• Title/Summary/Keyword: 수술시기

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Clinical Evaluation of Surgical Resection on Pulmonary Tuberculosis -Multiple Drug Resistent Pulmonary Tuberculosis (폐결핵 환자에 적용된 폐절제술의 임상적 연구 -다제약제내성 결핵환자를 중심으로-)

  • 전희재;한동기
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.786-792
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    • 1997
  • A clinical study of 71 cases of pulmonary tuberculosis that had had surgical resection during the period of 7 years and 6months from January 1989 to June 1996 in National Masan Tuberculosis Hospital. The results were as follows. 1. The ratio of male to female was 3.7:1 and in the age incidence the fourth decade was 22%, the third decade 15%. Although medical treatment was performed for more than 3 to 6 months, preoHeratively the conversion failure rate of positive sputum to negative state was 66.2%(47 cases). Of the failure cases, multiple-drug-resistant(MDR) patients were 41 cases(87.2%), 3. In MDR group, preoperatively conversion failure rate was 71.9%. 4. From the view of indica ion for lung resection on the radiographic finding, cavitary lesions were 43 cases(60.6%), destroyed lung lesions were 24 cases(33.8%). 5. The incidence of postoperative complication was 28.2%(20 cases). All cases were MDR 6. group and the most common of complication was tuberculosis spreading. In bilateral lesion, incidence of postoperative tuberculosis spreading was 25%(7 cases). Of the 7 cases, there was the cavitary lesion in 6 cases(86.7%). Total conversion rate of AFB positive sputum to negative state related to resectional sugery was 76.6% and in MDR group conversion rate of AFB positive sputum to negative state was 73.2% Conversion rate of MDR group with bilateral lesion was the lowest(60%). Conversion rate of drug-sensitivity group was 100% regardeless of lesions Slt to. In conclusion, despite of long-standing medical treatment, it is difficult to converse sputum-positive to negative state in multiple-drug resistance patients and that increases postoperative complications su h as tuberculosis relapse as a lack of appropriate drugs postoperatively. Postoperative conversion rate of sputum-positive to negative state was decreased in multiple-drug resistance patients. Because multiple-drug resistance patients have inireased due to several factors in Korea, it is important to prevent spreading of multiple-drug resistnce patients through the aggressive operative treatment. When the first medical therapy is fail or drug-resistance is found, operative treatment should be considered with the secondary medical therapy. The operation should be aggressively attempted even though at first medical treatment if indicated.

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Guidelines for the Management of Hydronephrosis Detected in the Perinatal Period (주산기에 발견된 수신증의 자연 경과와 치료 방침)

  • Chae Soo-Ho;Lee Ji-Hyuk;Jin Dong-Kyu;Park Kwan-Hyun;Paik Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.33-39
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    • 2006
  • Purpose : Neonatal hydronephrosis is diagnosed with an incidence of 4.5-7% of pregnancies. Recently, early detection of neonatal hydroneprosis with antenatal ultrasonography has be-come possible. But consensus about its management has not been reached, especially concerning surgical intervention. The purpose of this study is to analyze the natural course of neonatal hydronephrosis and to determine the guideline of surgical intervention and follow up study. Methods : Sixty nine hydronephrotic kidneys were confirmed from April 2001 to April 2005. All cases were rechecked by ultrasonography once at least and had a minimum follow-up of 6 months. We classified the patients into 4 groups according to the anterior posterior pelvic diameter(APPD) on perinatal ultrasonography. Ultrasonography to measure the APPD diameter and Society for Fetal Urology(SFU) grade, $^{99m}Tc-MAG3$ scan were done to a set protocol. Pyeloplasty was peformed according to the protocol. Results : Pyeloplasty was not needed in most cases where the APPD was below 10 mm and where the SFU grade were less than grade 3. Many cases with APPD 10 mm above or SFU grade III above had undergone pyeloplasty. We found a correlation between obstruction grade on MAG3 scan and whether surgery was performed or not. Conclusion : If APPD is above 10 mm, SFU grade is above grade 3 or urinary tract obstruction is suspected by MAG3 scan, pyeloplasty must be considered. In cases where APPD is below 10mm and SFU grade is less than grade 3, we can observe the natural course of neonatal hydronephrosis with consecutive follow-up. (J Korean Soc Pediatr Nephrol 2006;10:33-39)

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Initial changes of dental plaque, gingivitis and decalcification in Korean orthodontic patients with fixed appliance (한국인 고정식 교정 환자의 치태, 치은염 및 탈회의 초기 변화에 관한 연구)

  • Kang, Kook-Jin;Shon, Byung-Hwa
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.361-374
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    • 1999
  • Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

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Final height of patients with congenital heart disease (선천성 심장질환을 가진 환자의 최종 키)

  • Lee, Soon Joo;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.203-209
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    • 2010
  • Purpose : Growth impairment is usually observed in children with congenital heart disease (CHD). Studies on the final height and weight of this population are insufficient. Our aim was to evaluate the final height of children with CHD and to identify the relationship between CHD and growth. Methods : We recorded the values of final height and weights of 105 CHD patients (age, <19 years) who visited Chonnam National University Hospital between November 2000 and March 2009, and we reviewed the medical records. Results : The mean values of weight and height of male CHD patients were significantly lower than those of the normal subjects. Patients with severe growth impairment (below the third percentile of normal) included 5 males (8.6%) and 4 females (8.5%) with height less than normal and 9 males (15.5%) and 8 females (17.0%) with weight less than normal. The mean growth of the patients in the cyanotic heart disease group was lower than that of normal subjects, but a statistically significant difference was noted in the weights of males. In a comparative study based on the type of CHD, a significant difference was noted in weights of males. Patients with patent ductus arteriosus and those with tetralogy of Fallot had the highest and lowest mean values of weight, respectively. Conclusion : Growth impairment was more evident in children with CHD than normal children. Patients should be treated during an optimal time frame. Thus, CHD patients should be treated if follow-up studies indicate growth impairment.

Flowering, Fruiting, Seed Fall and Seed Viability of Acer pseudosieboldianum in Mt. Jungwang, Gangwondo (강원도 중왕산 당단풍나무의 개화, 결실, 종자 낙하량 및 종자활력)

  • Kim, Hoi Jin;Kim, Gab Tae
    • Journal of Korean Society of Forest Science
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    • v.105 no.1
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    • pp.42-47
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    • 2016
  • To examine the natural regeneration in the natural mixed-broadleaved forest, flowering, fruiting, seed-fall, and seed viabilities of Acer pseudosieboldianum (Ap) were investigated in Mt. Jungwang, Gangwon-do, from 2009 to 2015. The flower of Ap consisted many male and bisexual flowers on the corymb. Flowering dates are differed between sex morph in the same inflorescence. Stamens are stop growing and disappeared after pollinated pistil begin to grow in bisexual flowers, and male flowers have vestial pistil. The flowers of Ap might be pollinated by Apis mellifera, Andrenidae spp. and Syrphinae spp. Ap had some mechanism to prevent from self pollination with heterodichogamy. Mean annual seedfall of Ap was 70,780 ea/ha (ranged 310~234,840 ea/ha). Annual seedfall of Ap varied severely, and the maximum was about 760 times the minimum. Annual seed production of Ap might be to a normal distribution. Rates of damaged or decayed seeds are highest 59.3%, and those of sound seeds are 23.9%, Those of undeveloped and empty seeds are 9.2% and 7.6%, respectively. The most important factors influencing sound seed production might be the density and activities of insect pollinators and sucking pest in the flowerwing period, middle-late May. Successful regeneration of Ap might be in masting year and on the gap sites with proper conditions to germinate and grow. To understand the natural regeneration of deciduous hardwoods, further study on the characteristics of flowering and fruiting, pre- and post-dispersal seed predation, and annual variation on these factor should be needed.

A Localization Method Using RF Transmission Levels in Wireless Sensor Networks (무선 센서 네트워크에서 RF 전송 레벨을 이용한 위치 측정 기법)

  • Yun, Chae-Sang;Hahn, Joo-Sun;Ha, Rhan
    • Proceedings of the Korean Information Science Society Conference
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    • 2007.10d
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    • pp.366-371
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    • 2007
  • 무선 센서 네트워크는 경제적, 환경적 목적으로 다양한 방면에서 활용되고 있다 이 때, 배치된 각 센서의 위치를 파악하는 것은 센서 네트워크에서 가장 기본적이며 가장 중요한 문제 중의 하나이다. 기존 논문에서 제안된 센서 위치 측정 방법은 특별한 장비를 장착하거나 특정한 환경의 지역에 한정시킨 방범으로 제한하고 있는 경우가 대부분이다. 하지만 어떠한 관심 지역의 환경은 언제라도 바뀔 수 있다. 또한, 센서가 위치할 환경의 기온, 풍속 등을 미리 안다는 것은 비현실적인 가정이다. 더구나 각각의 센서에 특별한 장비를 장착한다는 것은 비용 절감을 이유로 센서 네트워크를 운영하는 경우 오히려 그것을 이용하지 않는 경우보다 비용이 더 들 수도 있다. 이에 본 논문에서는 센서 노드의 기본적인 통신 기능은 이용하여, 환경에 순응적으로 센서의 위치를 측정할 수 있는 방법을 제안하고자 한다. 센서 노드에서 기본적으로 제공하는 통신 기능은 RF 전파를 보낼 때 전송 레벨을 달리하여 보낼 수 있다. 이러한 기본적인 기능을 이용하여 위치를 측정하게 되면 전체적인 센서 네트워크의 비용이 절감될 뿐만 아니라 환경에 순응적인 위치 측정이 가능하게 된다. 또한, 각 노드의 위치가 정해진 후 다른 노드와 통신할 때 전파의 세기를 조정함으로써 RF 통신에서 소모되는 전력량을 줄일 수 있다. 따라서 본 논문에서 제안하는 전송 레벨을 이용한 위치 측정 방법은 단순히 위치를 측정한다는 의미뿐 아니라 환경에 순응적으로 작동한다는 장점이 있다. 향후 네트워크 내에서 통신에 소비되는 전력을 줄일 수 있다는 점에서도 중요한 의미를 지닌다.를 집행하는 caspase의 활성 형태인 cleaved caspase-8, -9, -7, -3의 단백질 수준이 목향 헥산추출물의 처리에 의해 증가하였고 caspase-3의 표적 단백질 중 하나인 PARP의 불활성 형태인 cleaved PARP의 단백질 수준도 현저하게 증가하였다. 이 결과들은 목향 헥산 추출물이 LNCaP 세포의 apoptosis를 유도함으로써 전립선 암세포의 증식을 억제함을 보여주는 것이며 목향 헥산추출물에 의한 apoptosis 유도는 caspase 활성 증가와 Bak 및 t-Bid 단백질의 증가에 의한 것임을 제시한다. 따라서 앞으로 항암효과를 나타내는 성분의 동정 및 동물실험을 통하여 좀 더 면밀한 기전 연구가 수행된다면 목향 헥산추출물은 화학적 암예방 물질이나 치료제로 개발될 수 있을 것으로 사료된다.적 분해층과 마모질이가 가장 깊은 것으로 나타났으며 flowable type의 복합레진과 컴포머는 표면 경도와 마모도에서 양호한 결과를 보였다. 이상의 결과 복합레진과 컴포머의 평가요소로서 마모도와 함께 가수분해도 고려되어야 할 것으로 사료된다.증후군 환자에서 대조군에 비해 높은 비율을 보였다.er thinning은 3 군모두에서 관찰되었고 항암 3 일군이 가장 심하게 나타났다. 이상의 실험결과를 보면 술전 항암제투여가 초기에 시행한 경우에는 조직의 치유에 초기 5 일정도까지는 영향을 미치나 7 일이 지나면 정상범주로 회복함을 알수 있었고 실험결과 항암제 투여후 3 일째 피판 형성한 군에서 피판치유가 늦어진 것으로 관찰되어 인체에서 항암 투여후 수술시기는 인체면역계가 회복하는 시기를 3

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Comparative Study of Postoperative Analgesic Effect of IV-PCA According to Timing of Infusion in Patients with Total Abdominal Hysterectomy (자궁적출술 환자의 진통제 투여시작 시기에 따른 수술 후 통증호소 비교(IV-Patient Controlled Analgesia를 이용하여))

  • Park Jeong-Ok;Lee Pyung-Ae;Cho You-Sook;Park Mi-Mi;Kim Hye-Sook;Park Jee-Won;Min Sang-Kee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.323-334
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    • 2002
  • Purpose: This study was designed to verify preemptive effects of intravenous patient-controlled analgesia (IV-PCA) infusion on postoperative pain in women having a total abdominal hysterectomy. Method: The research design was a nonequivalent control group post test only design. The participants in this study were 50 women who were scheduled for a total abdominal hysterectomy at a University affiliated Hospital in Suwon, Korea. The subjects were divided into two groups. For the experimental group, IV-PCA infusion was started before the skin incision and for the control group. IV-PCA infusion was started after the skin was closed. Each group was evaluated in terms of pain score by the visual analogue scale (VAS) and the number of times they pushed the button for IV-PCA at postoperative hours 1, 2, 3, 6, 12, and 24. The data were collected from July 1 to December 10, 2001. Collected data was analyzed by SPSS/PC + program. Result: 1. There was no difference between the two groups, over six points for the number of times the control button for IV-PCA was used. Group differences and interaction effect were not significant. 2. There was no significant difference in pain scores between the two groups, over seven time points. A significant interaction effect was observed between groups and measurement Points in time. 3. There was a significant difference in the requirements for additional analgesia between the two groups, 32% of the control group received additional analgesia. Conclusion: Preemptive analgesics administration may have a better effect in relieving postoperative pain than the usual analgesic treatment which is started after surgery.

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Acute Appendicitis: A Rare But Probable Manifestation of Kawasaki Disease

  • Wonshik Choi;Sin Weon Yun;Mineui Hong;Suk-Won Suh;Dae Yong Yi;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.97-103
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    • 2023
  • Kawasaki disease (KD) is an acute, systemic inflammatory disorder that often targets coronary arteries. Being the common cause of acquired heart disease in children, timely diagnosis and intravenous immunoglobulin treatment are crucial. However, it is challenging for physicians to diagnose KD if it presents with atypical manifestations. We report the case of a 5-year-old boy who initially presented with appendicitis; after an appendectomy, he had a prolonged fever. He was finally diagnosed with atypical KD and successfully recovered after intravenous immunoglobulin treatment. Through a literature review, we found 21 cases of appendicitis associated with KD. In most cases, the patients were male with a mean age of 5.3 years. Most had higher proportions of incomplete KD and coronary artery complications than expected for typical KD. In conclusion, appendicitis could be a rare complication of KD; therefore, multidisciplinary cooperation and early recognition of atypical KD are essential for timely diagnosis.

심근조영심초음파에서 심장의 움직임을 보정한 비침습적 심근관류모델의 정량적 평가

  • 이재훈;김희중;정남식;임세중;김기황
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.49-49
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    • 2003
  • 목적 : 심초음파는 비침습적이므로 반복적으로 정확히 심질환의 경과를 관찰하여 치료효과 및 수술시기를 정할 수 있는 검사로서 임상적으로 매우 유용하다. 실시간 심근조영심초음파에 의한 time intensity 평가는 부위별로 수행됨으로 연속적으로 위치하는 관심영역이 intensity에 있어 심장의 움직임 변화에 영향을 받는다. Time intensity 곡선의 최적의 곡선맞춤을 위해 주기적인 심장 운동 매개변수를 조합해 기존의 모델을 보정한 안정적인 측정방법을 제시한다. 방법 : 심장의 운동에 의한 특징적인 정보를 설명하기 위해 기존의 문헌에 제시된 지수 함수에 주어진 심박수로 만들어진 시간에 관한 일반적인 정형파 함수를 추가한다. C(t) = A[1 - exp($\beta$t)] + Dsine(2$\pi$ft + $\theta$) C(t): videointensity A: plateau videointensity (blood volume) $\beta$: capillary blood velocity (rate constant of rise in videointensity) t: pulsing interval (ms) D: displacement from the periodic variance of the curve (estimated motion field from the ejection point for the ratio between systole and diastole) f: heart rate $\theta$: transit time issue A $\times$ $\beta$ : myocardial blood flow 관상동맥의 관류 데이터에 대한 실험이 펄스간격에 대한 비디오 세기로 수행되었다. 그리고 이러한 결과들이 the sum of squares due to error, R square, root mean squared error로 평가되었다. 결과 : 실험결과, 주기적인 심장의 움직임과 심박출 시점으로부터의 변위를 잘 기술하고 곡선에서의 측정 점들이 예측된 심장 움직임에 따라 성공적으로 표시되었다. 뿐만 아니라 보정된 모델이 현저한 적합도의 향상을 보여주었다. 결론 : 제시된 접근방법은 각각의 측정에서 심장 운동 영역의 변화에 독립적이며 측정 시점에 의해 영향받지 않고 심근 관류의 안정적인 측정이 가능하다. 심장의 움직임에 관한 매개변수를 조합한 모델로 곡선접합을 수행함으로써 관류의 정량적 정보를 좀더 정확하게 얻을 수 있으며 임상적 이용을 가능하게 할 것으로 기대된다.

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Furlow Palatoplasty in Submucous Cleft Palate-Timing of Operation (점막하 구개열에서 Furlow 구개성형술의 수술시기)

  • Kim, Suk Wha;Park, Joon Kyu
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.741-747
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    • 2007
  • Purpose: In order to determine the differences in speech outcome based on timing of operation in submucous cleft palate, we have reviewed our experiences in the Furlow palatoplasty over the last 11 years. Methods: From March 1996 to March 2006, 38 submucous cleft palate patients received Furlow palatoplasty. 10 developmentally delayed patients were excluded and 5 patients were lost to follow up. The rest 23 patients were reviewed. Speech was evaluated preoperatively and postoperatively, and speech therapy was performed accordingly. Perceptual speech assessment included hypernasality, nasal emission and articulation disorder. Cinefluorography was performed to aid perceptual assessment. Based on timing of operation, the patients were divided into 3 groups as following: Group A under 24 months(8 patients), Group B from 25 to 48 months(6 patients), and Group C over 49 months (9 patients). Except 1 patient under speech therapy yet, resultant speech was compared. 200707Results: The rate of abnormal speech was higher in Group C(3/9, 33.3%) than in Group A(0%) or B(0%). All 3 patients who had been discontinued of speech therapy from the parent's judgment had abnormal speech. The reason for the discontinuation was that the regular speech therapy was a burden at school age. Any patients who had continued speech therapy had normal speech. Conclusion: The results of our study shows that operative timing is associated with speech development. Maintenance of speech therapy was an important factor for normal speech development. It will be helpful to perform a palatoplasty before 48 months of age to complete speech therapy before the school age.