• Title/Summary/Keyword: 비인두

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Blood Gas Management of a Membrane Oxygenator During Cardiac Surgery with Deep Hypothermic Circulatory Arrest (막형산화기에 의한 저체온 순환정지 심장수술시 혈액가스 조절)

  • Kim, W. G.;Lim, C.;Baek, Y. H.
    • Journal of Biomedical Engineering Research
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    • v.19 no.3
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    • pp.279-284
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    • 1998
  • Deep hypothermic circulatory arrest(DHCA), in which systemic temperatures of 2$0^{\circ}C$ or less are used to allow temporary cessation of the circulation, is an useful adjunct in cardiac surgery. Because man in natural circumstances is never exposed to the extreme hypothermic condition, however, one of the controversial aspects is appropriate blood gas management($\alpha$STAT versus PH-STAT) during DHCA. This study aims to compare $\alpha$STAT with PH-STAT management for control of blood gases in experimental cardiopulmonary bypass(CPB) circuits with a membrane oxygenator. Fourteen young pigs were assigned to one of two strategies of gas manipulation. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopharyngeal temperature fell below 2$0^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below 2$0^{\circ}C$, the animals were subjected to circulatory arrest for 40mins. During cooling, blood gas was maintained according to either $\alpha$$\alpha$STAT or pH-STAT strategies. After DHCA, the body was rewarmed to normal body temperature. Arterial blood gases were measured before the onset of CPB, before cooling, before DHCA, at the point of 27$^{\circ}C$ during re-warming, on completion of re-warming. Cooling time was significantly shorter in $\alpha$-STAT than PH-STAT strategy, while there was no significant differences in rewarming time between two groups. Carbon dioxide was added between 5.5 and 3.0% in PH-STAT, while no carbon dioxide was added in $\alpha$STAT management. Amounts of oxygen administration were gradually lowered as temperature decreased. In this way, criteria of PH, PaCO, and PaO adjustments were satisfied in both $\alpha$STAT and PH-STAT management groups.

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The Meta-Educational Implications of Toson-Shibigok ("도산십이곡"에 나타난 메타교육적 함의)

  • Park, Mi-Young
    • Sijohaknonchong
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    • v.23
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    • pp.71-105
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    • 2005
  • Toson-Shibigok(Twelve Songs of Toson) which T'oegye, Yi Hwang, composed has received a lot of attention in terms of its educational implications. These implications have become the essential part of Gojeon Sigas(classic songs and poems), and solid evidence has also been accumulated in the literature. Therefore, the purposes of this study are twofold, that is 1) to explore the impact of T'oegye's fundamental structure of the first education at that time and 2) describe how these educational attitudes will eventually yield meta- educational values. What T'oegye meant by fundamental structure of the first education was that Sijos originated from his own experience should be the vital part of teaching method. One can say that T'oegye's teaching method is more integrative than that of modern literature education in that it includes songs. Not only using his own teaching method, but T'oegye tried to demonstrate his own literary structure to his colleagues and the future generations. In the end, Meta-Education which comprises the heart of recent educational theories well reflects Toegye's theoretical propositions. Rather than giving practical knowledge, his method offers the paradigms of thought patterns and shows the learners' attitudes in approaching the truth. Moreover, T'oegye's teaching method has become a good example to the future generations as well as his contemporary followers. In sum, although a lot of years have passed since he died, T'oegye's Sijo works and life still have invaluable impact on the field of education.

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Effect of estrogen on growth hormone receptor expression of human periodontal ligament cell line (치주인대세포 배양에서 estrogen이 growth hormone receptor의 발현유도에 미치는 영향)

  • Hong, Sung-Gyu;Jeon, Young-Mi;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.441-452
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    • 2000
  • The present studies were performed to investigate the interaction of $17{\beta}$-estradiol and human growth hormone(hGH) on the proliferation of human periodontal ligament(WDL) cell. The independent effects of $17{\beta}$ estradiol and hGH on hPDL cell proliferation were investigated and the effects of hGH on hPDL cell proliferation after $17{\beta}$-estradiol pre-treatment were also investigated. Lastly, the change of hGH receptor expression in hPDL cell after $17{\beta}$-estradiol pre-treatment were investigated. The obtained results were as follows; 1. The treatment of $17{\beta}$-estradiol or hGH had no significant effects on hPDL cell proliferation. 2. After pre-treatment of $17{\beta}$-estradiol, hGH stimulated the proliferation of the hPDL cell, regardless of hHG concentration. 3. Although there was not hGH receptor in the hPDL cell, hGH receptors were expressed in hPDL cell after more than 6 hours pre-treatment of $17{\beta}$-estradiol. 4. The effect of hGH on hPDL cell proliferation was related to the hGH receptor expression. $17{\beta}$-estradiol pre-treaaent contributed to the hGH effects on the hPDL cell by stimulating hGHR expression.

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A Clinical Study of Hoarseness (애성을 주소로 한 후두질환의 임상 통계적 고찰)

  • 윤완규;조규모;송기준;김홍수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.6.4-7
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    • 1983
  • Hoarseness is the most common and early symptom in laryngeal diseases. A clinico - statistical analysis was performed on 228 cases with chief complaint of hoarseness at the department of otolaryngology, Jeonbug National University during the past 3 years from January 1980 to December 1980. 1) The number of the patient with hoarseness were 228 cases (2.3 %) among total outpatient of 10110 cases. 2) Among the 228 cases with hoarseness, male were 115 cases and female were 113 cases, so sex ratio was nearly same. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 43 cases (18.9 %), chronic laryngitis 36 cases (15.8 %), vocal nodule 30 cases(13.2 %), vocal polyp 30 cases (13.2 %), vocal cord paralysis 26 cases (11.4 %), laryngeal carcinoma 18 cases (7.9 %) and laryngeal tuberculosis 15 cases (6.6 %). There were other diseases of larynx in 30 cases (13.2 %). 4) The incidence of age distribution in order of frequency were 4th decade (26.8 % ), 3rd decade (18.9%), 5th decade (17.1 %), 2nd decade (15.8 %) and 6th decade (9.6 %). 5) The duration from onset to consultation in order of frequency were 11 days-1 month (22.8 %), 1 month-3 months(19.7%), 3 months -6 months (18.9 %), within 10 days (13.6 %), 6 months-l year (13.2 % ), 1 year -3 years(7. 9 %) and 3 years over. 6) The duration from onset to consultation for underlying diseases were as follows ; acute laryngitis was within 10 days, chronic laryngitis was 3 months - 6 months, vocal nodule was 1 month-3 months, vocal polyp was 3 months -1 year, vocal cord paralysis was 11 days -1 month. 7) Associated symptoms with hoarseness in order of frequency were sore throat (25 %), sputum (8.8 %), swallowing difficulty (7.9 %) and dyspnea (6.1 %). But 84 cases (36.8 %), there were no other symptoms except hoarseness.

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Radiographic Evaluation of Adenoidal Size and Assessment of Impedance Audiometry in Children (소아 인두편도의 방사선적 고찰 및 Impedance 청력검사 소견)

  • 김주일;김철우;이병희;천경두
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.41.2-41
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    • 1981
  • Tonsillectomy and adenoidectomy are the most common operations in the ENT field. Recent emphasis on careful selection of patients for these procedures derives from concern for complications of surgery, as well as the immunologic and anatomic functions of tonsils and adenoids. Adenoidectomy can relieve nasopharyngeal airway obstruction caused by enlarge adenoids, and can prevent complications such as heart failure and recurrent or chronic otitis media. We researched 117 cases of tonsilloadenoidectomy patients and 266 patients having routine examination from March, 1979 to February, 1981, and described the A/N ratio derived from linear measurements of lateral radiographs of the nasopharynx. The results of Impedance Audiometry and X-ray films from 117 cases of T&A patients were compared: 1) The average A/N ratio by age groups for 266 cases of normal children showed: 0.508 for age group, 0 to 3 years old, 0.533 for age group, 4 to 6 years old, 0.524 for age group, 7 to 9 years old, 0.519 for age group, 10 to 12 years old, 0.507 for age group, 13 to 15 years old, 0.481 for age group over 15 years old. The peak value lies in the age group of 4 to 6 years old. The sex difference of A/N ratio was not significant. 2) The average A/N ratio by age groups from 117 cases of T&A patients showed: 0.709 for age group, 0 to 3 years old, 0.733 for age group, 4 to 6 years old, 0.693 for age group, 7 to 9 years old, 0.707 for age group, 10 to 12 years old, 0.620 for age group, 13 to 15 years old, 0.756 for age group over 15 years old. 3) Among the 117 cases of T&A patients, the average A/N ratio for 57 cases in normal tympanogram was 0.688 and the average A/N ratio for 60 cases in abnormal tympanogram was 0.705. 4) Among 57 cases in abnormal tympanogram: 6 cases (10.5%) showed 0.40-0.59 of A/N ratio, 44 cases (77.2%) showed 0.60-0.79 of A/N ratio, and 7 cases (12.3%) showed 0.80-0.99 of A/N ratio. 5) Among 117 cases of T&A patients, 3 of 15 cases showing A/N ratio under 0.6, and 67 of 102 cases showing A/N ratio over 0.6, had paranasal sinusitis.

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Clinical Result of Aortic Arch Replacement using Antegrade Brain Perfusion Via Right Axillary Artery (우액와동맥을 통한 순행성 뇌관류법을 이용한 대동맥궁 치환의 임상성적)

  • Kim, Dong-Jin;Na, Yong-Jun;Jeong, Dong-Seop;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.25-31
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    • 2007
  • Background: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. Material and Method: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45,5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was $60.3{\pm}12.8$ years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. Result: The mean total circulatory arrest time was $31.1{\pm}16.9$ minutes and the mean retrograde brain perfusion time was $21{\pm}17.8$ minutes. Mean antegrade brain perfusion time was $77.9{\pm}17.5\;(43{\sim}101)$ minutes. We had neither operative mortality nor permanent neurological complications. Conclusion: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with iarge patient populations will be required.

Clinical Usefulness of Rapid Antigen Test on the Diagnosis of Influenza (인플루엔자 진단을 위한 신속 항원검사의 유용성)

  • Kim, Jae Seon;Choi, Hyon Joo;Ahn, Young Min;Hwang, Young Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1348-1353
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    • 2005
  • Purpose : Influenza is a respiratory disease which prevails widely every year and shows high morbidity and mortality among not only chronic invalids and the old, but also among infants and young children. To prevent community-acquired influenza infection, to facilitate prompt antiviral therapy and to avoid unnecessary use of antibiotics, an easy, rapid diagnostic method for the influenza virus is needed. We evaluated a lateral-flow immunoassay(QuickVue Influenza Test), compared to viral culture. Methods : During two consecutive years from Jan. 2004 to June 2004 and from Feb. 2005 to Jan. 2005, 408 patients who were suffering from fever, cough and/or sore throat and myalgia were enrolled in our study. A total of 408 patients were tested with $QuickVue^{(R)}$(Quidel Co., San Diego, USA) influenza rapid antigen test and virus cultures at the same time. Results : Of the 408 patients tested, children who showed positive results at the virus culture numbered 77; among them, 55(71.4 percent) were type A/H3N2 and 22(28.5 percent) were type B. QuickVue influenza test had a sensitivity of 71.4 percent and a specificity of 95.8 percent. The positive and negative predictive values were 79.7 percent and 93.5 percent, respectively. Conclusion : In our study, this test had comparable high sensitivity and high specificity and many advantages, such as being easy to perform and simple to interpret, and showing rapid results. If rapid influenza antigen tests are widely applied in the clinic, we can begin treatment more rapidly and reduce influenza complications and the abuse of antibiotics.

A Study on the Distribution of Mycoplasma pneumoniae Infectious Disease in Children from 2016 to 2018 According to Age (2016년에서 2018년의 소아 마이코플라즈마폐렴균 감염질환의 연령별 발생분포에 대한 연구)

  • Junhyung Choi;Ki Hwan Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.121-128
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    • 2023
  • Purpose: This study aimed to investigate the recent age distribution of Mycoplasma pneumoniae in patients with respiratory infections and the differences in diagnostic usefulness according to the methods used in these patients. Methods: We retrospectively reviewed the medical records of patients aged ≤18 years with respiratory infectious diseases who underwent polymerase chain reaction (PCR) or a specific immunoglobulin M (IgM) test between July 2016 and February 2019. The diagnosis of M. pneumoniae infection was confirmed by a positive result in the PCR or IgM test. Results: Of the 2,721 patients tested for M. pneumoniae, 2,197 underwent IgM, and 1,144 underwent PCR, with positivity rates of 17% and 20%, respectively. Among the 620 patients tested for both IgM and PCR tests simultaneously, 35% had M. pneumoniae infection, with 14% under 1 year old and 13% under 1-2 years old. The positive rate increased with age in both tests. Higher positive rates were observed in the IgM test before 3 years of age and in the PCR test after 3 years of age. The agreement rate between the two tests was 77.9% (Cohen's kappa 0.402). Conclusions: As age increased, the rates of M. pneumoniae infection also increased. In patients under 2 years of age, 4¬-14% of infections were confirmed depending on the method used. The moderate agreement between the PCR and IgM tests suggests that the simultaneous use of PCR and the IgM test for the early diagnosis should be approached with caution.

The Clinical Effects of Normocapnia and Hypercapnia on Cerebral Oxygen Metabolism in Cardiopulmonary Bypass (체외순환 시 뇌대사에 대한 정상 탄산분압과 고 탄산분압의 임상적 영향에 관한 비교연구)

  • 김성룡;최석철;최국렬;박상섭;최강주;윤영철;전희재;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.712-723
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    • 2002
  • Substantial alterations in cerebral blood flow(CBF) are known to occur during cardiopulmonary bypass(CPB). Many investigators have speculated that these changes may be responsible for both minor and major cerebral damages after CPB. More recently, these changes in CBF have been observed to be intimately related to the arterial carbon dioxide tension(Pa$CO_2$) maintained during CPB. The present study was prospectively designed to investigate the clinical effects of normocapnic and hypercapnic CPB on the cerebral oxygen metabolism in cardiac surgery Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to either normocapnic group (Pa$CO_2$35~40 mmHg, n=18) or hypercapnic group(Pa$CO_2$, 45~55 mmHg, n=18) with moderately hypothermic nonpulsatile CPB(nasopharyngeal temperature of 29~3$0^{\circ}C$). In each patient, middle cerebral artery blood flow velocity( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), cerebral oxygen extraction(COE), cerebral metabolic rate for oxygen(CMR $O_2$), cerebral oxygen transport( $T_{E}$ $O_2$), $T_{E}$ $O_2$/CMR $O_2$ ratio, cerebral desaturation(internal jugular bulb blood oxygen saturation $\leq$ 50%), and arterial and jugular bulb blood gas were evaluated throughout the operation. Postoperative neuropsychologic complications were assessed in all patients. All variables were compared between the two groups. Result: VMCA(169.13 $\pm$ 8.32 vs 153.11 $\pm$8.98%), TE $O_2$(1,911.17$\pm$250.14 vs 1,757.40$\pm$249.56), $T_{E}$ $O_2$,/CMR $O_2$ ratio(287.38$\pm$28.051 vs 246.77$\pm$25.84), $O_2$ tension in internal jugular bulb (41.66$\pm$9.19 vs 31.50$\pm$6.09 mmHg), and $O_2$saturation in internal jugular bulb(68.97$\pm$10.96 vs 58.12$\pm$12.11%) during CPB were significantly lower in normocapnic group(p=0.03), whereas hypercapnic group had lower C(a-v) $O_2$(3.9$\pm$0.3 vs 4.9$\pm$0.3 mL/dL), COE(0.3$\pm$0.03 vs 0.4$\pm$0.03), CMR $O_2$(5.8 $\pm$0.5 vs 6.8$\pm$0.6), and arterial blood pH(7.36$\pm$0.09 vs 7.46$\pm$0.07, p=0.04) during CPB. Hypercapnic group had lower incidence of cerebral desaturation than normocapnic group(3 vs 9 patients, p=0.03). Duration of the neuropsychologic complication(delirium) were shorter in hypercapnic group than in normocapnic group(36 vs 60 hrs, p=0.009). Conclusion: These findings suggest that hypercapnic CPB may have salutary effects on the cerebral oxygen metabolism and postoperative neurologic outcomes in cardiac surgery.surgery.

Epidemiologic and Clinical Features of Enteroviral Infections in Children; 1996~1998 (소아에서 장바이러스 감염의 역학 및 임상적 특성에 관한 연구; 1996년~1998년)

  • Park, Jung Sick;Kim, Mi Ran;Kim, Dug Ha;Park, Chong Young;Lee, Kon Hee;Lee, Hae Ran;Kang, Hee Jung;Lee, Kyu Man
    • Pediatric Infection and Vaccine
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    • v.6 no.2
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    • pp.210-218
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    • 1999
  • Purpose : As several epidemics of aseptic meningitis had been reported in Korea since 1990, the need of epidemiologic study about enteroviral infections was recognized. We studied epidemiologic and clinical features of enteroviral infections in children. Methods : We analyzed the seasonal occurrence of enteroviral infections and age, sex and clinical diagnosis of the children admitted to five branch hospitals of Hallym University and diagnosed to have enteroviral infections by culture from January 1996 to December 1998. Results : Enterovirus was isolated in 126 out of 245(51.4%) stools, 15 out of 89(16.8%) nasopharyngeal aspirates and 195 out of 1,835(10.6%) cerebrospinal fluids. There were 273 echoviruses(Echo)(197 Echo 30, 46 Echo 9, 17 Echo 6, 13 unclassified), 24 coxsackieviruses B(CB)(11 CB 2, 2 CB 5, 11 unclassified), 7 coxsackieviruses A 24 and 32 unclassified enteroviruses. Yearly number of isolates was 65(46 Echo 9) in 1996, 239(197 Echo 30) in 1997 and 32(15 CB: 9 CB 2) in 1998. Epidemics of enteroviruses occurred mainly during the months May to October. The mean age of the infected children was $62.1{\pm}38.0$ months and 74.6% of the patients were younger than 7 years of age. There were 203 boys and 100 girls and 79.3% of the patients were diagnosed as aseptic meningitis. Conclusions : We confirmed that enteroviral infections occurred in epidemics from late spring to fall during the study period. Enteroviral infections occurred predominantly in boys and the preschool children. Aseptic meningitis was the main illness in the hospitalized children.

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