• Title/Summary/Keyword: 분류분과

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Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

A Study on the Funerary Mean of the Vertical Plate Armour from the 4th Century - Mainly Based on the Burial Patterns Shown by the Ancient Tombs No.164 and No.165 in Bokcheon-dong - (종장판갑(縱長板甲) 부장의 다양성과 의미 - 부산 복천동 164·165호분 출토 자료를 중심으로 -)

  • Lee, Yu Jin
    • Korean Journal of Heritage: History & Science
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    • v.44 no.3
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    • pp.178-199
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    • 2011
  • The ancient tombs found in Bokcheon-dong, Busan originate from the time between the $4^{th}$ and $5^{th}$ centuries, the period of the Three Nations. They are known as the tombs where the Vertical Plate Armour was mainly buried. In 2006, two units of the Vertical Plate Armour were additionally investigated in the tombs No.164 and No.165 which had been constructed at the end of the eastern slope near the hill of the group of ancient tombs in Bokcheon-dong. Throughout this study, the contents of the two units of the Vertical Plate Armour, whose preservation process has been completed, have been arranged, while the group of constructed ancient tombs in Bokcheon-dong from the $4^{th}$ century has been observed through the consideration of the burial pattern. The units of the Vertical Plate Armour from the tombs No.164 and No.165 can be classified as the IIa-typed armor showing the Gyeongju and Ulsan patterns, according to the attribute of the manufacturing technology. Also, they can be chronologically recorded as those from the early period of Stage II among the three stages regarding the chronological recording of the Vertical Plate Armour. While more than two units of the Vertical Plate Armour were buried in the largesized tomb on the top of the hill of the group of ancient tombs, one unit of the Vertical Plate Armour was buried in the small-sized tomb. By considering such a trend, it can be said that in the stage of burying the armor showing the Gyeongju and Ulsan patterns (I-type and IIa-type), different units of the Vertical Plate Armour were buried according to the size of the tomb. However, as the armor showing the Busan pattern (IIb-type) was settled, only one unit was buried. Meanwhile, the tombs No.164 and No.165 can be included in the wooden chamber tomb showing the Gyeongju pattern, which is a slender rectangular wooden chamber tomb with the aspect ratio of more than 1:3. However, according to the trend shown by the buried earthenware, it can be said that there seem to be common types and patterns shared with the earthenware which has been found in the area of Gimhae and is called the one showing the Geumgwan Gaya pattern. In other words, there seem to be close relationships between the subject tombs and the tomb No.3 in Gujeong-dong and the tomb No.55 in Sara-ri, Gyeongju, regarding the types of armor and tombs and the arrangement of buried artifacts. However, the buried earthenware shows a relationship with the areas of Busan and Gimhae. By considering the combined trend of the Gyeongju and Gimhae elements found in one tomb, it is possible to assume that the group of constructed ancient tombs in Bokcheon-dong used to be actively related with both areas. It has been thought that the Vertical Plate Armour used to be the exclusive property of the upper hierarchy until now, since it was buried in the large-sized tomb located on the top of the hill of the group of ancient tombs in Bokcheondong. However, as shown in case of the tombs No.164 and No.165, it has been verified that the Vertical Plate Armour was also buried in the small-sized tomb in terms of such factors as locations, sizes, the amount of buried artifacts and the qualitative aspect. Therefore, it is impossible to discuss the hierarchical characteristic of the tomb just based on the buried units of the Vertical Plate Armour. Also, it is difficult to assume that armor used to symbolize the domination of the military forces. The hierarchical characteristic of the group of constructed ancient tombs in Bokcheon-dong from the $4^{th}$ century can be verified according to the location and size of each tomb. As are sult, the re seem to be some differences regarding the buried units of the vertical plate armour. However, it would be necessary to carry out amore multilateral examination in order to find out whether the burial of the vertical plate armour could be regarded as the artifact which symbolizes the status or class of the deceased.

The Literary Investigation On Types and Cooking Method of Bap (Boiled Rice) During Joseon Dynasty($1400's{\sim}1900's$) (조선시대 밥류의 종류와 조리방법에 대한 문헌적 고찰(1400년대${\sim}1900$년대까지))

  • Bok, Hye-Ja
    • Journal of the Korean Society of Food Culture
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    • v.22 no.6
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    • pp.721-741
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    • 2007
  • 1. For the types of boiled rice, there were 1 type of bap, 1 type of jebap cooked with glutinous rice, 13 types of boiled rice cooked by mixing grains and nuts such as daemakban, somakban, jobap, cheongryangmiban, jobap, gijangbap, yulmubap, hyeonmibap, boribap and patmulbap as well as patbap, congbap, byeolbap and bambap etc as ogokbap. Also, there were 12 types of bap cooked by mixing herb medicinal ingredients such as cheongjeong, oban, boksungabap, gumeunsaekbap, hwanggukgamchobap, yeongeunbap, okjeongbap, gogumabap, dububap, samssibap, dorajibap, gamjabap, songibap and jukshilbap. There were 7 types bap cooked as unique one bowl dish at the present as bapby mixing fish, meat, shellfish and milk as ingredients are hwangtang, gyejanggukbap, janggukbap, gulbap, kimchibap, chusaban and bibimbap, etc and the types of bap that have been analyzed are 34 total. 2. For the food ingredients used in bap types 23 types of miscellaneous grains, 5 types of nuts and 11 types of meat, 6 types of fish, 35 types of vegetables, 2 types of fruit including pears or peaches were used. Garlic wasn't used perhaps because of it being boiled rice 3. Types of Sap by Cooking Methods. (1) The ssalbap was cooked by first boiling water, putting in rice grains and boiling hard to be cooked as overcooked bap (rice). (2) The japgokbap (boiled cereals) has used buckwheat, barley job's tear, etc to be boiled down by soaking the ones with large grains (beans) first in advance to be boiled down or cooked by crushing into fine pieces. The red bean, etc was boiled down in advance or placed at the bottom of pot by cutting into two pieces while jujube or nut was cut into three pieces to cook the bap by pouring a lot of water and mixing other ingredients. (3) The gukbap (soup boiled rice), etc were cooked by squeezing out the yellow chrysanthemum that has dried chrysanthemum to cook the boiled rice by putting in rice and gukbap, meat or bones, etc were boiled down for a long time and decorated with meat or wild greens by mixing the bap in the meat juice. For gulbap (oyster boiled rice), etc, it was cooked as ingredients were stir fried in advance or washed and put in when the bap was about half cooked. (4) For bibimbap (mixed boiled rice), after the bap was overcooked first with rice, the wild greens were mixed lightly with bap beforehand, then the wild greens, decorations and garnishings were laid above rice and red pepper powder was sprinkled. (5) Namchok leaves, etc were boiled to cook the boiled rice with rice after being cooled while namchok stem and leaves were pounded to make juice and cooked the bap with rice. The peach, lotus root and yams were cut into fine pieces to be put in together when rice was about half done. The bellflower was soaked in water to be boiled down for a long time while potatoes and pine mushrooms, etc were cut into fine pieces to cook the bap (boiled rice) with rice.

Clinical Characteristics of precocious puberty girls and Comparison Analysis of GnRH Test results with Diagnosis type (성조숙증 여아들의 임상적 특징 및 진단별 성선자극호르몬 분비호르몬 GnRH (Gonado Tropin Releasing Hormone) 검사결과의 비교분석평가)

  • Kim, Jung-In;Kwon, Won-Hyun;Moon, Ki-Choon;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.54-61
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    • 2016
  • Purpose Precocious Puberty is defined as the development of secondary sexual characteristics in girls younger than 8 years, and boys 9 years. Cause premature closure of the epiphysis is a disease that eventually decreases the final adult height. In this study, we retrospectively analyzed to evaluate the diagnostic difference the GnRH (Gonado-tropin-releasing Hormone) stimulation test results with medical records of precocious puberty in girls. Materials and Methods From February 2015 to December 2015 it was enrolled in the girls 118 people who visited the Seoul National University Bundang Hospital, Pediatrics, Endocrinology Internal Medicine. True precocious puberty group (n=57), early puberty group (n=39), were divided into Premature thelarche (n=22) group. A Tanner stage, chronological age, bone age, height, body weight for each group was determined by examining the mean${\pm}$standard deviation. GnRH test result was compared LH (Basal, 30 min, 45 min, 60 min), FSH (Basal, 30 min, 60 min) for each group, Each group LH, FSH Peak value distribution, the mean${\pm}$standard deviation was calculated for the peak LH/LH basal ratio, peak LH/Peak FSH ratio. The significance probability (P-value) between the value of each third group was determined. Results The average height of the true precocious puberty group $131{\pm}14.85$, the mean weight was $28.80{\pm}4.93$, the average chronological age $7.1{\pm}0.81$, the mean bone age was $9.9{\pm}0.9$, The average height of early puberty group was $134{\pm}5.10$, the average weight $28.50{\pm}4.43$, the average chronological age $8.05{\pm}0.03$, the mean bone age was $10.0{\pm}0.62$, The average height of Premature thelarche $129{\pm}6,01$, the average weight was $28.65{\pm}5.98$, the average chronological age $7.02{\pm}0.58$, the mean bone age was $8.04{\pm}1.29$. There was no significant difference when compared to the height and weight. There was a significant difference between the groups in the chronologic age and bone age difference (P <0.0002) True precocious puberty group showed peak LH levels at 30'(82.5%), 45'(12.3%), 60'(5.3%), in Peak FSH 30'(8.8%), 60'(91.2%). Early Puberty group showed high values in Peak LH at 30'(79.5%), 45'(17.9%), 60'(2.6%), in peak FSH levels at 30'(7.7%), 60'(92.32%). In Premature thelarche Group it showed the Peak LH levels at 30'(30%), 45'(59%), 60'(9.09%), Peak FSH levels at 30'(0%) 60'(100%). When compared with the The Peak LH/basal LH ratio, True precocious puberty group was $19.09{\pm}17.15$, early puberty group was $15.23{\pm}10.88$, Premature thelarche group showed significant differences between the three groups as $4.93{\pm}4.36$.(P <0.0001) LH Peak/FSH Peak ratio, true precocious puberty group was $1.222{\pm}0.77$, early puberty group was $1.34{\pm}1.23$, Premature thelarche group showed significant differences between the three groups as $0.3{\pm}0.09$(P <0.0001) Conclusion In order to diagnose the true precocious puberty have a diagnostic value when the LH peak after GnRH stimulation is increased by more than two to three times compared to baseline or a predetermined level or more than 5~10 IU/L increases. GnRH Test is a test for a long time and the patient discomfort due to repeated blood sampling, but the hypothalamus-pituitary gland- gonad axis activity evaluate and is the most basic accurate test in the differential diagnosis of precocious puberty disorders.

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