Mason D. Vialonga;Luke G. Menken;Alex Tang;John W. Yurek;Li Sun;John J. Feldman;Frank A. Liporace;Richard S. Yoon
Hip & pelvis
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v.34
no.1
/
pp.25-34
/
2022
Purpose: Mortality rates following hip fracture surgery have been well-studied. This study was conducted to examine mortality rates in asymptomatic patients presenting for treatment of acute hip fractures with concurrent positive COVID-19(+) tests compared to those with negative COVID-19(-) tests. Materials and Methods: A total of 149 consecutive patients undergoing hip fracture surgery during the COVID-19 pandemic at two academic medical centers were reviewed retrospectively. Patients were divided into two groups for comparative analysis: one group included asymptomatic patients with COVID-19+ tests versus COVID-19- tests. The primary outcome was mortality at 30-days and 90-days. Results: COVID-19+ patients had a higher mortality rate than COVID-19- patients at 30-days (26.7% vs 6.0%, P=0.005) and 90-days (41.7% vs 17.2%, P=0.046) and trended towards an increased length of hospital stay (10.1±6.2 vs 6.8±3.8 days, P=0.06). COVID-19+ patients had more pre-existing respiratory disease (46.7% vs 11.2%, P=0.0002). Results of a Cox regression analysis showed an increased risk of mortality at 30-days and 90-days from COVID-19+ status alone without an increased risk of death in patients with pre-existing chronic respiratory disease. Conclusion: Factors including time to surgery, age, preexisting comorbidities, and postoperative ambulatory status have been proven to affect mortality and complications in hip fracture patients; however, a positive COVID-19 test result adds another variable to this process. Implementation of protocols that will promote prompt orthogeriatric assessments, expedite patient transfer, limit operating room traffic, and optimize anesthesia time can preserve the standard of care in this unique patient population.
Journal of agricultural medicine and community health
/
v.27
no.1
/
pp.115-123
/
2002
Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.
Zoz, H.;Benz, H.U.;Huettebraeucker, K.;Furken, L.;Ren, H.;Reichardt, R.
Proceedings of the Korean Powder Metallurgy Institute Conference
/
2000.04a
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pp.9-10
/
2000
An important business-field of world-wide steel-industry is the coating of thin metal-sheets with zinc, zinc-aluminum and aluminum based materials. These products mostly go into automotive industry. in particular for the car-body. into building and construction industry as well as household appliances. Due to mass-production, the processing is done in large continuously operating plants where the mostly cold-rolled metal-strip as the substrate is handled in coils up to 40 tons unwind before and rolled up again after passing the processing plant which includes cleaning, annealing, hot-dip galvanizing / aluminizing and chemical treatment. In the liquid Zn, Zn-AI, AI-Zn and AI-Si bathes a combined action of corrosion and wear under high temperature and high stress onto the transfer components (rolls) accounts for major economic losses. Most critical here are the bearing systems of these rolls operating in the liquid system. Rolls in liquid system can not be avoided as they are needed to transfer the steel-strip into and out of the crucible. Since several years, ceramic roller bearings are tested here [1.2], however, in particular due to uncontrollable Slag-impurities within the hot bath [3], slide bearings are still expected to be of a higher potential [4]. The today's state of the art is the application of slide bearings based on Stellite\ulcorneragainst Stellite which is in general a 50-60 wt% Co-matrix with incorporated Cr- and W-carbides and other composites. Indeed Stellite is used as the bearing-material as of it's chemical properties (does not go into solution), the physical properties in particular with poor lubricating properties are not satisfying at all. To increase the Sliding behavior in the bearing system, about 0.15-0.2 wt% of lead has been added into the hot-bath in the past. Due to environmental regulations. this had to be reduced dramatically_ This together with the heavily increasing production rates expressed by increased velocity of the substrate-steel-band up to 200 m/min and increased tractate power up to 10 tons in modern plants. leads to life times of the bearings of a few up to several days only. To improve this situation. the Mechanical Alloying (MA) TeChnique [5.6.7.8] is used to prOduce advanced Stellite-based bearing materials. A lubricating phase is introduced into Stellite-powder-material by MA, the composite-powder-particles are coated by High Energy Milling (HEM) in order to produce bearing-bushes of approximately 12 kg by Sintering, Liquid Phase Sintering (LPS) and Hot Isostatic Pressing (HIP). The chemical and physical behavior of samples as well as the bearing systems in the hot galvanizing / aluminizing plant are discussed. DependenCies like lubricant material and composite, LPS-binder and composite, particle shape and PM-route with respect to achievable density. (temperature--) shock-reSistibility and corrosive-wear behavior will be described. The materials are characterized by particle size analysis (laser diffraction), scanning electron microscopy and X-ray diffraction. corrosive-wear behavior is determined using a special cylinder-in-bush apparatus (CIBA) as well as field-test in real production condition. Part I of this work describes the initial testing phase where different sample materials are produced, characterized, consolidated and tested in the CIBA under a common AI-Zn-system. The results are discussed and the material-system for the large components to be produced for the field test in real production condition is decided. Outlook: Part II of this work will describe the field test in a hot-dip-galvanizing/aluminizing plant of the mechanically alloyed bearing bushes under aluminum-rich liquid metal. Alter testing, the bushes will be characterized and obtained results with respect to wear. expected lifetime, surface roughness and infiltration will be discussed. Part III of this project will describe a second initial testing phase where the won results of part 1+11 will be transferred to the AI-Si system. Part IV of this project will describe the field test in a hot-dip-aluminizing plant of the mechanically alloyed bearing bushes under aluminum liquid metal. After testing. the bushes will be characterized and obtained results with respect to wear. expected lifetime, surface roughness and infiltration will be discussed.
A sewage was treated using a serially combined vertical(VFCW) and horizontal flow double media (sand and zeolite for VFCW and sand and waste oyster-shell for HFCW) reed constructed wetland(HFCW) with intermittent feeding (see Fig. 1). The sewage was fed into the reed constructed wetland for 10 minutes every 6 hours at the hydraulic load of $314L/m^2{\cdot}day$. The summarized results were as follows: pH values in the effluent depended very heavily on oyster-shell height filled in the HFCW. They were maintained at less than pH 6.24 when the height of the oyster-shell layer was 200 mm. Influent DO(oxygen demand) values(average 0.19 mg/L) were increased in the VFCW(average 7.65 mg/L) and decreased again in the HFCW(average 6.49 mg/L). They were higher in the winter than in the summer. The OTR(oxygen transfer rate) was $57.15g\;O_2/m^2{\cdot}day$ in the VFCW and $5.65g\;O_2/m^2{\cdot}day$ in the HFCW. The removal efficiency of $NH_4{^+}$-N was 80.17%(6.01 $NH_4{^+}$-N mg/L in the effluent). It was lower than that in the case where only zeolite was filled in the reed constructed wetland. But it was expected that treated sewage effluent using a double media reed constructed wetland with 300 mm zeolite layer could stably meet the Korean treated sewage effluent standard(20 mg T-N/L). Average removal efficiencies were SS 88.09%, BOD 88.12%, $COD_{Cr}$ 83.11%, $COD_{Mn}$ 85.58%, T-N 57.21%, $NH_4{^+}$-N 80.17%, T-P 86.73%. Nearly, The concentration of $NO_3{^-}$-N in the effluent of the VFCW was decreased in that of the HFCW. More than half of T-N in the effluent was $NO_3{^-}$-N(7.92 mg/L) but the concentration of $NO_2{^-}$-N in the effluent was average 0.90 mg/L. The removal efficiencies of T-P were 93.24%, 86.30% and 55.44% at the height of the oyster-shell-filled constructed wetland of 800 mm, 500 mm and 200 mm, respectively and therefore, they were proportional to oyster-shell height filled in the HFCW.
SK Telecom has already constructed GIMS system as the base common framework of LBS/GIS service system based on OGC(OpenGIS Consortium)'s international standard for the first mobile vector map service in 2002, But as service content appears more complex, renovation has been needed to satisfy multi-purpose, multi-function and maximum efficiency as requirements have been increased. This research is for preparation ion of GML3-based platform to upgrade service from GML2 based GIMS system. And with this, it will be possible for variety of application services to provide location and geographic data easily and freely. In GML 3.0, it has been selected animation, event handling, resource for style mapping, topology specification for 3D and telematics services for mobile LBS multimedia service. And the schema and transfer protocol has been developed and organized to optimize data transfer to MS(Mobile Stat ion) Upgrade to GML 3.0-based GIMS system has provided innovative framework in the view of not only construction but also service which has been implemented and applied to previous research and system. Also GIMS channel interface has been implemented to simplify access to GIMS system, and service component of GIMS internals, WFS and WMS, has gotten enhanded and expanded function.
The calculation method of infiltration loss in greenhouse has different ideas in each design standard, so there is a big difference in each method according to the size of greenhouses, it is necessary to establish a more accurate method that can be applied to the domestic. In order to provide basic data for the formulation of the calculation method of greenhouse heating load, we measured the infiltration rates using the tracer gas method in plastic greenhouses equipped with various thermal curtains. And then the calculation methods of infiltration loss in greenhouses were reviewed. Infiltration rates of the multi-span and single-span greenhouses were measured in the range of $0.042{\sim}0.245h^{-1}$ and $0.056{\sim}0.336h^{-1}$ respectively, single-span greenhouses appeared to be slightly larger. Infiltration rate of the greenhouse has been shown to significantly decrease depending on the number of thermal curtain layers without separation of single-span and multi-span. As the temperature differences between indoor and outdoor increase, the infiltration rates tended to increase. In the range of low wind speed during the experiments, changes of infiltration rate according to the outdoor wind speed could not find a consistent trend. Infiltration rates for the greenhouse heating design need to present the values at the appropriate temperature difference between indoor and outdoor. The change in the infiltration rate according to the wind speed does not need to be considered because the maximum heating load is calculated at a low wind speed range. However the correction factors to increase slightly the maximum heating load including the overall heat transfer coefficient should be applied at the strong wind regions. After reviewing the calculation method of infiltration loss, a method of using the infiltration heat transfer coefficient and the greenhouse covering area was found to have a problem, a method of using the infiltration rate and the greenhouse volume was determined to be reasonable.
Kim, Gye-Hwan;Choi, Hyeon-Joon;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyun-Joo
The Korean Journal of Nuclear Medicine Technology
/
v.14
no.2
/
pp.38-40
/
2010
Purpose: This study was performed to find the current problems of PET/CT data from other hospitals. Materials and Methods: The subjects were acquired from 64 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data were reviewed and the phone questionnaire survey about these were performed. Results: PET/CT data from 39 of 64 hospitals (61%) included all transaxial CT and PET images with DICOM (Digital Imaging Communications in Medicine) standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. Conclusion: The majority of hospitals provided limited PET/CT data which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data to transfer including all transaxial CT and PET images with DICOM standard format.
Although IVF-ET is widely applied in the treatment of couples with male factor infertility, it may fail in many infertile couples with normal semen parameters, and certain couples cannot be accepted for standard IVF-ET due to unfertilization or extremely low fertilization rate of oocytes. Recently, several procedures of microassisted fertilization (MAF) using micromanipulation have been introduced, and pregnancies and births have been obtained after partial zona dissection (PZD), subzonal insertion (SUZI), and intracytoplasmic sperm injection (ICSI). This clinical study was performed to develop and establish ICSI as an effective procedure of MAF in infertile couples who could not undergo standard IVF-ET repetitively because of failure in fertilization or extremely low fertilization rate of oocytes with the conventional fertilization technique in the previous IVF-ET cycles. From March, 1995 to May, 1996, 27 cycles of IVF-ET with ICSI in 19 infertile patients were included in study group, and the outcomes of ICSI were analyzed according to fertilization rate, cumulative embryo score (CES), and pregnancy rate. The number of oocytes retrieved after controlled ovarian hyperstimulation (COH) was $10.50{\pm}6.13$ in 30 previous cycles, and $10.57{\pm}5.53$ in 27 ICSI cycles. In ICSI cycles, the number of oocytes optimal for ICSI procedure was $7.89{\pm}4.30$, and the fertilization rate of $67.9{\pm}20.2%$ could be obtained after ICSI. The number of embryos transferred was $1.43{\pm}2.40$ in previous cycles, and $4.36{\pm}1.77$ with the mean CES of $41.8{\pm}27.4$ in ICSI cycles. In ICSI cycles, the overall pregnancy rate was 29.6% (8/27) per cycle and 42.1% (8/19) per patient with the clinical pregnancy rate of 22.2% (6/27) per cycle and 31.6% (6/19) per patient. In conclusion, MAF of human oocytes with ICSI is a promising fertilization method for IVF-ET patients, especially with the past history of failure in fertilization or low fertilization rate of oocytes in the previous IVF-ET cycles, and ICSI using micromanipulation procedures applied to human oocytes will provide a range of novel techniques which may dramatically improve the pregnancy rate in IVF-ET program and contribute much to effective management of infertile couples.
Asia-Pacific Journal of Business Venturing and Entrepreneurship
/
v.6
no.3
/
pp.109-129
/
2011
Since the introduction of local autonomy system, various specific theories and practical approaches for private commission system have been common concerns and interests of the fields practicing social welfare. In the discussion about private consignment system of social welfare facility and organization, both of private section and government have shown different opinions from various aspects such as related regulation, consignment procedure, proper period and consignment condition. According to the discussion about the consignment system of social welfare facility, the purpose of this study is as follows. The first purpose is to suggest the current status of private consignment of social welfare facility and the characteristic and issue of consignment procedure by considering domestic & overseas literatures about the characteristic of private consignment system. The second purpose is to find out the general characteristics and current statuses of consignment process and system of social welfare facilities (organizations) located in Gyeonggi-do area. The third purpose is to draw the current status and general problem of field consignment system and suggest the practical alternative plan and improvement method of private consignment system of social welfare facility in the future. The result of researching private consignment process by head and manager of social welfare facility (organization), private consignment agreement and its conclusion process and current consignment system improvement method revealed that the number of reconsigned (over 1~3 times) facilities was more than that of initially consigned facilities and senior welfare facility and general social welfare center were most frequent in private consignment organization. In addition, as an improvement method of current private consignment process, the consideration on each organization and standard was required for new consignment and reconsignment and the problem of fairness and objectiveness was indicated when deliberation committee was organized in private consignment process. Besides them, it was found that consignment period shall be adjusted on the basis of facility type and business characteristic and the problems such as worker's succession, worker's transfer and service disconnection were suggested when consignment organization was changed. For conclusion and suggestion, the study suggested the establishment of common standard about private consignment, alternative plan of private consignment process issue and improvement method of consignment period issue.
Ha, Seongmin;Jung, Sunghee;Chang, Hyuk-Jae;Park, Eun-Ah;Shim, Hackjoon
Progress in Medical Physics
/
v.26
no.1
/
pp.28-35
/
2015
In this study, we investigated the effects of an iterative reconstruction algorithm and an automatic exposure control (AEC) technique on image quality and radiation dose through phantom experiments with coronary computed tomography (CT) angiography protocols. We scanned the AAPM CT performance phantom using 320 multi-detector-row CT. At the tube voltages of 80, 100, and 120 kVp, the scanning was repeated with two settings of the AEC technique, i.e., with the target standard deviations (SD) values of 33 (the higher tube current) and 44 (the lower tube current). The scanned projection data were reconstructed also in two ways, with the filtered back projection (FBP) and with the iterative reconstruction technique (AIDR-3D). The image quality was evaluated quantitatively with the noise standard deviation, modulation transfer function, and the contrast to noise ratio (CNR). More specifically, we analyzed the influences of selection of a tube voltage and a reconstruction algorithm on tube current modulation and consequently on radiation dose. Reduction of image noise by the iterative reconstruction algorithm compared with the FBP was revealed eminently, especially with the lower tube current protocols, i.e., it was decreased by 46% and 38%, when the AEC was established with the lower dose (the target SD=44) and the higher dose (the target SD=33), respectively. As a side effect of iterative reconstruction, the spatial resolution was decreased by a degree that could not mar the remarkable gains in terms of noise reduction. Consequently, if coronary CT angiogprahy is scanned and reconstructed using both the automatic exposure control and iterative reconstruction techniques, it is anticipated that, in comparison with a conventional acquisition method, image noise can be reduced significantly with slight decrease in spatial resolution, implying clinical advantages of radiation dose reduction, still being faithful to the ALARA principle.
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