Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than
Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of
Background: Anemia in chronic renal failure plays an important role in increasing morbidity of dialysis patients. The causes of the anemia are multifactorial. With using of erythropoietin(EPO) most of uremia-induced anemia can be overcome. However, about 10% of renal failure patients shows EPO-resistant anemia. Hyporesponsiveness to EPO has been related to many factors: iron deficiency, aluminum intoxication, inflammations, malignancies and secondary hyperparathyroidism. So I evaluated the improvement of EPO responsiveness after correction of above several factors. Materials and Methods: Seventy-two patients on hemodialysis over 6 months were treated with intravenous ascorbic acid(IVAA, 300 mg t.i.w. for 12 weeks), After administration of IVAA for 12 weeks, patients were classified into several groups according to iron status, serum aluminum levels and i-PTH levels. Indivisualized treatments were performed: increased iron supplement for absolute iron deficiency, active vitamin D3 for secondary hyperparathyroidism and desferrioxamine(DFO, 5 mg/kg t.i.w.) for aluminum intoxication or hyperferritinemia. Results: 1) Result of IVAA therapy for 12 weeks on all patients(n=72). Hemoglobin levels at 2, 4, 6 week were significantly elevated compared to baseline, but those of hemoglobin at 8, 10, 12 week were not significantly different. 2) Result of IVAA therapy for 20 weeks on patients with 100
Compaction of soil is very important for construction of soil structures such as highway fills, embankment of reservoir and seadike. With increasing compaction effort, the strength of soil, interor friction and Cohesion increas greatly while the reduction of permerbilityis evident. Factors which may influence compaction effort are moisture content, grain size, grain distribution and other physical properties as well as the variable method of compaction. The moisture content among these parameter is the most important thing. For making the maximum density to a given soil, the comparable optimum water content is required. If there is a slight change in water content when compared with optimum water content, the compaction ratio will decrease and the corresponding mechanical properties will change evidently. The results in this study of soil compaction with different water content are summarized as follows. 1) The maximum dry density increased and corresponding optimum moisture content decreased with increasing of coarse grain size and the compaction curve is steeper than increasing of fine grain size. 2) The maximum dry density is decreased with increasing of the optimum water content and a relationship both parameter becomes rdam-max=2.232-0.02785
Regardless of the recent observed warmer winters in Korea, more freeze injuries and associated economic losses are reported in fruit industry than ever before. Existing freeze-frost forecasting systems employ only daily minimum temperature for judging the potential damage on dormant flowering buds but cannot accommodate potential biological responses such as short-term acclimation of plants to severe weather episodes as well as annual variation in climate. We introduce 'dormancy depth', in addition to daily minimum temperature, as a complementary criterion for judging the potential damage of freezing temperatures on dormant flowering buds of grape vines. Dormancy depth can be estimated by a phonology model driven by daily maximum and minimum temperature and is expected to make a reasonable proxy for physiological tolerance of buds to low temperature. Dormancy depth at a selected site was estimated for a climatological normal year by this model, and we found a close similarity in time course change pattern between the estimated dormancy depth and the known cold tolerance of fruit trees. Inter-annual and spatial variation in dormancy depth were identified by this method, showing the feasibility of using dormancy depth as a proxy indicator for tolerance to low temperature during the winter season. The model was applied to 10 vineyards which were recently damaged by a cold spell, and a temperature-dormancy depth-freeze injury relationship was formulated into an exponential-saturation model which can be used for judging freeze risk under a given set of temperature and dormancy depth. Based on this model and the expected lowest temperature with a 10-year recurrence interval, a freeze risk probability map was produced for Hwaseong County, Korea. The results seemed to explain why the vineyards in the warmer part of Hwaseong County have been hit by more freeBe damage than those in the cooler part of the county. A dormancy depth-minimum temperature dual engine freeze warning system was designed for vineyards in major production counties in Korea by combining the site-specific dormancy depth and minimum temperature forecasts with the freeze risk model. In this system, daily accumulation of thermal time since last fall leads to the dormancy state (depth) for today. The regional minimum temperature forecast for tomorrow by the Korea Meteorological Administration is converted to the site specific forecast at a 30m resolution. These data are input to the freeze risk model and the percent damage probability is calculated for each grid cell and mapped for the entire county. Similar approaches may be used to develop freeze warning systems for other deciduous fruit trees.
The formation of brown-colored precipitates is one of the serious problems frequently encountered in the development and supply of groundwater in Korea, because by it the water exceeds the drinking water standard in terms of color. taste. turbidity and dissolved iron concentration and of often results in scaling problem within the water supplying system. In groundwaters from the Pajoo area, brown precipitates are typically formed in a few hours after pumping-out. In this paper we examine the process of the brown precipitates' formation using the equilibrium thermodynamic and kinetic approaches, in order to understand the origin and geochemical pathway of the generation of turbidity in groundwater. The results of this study are used to suggest not only the proper pumping technique to minimize the formation of precipitates but also the optimal design of water treatment methods to improve the water quality. The bed-rock groundwater in the Pajoo area belongs to the Ca-
As conventional oil and gas reservoirs become depleted, interests for oil sands has rapidly increased in the last decade. Oil sands are mixture of bitumen, water, and host sediments of sand and clay. Most oil sand is unconsolidated sand that is held together by bitumen. Bitumen has hydrocarbon in situ viscosity of >10,000 centipoises (cP) at reservoir condition and has API gravity between
Introduction: Diffusion is process by which an innovation is communicated through certain channel overtime among the members of a social system(Rogers 1983). Bass(1969) suggested the Bass model describing diffusion process. The Bass model assumes potential adopters of innovation are influenced by mass-media and word-of-mouth from communication with previous adopters. Various expansions of the Bass model have been conducted. Some of them proposed a third factor affecting diffusion. Others proposed multinational diffusion model and it stressed interactive effect on diffusion among several countries. We add a spatial factor in the Bass model as a third communication factor. Because of situation where we can not control the interaction between markets, we need to consider that diffusion within certain market can be influenced by diffusion in contiguous market. The process that certain type of retail extends is a result that particular market can be described by the retail life cycle. Diffusion of retail has pattern following three phases of spatial diffusion: adoption of innovation happens in near the diffusion center first, spreads to the vicinity of the diffusing center and then adoption of innovation is completed in peripheral areas in saturation stage. So we expect spatial effect to be important to describe diffusion of domestic discount store. We define a spatial diffusion model using multinational diffusion model and apply it to the diffusion of discount store. Modeling: In this paper, we define a spatial diffusion model and apply it to the diffusion of discount store. To define a spatial diffusion model, we expand learning model(Kumar and Krishnan 2002) and separate diffusion process in diffusion center(market A) from diffusion process in the vicinity of the diffusing center(market B). The proposed spatial diffusion model is shown in equation (1a) and (1b). Equation (1a) is the diffusion process in diffusion center and equation (1b) is one in the vicinity of the diffusing center.