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Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Effects of the Substances Extracted from Dried Mushroom(Lentinus edodes) by Several Organic Solvents on the Stability of Fat (건조(乾燥)표고버섯의 각종(各種) 용매추출물(溶媒抽出物)의 항산화작용(抗酸化作用)의 효과(效果))

  • Ma, Sang-Jo
    • Korean Journal of Food Science and Technology
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    • v.15 no.2
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    • pp.150-154
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    • 1983
  • Mushroom, Lentinus edodes which had been dried at $50^{\circ}C$ for 20 hours were extracted with small amount of ethanol, methanol, chloroform and petroleum ether, respectively. The extracts were then dissolved in edible soybean oil, and the resulting substrates and a portion of the soybean oil (control) were placed in an incubator $(37.0{\pm}1.0^{\circ}C)$ for eight weeks. Peroxide values and TBA values of control and the substrates were determined regularly during the storage period. The results of the present study were as follows: 1. The moisture contents of the mushroom which was 84.88% on wet basis at the time of harvest were reduced to 15.12% after drying. 2. Extracts obtained from alcohols were effective in retarding the POV development. 3. There was not much difference among the TBA values after 14 days, but significant difference of the TBA values in control and the substrates extracts were observed in longer storage period TBA values of substrate containing ethanol and methanol in the later stage period were smaller than that of the substrates containing petroleum ether and chloroform. 4. In view of the POV and TBA value development, ethanol and methanol were more effective solvents for the extraction of antioxidant compounds in the dried mushroom than chloroform and petroleum ether.

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8MHz RF Capacitive Heating on Rabbit Lung (가토의 정상폐의 고주파 유전형 가온에 관한 연구)

  • Jang, Hong, Seok;Kim, Jong-Woo
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.1-6
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    • 1992
  • The usefulness of hyperthermia for cancer therapy has been established. The purpose of the present investigation was to access feasibility of heating normal lung and the temperature and power requirement were compared with that for liver as solid organ in rabbits by using radiofrequent heating machine. In this study, 20 rabbits were divided into 2 groups according to the heating site and the method of temperature measurement; in group I : lung heating and temperature measuring in skin, esophagus and lung parenchyme; in group II : liver heating and temperature measuring in skin and liver parenchyme. The results were as follows; 1) When the maximum temperature was almost same in lung heating group and liver heating group, the power for liver heating was lesser required than the power for lung heating (p<0.05). 2) The temperature of esophagus for the measurement of mediastinum temperature was $1.1{\pm}0.9^{\circ}C$ higher than the temperature of lung parenchyme (p<0.05). Therefore the above findings suggest lung, air containing organ, is well heated as same as liver, solid organ. So more active trials of lung heating in the lung cancer must be likely considered. But when the lung is heated, the esophageal temperature is higher than lung parenchyme, so the mediastinum damage must be considered seriously.

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Extubation Time by Birth Weight and the Predictors for Success/Failure at the First Extubation in Extremely Low Birth Weight Infants (초극소저출생체중아에서 출생체중별 발관시기 및 첫 발관 시의 성공/실패 예측인자)

  • Choi, Chang Won;Park, Sung Eun;Jeon, Ga Won;Yoo, Eun Jung;Hwang, Jong Hee;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.488-494
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    • 2005
  • Purpose : To outline the aspects of extubation by birth weight and find the predictors for success/failure at the first extubation in extremely low birth weight infants. Methods : One hundred thirteen extremely low birth weight infants(<1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. Results : As the birth weight decreased, extubation success day was significantly delayed : $16{\pm}3day(d)$ in 900-999 g; $20{\pm}3d$ in 800-899 g; $35{\pm}4d$ in 700-799 g; $37{\pm}9d$ in 600-699 g; $49{\pm}12d$ in ${\leq}599g$. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. Conclusion : We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.

Surgical Treatment of Multidrug-resistant Pulmonary Tuberculosis (다제내성 폐결핵의 수술적 치료)

  • Kim, Jin Hee;Min, Jin Hong;Park, Jun Ho;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.613-618
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    • 2005
  • Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.

Development of a 2-fluid Jet Mixer for Preventing the Sedimentation in Livestock Liquid Manure Storage Tank (가축분뇨액비저장조 침전물 퇴적 방지를 위한 2류체 제트노즐식 교반장치 개발에 관한 연구)

  • Yu, B.K.;Hong, J.T.;Kim, H.J.;Kweon, J.K.;Oh, K.Y.;Park, B.K.
    • Journal of Animal Environmental Science
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    • v.18 no.3
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    • pp.207-220
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    • 2012
  • There are around 7,500 manure tanks to treat the manures from pigs in Korea. In the tank, there are too much sediments deposited on the base and wall, which causes low efficiency of stock capacity and manure fermentation. In order to minimize sediments and to ferment manure effectively, we developed a 2-fluid jet mixer for mixing sediments in liquid livestock manure tank. For developing the prototype, we tested a factorial experimental system with various nozzles, and simulated CFD models with two kinds of nozzle arrangement. From the results of factorial experiment and CFD simulation, we concluded the dia. ratio of primary : secondary nozzle should be 1:2 and the nozzles should be arranged at the same distances toward to the circumferential direction. With this results, we manufactured a 2-fluid jet mixer which is consists of four 2-phase nozzles, centrifugal slurry pump and root's type air blower. And, we carried out the performance test of the prototype in the round shaped liquid manure tank in the farm. The performance test results showed that the uniformity of TS (Total Solid) and VS (Volatile Solid) was raised from 21.3 g/L, 13.3 g/L In steady state to TS and VS to 23.0 g/L, 14.1 g/L in the mixing operation. Therefore, we could conclude that the prototype of 2-fluid mixer could make the solid material which could be sediments in the tank not to be deposited in the tank and to be contacted to air bubbles which could enhance the efficiency of the fermentation of livestock manure.

Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center (단일 병원에서의 재발성 장중첩증과 병적 선두에 대한 임상적 고찰)

  • Lee, Kun-Song;Park, Yun-Joon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.163-170
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    • 2009
  • Purpose: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. Methods: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. Results: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130${\pm}$175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7${\pm}$1.9 in 7 patients with PLP, which was significantly higher than (2.4${\pm}$0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4${\pm}$19.8 months (range, 2 days to 72 months). Conclusion: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

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Actual State of Structures and Environmental Control Facilities for Tomato Greenhouses in Chungnam Region (충남지역 토마토 재배온실의 구조와 환경조절설비 실태분석)

  • Nam, Sang-Woon;Kim, Young-Shik
    • Korean Journal of Agricultural Science
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    • v.36 no.1
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    • pp.73-85
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    • 2009
  • An investigation was conducted to get the basic data for establishing structural safety and environmental management of tomato greenhouses in Chungnam region. The contents of the investigation consisted of actual state of greenhouse structures and environmental control facilities. Most of greenhouses were arch type single-span plastic houses and they had too low height for growing tomatoes. Frameworks of multi-span greenhouses were suitable, but those of single-span were mostly insufficient. Every greenhouse had thermal curtain movable or covering fixed inside the greenhouse for energy saving, and heating facilities were mostly warm air heater. Irrigation facilities were mostly drip tube and controlled by manual operation or timer. Almost all of the greenhouses didn't install high level of environmental control facilities such as ventilator, air circulation fan, $CO_2$ fertilizer, insect screen, supplemental light, and cooling device.

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Scheduling Algorithms and Queueing Response Time Analysis of the UNIX Operating System (UNIX 운영체제에서의 스케줄링 법칙과 큐잉응답 시간 분석)

  • Im, Jong-Seol
    • The Transactions of the Korea Information Processing Society
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    • v.1 no.3
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    • pp.367-379
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    • 1994
  • This paper describes scheduling algorithms of the UNIX operating system and shows an analytical approach to approximate the average conditional response time for a process in the UNIX operating system. The average conditional response time is the average time between the submittal of a process requiring a certain amount of the CPU time and the completion of the process. The process scheduling algorithms in thr UNIX system are based on the priority service disciplines. That is, the behavior of a process is governed by the UNIX process schuduling algorithms that (ⅰ) the time-shared computer usage is obtained by allotting each request a quantum until it completes its required CPU time, (ⅱ) the nonpreemptive switching in system mode and the preemptive switching in user mode are applied to determine the quantum, (ⅲ) the first-come-first-serve discipline is applied within the same priority level, and (ⅳ) after completing an allotted quantum the process is placed at the end of either the runnable queue corresponding to its priority or the disk queue where it sleeps. These process scheduling algorithms create the round-robin effect in user mode. Using the round-robin effect and the preemptive switching, we approximate a process delay in user mode. Using the nonpreemptive switching, we approximate a process delay in system mode. We also consider a process delay due to the disk input and output operations. The average conditional response time is then obtained by approximating the total process delay. The results show an excellent response time for the processes requiring system time at the expense of the processes requiring user time.

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A Study on the Effect of Fluidizing Media on the N2O Production in Fluidized Bed Incineration of Sewage Sludge (하수슬러지 유동층 소각에서 유동매체가 N2O 발생에 미치는 영향에 관한 연구)

  • Park, Jong-Ju;Lee, Seung-Jae;Ryu, In-Soo;Jeon, Sang Goo;Park, Yeong-Sung;Moon, Seung-Hyun
    • Clean Technology
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    • v.20 no.4
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    • pp.390-397
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    • 2014
  • This study was performed to investigate the effects of fluidizing media on $N_2O$ production in fluidized bed incineration of sewage sludge. The fluidized media were prepared in a form of 2 mm bead by mixing zeolite powders in our lab. Sand having 0.4 mm of the mean size showed 0.44 m/s of minimum fluidization velocity ($U_{mf}$), while the prepared zeolite media 0.5 m/s. When the ratio of fluidizing media height to the inside diameter of the incinerator (bed aspect ratio) increased from 1.4 to 3.1, it was found that $U_{mf}$ of the zeolite media was varied from 0.5 m/s to 0.7 m/s. Under the operation conditions in 1.79 of excess air ratio, $909^{\circ}C$ of bed temperature and ca. 1.65 m/s of superficial velocity, as the weight of fluidizing meadia was increased, $O_2$ concentration in the flue gas was slightly decreased, and $CO_2$ increased. Above 6 kg of fluidizing media weight (1.98 of bed aspect ratio), it was observed that $N_2O$ concentration was significantly reduced, which might result from the decomposition of $N_2O$ on the zeolite media rather than transformation of $N_2O$ to NOx. On the other hand, in a variation of the zeolite media mixing ratio to sand and bed temperature at a constant total bed height, significant difference was exhibited in $N_2O$ emission concentration according to the temperature. Considering the operation temperature in the incineration, the effective calcination temperature of the zeolite media was suggested to be around $900^{\circ}C$.