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Comparison of Adolescent Minimal Change Nephrotic Syndrome with Childhood Minimal Change Nephrotic Syndrome (청소년기와 소아기 미세변화형 신증후군의 임상양상에 대한 비교연구)

  • Choi, Chung-Yun;Kim, Ji-Hong;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.11-19
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    • 1999
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. MCNS most commonly appears between the ages of 2 and 10 yr. But the incidence and prognosis in adolescent MCNS are different from those found in young children; the prognosis and the response to therapy is unfavorable with increasing ages. So we compared the prevalence and the clinical manifestations of adolescent MCNS with that of childhood MCNS for management of adolescent MCNS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of the 216 cases with MCNS which were divided into children group and adolescent group by their age of onset; under 12 years(childhood) and between 12-18 years(adolescent). Results: 1) The number of childhood idiopathic nephrotic syndrome was 245 cases, and that of adolescent idiopathic nephrotic syndrome was 55 cases. 188 cases($77\%$) showed MCNS, 30 cases($12\%$) FSGS, 4 cases($1.6\%$) MSPCN in childhood idiopathic nephrotic syndrome; 28 cases($51\%$) showed MCNS, 12 cases($22\%$) FSGS in adolescent idiopathic nephrotic syndrome. 2) The mean onset age was $7.53{\pm}5.5$ years, and the male to female ratio was 3.8:1 in childhood onset and 2.5:1 in adolescent onset with male predominance. 3) Hematuria was associated with $17\%$ of childhood onset and $39.3\%$ of adolescent onset disease(P=0.005). Hypertension appeared in $0.5\%\;and\;7\%$ in each group without significant difference between the groups. 4) 24 hour urine protein, SPI, albumin, BUN, cholesterol level showed no significant difference. 5) The response of childhood onset and adolescent onset MCNS to steroid therapy showed complete remission in $11.7\%\;&\;14.7\%$, infrequent relapsing in $29.2\%\;&\;28.5\%$, frequent relapsing in $23.9\%\;&\;14.7\%$, steroid dependent in $21.8\%\;&\;28.6\%$ each. Steroid resistant showed $13.3\%\;&\;14.7\%$ with no significance. 6) Immunosuppresant therapy was performed $57\%$ in childhood onset and $65\%$ in adolescent onset. 7) Mean number of relapse and duration from onset to first relapse showed no significance between two groups. Conclusion : Our results indicate that the incidence of hematuria, the rate of steroid dependent and frequent relapsing, and the recurrence rate were higher in adolescent MCNS; showed poorer steroid responsiveness and prognosis. Our data also point to the need for a more aggressive therapy to treat and make recommendations for the adolescent population as a whole.

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Activities of Daily Living and Instrumental Activities of Daily Living of Elderlies in Chollabuk-Do Area (일부 전북지역 노인들의 일상생활동작능력과 수단적 일상생활동작능력)

  • Lee, Ki-Nam;Jeung, Jae-Yeal;Jahng, Doo-Sub;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.65-83
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    • 2000
  • To know the relationship of general characteristics with activities of daily living(ADL) and instrumental activities of daily living(IADL), we carried out the study on the elderies living in Chollabuk-Do area during 6 months, from June to December in 1999. Study subjects were 281, women and men were 195(69.6%) and 85(30.4%) respectively. Mean ages of women and men were 71.9 and 70.8 respectively. 81.1% elderies has disease and 18.9% were disease free. Disease prevalences of movement joint disease, others, circulatory disease, digestive disease, dental disease, respiratory disease were 50.1%, 25.0%, 10.5%, 9.4%, 8.5%, and 6.3% respectively. The percentages to the use of medical institution in recent were 40.0% for hospital, 16.8% for oriental hospital, 14.5% for public health center, 10.9% for drug store, 10.0% for others, and 7.8% for dental service. The percentages to the improvement of symptom after the use of medical institution were 62.3% for normal, 19.4% for improvement, and 18.2% for non-improvement. The percentages to the health situation were 37.1% for bad, 35.7% for good, and 27.1% for normal. Activities of daily living were 67.1% for 6 scores, 27.9% for 5 scores, 2.1% for 4 scores and ADL of women was lower than the men's. Instrumental activities of daily living were 50.4% for 5 scores, 19.3% for 3 scores, 12.1% for 4 scores and IADL of women was lower than the men's. Frequencies of disability in ADL were 28.9% for incontinence, 6.1% for bathing, 2.9% for meal, 2.5% for walking around house, 1.8% for toilet use, 1.4% for dressing and disability frequencies of women in 6 items of ADL were higher than the men's. The percentages of high, intermediate, low ADL in activities of daily living were 67.1%, 32.5%, 0.4% respectively and decrease of high ADL, increase of intermediate ADL were found with the increasing of age. Frequencies of disability in IADL were 42.9% for payment in and out, 31.8% for payment of written claim, 21.1% for shopping, 16.4% for preparation of meal, and 11.8% for use of bus. All items of women in IADL was higher than the men's but preparation of meal. The percentages of high, intermediate, low IADL in instrumental activities of daily living were 50.4%, 42.5%, 7.1% and decrease of high IADL, increase of intermediate IADL were found with the increasing of age. Mean of ADL with the general characteristics was 5.56 and 2 variables of level of education, health situation were statistically significant. Mean of IADL with the general characteristics was 3.76 and 8 variables of age, sex, level of education, occupation, presence of spouse, duty of living cost, health situation, category of ADL were statistically significant. With the result of stepwise regression, ADL was statistically related with religion, health situation and ADL was statistically related with level of education, living together with family, duty of living cost, health situation.

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Interlaboratory Comparison of Blood Lead Determination in Some Occupational Health Laboratories in Korea (일부 산업보건기관들의 혈중연 분석치 비교)

  • Ahn, Kyu Dong;Lee, Byung Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.5 no.1
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    • pp.8-15
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    • 1995
  • The reliable measurement of metal in biological media in human body is one of critical indicators for the proper evaluation of its toxic effect on human health. Recently in Korea the necessity of quality assurance of measurement in occupational health and occupational hygiene fields brought out regulatory quality control program. Lead is often used as a standard metal for the program in both fields of occupational health and hygiene. During last 20 years lead poisoning was prevalent in Korea and still is one of main heavy metal poisoning and the capability of the measurement of blood lead is one of prerequisites for institute of specialized occupational health in Korea. Furthermore blood lead is most important indicator to evaluate lead burden of human exposure to lead and the reliable and accurate analysis is most needed whenever possible. To evaluate the extent of the interlaboratory differences of blood lead measurement in several well-known institute specialized in occupational health in Korea, authors prepared 68 blood samples from two storage battery industries and all samples were divided into samples with 2 ml. One set of 68 samples were analyzed by authors's laboratory(Soonchunhyang University Institute of Industrial Medicine: SIIM) and 40 samples of other set were analyzed by C University Institute of Industrial Medicine(CIIM) and the rest 28 samples of other set were analyzed by Japanese institute(K Occupational Health Center:KOHC). Authors also prepared test bovine samples which were obtained from Japanese Federation of Occupational Health Organization (JFOHO) for quality control. Authors selected 2 other well-known occupational health laboratories and one laboratory specialized for instrumental analysis. A total of 6 laboratories joined the interlaboratory comparison of blood lead measurement and the results obtained were as follows: 1. There was no significant difference in average blood lead between SIIM and CIIM in different group of blood lead concentration, and the relative standard deviation of two laboratories was less than 3.0%. On the other hand, there was also no significant difference of average blood lead between SIIM and KOHC with relative standard deviation of 6.84% as maximum. 2. Taking less than 15% difference of mean or less than 6 ug/dl difference in below 40 ug/dl in whole blood as a criteria of agreement of measurement between two laboratories, agreement rates were 87.5%(35/40) and 78.6%(22/28) between SIIM and CIIM, SIIM and KOHC respectively. 3. The correlation of blood lead between SIIM and CIIM was 0.975 (p=0.0001) and the regression equation was SIIM = 2.19 + 0.9243 ClIM, whereas the correlation between SUM and KOHC was O.965(p=0.0001) with the equation of SIIM = 1.91 + 0.9794 KOHC. 4. Taking the reference value as a dependent variable and each of 6 laboratories's measurement value as a independent variable, the determination coefficient($R^2$) of simple regression equations of blood lead measurement for bovine test samples were very high($R^2>0.99$), and the regression coefficient(${\beta}$) was between 0.972 and 1.15 which indicated fairly good agreement of measurement results.

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Comparison of Tc-99m-Tetrofosmin and Tc-99m-MIBI Scintimammography in Differential Diagnosis of Breast Mass (유방종양의 감별진단에서 Tc-99m-Tetrofosmin과 Tc-99m-MIBI 유방신티그라피의 비교)

  • Park, Jung-Mi;Choi, Joon-Young;Lee, Kyung-Han;Choi, Yong;Choe, Yearn-Seong;Kim, Sang-Eun;Kim, Byung-Tae;Nam, Seok-Jin;Yang, Jeong-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.393-402
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    • 2000
  • Purpose: Tc-99m-MIBI (MIBI) and Tc-99m-Tetrofosmin (TF) are commonly used for scintimammog (SMM). We compared the diagnostic ability of SMM using Tc-99m-MIBI and Tc-99m-TF for the diagnosis of breast mass. Materials and Methods: The study subjects were comprised of 123 breast lesior 86 normal breasts of 114 patients who underwent SMM. Bilateral prone images and anterior supine images obtained at 5 minutes and 1 or 3 hours after intravenous injection of 740 MBq of either MIBI or TF. of tumors were not significantly different between the MIBI and TF groups. First, two observers read the SMM without clinical information (1st interpretation), then read again with information about location (2nd interpretation). Sensitivity and specificity of each radiopharmaceutical for the diagnosis of cancer were evaluated in terms of image acquisition time, tumor size, and location. Results: The SMM a good agreement between two observers for 1st and 2nd interpretation, except for TF SMM at 3 hr. first interpretation, the sensitivities at 5 min, 1 hr, and 3 hr were not significantly different between MIBI TF SMM (81.6%, 80.0%, 60.9% in MIBI vs. 88.9%, 80.6%, 42.9% in TF), although the sensitivities of images were significantly lower than 5 min images in both MIBI and TF SMM. The specificity of TF at was superior to that of MIBI (81.5%, 90.0%, 82.9% in MIBI vs. 96.7%, 100%, 90.0% in TF, p<0.01 MIBI TF at 5 min). For the second interpretation with information of mass location, the sensitivities at 3 hr were significantly lower than 5 min images (86.8%, 86.7%, 78.3% in MIBI vs. 88.9%, 93.5%, 57.1% between MIBI and TF SMM. However, there was no significant difference in the specificity (60.0%, 75.0% for MIBI vs. 86.7%, 100%, 100% for TF). MIBI and TF SMM showed lower sensitivities for the with less than 1 cm than tumors with more than 1 cm. However, the location of tumors did not sensitivity and specificity between MIBI and TF SMM. Conclusion: The ability for the differential of breast tumor is similar between MIBI and TF SMM, and delayed image is not necessary. TF may be than MIBI considering the specificity of SMM without clinical information and labeling convenience.

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The Measurement of Sensitivity and Comparative Analysis of Simplified Quantitation Methods to Measure Dopamine Transporters Using [I-123]IPT Pharmacokinetic Computer Simulations ([I-123]IPT 약역학 컴퓨터시뮬레이션을 이용한 민감도 측정 및 간편화된 운반체 정량분석 방법들의 비교분석 연구)

  • Son, Hye-Kyung;Nha, Sang-Kyun;Lee, Hee-Kyung;Kim, Hee-Joung
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.19-29
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    • 1997
  • Recently, [I-123]IPT SPECT has been used for early diagnosis of Parkinson's patients(PP) by imaging dopamine transporters. The dynamic time activity curves in basal ganglia(BG) and occipital cortex(OCC) without blood samples were obtained for 2 hours. These data were then used to measure dopamine transporters by operationally defined ratio methods of (BG-OCC)/OCC at 2 hrs, binding potential $R_v=k_3/k_4$ using graphic method or $R_A$= (ABBG-ABOCC)/ABOCC for 2 hrs, where ABBG represents accumulated binding activity in basal ganglia(${\int}^{120min}_0$ BG(t)dt) and ABOCC represents accumulated binding activity in occipital cortex(${\int}^{120min}_0$ OCC(t)dt). The purpose of this study was to examine the IPT pharmacokinetics and investigate the usefulness of simplified methods of (BG-OCC)/OCC, $R_A$, and $R_v$ which are often assumed that these values reflect the true values of $k_3/k_4$. The rate constants $K_1,\;k_2\;k_3$ and $k_4$ to be used for simulations were derived using [I-123]IPT SPECT and aterialized blood data with a standard three compartmental model. The sensitivities and time activity curves in BG and OCC were computed by changing $K_l$ and $k_3$(only BG) for every 5min over 2 hours. The values (BG-OCC)/OCC, $R_A$, and $R_v$ were then computed from the time activity curves and the linear regression analysis was used to measure the accuracies of these methods. The late constants $K_l,\;k_2\;k_3\;k_4$ at BG and OCC were $1.26{\pm}5.41%,\;0.044{\pm}19.58%,\;0.031{\pm}24.36%,\;0.008{\pm}22.78%$ and $1.36{\pm}4.76%,\;0.170{\pm}6.89%,\;0.007{\pm}23.89%,\;0.007{\pm}45.09%$, respectively. The Sensitivities for ((${\Delta}S/S$)/(${\Delta}k_3/k_3$)) and ((${\Delta}S/S$)/(${\Delta}K_l/K_l$)) at 30min and 120min were measured as (0.19, 0.50) and (0.61, 0,23), respectively. The correlation coefficients and slopes of ((BG-OCC)/OCC, $R_A$, and $R_v$) with $k_3/k_4$ were (0.98, 1.00, 0.99) and (1.76, 0.47, 1.25), respectively. These simulation results indicate that a late [I-123]IPT SPECT image may represent the distribution of the dopamine transporters. Good correlations were shown between (3G-OCC)/OCC, $R_A$ or $R_v$ and true $k_3/k_4$, although the slopes between them were not unity. Pharmacokinetic computer simulations may be a very useful technique in studying dopamine transporter systems.

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Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer (비소세포폐암에서 p53과 bcl-2의 발현이 예후에 미치는 영향)

  • Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.962-974
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    • 1998
  • Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.

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Improvement of Certification Criteria based on Analysis of On-site Investigation of Good Agricultural Practices(GAP) for Ginseng (인삼 GAP 인증기준의 현장실천평가결과 분석에 따른 인증기준 개선방안)

  • Yoon, Deok-Hoon;Nam, Ki-Woong;Oh, Soh-Young;Kim, Ga-Bin
    • Journal of Food Hygiene and Safety
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    • v.34 no.1
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    • pp.40-51
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    • 2019
  • Ginseng has a unique production system that is different from those used for other crops. It is subject to the Ginseng Industry Act., requires a long-term cultivation period of 4-6 years, involves complicated cultivation characteristics whereby ginseng is not produced in a single location, and many ginseng farmers engage in mixed-farming. Therefore, to bring the production of Ginseng in line with GAP standards, it is necessary to better understand the on-site practices of Ginseng farmers according to established control points, and to provide a proper action plan for improving efficiency. Among ginseng farmers in Korea who applied for GAP certification, 77.6% obtained it, which is lower than the 94.1% of farmers who obtained certification for other products. 13.7% of the applicants were judged to be unsuitable during document review due to their use of unregistered pesticides and soil heavy metals. Another 8.7% of applicants failed to obtain certification due to inadequate management results. This is a considerably higher rate of failure than the 5.3% incompatibility of document inspection and 0.6% incompatibility of on-site inspection, which suggests that it is relatively more difficult to obtain GAP certification for ginseng farming than for other crops. Ginseng farmers were given an average of 2.65 points out of 10 essential control points and a total 72 control points, which was slightly lower than the 2.81 points obtained for other crops. In particular, ginseng farmers were given an average of 1.96 points in the evaluation of compliance with the safe use standards for pesticides, which was much lower than the average of 2.95 points for other crops. Therefore, it is necessary to train ginseng farmers to comply with the safe use of pesticides. In the other essential control points, the ginseng farmers were rated at an average of 2.33 points, lower than the 2.58 points given for other crops. Several other areas of compliance in which the ginseng farmers also rated low in comparison to other crops were found. These inclued record keeping over 1 year, record of pesticide use, pesticide storages, posts harvest storage management, hand washing before and after work, hygiene related to work clothing, training of workers safety and hygiene, and written plan of hazard management. Also, among the total 72 control points, there are 12 control points (10 required, 2 recommended) that do not apply to ginseng. Therefore, it is considered inappropriate to conduct an effective evaluation of the ginseng production process based on the existing certification standards. In conclusion, differentiated certification standards are needed to expand GAP certification for ginseng farmers, and it is also necessary to develop programs that can be implemented in a more systematic and field-oriented manner to provide the farmers with proper GAP management education.

When do we use the Recycling Autograft in Limb Salvage Surgery? (사지구제술에서 언제 재활용 자가골 이식술이 유용한가?)

  • Kim, Jae-Do;Jang, Jae-Ho;Cho, Yool;Kim, Ji-Youn;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.95-105
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    • 2008
  • Purpose: To identify which is the best procedure in recycling autograft according to the resection & reconstruction type and recycling methods, and so when the recycling autograft is used in limb salvage surgery. Materials and Methods: We have treated fifty-eight patients (34 male, 24 female; age range 5 to 74 years, mean age 36.5 years), who had the malignant musculoskeletal tumors, with recycling autograft (47 patients with extracoporeal irradiation, 11 patients with pasteurization) from December 1995 to February 2006. The resection and reconstruction type was 3 cases with fragmentary, 8 intercalary, 23 rAPC (recycling-Autograft-Prosthesis composite), 18 osteoarticular, 5 total joint and 1 soft tissue (achilles tendon). The result was evaluated by the radiologic union at junctional site, the functional score by musculoskeletal tumor society score and complications according to the resection & reconstruction type and recycling methods. Results: The junctional union was obtained at 15.0 months in extracoporeal irradiation and 12.6 months in pasteurization. Also the mean radiologic union was shown at 6.0 months in fragmentary, 12.8 months in intercalary, 10 months in rAPC, 23.3 months in osteoarticular and 15.6 months in total joint. The functional score was 65.5% in fragmentary, 60.8% in intercalary, 62.8% in APC (except pelvis), 66.0% in osteoarticular and 66.6% in total joint. We have experienced 1 infection, 1 prutrusio acetabuli in pasteurization (18.1%) and other 22 complications (3 deep infections, 8 nonunions, 2 fractures, 2 epiphyseal problems, 5 joint instabilities, 2 local recurrence) in extracoporeal irradiation (46.8%). Also we have experienced 3 complications (3 nonunions) in intercalary (37.5%), 9 complications (4 nonunions, 1 deep infection, 1 periprosthetic fracture, 1 epiphyseal problem, 1 local recurrence, 1 protrusio acetabuli) in rAPC (50.0%), 6 complications (2 deep infections, 2 nonunions, 1 epiphyseal problem, 1 pathologic fracture) in osteoarticular (33.3%), 5 complications (5 joint instabilities) in total joint (100%) and 1 complication(1 local recurrence) in soft tissue (100%). Conclusion: In our experience, according to the resection & reconstruction type fragmentary and intercalary may have several advantages such as good radiologic and functional result and low rate of complication. And it seems that rAPC was available in case which have no sufficient residual bone stock. Also the pasteurization may have more advantages than that of the extracorporeal irradiation.

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A Study on Risk Factors for Early Major Morbidity and Mortality in Multiple-valve Operations (중복판막수술후 조기성적에 영향을 미치는 인자에 관한 연구)

  • 한일용;조용길;황윤호;조광현
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.233-241
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    • 1998
  • To define the risk factors affecting the early major morbidity and mortality after multiple- valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9$\pm$11.5(mean$\pm$SD) years. Using the New York Heart Association(NYHA) classification, 41 patients(33.1%) were in functional class II, 60(48.4%) in class III, and 20(16.1%) in class IV preoperatively. Seven patients(5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients(61.3%), a history of cerebral embolism in 5(4.0%), and left atrial thrombus in 13(10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57(46.0%) of combined mitral valve replacement(MVR) and aortic valve replacement(AVR), 48(38.7%) of combined MVR and tricuspid annuloplasty(TVA), 12(9.7%) of combined MVR, AVR and TVA, 3(2.4%) of combined MVR and aortic valvuloplasty, 2(1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A(27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B(97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time(ACT, group A:153.4$\pm$42.4 minutes, group B:134.0$\pm$43.7 minutes, p=0.042), total bypass time(TBT, group A:187.4$\pm$65.5 minutes, group B:158.1$\pm$50.6 minutes, p=0.038), and NYHA functional class(I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death(n=10) and survivor(n=114), there were significant differences in age(early death:45.2$\pm$8.7 years, survivor:37.2$\pm$11.6 years, p=0.036), sex(female:12.7%, male:1.9%, p=0.043), ACT(early death:167.1$\pm$38.4 minutes, survivor:135.7$\pm$43.7 minutes, p=0.030), and NYHA functional class(I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.

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A study on the Degradation and By-products Formation of NDMA by the Photolysis with UV: Setup of Reaction Models and Assessment of Decomposition Characteristics by the Statistical Design of Experiment (DOE) based on the Box-Behnken Technique (UV 공정을 이용한 N-Nitrosodimethylamine (NDMA) 광분해 및 부산물 생성에 관한 연구: 박스-벤켄법 실험계획법을 이용한 통계학적 분해특성평가 및 반응모델 수립)

  • Chang, Soon-Woong;Lee, Si-Jin;Cho, Il-Hyoung
    • Journal of Korean Society of Environmental Engineers
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    • v.32 no.1
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    • pp.33-46
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    • 2010
  • We investigated and estimated at the characteristics of decomposition and by-products of N-Nitrosodimethylamine (NDMA) using a design of experiment (DOE) based on the Box-Behken design in an UV process, and also the main factors (variables) with UV intensity($X_2$) (range: $1.5{\sim}4.5\;mW/cm^2$), NDMA concentration ($X_2$) (range: 100~300 uM) and pH ($X_2$) (rang: 3~9) which consisted of 3 levels in each factor and 4 responses ($Y_1$ (% of NDMA removal), $Y_2$ (dimethylamine (DMA) reformation (uM)), $Y_3$ (dimethylformamide (DMF) reformation (uM), $Y_4$ ($NO_2$-N reformation (uM)) were set up to estimate the prediction model and the optimization conditions. The results of prediction model and optimization point using the canonical analysis in order to obtain the optimal operation conditions were $Y_1$ [% of NDMA removal] = $117+21X_1-0.3X_2-17.2X_3+{2.43X_1}^2+{0.001X_2}^2+{3.2X_3}^2-0.08X_1X_2-1.6X_1X_3-0.05X_2X_3$ ($R^2$= 96%, Adjusted $R^2$ = 88%) and 99.3% ($X_1:\;4.5\;mW/cm^2$, $X_2:\;190\;uM$, $X_3:\;3.2$), $Y_2$ [DMA conc] = $-101+18.5X_1+0.4X_2+21X_3-{3.3X_1}^2-{0.01X_2}^2-{1.5X_3}^2-0.01X_1X_2+0.07X_1X_3-0.01X_2X_3$ ($R^2$= 99.4%, 수정 $R^2$ = 95.7%) and 35.2 uM ($X_1$: 3 $mW/cm^2$, $X_2$: 220 uM, $X_3$: 6.3), $Y_3$ [DMF conc] = $-6.2+0.2X_1+0.02X_2+2X_3-0.26X_1^2-0.01X_2^2-0.2X_3^2-0.004X_1X_2+0.1X_1X_3-0.02X_2X_3$ ($R^2$= 98%, Adjusted $R^2$ = 94.4%) and 3.7 uM ($X_1:\;4.5\;$mW/cm^2$, $X_2:\;290\;uM$, $X_3:\;6.2$) and $Y_4$ [$NO_2$-N conc] = $-25+12.2X_1+0.15X_2+7.8X_3+{1.1X_1}^2+{0.001X_2}^2-{0.34X_3}^2+0.01X_1X_2+0.08X_1X_3-3.4X_2X_3$ ($R^2$= 98.5%, Adjusted $R^2$ = 95.7%) and 74.5 uM ($X_1:\;4.5\;mW/cm^2$, $X_2:\;220\;uM$, $X_3:\;3.1$). This study has demonstrated that the response surface methodology and the Box-Behnken statistical experiment design can provide statistically reliable results for decomposition and by-products of NDMA by the UV photolysis and also for determination of optimum conditions. Predictions obtained from the response functions were in good agreement with the experimental results indicating the reliability of the methodology used.