• Title/Summary/Keyword: risk process

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Effect of Additional 1 hour T-piece Trial on Weaning Outcome to the Patients at Minimum Pressure Support (최소압력보조 수준에서 추가적 1시간 T-piece 시도가 이탈에 미치는 영향)

  • Hong, Sang-Bum;Koh, Youn-Suck;Lim, Chae-Man;Ann, Jong-Jun;Park, Wann;Shim, Tae-Son;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.813-822
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    • 1998
  • Background: Extubation is recommended to be performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. Methods: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventilation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate $\times$ total ventilatory system resistance) at the 15cm $H_2O$ of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at PSmin). The measurements were repeated at PSmm, during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extubation. In intervention group, failure to continue weaning process was also considered as weaning failure. Results: Thirty-six patients with 42 times weaning trial were satisfied to the protocol. Mean PSmin level was 7.6 (${\pm}1.9$)cm $H_2O$. There were no differences in total ventilation times (TVT), APACHE III score, nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, and tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group ($10.4{\pm}1.25$ and $1.66{\pm}1.08$ J/L in work of breathing) ($191{\pm}232$ and $287{\pm}217$cm $H_2O$ s/m in pressure time product) ($0.33{\pm}0.09$ and $0.29{\pm}0.09$ L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success ($246{\pm}195$ hr, $0.43{\pm}0.11$ L) and the those with weaning failure ($407{\pm}248$ hr, $0.35{\pm}0.10$L) (P<0.05 in each). Conclusion : There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PS min.

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The influence of some intrauterine growth variables on neonatal blood pressure (태아기 자궁내 성장지표와 신생아 혈압과의 관련성)

  • Min, Jungwon;Park, Eun Ae;Kong, Kyoungae;Park, Bohyun;Hong, Juhee;Kim, Young Ju;Lee, Hwayoung;Ha, EunHee;Park, Hyesook
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.966-971
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    • 2006
  • Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.

The Study of Metrics development for Entrepreneurial Program Effectiveness (청소년 창업교육프로그램 효과성 측정지표 개발 연구)

  • Byun, Youngjo;Kim, Myung Seuk;Yang, Young Seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.4
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    • pp.77-85
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    • 2014
  • A goal of Bizcool entrepreneurship education targeting on the youth falls on letting understand the process of starts-up, enhance entrepreneurship will and their business creativities rather than training trivial starts-up skills such as writing business plan for successful starts-up. The effects of education enable Bizcoo students to recognize rightly the concept of starts-up training and lead to spread out demand for entrepreneurship education. The feedback check-up for how entrepreneurship education affects students getting through of it is necessary and possible to bring its' improvement alternatives. Despite of such highlight, not many measuring tools and indexes of evaluating an effectiveness of entrepreneurship education are developed and studied up until. This research suggests for the optimal indexes for them. In specific, this research 49 the first question sets of evaluating an effectiveness of entrepreneurship education classified 3 large categories and 11 following sub categories each of them such as entrepreneurship orientation, creativity, entrepreneurship preparing activities etc,. representing embedding education effects though entrepreneurship education. This research carry out the empirical survey research utilizing driven question sets against 5 different Bizcools sampling 287 students. The survey research delivers the final 3 large categories and 8 following sub categories(Innovativeness, risk-taking, problem-solving potent, cooperative decision-making potent, efficient behavior capacity, data collecting potent, career search, starts-up search and preparation), and 38 measuring indexes by search and confirming factor analysis. This research never drop the confidence test over each indexes and obtain the proper figures. Last but not least, this research confirm the gap between starts-up club members and non members as to an effectiveness of entrepreneurship education and 9 different indexes.

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Dose Evaluation of TPS according to Treatment Sites in IMRT (세기조절방사선치료 시 치료 부위에 따른 치료계획 시스템 간 선량평가)

  • Kim, Jin Man;Kim, Jong Sik;Hong, Chae Seon;Park, Ju Young;Park, Su Yeon;Ju, Sang Gyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.181-186
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    • 2013
  • Purpose: This study executed therapy plans on prostate cancer (homogeneous density area) and lung cancer (non-homogeneous density area) using radiation treatment planning systems such as $Pinnacle^3$ (version 9.2, Philips Medical Systems, USA) and Eclipse (version 10.0, Varian Medical Systems, USA) in order to quantify the difference between dose calculation according to density in IMRT. Materials and Methods: The subjects were prostate cancer patients (n=5) and lung cancer patients (n=5) who had therapies in our hospital. Identical constraints and optimization process according to the Protocol were administered on the subjects. For the therapy plan of prostate cancer patients, 10 MV and 7Beam were used and 2.5 Gy was prescribed in 28 fx to make 70 Gy in total. For lung cancer patients, 6 MV and 6Beam were used and 2 Gy was prescribed in 33 fx to make 66 Gy in total. Through two therapy planning systems, maximum dose, average dose, and minimum dose of OAR (Organ at Risk) of CTV, PTV and around tumor were investigated. Results: In prostate cancer, both therapy planning systems showed within 2% change of dose of CTV and PTV and normal organs (Bladder, Both femur and Rectum out) near the tumor satisfied the dose constraints. In lung cancer, CTV and PTV showed less than 2% changes in dose and normal organs (Esophagus, Spinal cord and Both lungs) satisfied dose restrictions. However, the minimum dose of Eclipse therapy plan was 1.9% higher in CTV and 3.5% higher in PTV, and in case of both lungs there was 3.0% difference at V5 Gy. Conclusion: Each TPS according to the density satisfied dose limits of our hospital proving the clinical accuracy. It is considered more accurate and precise therapy plan can be made if studies on treatment planning for diverse parts and the application of such TPS are made.

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Radioactivation Analysis of Concrete Shielding Wall of Cyclotron Room Using Monte Carlo Simulation (PET 사이클로트론 가동에 따른 콘크리트 차폐벽의 방사화)

  • Jang, Donggun;Lee, Dongyeon;Kim, Junghoon
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.335-341
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    • 2017
  • Cyclotron is a device that accelerates positrons or neutrons, and is used as a facility for making radioactive drugs having short half-lives. Such radioactive drugs are used for positron emission tomography (PET), which is a medical apparatus. In order to make radioactive drugs from a cyclotron, a nuclear reaction must occur between accelerated positrons and a target. After the reaction, unncessary neutrons are produced. In the present study, radioactivation generated from the collisions between the concrete shielding wall and the positrons and neutrons produced from the cyclotron is investigated. We tracked radioactivated radioactive isotopes by conducting experiments using FLUKA, a type of Monte Carlo simulation. The properties of the concrete shielding wall were comparatively analyzed using materials containing impurities at ppm level and materials that do not contain impurities. The generated radioactivated nuclear species were comparatively analyzed based on the exposure dose affecting human body as a criterion, through RESRAD-Build. The results of experiments showed that the material containing impurities produced a total of 14 radioactive isotopes, and $^{60}Co$(72.50%), $^{134}Cs$(16.75%), $^{54}Mn$(5.60%), $^{152}Eu$(4.08%), $^{154}Eu$(1.07%) accounted for 99.9% of the total dose according to the analysis having the exposure dose affecting human body as criterion. The $^{60}Co$ nuclear species showed the greatest risk of radiation exposure. The material that did not contain impurities produced a total of five nuclear species. Among the five nuclear species, 54Mn accounted for 99.9% of the exposure dose. There is a possibility that Cobalt can be generated by inducive nuclear reaction of positrons through the radioactivation process of $^{56}Fe$ instead of impurities. However, there was no radioactivation because only few positrons reached the concrete wall. The results of comparative analysis on exposure dose with respect to the presence of impurities indicated that the presence of impurities caused approximately 98% higher exposure dose. From this result, the main cause of radioactivation was identified as the small ppm-level amount of impurities.

Enhancing Technology Learning Capabilities for Catch-up and Post Catch-up Innovations (기술학습역량 강화를 통한 추격 및 탈추격 혁신 촉진)

  • Bae, Zong-Tae;Lee, Jong-Seon;Koo, Bonjin
    • The Journal of Small Business Innovation
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    • v.19 no.2
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    • pp.53-68
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    • 2016
  • Motivation and activities for technological learning, entrepreneurship, innovation, and creativity are driving forces of economic development in Asian countries. In the early stages of technological development, technological learning and entrepreneurship are efficient ways in which to catch up with advanced countries because firms can accumulate skills and knowledge quickly at relatively low risk. In the later stages of technological development, however, innovation and creativity become more important. This study aims to identify a) the factors (learning capabilities) that influence technological learning performance and b) barriers to enhancing innovation capabilities for the creative economy and organizations. The major part of this study is related to learning capabilities in the post-catch-up era. Based on a literature review and observations from Korean experiences, this study proposes a technological learning model composed of various influencing factors on technological learning. Three hypotheses are derived, and data are collected from Korean machine tool manufacturers. Intense interviews with CEOs and R&D directors are conducted using structured questionnaires. Statistical analysis, such as correlation and ANOVA are then carried out. Furthermore, this study addresses how to enhance innovation capabilities to move forward. Innovation enablers and barriers are identified by case studies and policy analysis. The results of the empirical study identify several levels of firms' learning capabilities and activities such as a) stock of technology, b) potential of technical labor, c) explicit technological efforts, d) readiness to learn, e) top management support, f) a formal technological learning system, g) high learning motivation, h) appropriate technology choice, and i) specific goal setting. These learning capabilities determine firms' learning performance, especially in the early stages of development. Furthermore, it is found that the critical factors for successful technological learning vary along the stages of technology development. Throughout the statistical and policy analyses, this study confirms that technological learning can be understood as an intrinsic principle of the technology development process. Firms perform proactive and creative learning in the late stages, while reactive and imitative learning prevails in the early stages. In addition, this study identifies the driving forces or facilitating factors enhancing innovation performance in the post catch-up era. The results of the preliminary case studies and policy analysis show some facilitating factors such as a) the strategic intent of the CEO and corporate culture, b) leadership and change agents, c) design principles and routines, d) ecosystem and collaboration with partners, and e) intensive R&D investment.

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Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data (국민건강영양조사 자료를 이용한 한국 성인의 식생활평가지수 개발)

  • Yook, Sung-Min;Park, Sohee;Moon, Hyun-Kyung;Kim, Kirang;Shim, Jae Eun;Hwang, Ji-Yun
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.419-428
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    • 2015
  • Purpose: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. Results: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. Conclusion: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

Transformation of Asbestos-Containing Slate Using Exothermic Reaction Catalysts and Heat Treatment (발열반응 촉매제와 열처리를 이용한 석면함유 슬레이트의 무해화 연구)

  • Yoon, Sungjun;Jeong, Hyeonyi;Park, Byungno;Kim, Yongun;Kim, Hyesu;Park, Jaebong;Roh, Yul
    • Economic and Environmental Geology
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    • v.52 no.6
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    • pp.627-635
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    • 2019
  • Cement-asbestos slate is the main asbestos containing material. It is a product made by combining 10~20% of asbestos and cement components. Man- and weathering-induced degradation of the cement-asbestos slates makes them a source of dispersion of asbestos fibres and represents a priority cause of concern. When the asbestos enters the human body, it causes cellular damage or deformation, and is not discharged well in vitro, and has been proven to cause diseases such as lung cancer, asbestos, malignant mesothelioma and pleural thickening. The International Agency for Research on Cancer (IARC) has designated asbestos as a group 1 carcinogen. Currently, most of these slats are disposed in a designated landfill, but the landfill capacity is approaching its limit, and there is a potential risk of exposure to the external environment even if it is land-filled. Therefore, this study aimed to exam the possibility of detoxification of asbestos-containing slate by using exothermic reaction and heat treatment. Cement-asbestos slate from the asbestos removal site was used for this experiment. Exothermic catalysts such as calcium chloride(CaCl2), magnesium chloride(MgCl2), sodium hydroxide(NaOH), sodium silicate(Na2SiO3), kaolin[Al2Si2O5(OH)4)], and talc[Mg3Si4O10(OH)2] were used. Six catalysts were applied to the cement-asbestos slate, respectively and then analyzed using TG-DTA. Based on the TG-DTA results, the heat treatment temperature for cement-asbestos slate transformation was determined at 750℃. XRD, SEM-EDS and TEM-EDS analyses were performed on the samples after the six catalysts applied to the slate and heat-treated at 750℃ for 2 hours. It was confirmed that chrysotile[Mg3Si2O5(OH5)] in the cement-asbestos slate was transformed into forsterite (Mg2SiO4) by catalysts and heat treatment. In addition, the change in the shape of minerals was observed by applying a physical force to the slate and the heat treated slate after coating catalysts. As a result, the chrysotile in the cement-asbestos slate maintained fibrous form, but the cement-asbestos slate after heat treatment of applying catalyst was broken into non-fibrous form. Therefore, this study shows the possibility to safely verify the complete transformation of asbestos minerals in this catalyst- and temperature-induced process.

Antigenotoxic and Anticarcinogenic Effects of Styela plicata (오만둥이(Styela plicata)의 항유전독성 및 대장암 억제효과에 관한 연구)

  • Seo, Bo-Young;Kim, Jung-Mi;Lee, Seung-Cheol;Park, Eun-Ju
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.7
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    • pp.839-845
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    • 2009
  • Colorectal cancer is the third most common malignant neoplasm in the world. Much attention has been focused on reducing colon cancer risk through medical properties of natural compound that could act as anticarcinogens. In this study, we evaluated the antioxidant and antigenotoxic effects of Styela plicata (S. plicata) from in vitro experiments. S. plicata extracts showed antioxidant activity measured by TRAP assay and antigenotoxic effect in $200{\mu}M$ $H_2O_2$ induced DNA damage in human leukocytes. Especially, freeze-dried S. plicata extracted with methanol showed the highest level of TRAP (0.225 mM) and inhibition of DNA damage (66.8%). Additionally we observed the effect of S. plicata on the formation of aberrant crypt foci (ACF) induced by dimethylhydrazine (DMH) and DMH induced DNA damage (by comet assay) in male SD rats. The animals were divided into three groups and fed high-fat and low fiber diet (100 g lard+20 g cellulose/kg diet) without (normal control and DMH control) or with a 3% (w/w) of lyophilized S. plicata powder (DMH+S. plicata). One week after beginning the diets, rats were treated with DMH (30 mg/kg, s.c.) for 6 weeks except for normal control group, which was treated saline instead; dietary treatments were continued for the entire experiment. Nine weeks after DMH injection, administration of S. plicata resulted in reduction of ACF numbers, to 82.7% of the carcinogen control value ($7.67{\pm}2.04$ vs. $1.33{\pm}0.53$: p<0.01). S. plicata supplementation induced antigenotoxic effect on DMH-induced DNA damage in the blood cell (% tail intensity: $6.79{\pm}0.26$ vs. $6.13{\pm}0.22$). These data indicate that S. plicata extract has antigenotoxic and anticarcinogenic effects from in vitro experiments and S. plicata exerts a protective effect on the process of colon carcinogenesis, possibly by suppressing the DMH-induced DNA damage in blood cell and the development of preneoplastic lesions in colon.

Characterization and Modification of Milk Lipids (유지방의 특성과 변화)

  • Yeo, Yeong-Geun;Choe, Byeong-Guk;Im, A-Yeong;Kim, Hyo-Jeong;Kim, Su-Min;Kim, Dae-Gon
    • Journal of Dairy Science and Biotechnology
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    • v.16 no.2
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    • pp.119-136
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    • 1998
  • The lipids of milk provide energy and many essential nutrients for the newborn animal. They also have distinctive physical properties that affect the processing of dairy products. Milk fat globules mainly consist of neutral lipids like triacylglycerols, whereas the globule membranes contain the complex lipids mostly, Phospholipids are a small but important fraction of the milk lipids and are found mainly in the milk fat globule membrane and other membranous material in the skim-milk phase. The milk fats of ruminant animals are characterized by the presence of relatively high concentrations of short-chain fatty acids, especially butyric and hexanoic acids, which are rarely found in milks of non-ruminants. The fatty acids of milk lipids arise from de novo synthesis in the mammary gland and uptake from the circulating blood. The fatty acid compositions of milks are usually complex and distinctive, depending on the nature of the fatty acids synthesized de novo in the mammary gland and those received from the diet in each species. The content and composition of milks from different species vary widely; presumably, these are evolutionary adaptations to differing environments. The actual process by which these globules are formed is unkonwn, but there are indications that triglyceride-containing vesicles which bleb from endoplasmic reticulum may serve as nucleation sites for globules. Recent studies on milk have centred on the manipulation of milk lipids to increase specific fatty acids, i.e. 20-carbon omega-3 fatty acids (eicosapentaenoic acid 20:5n3, decosahexaenoic acid 22:6n3) from marine sources because the fatty acids are closely associated with a decreased risk of coronary heart disease.

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