• Title/Summary/Keyword: 분리 불안

Search Result 106, Processing Time 0.023 seconds

Surgical Closure of the Patent Ductus Arteriosus in Premature Infants by Axillary Minithoracotomy (액와 소개흉술에 의한 미숙아 동맥관 개존증의 외과적 치료)

  • Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Kim, Kwang-Ho;Hong, Yung-Jin;Jun, Yong-Hoon;Shinn, Helen Ki;Baek, Wan-Ki
    • Journal of Chest Surgery
    • /
    • v.40 no.12
    • /
    • pp.837-842
    • /
    • 2007
  • Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

CLINICAL CHARACTERISTICS AND TREATMENT COURSES OF THE CHILDREN WITH SELECTIVE MUTISM (선택적 함구증 아동의 임상특성 및 치료경과)

  • Chung, Sun-Ju;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.6 no.1
    • /
    • pp.74-89
    • /
    • 1995
  • Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

  • PDF

The Influence of Musical Activities on Social and Emotional Behavior of Infants (음악활동이 영아의 사회·정서적 행동에 미치는 영향 - 만 2세(25-36개월) 영아를 중심으로)

  • Nam, Ok Seon
    • Journal of Music and Human Behavior
    • /
    • v.4 no.2
    • /
    • pp.18-40
    • /
    • 2007
  • The purpose of this study was to verify the influence of musical activities on social and emotional behavior of infants, through providing musical activities to the infants who were cared in a nursery and observing the interactions between peer group, or a therapist and an infant derived during them. The subject is 24 infants who are under 2 years of age(25~36months) at two nurseries located in Bundang area, and 13 infants among them are randomly assigned as study group and 11 infants as control group. Pretest and posttest about social and emotional behavior are performed, and ITSEA developed by Brggs-Gowan and Carter(2001) and amended by Shin Ji Yeon(2004) was used as an evaluation tool. Infants' changes of interaction behaviors during musical play were also analyzed quantitatively and qualitatively, and for the analysis, infant's social play behavior examination tool developed by Holloway and Reichhart-Erickson(1988) was adopted. Based on time sampling method, each item of this tool was evaluated. Each session was performed for 15 minutes, and 60 times of analysis about interactions per session was conducted at every 15 seconds. The analysis result was showed with a table and a graph, and described qualitatively about behavior changes. When compared social and emotional positive behavior average figures and negative behavior average figures between study group and control group, this study showed that the positive behavior figure of study group was increased and the negative behavior figure was decreased. While concentration and empathy among positive behaviors increased meaningfully, aggression, defiance, separation anxiety and rejection to new things among negative activities also decreased meaningfully. The conclusion of this study is as follows. First, interactions with peers or a therapist based on music and musical experience make an effect on strengthening positive behavior among social and emotional behavior and decreasing negative behavior. Second, music has influence on negative behaviors more than positive behaviors of an infant, and produces a good effect on sub behaviors of negative behaviors specially.

  • PDF

Studies on the Production of Watermelon and Cantaloupe Melonjuice (수박 및 참외 쥬스 제조에 대하여)

  • Shin, Dong-Hwa;Koo, Young-Jo;Kim, Choung-Ok;Min, Byong-Yong;Suh, Kee-Bong
    • Korean Journal of Food Science and Technology
    • /
    • v.10 no.2
    • /
    • pp.215-223
    • /
    • 1978
  • In Korea, the annual production of watermelon and cantaloupe melon is around 110,000 to 170,000 Metric Tons, and as the fruit does not keep well, studies were conducted to determine the feasibility of preservation in the form of natural juice or lactic fermented juice. The results obtained in these studies are summarized as follows: (1) The average yield of juice obtained from watermelon was 56.2%, and from cantaloupe melon 65.8%, of the fresh weight. (2) The colloidal components of watermelon juice separated from the juice by sedimentation within 24 hours. Cantaloupe melon juice gave a stable colloidal dispersion. (3) No change in the colour of the juices was detected by sensory evaluation or instrumental methods after they were treated at $100^{\circ}C$ for 5 minutes. (4) The addition of canesugar to give a total solids content of 11/13 Brix gave juices which were preferred by most tasters. (5) Lactic fermentation of natural juices pasteurised at $90^{\circ}C$ for 5 minutes, and inoculated with a pure culture of lactic acid bacteria proceeded without interference from competing microorganisms. (6) Sensory evaluation of lactic fermented juices indicated that 60% of tasters found the juices as acceptable or better than commercial fruit nectars at present on the market. (7) Taste panels showed a preference for natural melon juices over the lactic fermented juices. (8) The peroxidase activity of cantaloupe melon juice was higher than that of watermelon juice, with juice extracted from the core of the fruit showing a higher activity than that from other portions of the tissue. (9) Two types of peroxidase, of differing heat stability were detected in both juices. The more heat stable peroxidase had a decimal reduction time of 40 minutes at $80^{\circ}C$ and a z value of $11^{\circ}C$.

  • PDF

Utility Estimation of the Manufactured Stereotactic Body Radiotherapy Immobilization (자체 제작한 정위적체부방사선치료(Stereotactic Body Radiotherapy) 고정용구의 유용성 평가)

  • Lee, Dong-Hoon;Ahn, Jong-Ho;Seo, Jeong-Min;Shin, Eun-Hyeok;Choi, Byeong-Gi;Song, Gi-Won
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.23 no.1
    • /
    • pp.1-6
    • /
    • 2011
  • Purpose: Immobilizations used in order to maintain the reproducibility of a patient set-up and the stable posture for a long period are important more than anything else for the accurate treatment when the stereotactic body radiotherapy is underway. So the purpose of this study is to adapt the optimum immobilizations for the stereotactic body radiotherapy by comparing two commercial immobilizations with the self-manufactured immobilizations. Materials and Methods: Five people were selected for the experiment and three different immobilizations (A: Wing-board, B: BodyFix system, C: Arm up holder with vac-lock) were used to each target. After deciding on the target's most stable respiratory cycles, the targets were asked to wear a goggle monitor and maintain their respiration regularly for thirty minutes to obtain the respiratory signals. To analyze the respiratory signal, the standard deviation and the variation value of the peak value and the valley value of the respiratory signal were separated by time zone with the self-developed program at the hospital and each tie-downs were compared for the estimation by calculating a comparative index using the above. Results: The stability of each immobilizations were measured in consideration of deviation changes studied in each respiratory time lapse. Comparative indexes of each immobilizations of each experimenter are shown to be A: 11.20, B: 4.87, C: 1.63 / A: 3.94, B: 0.67, C: 0.13 / A: 2.41, B: 0.29, C: 0.04 / A: 0.16, B: 0.19, C: 0.007 / A: 35.70, B: 2.37, C: 1.86. And when all five experimenters wore the immobilizations C, the test proved the most stable value while four people wearing A and one man wearing D expressed relatively the most unstable respiratory outcomes. Conclusion: The self-developed immobilizations, so called the arm up holder vac-lock for the stereotactic body radiotherapy is expected to improve the effect of the treatment by decreasing the intra-fraction organ motions because it keeps the respiration more stable than other two immobilizations. Particularly in case of the stereotactic body therapy which requires the maintenance of set-up state for a long time, the self-developed immobilizations is thought to more useful for stereotactic body radiotherapy rather than the rest two immobilizations with instable respiratory cycle as time passes.

  • PDF

Dismantling and Restoration of the Celadon Stool Treasure with an Openwork Ring Design (보물 청자 투각고리문 의자의 해체 및 복원)

  • KWON, Ohyoung;LEE, Sunmyung;LEE, Jangjon;PARK, Younghwan
    • Korean Journal of Heritage: History & Science
    • /
    • v.55 no.2
    • /
    • pp.200-211
    • /
    • 2022
  • The celadon stools with an openwork ring design which consist of four items as one collection were excavated from Gaeseong, Gyeonggi-do Province. The celadon stools were designated and managed as treasures due to their high arthistorical value in the form of demonstrating the excellence of celadon manufacturing techniques and the fanciful lifestyles during the Goryeo Dynasty. However, one of the items, which appeared to have been repaired and restored in the past, suffered a decline in aesthetic value due to the aging of the treatment materials and the lack of skill on the part of the conservator, raising the need for re-treatment as a result of structural instability. An examination of the conservation condition prior to conservation treatment found structural vulnerabilities because physical damage had been artificially inflicted throughout the area that was rendered defective at the time of manufacturing. The bonded surfaces for the cracked areas and detached fragments did not fit, and these areas and fragments had deteriorated because the adhesive trickled down onto the celadon surface or secondary contaminants, such as dust, were on the adhesive surface. The study identified the position, scope, and conditions of the bonded areas at the cracks UV rays and microscopy in order to investigate the condition of repair and restoration. By conducting Fourier-transform infrared spectroscopy(FT-IR) and portable x-ray fluorescence spectroscopy on the materials used for the former conservation treatment, the study confirmed the use of cellulose resins and epoxy resins as adhesives. Furthermore, the analysis revealed the addition of gypsum(CaSO4·2H2O) and bone meal(Ca10 (PO4)6(OH)2) to the adhesive to increase the bonding strength of some of the bonded areas that sustained force. Based on the results of the investigation, the conservation treatment for the artifact would focus on completely dismantling the existing bonded areas and then consolidating vulnerable areas through bonding and restoration. After removing and dismantling the prior adhesive used, the celadon stool was separated into 6 large fragments including the top and bottom, the curved legs, and some of the ring design. After dismantling, the remaining adhesive and contaminants were chemically and physically removed, and a steam cleaner was used to clean the fractured surfaces to increase the bonding efficacy of the re-bonding. The bonding of the artifact involved applying the adhesive differently depending on the bonding area and size. The cyanoacrylate resin Loctite 401 was used on the bonding area that held the positions of the fragments, while the acrylic resin Paraloid B-72 20%(in xylene) was treated on cross sections for reversibility in the areas that provided structural stability before bonding the fragments using the epoxy resin Epo-tek 301-2. For areas that would sustain force, as in the top and bottom, kaolin was added to Epo-tek 301-2 in order to reinforce the bonding strength. For the missing parts of the ring design where a continuous pattern could be assumed, a frame was made using SN-sheets, and the ring design was then modeled and restored by connecting the damaged cross section with Wood epos. Other restoration areas that occurred during bonding were treated by being filled with Wood epos for aesthetic and structural stabilization. Restored and filled areas were color-matched to avoid the feeling of disharmony from differences of texture in case of exhibitions in the future. The investigation and treatment process involving a variety of scientific technology was systematically documented so as to be utilized as basic data for the conservation and maintenance.