• Title/Summary/Keyword: 기관손상

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The Optimal Pulse Oxygen Saturation in Very Low Birth Weight or Very Preterm Infants (극소 저체중 출생아에서 경피적 산소포화도의 적정 범위)

  • You, Sun-Young;Kang, Hye-Jin;Kim, Min-Jung;Chang, Mea-Young
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.320-327
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    • 2011
  • Purpose: To determine the effect of changing practice guidelines designed to avoid hyperoxia or hypoxia in very low birth weight or very preterm infants. Methods: We analyzed a database of <1,500 g birth weight or <32 weeks of gestation infants who were born and admitted to the neonatal intensive care unit of Chungnam National University Hospital from January 2007 to July 2010. First, we defined the relationship between arterial partial pressure of oxygen ($PaO_2$) and pulse oxygen saturation ($SpO_2$). When we evaluated 96 pairs of $PaO_2$ and $SpO_2$ measurements, oxygen saturation was 90-94% at a $PaO_2$ of 43-79 mmHg on the oxyhemoglobin dissociation curve, according to pulse oximetry. Based on this observation, a change in practice was instituted in August 2008 with the objective of avoiding hypoxia and hyperoxia in preterm infants with targeting a $SpO_2$ 90-94% (period II). Before the change in practice, high alarms for $SpO_2$ were set at 100% and low alarms at 95% (period I). Results: Sixty-eight infants the met enrollment criteria and 38 (56%) were born during period II, after the change in $SpO_2$ targets. Demographic characteristics, except gender, were similar between the infants born in both periods. After correcting for the effect of confounding factors, the rates for mortality, severe retinopathy of prematurity, and IVH attended to be lower than those for infants in period II. No difference in the rate of patent ductus arteriosus needed to treat was observed. Conclusion: A change in the practice guidelines aimed at avoiding low oxygen saturation and hyperoxia did not increase neonatal complication rates and showed promising results, suggesting decreased mortality and improvements in short term morbidity. It is still unclear what range of oxygen saturation is appropriate for very preterm infants but the more careful saturation targeting guideline should be considered to prevent hypoxemic events and hyperoxia.

The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG (비체외순환 및 체외순환하에서의 관상동맥우회로술의 임상 고찰)

  • 안재범;김인섭;정성철;배윤숙;유환국;김병열;김우식
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.762-767
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    • 2004
  • With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with these having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-sin patients underwent on-pump CABG, fifty-one patients under-went off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups, Result: The were no differences in their sex ratios, ages, preoperative risk factors, preoperative Ml, Canadian classes, extent of coronary artery diseases and, echocardio-graphic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270$\pm$79.3 min vs 372$\pm$142.2 min, p<0.001), mean ventilation time (17.1$\pm$13.4 hr vs 24.3$\pm$17.8 hr) and CK-MB level (8,9$\pm$18.7 IU/L vs 25.7$\pm$8.4 IU/L) than on-pump CABG groups, On-pump CABG group had more distal grafts (2.2$\pm$0.5 vs 1.7$\pm$0.71 than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups. Conclusion: This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.

Clinical Study of Childhood Accidents from a Hospital Over Ten Years with Regard to Foreign Body Aspiration (단일병원에서 관찰한 최근 10년간의 소아 우발사고에 관한 연구 : 이물흡인을 중심으로)

  • Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1134-1140
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    • 2002
  • Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.

문경지역에 분포하는 변성 염기성암과 변성 퇴적암에 대한 백악기 화강암의 열변성작용

  • 오창환;김성원;김종섭
    • The Journal of the Petrological Society of Korea
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    • v.2 no.2
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    • pp.74-94
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    • 1993
  • Metabasites and metapelites in the Mungyong area were intruded by Cretaceous granites with radius of 4-8 km. As the distance from granite body increases, the mineral assemblage of metabasite changes from amphibole + plagioclase through amphibole + plagioclase + epidote to amphibole + plagioclase + epidote + chlorite. The compositional variations of amphibole and plagioclase according to the change of metamorphic grade and bulk rock compositions are very complex. Towards the Mungyong Cretaceous granite body, the mineral assemblage of metapelite changes from chlorite+ muscovite(ch1orite zone) through biotite + chlorite + muscovite(biotite zone) to andalusite+biotite + muscovite${\pm}$chlorite or cordierite+ biotite+ muscovite${\pm}$chlorite(cordierite zone). The estimated metamorphic conditions of cordierite zone are 480~$580^{\circ}C$ 1.5-3.3 kb. The theoretical study on the thermal metamorphism caused by the Cretaceous granite with radius longer than 4 km in the Mungyong area suggests the followings: The degree of metamorphism is mainly determined not by the size of granite body but by the temperature of granite intrusion; The country rocks within 2 km from Cretaceous granite have undergone metamorphism with temperature higher than $500^{\circ}C$, which is consistent with the petrological study in the Mungyong area. Mungyong Cretaceous granite caused a low P/T thermal metamorphism to the country rocks; the amphibolite facies metamorphism to the country rocks within 1-2 km from the granite body and the epidote-amphibolite and greenschist facies metamorphism to the country rocks within 2-5 km.

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A Study for the Evaluation of Container Modules; The Technology of Korean Container Tree Production Model (한국형 컨테이너 조경수 생산기술로서 컨테이너 모듈의 성능 평가)

  • Jung, Yong-Jo;Lim, Byung-Eul;Oh, Jang-keun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.5
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    • pp.59-67
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    • 2016
  • In landscape design by public institutions, although the costs and species of landscape trees stipulated by the Korean Public Procurement Service(PPS) are generally adhered to, the PPS regulations about planting trees with well-developed rootlets are almost entirely neglected. This study aimed to evaluate the performance of buried container modules, which are a new technology and product in landscape production that is able to reduce the defect rate while complying with regulations. To this end, this study measured rootlet density, rootlet development length, rootlet survival rate on excavation, and impairments of tree growth for 3 months after root pruning, and compared these variables for the container modules with those for trees that underwent root pruning in bare ground, and those that were cultivated in a container above ground. The results were as follows: First, the rootlet density was 88% for the trees in container modules, which was very high. Trees that underwent standard root pruning in bare ground had a somewhat lower density of 64%. Meanwhile, the trees that were cultivated in pots above ground died, invalidating measurement. Second, in terms of rootlet development and rootlet survival rate, the trees in container modules showed a mean length of 10.4cm, and 100% survival rate, indicating that there was no rootlet damage caused by excavation. For the trees that only underwent root pruning in bare ground, the mean length was 25.6cm and the rootlet survival rate was only half that of the trees in container modules, at 56%, demonstrating considerable damage. Rootlet development did not occur at all in the trees grown in pots. Third, the trees in container modules and those that underwent root pruning in bare ground did not show any deaths during the root pruning process, or any impairments such as stunted leaf growth. Conversely, the trees grown in pots nearly all died, and severe impairments of tree growth were observed. As shown by the results above, when we evaluated the performance of buried container modules, they showed the most outstanding performance of the three models tested in this study. The container modules prevent defects by stimulating early rooting in environments that with poor conditions for growth, or in trees that are not suited to the summer environment Therefore, it is expected that they would be an optimal means by which to enable compliance with rules such as the regulation presented by the PPS.

Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia (호흡곤란증후군과 기관지폐이형성증 예측 인자로서의 미숙아 제대혈 IL-10, IL-12)

  • Park, Jee Yoon;Kim, Ji Young;Cho, Soo Jin;Kim, Young Ju;Park, Hye Sook;Ha, Eun Hee;Park, Eun Ae
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.248-254
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    • 2007
  • Purpose : Inflammation plays a major role in the pathogenesis of RDS and BPD in the immature lung. We investigated the possible role of IL-10 and IL-12 in the cord blood of preterm newborns with RDS or BPD. Methods : Forty preterm newborns whose mothers received antenatal care at Ewha Womans University Mokdong Hospital between January 2003 to June 2005, and agreed to testing their cord blood samples were enrolled. The gestational ages were below 34 weeks. Cord blood level of IL-10 and IL-12 were determined by ELISA. We separated the patients into 2 groups (RDS group and non-RDS group, BPD group and non-BPD group) and compared the cytokine levels and clinical records of the groups. Results : Cord blood IL-10 level showed a significant inverse correlation with gestational age and birth weight (P=0.001, P=0.005). Preterm infants with RDS showed higher IL-10 level (1.0 vs 0.1 pg/mL; P=0.001) in the cord blood than those without RDS. The differences remained statistically significant after correction for the effect of gestational age between both preterm groups. Despite similar cord blood IL-10 levels, preterm infants with BPD showed no significant difference with those without BPD. Conclusion : Cord blood IL-10 levels are increased in preterm infants which may be due to the immuno-suppression occurring during pregnancy and to fetal immaturity because these levels are inversely correlated with the gestational age. So, Cord blood IL-10 level can be used as the predictor of RDS.

Incidence and Prognostic Factors of Radiation Pneumonitis in NSCLC Treated with Intensity Modulated Radiation Therapy(IMRT) (세기조절방사선치료(IMRT)로 치료한 비소세포폐암 환자에서의 방사선 폐렴)

  • Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.35-44
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    • 2008
  • Purpose: To evaluate the incidence and prognostic factors of treatment-related pneumonitis in non-small-cell lung cancer(NSCLC) patients treated with intensity modulated radiation therapy(IMRT). Materials and Methods: One-hundred-five patients with NSCLC treated with IMRT between 1 August 2004 and 30 November 2006 were analyzed retrospectively. The mean age of patients was 62.9 years, and squamous carcinomas were confirmed in 81 patients(77%). Sixty-six patients(62.9%) were classified as stage III, and 59 patients had lesions in the right lung. Twenty-seven patients were treated with a dose of 3,060 cGy preoperatively, and 10 patients were given a dose of 5,040 cGy postoperatively. Sixty-eight patients received a dose of 7,020 cGy for curative intent. Sixty-eight patients were treated with the use of the CORVUS planning system and 37 patients were treated with the use of the ECLIPSE planning system. Results: Of 105 patients, 21 patients(20%) had abnormal radiological findings, but only seven patients(6.7%) required treatment for radiation pneumonitis. Six of the seven patients had other serious lesions, including a bronchioesophageal fistula(one patient), recurrence in the treatment field(two patients), brain metastasis(one patient) and lung-to-lung metastasis(two patients); all of these patients died within 19 months after radiation treatment. Sixteen patients(23.5%) that received planning with the CORVUS system had abnormal lung findings. Five patients(13.5%) had abnormal lung findings with the use of the ECLIPSE planning system. Other prognostic factors such as perioperative radiation therapy, a volume over 10% of the V20 volume in the right lung, were also statistically significant. Conclusion: This retrospective analysis suggests that IMRT could be a beneficial treatment modality for the reduction of radiation pneumonitis in NSCLC patients. However, the higher incidence of abnormal radiological findings in perioperative patients treated with relatively lower doses($3,060{\sim}5,040$ cGy) suggest the need for judicious treatment planning in preoperative or postoperative treatment.

Physicochemical and Sensory Properties of Rice Stored in an Unused Tunnel (폐터널 저장 쌀의 이화학적 및 관능적 특성)

  • Moon, Gap-Soon;Kim, Mi-Jeong;Jin, Myung-Hee;Kim, Su-Yeon;Park, So-Young;Ryu, Bog-Mi
    • Korean journal of food and cookery science
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    • v.26 no.2
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    • pp.220-228
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    • 2010
  • This study was designed to examine the effectiveness of an unused tunnel as a rice storage place. The physicochemical changes of rice grains were investigated during 8-months of storage in the tunnel located at Kyungnam province, Korea. Two kinds of tunnel stored rices, NP(rice grown with no pesticides) and LP(rice grown with less pesticides) were compared with $5^{\circ}C$ stored rice as a control. The peroxidase activities, as an index of freshness of rice grains, gradually decreased and NP appeared to be fresher than LP. Whiteness, grain wholeness, and chalkyness were less desirable for the tunnel stored rice than the control, with no significant difference of physicochemical properties, including the broken, damaged, colored rice, and contents of moisture, protein, and amylose. Palatability dropped below 70 in all three groups at later phase. The sensory evaluation showed that overall preference was slightly higher for the control but not significantly different from the other two groups. From all the evidences shown, unused tunnels may be an effective place for a long-term rice storage, since the average temperature inside the tunnel was maintained very constantly around $14.3^{\circ}C$ and relative humidity was optimal for rice storage, especially during spring and summer seasons.

Evaluation of the testicular toxicity caused by 2-bromopropane in rats (랫드에 있어서 2-bromopropane에 의해 유발된 정소독성의 평가)

  • Kim, Jong-choon;Lee, Hyun-sook;Yun, Hyo-in;Chung, Moon-koo
    • Korean Journal of Veterinary Research
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    • v.40 no.2
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    • pp.361-371
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    • 2000
  • It has been recently reported that 2-bromopropane (2-BP) induces male reproductive toxicity in both human and experimental animals. However, delayed effects of 2-BP on male reproductive system have not been investigated in detail. The present study was conducted to investigate the testicular toxicity of 2-BP and to determine the recovery of normal spermatogenesis in Sprague-Dawley rats. Male rats aged 5 weeks were administered 1,000mg/kg 2-BP by gavage daily for 4 weeks and sacrificed sequentially at 1, 2, 3, 4 and 12 weeks after initiation of 2-BP treatment. Testicular toxicity was evaluated qualitatively by histopathological examinations and quantitatively by reproductive organ weights, spermatid head count, and repopulation index. In the 2-BP treated rats, the body weights was significantly suppressed and the weights of testes and epididymides were also decreased in a time-dependent manner. On histopathological examination, spermatogonia in stages I-VI and preleptotene and leptotene spermatocytes in stages VII-IX were strongly depleted at 1 week of dosing. Spermatogonia were depleted extensively in all spermatogenic stages at 2 weeks. Continuing with the evolution of spermatogenic cycle, zygotene spermatocytes, pachytene spermatocytes, and round spermatids were sequentially depleted at 2, 3, and 4 weeks of dosing due to the depletion of their precursor cells. Vacuolization of Sertoli cells and spermatid retention were also observed at all time points, suggesting that 2-BP induced Sertoli cell dysfunction. At 12 weeks, after 8 weeks recovery, most of the tubules appeared severely atrophic and were lined by Sertoli cells only. Leydig cell hyperplasia in the interstitial tissue was also found. In addition, dramatic reductions in the number of spermatid heads and repopulation index were observed, indicating that 2-BP-induced testicular injury is irreversible. These results indicate that 4 weeks repeated-dose of 1,000mg/kg 2-BP results in a progressive germ cell loss due to the depletion of spermatogonia followed by long-term testicular atrophy in SD rats.

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Correlation of serum total hydroperoxide levels and diseases of prematurity (미숙아 합병증 발생과 혈중 활성 산화물 농도와의 관계)

  • Kim, Shin-Hye;Hur, Hae Young;Lee, Kyu Hyoung;Moon, Ja Young;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.746-752
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    • 2007
  • Purpose : Total hydroperoxide (TH), free radical-mediated oxidation product can be used as a measure of free radical injury. The aim of the present study was to see if preterm newborns are at increased risk for oxidative stress compared with term newborns, and to determine whether oxidative stress during postnatal first 1 week is associated with clinical outcomes in preterm infants. Methods : Serum TH levels of preterm infants (n=39) were compared with those of term infants (n=24) on the postnatal day 1. Among the preterm infants, serum TH levels of uncomplicated group (n=23) were also compared with those of complicated group (n=16) who developed oxygen radical related diseases on the postnatal day 1 and 7. Retrospective analysis was performed to find out risk factors for oxygen radical injuries based on birth history, laboratory data, neuroimaging findings and clinical progress in two preterm groups. Results : Serum TH levels on postnatal day 1 were higher in the preterm infant group than the term infant group. Serum TH levels on postnatal day 1 in the complicated preterm infant group were significantly higher compared with uncomplicated group, but there was no significant difference in serum TH levels on postnatal day 7. Also, there was no significant difference in serum TH levels between uncomplicated preterm infants and term infants. Serum TH level on postnatal day 1 was independently associated with higher morbidity after adjusting for gestational age, Apgar score (5 min), arterial blood gas analysis. Conclusion : Complicated preterm newborns are at increased risk for oxidative stress compared with uncomplicated newborns and term newborns. Oxidative injury during the prenatal or postnatal day 1 is associated with adverse outcomes in preterm infants. Elevated TH levels on postnatal day 1 may have a value to predict clinical outcomes in preterm infants.