• Journal of the Korean Society for Nondestructive Testing
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• v.28 no.4
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• pp.323-330
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• 2008

High cycle bending fatigue of socket welded small bore pipe was characterized, and also the fatigue crack initiation of small bore pipe was monitored in situ by the acoustic emission (AE) technique. The STS 316L stainless steel specimens were prepared by gas tungsten arc welding (GTAW) process having the artificial defect (i.e., lack of penetration) and defect free at the root. The fatigue failure was occurred at the loc for high stress and root for relatively low stress. The crack initiation cycles ($N_i$) was defined to the abrupt increase in AE counts during the fatigue test, and then the cracks were observed by the radiographic test and electron microscope before and after the fatigue crack initiation cycles. The socket welded pipe damaged by bending fatigue was studied regarding the welding defect, failure mode, and crack initiation cycles for the diagnosis and monitoring.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1296-1307
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• 1997

Background : Erdosteine is a thiol derivative developed for the treatement of chronic obstructive bronchitis, including acute infective exacerbation of chronic bronchitis. Erdosteine has mucomodulating and antioxidant properties and especially exhibits excellent gastrointestinal tolerability. Methods : The study was conducted as a prospective evaluation, with 2 comparative groups orally treated with erdosteine 300mg (bid.) or ambroxol 30mg (b.i.d.) for 7 days and the design of trial was double-blind. The treatments have been assigned randomly to patients (n=80) with acute or chronic bronchitis. The primary end-point used to determine efficacy in this study was subjective symptoms including expectorating frequence, expectoration volume, expectorating difficulty, expectoration viscosity, cough intensity and dyspnea. The secondary end-points of efficacy was the result of arterial blood gas analysis and pulmonary function test. Safety was evaluated with adverse drug reactions and laboratory tests monitoring. 61 patients was included in the efficacy analysis, due to the fact that 19 patients drop-out for different reasons. The obtained values have been analyzed with paired Hest., ANOVA test., multivariate $t^2$-test, repeated measures analysis of covariance, two sample t-test, loglinear-logit model analysis, Fisher's exact test. Results : 1) There was no significant difference on demographic data and vital signs between erdosteine and ambroxol treated groups. 2) The comparison between erdosteine and ambroxol treated groups showed no significant difference in improvement of each symptom in spite of the more favorable efficacy obtained with erdosteine. No difference on the contrary was observed for arterial blood gas analysis and pulmonary function test. 3) As safety is concerned, no clinical significant changes in laboratory test and symptom were induced in erdosteine and ambroxol treated group and two patients in ambroxol treated group drop-out for adverse reactions in symptom. 4) In the evaluation of final clinical efficacy, erdosteine improved more effectively patient's overall symptoms {very good effect (11/31), good effect (12/31), moderate effect (6/31), no effect (2/31), aggravation (0/31)} than ambroxol {very good effect (6/30), good effect (14/30), moderate effect (5/30), no effect (4/30), aggravation (2/30)}. And the probability of symptomatic improvement by erdosteine compared to ambroxol was 2.5 times. (p<0.05). Conclusion : This study showed that erdosteine was clinically effective and safe drug for treatment of acute and chronic bronchitis.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.216-219
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• 2014

An 1-year-old, female, mixed-breed dog weighing 17 kg was referred for abrupt collapse. She had remarkable hypocalcemia and hyperphosphatemia, and survey radiographs revealed a severe gas-filled intestine. Treatment with serial injections of calcium gluconate was initiated promptly and most of the gastrointestinal distension disappeared after 4 h. However, the clinical signs were not resolved completely. The serum intact parathyroid hormone concentration was not elevated in the context of hypocalcemia, which suggested primary hypoparathyroidism. The clinical signs and laboratory abnormalities in the patient were resolved completely 3 days after administration of calcium gluconate and calcitriol. This case describes the unique presentation of severe gastrointestinal distension in a dog diagnosed with primary hypoparathyroidism.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.874-882
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• 1999

배경: 체외순환 후의 부종현상 및 이에 따른 여러 장치의 기능 저하를 방지하기 위하여, 최근에 체외 순환 이탈 후 환자의 혈액을 짧은 시간에 관류하여 여과해 주는 변형 초여과법의 사용이 늘고 있다. 이에 대한 긍정적인 임상결과들의 보고도 있으나, 다른 한편 체외 순환 후 염증반응을 포함한 폐손상의 기전에 혈구 성분의 영향이 보고되고 있는 바, 변형 초여과법의 효과, 특히 폐 조직에 대한 영향을 밝혀 보고자 하였다. 대상 및 방법: 몸무게 15에서 22 Kg(평균 16.5$\pm$0.5)의 16 쌍의 잡견을 이용한 정소성 심장이식, 실험에서, 통상적인 인공심폐기 작동군과 인공심폐기 작동 후 변형 초여과 관류를 시행한 군으로 무작위 구분하였다. 변형초여과법은 체외순환 정지 후에 대동맥관에서 나온 혈류를 Roller pump를 거쳐 Amicon Diafilter 초여과 관에 150 mL/m 정도의 속도로 10~15 분 정도 관류시켜 정맥관을 통하여 우심방에 직접 주입하였다. 혈액 채취 및 폐생검은 심폐기 시작 전과 정지 직후, 그리고 변형초여과 시행 군은 초여과 완료 직후에, 대조군은 심폐기 정지 10~15분 후에 각각 시행하였다. 혈류역학 측정요소는 동맥압, 우심방압, 좌심방압 등이었으며, 혈액 검사 항목은 동맥혈 가스분석, 혈색소 농도, 헤마토크릿, 백혈구 수, 혈소판 수, 혈중 단백 성분, 알부민 성분 등이었다. 폐 생검 조직으로는 냉동 건조법을 이용한 수분 함유량을 측정하였고, 광학 및 전자현미경으로 관찰을 하였다. 결과: 변형 초여과 군에서 혈중 혈색소 농도는 수술전 10.3$\pm$1.7 mg/dL, 심폐기 정지 직후 6.3$\pm$1.7 mg/dL, 초여과 직후는 8.3$\pm$2.8 mg/dL의 변화를(p=0.0078, 0.0117), 혈중 총 단백질의 농도 변화는 4.3$\pm$0.9, 3.1$\pm$1.5, 4.1$\pm$1.6 mg/dL, 혈중 알부민의 농도는 1.9$\pm$0.5, 1.4$\pm$0.7, 1.8$\pm$0.8 mg/dL로서, 각각 초여과법의 시행 전후에 유의한 증가를 가져왔고(p=0.0280, 0.0277), 폐조직의 수분 함유량의 변화는 수술전 75.1$\pm$8.6%, 심폐기 정지 직후 82.8$\pm$6.0%, 초여과 직후 77.88%를 보인 반면, 대조군에서는 각각 74.7$\pm$4.9, 82.1$\pm$5.9, 82.3$\pm$5.1%의 변화를 보였다. 미세 구조의 관찰에서, 폐포의 내포세피의 융합 기저막층과 미토콘드리아에서의 부종은 변형 초여과 후에 급격히 감소하였으나, 미토콘드리아내 크리스티의 파괴성 변화와 막성 파괴 성향이 초여과 후에 심화되게 관찰되었고, 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 세포질 내 소체의 팽창과 공포화 현상도 심폐기 가동 후 발생하여 초여과 후에 더 심화되게 관찰되었다. 폐조직 내의 백혈구는 심폐기 작동 후에 그 수에 있어서 증가하였으며 백혈구의 괴변, 탈과립 정도도 심폐기 작동 후 및 초여과 후에 증가한 소견을 보였다. 결론: 변형 초여과법은 인공 심폐기 후의 혈색소 농도 및 혈중 단백질 농도의 복원에 효과가 있었으며 변형 초여과 관류후 폐의 미세 조직내에서 부종의 급격한 감소 등을 관찰할 수 있었다.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.97-101
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• 2007

We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

• Tuberculosis and Respiratory Diseases
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• v.46 no.3
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• pp.317-326
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• 1999

Background: Neural control of airway function is through parasympathetic, sympathetic and non-adrenergic, non-cholinergic mechanisms. The autonomic nervous system controls the airway smooth muscle tone, mucociliary system, permeability and blood flow in the bronchial circulation and release of mediators from the mast cells and other inflammatory cells. The cardiovascular and respiratory autonomic efferent fibers have a common central origin, so altered cardiovascular autonomic reflexes could reflect the altered respiratory autonomic status. Therefore, we performed this study to assess the autonomic abnormality and determine the correlating factors of severity of autonomic neuropathy in patients with chronic obstructive pulmonary disease(COPD) using easily reproducible cardiovascular autonomic reflex function test. Method: The study included 20 patients with COPD and 20 healthy persons obtained on Health Promotion Center in Yeungnam university hospital. All the patients had history and clinical features of COPD as defined by the American Thoracic Society. Any patients with myocardial ischemia, cardiac arrythmia, hypertension, central or peripheral nervous system disease, diabetes mellitus, or any other diseases known to produce autonomic neuropathy, has excluded. The autonomic nervous system function tests included three tests evaluating the parasympathetic system and two tests evaluating the sympathetic system. And also all subjects were subjected to pulmonary function test and arterial blood gas analysis. Results: Autonomic dysfunction was more commonly associated with patients with COPD than healthy person The parasympathetic dysfunction was frequent in patient with COPD, but sympathetic dysfunction seemed preserved. The severity of parasympathetic dysfunction in patients with COPD was correlated with the degree of duration of disease, smoking, reductions in the value of $FEV_1$ and FVC, and arterial hypoxemia but no such correlation existed for age, type of COPD, $FEV_1$/FVC, or $PaCO_s$. Conclusion: There is high frequency of parasympathetic dysfunction associated with COPD and the parasympathetic abnormality in COPD is increased in proportion to severity of airway disease. In COPD, parasympathetic dysfunction probably does not the cause of disease, but it may be an effect of disease progression.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1204-1212
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• 2002

Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm $H_2O$ within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was $5.4{\pm}0.5cm$ $H_2O$. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1073-1079
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• 2003

Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1158-1164
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• 2008

Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.