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Clinical Experiences of St. Jude Medical Cardiac Valve Replacement (St. Jude Medical valve의 임상적 고찰)

  • 김종원
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.518-525
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    • 1992
  • 50 months experience with St-Jude Medical Cardiac Valve Prosthesis The St. Jude Medical valve has become our mechanical valvular prosthesis of choice because of favorable hemodynamic results that associated with marked clinical improvement and low incidence of thromboembolism. The data for this study was collected from April 1986 to May 1990, four years period. There were total of 110 patients[female 53, male 58] in this series with 22 isolated aortic valve, 66 isolated mitral valve, 20 double valve, 2 tricuspid valve replacement. The mean follow up time was 23 months. Postoperatively, 77% of cases were in New York Heart Association[NYHA] functional class I, and mild and moderate symptoms[NYHA II ] were present in 20% and there were very few patients remaining in higher functional classifications. In postoperative echocardiographic study showed marked improved cardiac function. The overall early mortality was 5.4% and was higher after double[13.3%] and mitral valve replacement[5.6%] and the late mortality was one case after mitral valve replacement due to endocarditis. The cause of death in early mortality was attributed to heart failure, acute renal failure, sepsis, etc.

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A Case of Idiopathic Sequential Profound Bilateral Sudden Sensorineural Hearing Loss Occurring 37 Days After Unilateral Presentation

  • Woo, Joo Young;Ji, Chang Lok;Park, Geun Hyung;Yoon, Byungwoo
    • Korean Journal of Audiology
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    • v.25 no.4
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    • pp.235-240
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    • 2021
  • Sudden sensorineural hearing loss (SSNHL) is a common disorder; however, sequential, bilateral presentation of the disease is rarer than unilateral presentation. Clinical otologists usually focus on treating the side with impaired hearing when patients first present with unilateral SSNHL, and therefore, may not warn patients of the possibility of subsequent hearing impairment in the contralateral ear. Furthermore, it is professionally discouraging when a patient presents with profound, sequential SSNHL after initial treatment. This may adversely impact the doctor-patient relationship, even if the patient is offered the best possible care from their first visit. Herein, we report the case of a patient with profound, idiopathic, bilateral SSNHL with a time interval of 37 days between involvement of both ears. Even though high-dose steroids were administered intraorally and intratympanically, the patient's hearing was not restored, and the patient eventually required bilateral cochlear implant surgery. Our report demonstrates that sequential, profound, bilateral SSNHL may manifest without any specific signs.

A Case of Idiopathic Sequential Profound Bilateral Sudden Sensorineural Hearing Loss Occurring 37 Days After Unilateral Presentation

  • Woo, Joo Young;Ji, Chang Lok;Park, Geun Hyung;Yoon, Byungwoo
    • Journal of Audiology & Otology
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    • v.25 no.4
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    • pp.235-240
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    • 2021
  • Sudden sensorineural hearing loss (SSNHL) is a common disorder; however, sequential, bilateral presentation of the disease is rarer than unilateral presentation. Clinical otologists usually focus on treating the side with impaired hearing when patients first present with unilateral SSNHL, and therefore, may not warn patients of the possibility of subsequent hearing impairment in the contralateral ear. Furthermore, it is professionally discouraging when a patient presents with profound, sequential SSNHL after initial treatment. This may adversely impact the doctor-patient relationship, even if the patient is offered the best possible care from their first visit. Herein, we report the case of a patient with profound, idiopathic, bilateral SSNHL with a time interval of 37 days between involvement of both ears. Even though high-dose steroids were administered intraorally and intratympanically, the patient's hearing was not restored, and the patient eventually required bilateral cochlear implant surgery. Our report demonstrates that sequential, profound, bilateral SSNHL may manifest without any specific signs.

Species Diversity and Community Structure of Macrobenthic Invertebrate Inhabiting the Intertidal Zone near Songacksan Area, Jeju Island (송악산 주변 조간대 저서 대형무척추동물의 종다양성과 군집구조에 관한 연구)

  • 이정재;현재민
    • The Korean Journal of Malacology
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    • v.18 no.1
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    • pp.41-52
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    • 2002
  • This study was performed to know the vertical distribution pattern and community structure of intertidal invertebrates at 9 sampling stations near Songacksan area located in Jeju Island from June 2000 to May, 2001. A total of 104 benthic invertebrate species was recorded during the survey period and it was composed of 50 families, 25 orders, 12 classes and 6 phyla. Among them, the most highest species richness was observed in the mollusks comprising 66.3% (69 species) and the next one in the arthropods showing 16.3% (17 species). Species diversity was largely different depending on their vertical distribution, revealing much higher in the lower intertidal zone than in the middle or upper zone, while there were no distinct differences between sampling stations. The dominant species were Nodilittorina exigua, Littorina brevicula, Pollicipes mitella mitella and Nerita japonica in the upper zone, Monodonta neritoides, Lunella coronata coreensis and Nerita japonica in the middle zone and Notoacmea schrenckii, Omphalius nigerimus, Purpura clavigera and Chlorostoma argyrostoma lishckei in the lower zone. The macrobenthic fauna surveyed could be divided into two groups based on their species similarities between sampling stations but their differences were not distinctive.

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Comparing Perceptions, Determinants, and Needs of Patients, Family Members, Nurses, and Physicians When Making Life-Sustaining Treatment Decisions for Patients with Hematologic Malignancies

  • Kim, Semi;Ham, Eun Hye;Kim, Dong Yeon;Jang, Seung Nam;Kim, Min kyeong;Choi, Hyun Ah;Cho, Yun A;Lee, Seung A;Yun, Min Jeong
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.12-24
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    • 2022
  • Purpose: This descriptive study compared the perceptions, determinants, and needs of patients, family members, nurses, and physicians regarding life-sustaining treatment decisions for patients with hematologic malignancies in the hematology-oncology department of a tertiary hospital in Seoul, Korea. Methods: In total, 147 subjects were recruited, gave written consent, and provided data by completing a structured questionnaire. Data were analyzed using analysis of variance, the chi-square test, and the Fisher exact test. Results: Nurses (F=3.35) and physicians (F=3.57) showed significantly greater familiarity with the Act on Decisions on Life-Sustaining Treatment than patients (F=2.69) and family members (F=2.59); (F=19.58, P<0.001). Many respondents, including 19 (51.4%) family members, 16 (43.2%) physicians, and 11 (29.7%) nurses, agreed that the patient's opinion had the greatest effect when making life-sustaining treatment decisions. Twelve (33.3%) patients answered that mental, physical, and financial burdens were the most important factors in life-sustaining treatment decisions, and there was a significant difference among the four groups (P<0.001). Twenty-four patients (66.7%), 27 (73.0%) family members, and 21(56.8%) nurses answered that physicians were the most appropriate people to provide information regarding life-sustaining treatment decisions. Unexpectedly, 19 (51.4%) physicians answered that hospice nurse practitioners were the most appropriate people to talk to about life-sustaining treatment (P<0.001). Conclusion: It is of utmost importance that the patient and physician determine when life-sustaining treatment should be withdrawn, with the patient making the ultimate decision. Doctors and nurses have the responsibility to provide detailed information. The goal of end-of-life planning is to ensure patients' dignity and respect their values.

Physicochemical Characterization of Powder Byproducts Generated from a Metallization Process and Its 1st Scrubber in the Semiconductor Industry (반도체 메탈공정 및 1차 스크러버에서 생성되는 파우더 부산물의 물리화학적 특성분석)

  • Choi, Kwang-Min;Jung, Myung-Koo;An, Hee-Chul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.3
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    • pp.294-300
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    • 2015
  • Objectives: The aim of this study is to identify physicochemical properties such as chemical composition, size, shape and crystal structure of powder byproducts generated from a metallization process and its 1st scrubber in the semiconductor industry. Methods: Powder samples were collected from inner chambers during maintenance of the W-plug process equipment (using tungsten hexafluoride as a precursor material) and its 1st scrubber. The chemical composition, size and shape of the powder particles were determined by field emission scanning electron microscopy (SEM) and transmission electron microscopy (TEM) equipped with an energy dispersive spectroscope (EDS). The crystal structure of the powders was analyzed by X-ray diffraction (XRD). Results: From the SEM-EDS and TEM-EDS analyses, O and W were mainly detected, which indicates the powder byproducts are tungsten trioxide ($WO_3$), whereas Al, F and Ti were detected as low peaks. The powder particles were spherical and nearly spherical, and the particle size collected from the process equipment and its 1st scrubber showed 10-20 nm (agglomerates: 55-90 nm) and 16-20 nm (agglomerates: 80-120 nm) as primary particles, respectively. The XRD patterns of the yellow powder byproducts exhibit five peaks at $23.8^{\circ}$ $33.9^{\circ}$ $41.74^{\circ}$ $48.86^{\circ}$ and $54.78^{\circ}$ which correspond to the (200), (220), (222), (400), and (420) planes of cubic $WO_3$. Conclusions: We elucidated the physicochemical characteristics of the powder byproducts collected from W-plug process equipment and its 1st scrubber. This study should provide useful information for the development of alternative strategies to improve the working environment and workers' health.

Arterial Tortuosity Syndrome in a Neonate

  • Kim, Kyung Min;Hur, Sun-Mi;Yoon, Ji Hong;Lee, Eun-Jung;Lee, Jae Young
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.49-52
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    • 2018
  • Arterial tortuosity syndrome (ATS) is a very rare autosomal recessive connective tissue disease characterized by generalized elongation and tortuosity of the medium- to large-sized arteries, and other systemic connective tissue manifestations. To date, this disease entity has not been reported in Korea. We report a case of ATS diagnosed in a neonate who presented with severe elongation and tortuosity of the aorta and its major branches, as well as the intracranial arteries. Additionally, the patient presented with a tortuous dilatation of the inferior vena cava, an aneurysmal dilatation of the extra-hepatic bile ducts, and an inguinal and sliding hiatal hernia. The diagnosis was confirmed using DNA sequencing analysis, and the patient demonstrated a compound heterozygosity for two novel mutations (c.738delG [p.Gln247Serfs*33] and c.362T>C [p.Ile121Thr]) in exon 2 of the SLC2A10 gene. Genetic analysis also confirmed that both parents were heterozygous carriers of the responsible mutations. Owing to such clinical manifestations, ATS is often misdiagnosed as other connective tissue diseases including Loeys-Dietz syndrome, Marfan syndrome, and Ehlers-Danlos syndrome. In patients presenting with a high index of suspicion, thorough clinical evaluation and screening for ATS including computed tomography or magnetic resonance angiography and target gene analysis are necessary for early diagnosis and management.

Wolbachia Sequence Typing in Butterflies Using Pyrosequencing

  • Choi, Sungmi;Shin, Su-Kyoung;Jeong, Gilsang;Yi, Hana
    • Journal of Microbiology and Biotechnology
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    • v.25 no.9
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    • pp.1410-1416
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    • 2015
  • Wolbachia is an obligate symbiotic bacteria that is ubiquitous in arthropods, with 25-70% of insect species estimated to be infected. Wolbachia species can interact with their insect hosts in a mutualistic or parasitic manner. Sequence types (ST) of Wolbachia are determined by multilocus sequence typing (MLST) of housekeeping genes. However, there are some limitations to MLST with respect to the generation of clone libraries and the Sanger sequencing method when a host is infected with multiple STs of Wolbachia. To assess the feasibility of massive parallel sequencing, also known as next-generation sequencing, we used pyrosequencing for sequence typing of Wolbachia in butterflies. We collected three species of butterflies (Eurema hecabe, Eurema laeta, and Tongeia fischeri) common to Korea and screened them for Wolbachia STs. We found that T. fischeri was infected with a single ST of Wolbachia, ST41. In contrast, E. hecabe and E. laeta were each infected with two STs of Wolbachia, ST41 and ST40. Our results clearly demonstrate that pyrosequencing-based MLST has a higher sensitivity than cloning and Sanger sequencing methods for the detection of minor alleles. Considering the high prevalence of infection with multiple Wolbachia STs, next-generation sequencing with improved analysis would assist with scaling up approaches to Wolbachia MLST.