion from VA ECMO to VAV ECMO was approximately 56%. Conclusion: Rapid detection of differential hypoxia is required when VA ECMO is applied, and efficient conversion to VAV ECMO may be critical for patient survival.

Physical Activity Participation and Body Composition in Colorectal and Gastric Cancer Survivor (위암과 대장암 경험자의 신체구성 및 신체활동 참여 실태)

  • Lee, Mi Kyung;Min, Ji Hee;Jeon, Justin Y.
    • 한국체육학회지인문사회과학편
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    • v.55 no.3
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    • pp.465-472
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    • 2016
  • The purpose of this study was to analyze the amount of physical activity and body composition and to investigate physical activity according to cancer type, sex, and age among colorectal and gastric cancer survivors. A total of 354 participants who were colorectal (n=185) and gastric (n=169) cancer survivors had completed all treatment less than 4 years ago at Y university hospital between June 2014 and April 2015. The Global Physical Activity Questionnaire (GPAQ) was used to measure time and intensity of physical activity according to the different types of activity. The colorectal cancer survivors were significantly higher in body mass index, waist circumference, percent body fat, blood pressure, and the prevalence of diabetes compared to gastric cancer survivors. In addition, the results showed that only 26.5% of colorectal cancer survivors met American College of Sports Medicine (ACSM) guidelines (at least of 150 min of moderate intensity of higher physical activity per week) for physical activity, compared with 41.4% of gastric cancer survivors. Additionally, only 13.6% of colorectal and gastric cancer survivors met strength exercise guidelines. The male cancer survivors were significantly higher in moderate physical activity, participation in resistance exercise, and sedentary behaviors compared to female cancer survivors. In additions, less than 65 years cancer survivors were higher in strenuous intensity exercise and moderate physical activity compared to more than 65 years cancer survivors. The alternative for promoting physical activity participation rates of colorectal and gastric cancer survivors should be presented.

Seismic performance assessment of single pipe piles using three-dimensional finite element modeling considering different parameters

  • Duaa Al-Jeznawi;Jitendra Khatti;Musab Aied Qissab Al-Janabi;Kamaldeep Singh Grover;Ismacahyadi Bagus Mohamed Jais;Bushra S Albusoda;Norazlan Khalid
    • Earthquakes and Structures
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    • v.24 no.6
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    • pp.455-475
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    • 2023
  • The present study investigates the non-linear soil-pile interaction using three-dimensional (3D) non-linear finite element models. The numerical models were validated by using the results of extensive pile load and shaking table tests. The pile performance in liquefiable and non-liquefiable soil has been studied by analyzing the liquefaction ratio, pile lateral displacement (LD), pile bending moment (BM), and frictional resistance (FR) results. The pile models have been developed for the different ground conditions. The study reveals that the results obtained during the pile load test and shaking cycles have good agreement with the predicted pile and soil response. The soil density, peak ground acceleration (PGA), slenderness ratio (L/D), and soil condition (i.e., dry and saturated) are considered during modeling. Four ground motions are used for the non-linear time history analyses. Consequently, design charts are proposed depended on the analysis results to be used for design practice. Eleven models have been used to validate the capability of these charts to capture the soil-pile response under different seismic intensities. The results of the present study demonstrate that L/D ratio slightly affects the lateral displacement when compared with other parameters. Also, it has been observed that the increasing in PGA and decreasing L/D decreases the excess pore water pressure ratio; i.e., increasing PGA from 0.1 g to 0.82 g of loose sand model, decrease the liquefaction ratio by about 50%, and increasing L/D from 15 to 75 of the similar models (under Kobe earthquake), increase this ratio by about 30%. This study reveals that the lateral displacement increases nonlinearly under both dry and saturated conditions as the PGA increases. Similarly, it is observed that the BM increases under both dry and saturated states as the L/D ratio increases. Regarding the acceleration histories, the pile BM was reduced by reducing the acceleration intensity. Hence, the pile BM decreased to about 31% when the applied ground motion switched from Kobe (PGA=0.82 g) to Ali Algharbi (PGA=0.10 g). This study reveals that the soil conditions affect the relationship pattern between the FR and the PGA. Also, this research could be helpful in understanding the threat of earthquakes in different ground characteristics.

Determination of fluoride in fluorite mine wastewater by ion chromatography with post-wash technique (후세척-이온크로마토그래피를 이용한 형석 광산 폐수 중 플루오라이드 정량)

  • Song, Kyung-Sun;Eum, Chul-Hun;Kim, Sang-Yeon
    • Analytical Science and Technology
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    • v.19 no.5
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    • pp.383-388
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    • 2006
  • Simple post-wash method by ion chromatography (IC) was established for the rapid and precise determination of fluoride ion in wastewater from mine in fluorite mineralized area. High sulfate in sample was retained in a pre-column and less strongly held fluoride ion was transferred to the principal separation system using modified conventional IC with switching technique. An analytical column with high capacity (AS 9 HC) was used as a pre-column to retain the amount of high sulfate. A guard column (AG 14) as a separation column was used to increase the response of fluoride and reduce the system pressure. According to the recovery of fluoride ion with one detector and the observation of sulfate peak with another conductivity detector, the optimum switching time of 10-port chromatographic injector was 4.3 min. The limit of detection (S/N = 3) of fluoride in synthetic solution containing $500mg\;L^{-1}$ sulfate was $2.4{\mu}g/L$, with $25{\mu}L$ sample volume.

Field Evaluation of Traffic Wandering Effect on Asphalt Pavement Responses (차량의 횡방향 주행이격에 의한 아스팔트 콘크리트 포장의 응답특성 분석)

  • Seo, Youngguk;Kwon, Soon-Min;Lee, Jae-Hoon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.3D
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    • pp.453-459
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    • 2006
  • This paper presents an experimental evaluation of wandering effect on asphalt concrete pavement responses. A laser-based wandering system has been developed and its performance is verified under various field conditions. The portable wandering system composed of two laser sensors with Position Sensitive Devices can allow one to measure the distance between laser sensors and tire edges of moving vehicle. Therefore, lateral position of each wheel on the pavement can be determined in a real time manner. Pavement responses due to different loading paths are investigated using a roll over test which is carried out on one of asphalt surfaced pavements in the Korea Highway Corporation test road. The pavement section (A5) consists of 5 cm thick surface course; 7 cm intermediate course; and 18 mm base course, and is heavily instrumented with strain gauges, vertical soil pressure cells and thermo-couples. From the center of wheel paths, seven equally-spaced lateral loading paths are carefully selected over an 140 cm wandering zone. Test results show that lateral horizontal strains in both surface and intermediate courses are mostly compressive right under the loading path and tensile strains start to develop as the loading offset becomes 40 cm from the wheel path. The development of the vertical stresses in the top layers of subbase and anti-frost is found to be minimal once the loading offset becomes 50 cm.

Performance Evaluation for All-In-One Construction Method of Curbstone and Gutter Using Formwork Rail and Jig (거푸집 레일과 지그를 이용한 경계석 및 측구의 일체형 시공법에 대한 성능평가)

  • Choi, Jae-Jin;Ko, Man-Gi;Kim, Kyoung-Ju;Choi, Khyung-Dong
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.30 no.6A
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    • pp.525-534
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    • 2010
  • A road curbstone is a structure installed at the boundary of the sidewalk and the street with the objectives of road drainage, drawing attention and such. The current general construction method of curbstones places foundation concrete for the curbstones first, waits until the concrete reaches the strength to support the curbstones, places the curbstones on top, and then places the gutter and rear filling concrete. Such method has the issues of poor compaction and weakened bond strength of concrete due to split placing of concrete, and causes the curbstones to easily separate due to vehicle impact or earth pressure, in turn creating maintenance costs and spoiling the aesthetics. To improve such conventional construction methods, an all-in-one method was developed using formwork rail and jig where both the curbstones and gutter can be worked at the same time, and to evaluate the structural performance, static tests of lateral loading test, pullout test, and bending test were executed, and dynamic tests such as pendulum test and actual vehicle impact test were executed. In all tests, the all-in-one construction method using formwork rail and jig was shown to be superior to the conventional construction method by the increase of construction quality and bond strength of concrete.

Research on Relationship between Drivers' Self-control, Driving Behavior and Driving Stress (운전자의 자기통제력, 운전행동과 운전스트레스의 관련성)

  • Hwang, Do-Yeon;Kim, Hee-Dong;Baek, Ji-Young
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.5
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    • pp.229-238
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    • 2019
  • The aim of the research is to investigate relationship between drivers' self-control, driving behavior and driving stress. 180 people who have driver's licence and have experiences in driving in Gwangju and Jeonnam area participated for the research. The survey was conducted from 29th April 2015 to 24th July 2015 and data was analysed to figure out the relationship between drivers' self-control, driving behavior and driving stress. As a result, Firstly, drivers' self-control affected mistakes, violations, errors of driving behavior, and driving environment, traffic regulations, accident control, time pressure of driving stress. It showed a statistical significant difference and the higher drivers' self-control is, the lower sub construct factor of driving behavior and driving stress. Secondly, those factors of drivers' self-control, driving behavior and driving stress were correlated. The result showed the relationship between drivers' self-control, driving behavior and driving stress. It is also possible to utilize the information to prevent car accidents. Finally, it is expected to do research further by expanding the participants into multiple areas of people.

The Relationship between Enterance Exam Stress and Oral Care Self-Efficacy in 3rd year Girl High School Students (인문계 3학년 여자 고등학생의 입시스트레스와 구강관리 자기효능감과의 관련성)

  • Cho, Hye-Eun;Chung, Kyung-Yi
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.8
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    • pp.551-561
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    • 2019
  • The purpose of this study was to investigate the relationship between entrance exam stress and oral care self-efficacy in girls high school. From June to July 2018, A self-reported questionnaire was administered to 192 high school students in the G area. The data were analyzed for independent t-test, one-way ANOVA and Pearson's correlation coefficient by using SPSS/WIN 21.0 program. Among the sub-sectors of entrance exam stress, exam tension/poor was the highest with 3.07 points, followed by Insufficient spare time stress 2.83 points, future uncertainty stress 2.57 points, and parent pressure stress 2.44 points. the variables related to exam tension/poor stress were academic performance (p<.01), family income level (p<.05), Subjective oral health status(p<.05), and daily brushing frequency(p<.01). The highest level of oral care self-efficacy was 3.13 points for brushing self-efficacy, followed by dental visits 2.80 points and interdental hygiene 2.64 points. As a result of analyzing the general characteristics and oral care self-efficacy, subjects related to brushing self-efficacy were subjective oral health status, caries snacking(daily), and caries drinks(daily)(p<.01). There were negative correlations between entrance exam stress and oral care self-efficacy. The higher the entrance stress, the lower the oral care self-efficacy. To prevent oral disease and increase oral care self-efficacy of students with high entrance stress, it is necessary to provide school oral health education programs that can facilitate oral health behaviors.

A comparative study of impression methods using stock tray and intraoral scanner in a completely edentulous patient with an atypical arch shape: a case report (비정형적인 악궁을 가진 완전 무치악 환자에서 기성 트레이와 구강 스캐너를 이용한 인상 채득 방법의 비교 연구: 증례 보고)

  • Jae-Hoon Park;Ji-Hyun Kim;Jae-Min Seo;Jung-Jin Lee;Yeon-Hee Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.344-355
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    • 2023
  • In complete denture fabrication, accurate preliminary impressions are crucial for obtaining an accurate final impression. However, it can be challenging in cases of atypical arch shapes. This case report compares diagnostic casts made with a stock tray and an intraoral scanner (IOS) in a patient with an atypical arch shape. A 58-year-old edentulous male patient with long, narrow, atypical arches was referred to the Oral and Maxillofacial Surgery department for complete denture fabrication. Compared to the diagnostic cast obtained using IOS with adequately captured anatomical parameters, the primary model obtained using a stock tray showed prominent overextended flanges on the labial and buccal sides of the maxillary arch and less prominent overextended flanges in the mandibular arch with pressure spots in the posterior palatal seal area. The custom tray fabricated from such a model required additional adjustment resulting in increased chair time during the final impression procedure.

Numerical Modelling of Typhoon-Induced Storm Surge on the Coast of Busan (부산 연안에서 태풍에 의한 폭풍해일의 수치모델링)

  • Cha-Kyum Kim;Tae-Soon Kang
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.29 no.7
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    • pp.760-769
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    • 2023
  • A numerical simulations were performed to investigate the storm surge during the passage of Typhoon Maemi on the coast of Busan. The typhoon landed on the southern coasts of Korean Peninsula at 21:00, September 12, 2003 with a central pressure of 950 hPa, and the typhoon resulted on the worst coastal disaster on the coast of Busan in the last decades. Observed storm surges at Busan, Yeosu, Tongyoung, Masan, Jeju and Seogwipo harbors during the passage of the typhoon were compared with the computed data. The simulated storm surge time series were in good agreement with the observations. The simulated peak storm surges were estimated to be 230 cm at Masan harbor, 200 cm at Yeosu harbor and Tongyoung harbor, and 75 cm at Busan harbor. The computed storm surges along the east coast of Busan measure 52 to 55 cm, exhibiting a gradual reduction in surge height as one moves further from the coast of Busan. Therefore, coastal inundation due to the storm surge in the semi-enclosed bay can induce great disasters, and the simulated results can be used as the important data to reduce the impact of a typhoon-induced coastal disaster in the future.