• Title/Summary/Keyword: 수술실

Search Result 427, Processing Time 0.032 seconds

Analysis of 25-Hydroxy Vitamin D in the Aqueous Humor of Age-related Macular Degeneration Patients (습성 연령관련황반변성 환자에서 안구 방수 내 비타민 D 분석)

  • Song, Won Seok;Yoon, Won Tae;Kim, Yong-Kyu;Park, Sung Pyo
    • Journal of The Korean Ophthalmological Society
    • /
    • v.59 no.11
    • /
    • pp.1024-1029
    • /
    • 2018
  • Purpose: We examined aqueous humor levels of 25-hydroxyvitamin D (vitamin D) in patients with age-related macular degeneration to investigate possible relationships between aqueous humor vitamin D levels and clinical manifestations. Methods: Patients > 50 years of age, 52 eyes of 34 patients with age-related macular degeneration, and 23 eyes of 17 patients treated with cataract surgery without retinal disease, were examined for aqueous humor vitamin D levels and compared. The experimental group was divided into two groups according to the median value of aqueous humor vitamin D levels. We compared the clinical manifestations of macular degeneration in both groups and identified relationships between aqueous humor vitamin D levels and clinical features. Results: Vitamin D levels in the aqueous humor were significantly lower in the experimental group than in the control group (experimental, $10.03{\pm}10.1ng/mL$ vs. control group, $40.8{\pm}16.4ng/mL$; p < 0.001). Patients with high vitamin D levels in the macular degeneration group had a higher percentage of fibrovascular pigment epithelial detachments than those in the low grade group (high grade group, 65% vs. low grade group, 27%; p = 0.003). Multiple linear regression analysis showed a significant correlation between vitamin D levels and the total number of anti-vascular endothelial growth factor intravitreal injections within 6 months (standardize coefficient, ${\beta}=-0.336$). Conclusions: Patients with wet age-related macular degeneration had significantly lower vitamin D levels in the aqueous humor compared to control group subjects of similar ages. However, in patients with macular degeneration, low vitamin D levels were associated with a greater number of intravitreal injections, while higher levels of vitamin D may lead to more advanced forms of fibrovascular retinal pigment epithelium and related low vision. These relationships were not always constant, so further studies on the relationships between local vitamin D levels and ocular disorders are needed.

Improvement of Flood Forecasting System in the Nakdong River (낙동강홍수예보시스템 개선)

  • Yoon, Kwang-Seok;Lee, Min-Ho;Lee, Byung-Soo
    • Proceedings of the Korea Water Resources Association Conference
    • /
    • 2005.05b
    • /
    • pp.806-810
    • /
    • 2005
  • 홍수로 인한 국민의 재산과 인명피해를 방지 또는 최소화하기 위한 방법으로 주요지점을 선정하여 홍수예보를 수행하고 있다. 이러한 홍수예보는 초기 강우법, 수위법 등의 단순한 방법으로 수행되었으나, 컴퓨터가 발달되면서 여러 형태의 홍수유출모형이 개발되어 현재에는 홍수유출모형을 이용한 홍수예보를 수행하고 있다. 낙동강홍수예보 시스템은 1987년 낙동강홍수통제소의 개소시 42개소의 수위관측소와 54개소의 우량관측소를 중심으로 43개 소유역을 구분하고 티센망을 구성하여 홍수예보시스템을 구축하였다. 홍수예보시스템이 구축된 후 여러 차례의 매개변수 개선과정을 거쳐 운용하고 있다. 반면, 지속적인 수문관측소의 증설이 이루어졌으나 이를 모형에 반영하지 않아 증설된 수위관측소를 반영하여 114개 소유역으로 구분하고 추가된 우량관측소를 이용하여 티센망을 구성하였으며, 당초 반영되지 않았던 소규모댐을 모형에 추가하여 예측의 정확도를 재고하였다. 증설된 수문관측소를 모형에 반영과 함께 우량자료의 신뢰성 및 안정성을 확보하기 위한 우량관측소의 확장방안을 제시하였다. 본 연구에서 수행한 낙동강홍수예보 시스템의 소유역을 114개로 나누고 기존의 유효우량산정법, 유역유출모형 하도유출모형의 매개변수를 전통적인 방법으로 재산정하여 홍수기에 적용한 결과 당초의 홍수예보시스템으로 예측한 결과보다 소유역의 적절하게 재구성하는 것으로도 예측의 정밀도가 개선되었음을 확인할 수 있었다. 그러나, 소유역의 수와 하도의 수가 증가하면서 발생하는 오차를 감소시킬 필요성이 있으며, 이는 지속적인 시스템의 운용을 통하여 모형구성을 개선함으로서 어느 정도 개선될 것으로 판단된다. 그밖에 기존의 매개변수산정을 전통적인 방법에서 우리나라 하천 또는 낙동강유역의 하천에 적당한 방법을 개발하여 개선시킬 필요성이 있다.>$4.3\%$로 가장 근접한 결과를 나타내었으며, 총 유출량에서도 각각 $7.8\%,\;13.2\%$의 오차율을 가지는 것으로 분석되어 타 모형에 비해 실유량과의 차가 가장 적은 것으로 모의되었다. 향후 도시유출을 모의하는 데 가장 근사한 유출량을 산정할 수 있는 근거가 될 것이며, 도시재해 저감대책을 수립하는데 기여할 수 있을 것이라 판단된다.로 판단되는 대안들을 제시하는 예비타당성(Prefeasibility) 계획을 수립하였다. 이렇게 제시된 계획은 향후 과학적인 분석(세부평가방법)을 통해 대안을 평가하고 구체적인 타당성(feasibility) 계획을 수립하는데 토대가 될 것이다.{0.11R(mm)}(r^2=0.69)$로 나타났다. 이는 토양의 투수특성에 따라 강우량 증가에 비례하여 점증하는 침투수와 구분되는 현상이었다. 경사와 토양이 같은 조건에서 나지의 경우 역시 $Ro_{B10}(mm)=20.3e^{0.08R(mm)(r^2=0.84)$로 지수적으로 증가하는 경향을 나타내었다. 유거수량은 토성별로 양토를 1.0으로 기준할 때 사양토가 0.86으로 가장 작았고, 식양토 1.09, 식토 1.15로 평가되어 침투수에 비해 토성별 차이가 크게 나타났다. 이는 토성이 세립질일 수록 유거수의 저항이 작기 때문으로 생각된다. 경사에 따라서는 경사도가 증가할수록 증가하였으며 $10\% 경사일 때를 기준으로 $Ro(mm)=Ro_{10}{\times}0.797{\times}e^{-0.021s(\%)}$로 나타났다.천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보

  • PDF

Biventricular Repair of Critically III Neonate with Ebstein′s Anomaly - Report of 1 case - (증상이 심한 신생아 Ebstein 기형의 양심실성교정 -1례 보고-)

  • Kong, Joon-Hyuk;Kim, Woong-Han;Ryu, Jae-Wook;Lee, Seog-Ki;Baek, Man-Jong;Lim, Cheong;Kim, Soo-Cheol;Oh, Sam-Se;Na, Chan-Young;Kim, Soo-Jin;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
    • /
    • v.35 no.4
    • /
    • pp.303-306
    • /
    • 2002
  • Patients with severe Ebstein's anomaly showing in the neonatal period, represent progressive cardiac enlargement with pulmonary hypoplasia and functional pulmonary atresia with patent ductus alteriosus-dependent pulmonary circulation. Biventricular repair in these patients had been mostly unsuccessful except for Starnes' procedure that converts the anatomy to single ventricle physiology for Fontan procedure. A 4-days old male was admitted with the diagnosis of severe Ebstein's anomaly with anatomic pulmonary atresia and severe cardiac enlargement. He successfully underwent biventricular repair with vertical plication method of atrialized right ventricle, tricupid annuloplasty, transannular right ventricular outflow tract reconstrulltion, atrial septal defect patch closure with fenestration, and right atrial reduction angioplasty Postoperatively, cardiothoracic ratio was significantly reduced and mild tricuspid regurgitation was remnant in echocardiography. The patient is currently 10 months old and is fully active without restrictions.

Noninvasive Evaluation of Coronary Artery Bypass Graft Patency by Electron Beam Tomography (전자선 단층 촬영을 이용한 관상동맥 우회로 개존의 비침습적 평가)

  • 최규옥;김호석;조범구
    • Journal of Chest Surgery
    • /
    • v.32 no.8
    • /
    • pp.693-701
    • /
    • 1999
  • Recently non-invasive diagnostic imaging replaced the invasive catheter angiography in the diagnosis of vascular disease. Catheter methods are now almost confined to the purpose of intervention. Coronary artery or coronary artery bypass graft still needs catheter technique because of small diameter and the cardiac motion. The last challenge for radiologists in this domain is to obtain a non-invasive imaging. Electron beam tomography(EBT) for high temporal resolution is able to obtain a coronary arteriogram or coronary artery bypass graft (CABG), of which CABG imaging is quite useful for the evaluation of patency. In our experience as well as others, the accuracy of EBT angiogram in evaluating CABG patency revealed that the accuracy of patency of saphenous vein grafts(SVG) is high due to relatively wide lumen, short and straight course and less influence from cardiac motion. The sensitivity and specificity of patency of SVGs were 92%, 97% respectively in the prospective evaluat on and 100% each in the retrospective evaluation. A false positive and a false negative case are rudimentary errors in the initial learing period. In contrast the analysis of left internal mammary artery(LIMA) graft was difficult due to the inherent small size and the adjacent surgical clips provoking beam-hardening artifact; therefore, the method of combining 3 dimensional reconstruction and flow mode study was important in improving the accuracy of LIMA patency. The sensitivity and specificity of LIMA patency were 100% and 80% in both prospective and retrospective evaluation. Therefore, EBT angiography is an accurate non-invasive diagnostic modality for evaluating the patency of CABG, particularly in SVGs. The accuracy can be improved with the improvement of the EBT and the development of the image reconstruction software.

  • PDF

Modified Nikaidoh Procedure for Patient with TGA, Restrictive VSD, and PS (페동맥 협착과 심실중격결손을 동반한 대혈관 전위에서 시행한 변형 니카이도 술식)

  • Jeon, Jae-Hyun;Seong, Yong-Won;Kim, Woong-Han;Chang, Hyoung-Woo;Chung, Eui-Suk;Kwak, Jae-Gun
    • Journal of Chest Surgery
    • /
    • v.42 no.1
    • /
    • pp.87-91
    • /
    • 2009
  • The surgical management of complete transposition of the great arteries, ventricular septal defect, and pulmonary stenosis still remain a significant challenge. The Rastelli (REV procedure) remains the most widely applied procedure for surgical repair of these lesions. Although the Rastelli procedure can be performed with good early results, the intermediate- and long-term results have been less than satisfactory because of deterioration of the hemodynamic performance of the LVOT or RVOT. We performed a modified Nikaidoh procedure as an alternative surgical procedure in a 19-month-old boy weighing 10.4 kg with this anomaly. Aortic translocation with biventricular outflow tract reconstruction resulted in a more "normal" anatomic repair and postoperative echocardiography showed straight, direct, and unobstructed ventricular outflow.

Palynological and Revisional Studies of Thalictrum L. in Korea (한국산 꿩의다리속(Thalictrum L.) 식물의 화분학적 연구와 분류학적 재검토)

  • Jeon, Kyoungsuk;Heo, Kyeongin;Lee, Sangtae
    • Korean Journal of Plant Taxonomy
    • /
    • v.37 no.4
    • /
    • pp.447-476
    • /
    • 2007
  • The pollen and revisional study aimed for an elucidation of taxonomic delimitation and relationship of Thalictrum taxa in Korea, especially among the morphologically confused taxa. Pollen grains of 63 populations of 17 taxa were investigated by light and scanning electron microscopy. Although pollen morphology was not useful for the species classification, it revealed a tendency in which Sects. Physocarpum, Erythrandra and Tripterium having broad filaments and round-tipped anthers possess closer distance between adjacent pores, less echinus number per unit area, smaller pollen, and higher echinus, on the contrary to Sects. Omalophysa, Camptonotum and Thalictrum having filiform filaments and acute-acuminate- or more or less round-tipped anthers. The palynological result did not support several section system by Tamura (1992) but one section system by Lecoyer (1885). If a infrasectional system is needed, it was suggested that the system dividing the section into two (Clauiformes and Filiformes sensu Lecoyer) would be natural on the basis of stamen and pollen characteristics. Revisional study found out that 17 taxa(16 species) of Thalictrum are distributed in Korean including T. filimentosum which presence in Korea was not confirmed.

Tissue Failure of the Standard-Profile lonescu-Shiley Pericardial Valve in Mitral Position (승모판에서의 표준형 이오네스류 판막의 조직실패)

  • 김종환
    • Journal of Chest Surgery
    • /
    • v.29 no.10
    • /
    • pp.1111-1117
    • /
    • 1996
  • Structural deterioration of the bioprosthetic xenograft valves due to primary tissue failure occurs in two modes: from fatigue lesions with tear and wear with or without calcification and from calcification with obstruction. Two groups of consecutive 56 patients with the Hancock porcine ortic valve(HM) and of 1 13 patients with the standard-profile onescu-Shiley bovine pericardial valve(ISM) explanted from mitral position at the time of re-replacement surgery for primary tissue failure at Seoul national University Hospital until 1994, were studied for clinical and pathological features. Their ages at primary implant were 31.9 $\pm$9.2 years In HM and 30.4$\pm$ 12.5 years in ISM. Hemodrnamic dysfunction of the failed mitral bloprostheses were predominantly insufficiency in HM(64.3%) and stenosis in ISM(51.3%)(p<0.001). Pathologic findings of the explanted mitral valves reflected these hemodynamic changes, revealing failure more often from tissue damage(tears and wears) in HM and more often from calcification in ISM(p< 0.001). Explant period(from primary implant to explant) was relatively short in ISM(8.7$\pm$2.6years), compared with the one in HM(10.4 $\pm$2.6 years)(p<0.001). In conclusion, both the Hancock and the lonescu-shiley valves would fail from calcification as well as issue damage. However, while the Hancock porcine valves in mitral position failed more frequently from tissue failure and insufficiency, the standard-profile lonescu-Shiley pericardial valves did from calcification and stenosis, especially in young pAtients . Although the possibility of less occurrence of valve failure from mechanical reasons may be expected with newer generation bloprostheses, it does not seem to Improve durability significantly unless further refinement in antimineralization is achieved. Therefore, clinical use of the glutaraldehyde-treated bioprosthetic valves is, at present, limited to the patients of advanced age groups.

  • PDF

Development of A-ABR System Using a Microprocessor (마이크로프로세서를 이용한 자동청력검사 시스템 개발)

  • Noh, Hyung-Wook;Lee, Tak-Hyung;Kim, Nam-Hyun;Kim, Soo-Chan;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
    • /
    • v.46 no.2
    • /
    • pp.15-21
    • /
    • 2009
  • Hearing loss is one of the most common birth defects among infants. Most of hearing-impaired children are not diagnosed until 1 to 3 years of age - which is too late for the critical period (6 month) for normal speech and language development. If a hearing impairment is identified and treated in its early stage, child's speech and language skills could be comparable to his or her normal-hearing peers. For these reasons, hearing screening at birth and throughout childhood is extremely important. ABR (Auditory brain-stem response) is nowadays one of the most reliable diagnostic tools in the early detection of hearing impairment. In this study, we have developed the system that automatically detects if there is hearing impairment or not for infants or children. For future studies, it will be developed as a portable system to be able to take a measurement not only in sound proof room but also in nursery for neonates.

Surgical Repair of Single Ventricle (Type III C solitus) (단심실 -III C Solitus 형의 수술치험-)

  • naf
    • Journal of Chest Surgery
    • /
    • v.12 no.3
    • /
    • pp.281-288
    • /
    • 1979
  • For years, physicians and anatomists have been interested in the heart that has one functioning ventricle. Various terms have been suggested for this entity including single ventricle, common ventricle, double-inlet left ventricle, cor biatriatum triloculare, and primitive ventricle. In this report, the term "single ventricle" is utilized as suggested by Van Praagh, and is defined as that congenital cardiac anomaly in which a common or separate atrioventricular valves open into a ventricular chamber from which both great arterial trunks emerge. An outlet chamber, or infundibulum, may or may not be present and give rise to the origin of either of the great arteries. This definition excludes the entity of mitral and tricuspid atresia. An 11 year old cyanotic boy was admitted chief complaints of exertional dyspnea and frequent upper respiratory infection since 2 weeks after birth. He was diagnosed as inoperable cyanotic congenital heart disease, and remained without any corrective treatment up to his age of 11 year when he suffered from aggravation of symptoms and signs of congestive heart failure for 2 months before this admission. On 22nd of May 1979, he was admitted for total corrective operation under the impression of tricuspid atresia suggested by a pediatrician. Physical check revealed deep cyanosis with finger and toe clubbing, and grade V systolic ejection murmur with single second heart sound was audible at the left 3rd intercostal space. Development was moderate in height [135 cm] and weight[28Kg]. Routine lab findings were normal except increased hemoglobin [21.1gm%], hematocrit [64 %], and left axis deviation with left ventricular hypertrophy on EKG. Cardiac catheterization and angiography revealed 1-transposition of aorta, pulmonic valvular stenosis, double inlet of a single ventricle with d-loop, and normal atriovisceral relationship [Type III C solitus according to the classification of Van Praagh]. At operation, longitudinal incision at the outflow tract of right ventricle in between the right coronary artery and its branch [LAD from RCA] revealed high far anterior aortic valve which had fibrous continuity with mitral annulus, and pulmonic valve was stenotic up to 4 mm in diameter positioned posterolaterally to the aorta. Ventricular septum was totally defective, and one markedly hypertrophied moderator band originated from crista supraventricularis was connected down to the imaginary septum of the ventricular cavity as a pseudoseptum of the ventricle. Size of the defect was 3X3 cm2 in total. Patch closure of the defect with a Teflon felt of 3.5 x 4 cm2 was done with interrupted multiple sutures after cut off of the moderator band, which was resutured to the artificial septum after reconstruction of the ventricular septum. Pulmonic valvotomy was done from 4 mm to 11 mm in diameter thru another pulmonary arteriotomy incision, and right ventriculotomy wound was closed reconstructing the right ventricular outflow tract with pericardial autograft of 3 x 4 cm2. Atrial septal defect of 2 cm in diameter was closed with 3-0 Erdeck suture, and atrial wall was sutured also when rectal temperature reached from 24`C to 35.5`C. Complete A-V block was managed with temporary external pacemaker with a pacing rate of 110/min. thru myocardial wire, and arterial blood pressure of 80/50 mmHg was maintained with Isuprel or Dopamine dripping under the CVP of 25-cm saline. Consciousness was recovered one hour after the operation when his blood pressure reached 100 /70 mmHg, but vital signs were not stable, and bleeding from the pericardial drainage and complete anuria were persisted until his heart could not capture the pacemaker impulse, and patient died of low output syndrome 320 min after the operation.

  • PDF

GML Application: Developing of Data Model for Geological Information and Its Implementation (GML(Geography Markup Language) 응용: 지질주제정보 데이터 모델개발과 시험구현)

  • Lee, Ki-Won;Moon, Sun-Hee;Chi, Kwang-Hoon
    • 한국공간정보시스템학회:학술대회논문집
    • /
    • 2003.11a
    • /
    • pp.78-83
    • /
    • 2003
  • OGC(Open GIS Consortium, Inc.)에서 2000년에 XML의 지리정보 처리를 위한 GML 1.0이 제안된 이후 최근 GML 3.0이 발표되기까지 국제적으로는 다양한 GIS 응용분야에서 GML을 현실 문제에 이용하고자 하는 시도가 이루어지고 있다. 현재 우리나라에서도 국가 GIS(NGIS)에서 GML을 도입하여 국내 표준안으로 추진하고자 다양한 기반연구가 진행되고 있다. 본 연구는 중요한 GIS 응용중의 하나인 지질자원 정보 분야에서 GML을 활용하기 위한 기반연구로서 우리나라의 표준 지질도(또는 수치지질정보)와 기타 지질자원 정보 인프라 구축에 적용될 수 있는 다양한 지구과학자료를 대상으로 하였다. 따라서 본 연구에서는 지질자원 분야에서의 GML 응용을 위한 기반 데이터 모델과 이를 처리하기 위한 아키텍처를 UML 기법으로 설명하고, 이를 바탕으로 시험 구현된 운용환경에서 실제 대상 지역을 선정하여, 연구지역에 대한 지질자원 정보의 GML 적용 사례를 제시하고자 한다. 이를 위한 연구 내용으로는 수치 지질도를 XML-GML의 기본 스키마구조에 따라 엔코딩한 뒤, 주제정보의 표현을 위한 XSLT, SVG 파일 변환 처리 등을 수행하였다. 결론적으로 본 연구는 지질자원 분야의 정보화 인프라 구축을 목적으로 하는 기초 시험연구로 수행되었는 바, 우리나라에서는 2001년 이후 GIS 수치 주제도로서 수치 지질도의 보급이 활성화되면서, 이 정보를 제작/공급하는 기관이나 업무에 사용하는 기관 등에서 GML 기반으로 데이터를 제작하거나 운용이 가능할 것으로 생각된다. 또한, 다른 분야에서 GIS 주제정보를 다루는 경우에도 GML을 주제정보와 연계하여 현실 문제에 적용이 가능한 창조 모델로 이용될 수 있을 것으로 생각된다.}94,\;29.4{\pm}30.3,\;45.1{\pm}44$로 Mel 10군과 Mel 30군이 유의적인 감소를 보였으나(p<0.05) 이들 두 군 간의 차이는 나타나지 않았다. 이상의 결과로, 랫트에서 복강수술 후 melatonin 10mg/kg투여가 복강 내 유착 방지에 효과적이라고 생각된다.-1}{\cdot}yr^{-1}$로서 두 생태계에 축적되었다.여한 3,5,7군에서 PUFA 함량이 증가한 반면, SFA 함량은 감소하여 P/S 비율, n-3P/n-6P 비율은 증가하는 경향이었으며 이는 간장의 인지질, 콜레스테롤 에스테르, 총 지질의 지방산조성에서도 같은 경향을 볼 수 있었다.X>$(C_{18:2})$와 n-3계 linolenic acid$(C_{18:3})$가 대부분을 차지하였다. 야생 돌복숭아 과육 중의 지방산 조성은 포화지방산이 16.74%, 단불포화지방산 17.51% 및 다불포화지방산이 65.73%의 함유 비율을 보였는데, 이 중 다불포화지방산인 n-6계 linoleic acid$(C_{18:2})$와 n-3계 linolenic acid$(C_{18:3})$가 지질 구성 총 지방산의 대부분을 차지하는 함유 비율을 나타내었다.했다. 하강하는 약 4일간의 기상변화가 자발성 기흉 발생에 영향을 미친다고 추론할 수 있었다. 향후 본 연구에서 추론된 기상변화와 기흉 발생과의 인과관계를 확인하고 좀 더 구체화하기 위한 연구가 필요할 것이다.게 이루어질 수 있을 것으로 기대된다.는 초과수익률이 상승하지만, 이후로는 감소하므로, 반전거래전략을 활용하는 경우 주식투자기간은 24개월이하의 중단기가 적합함을 발견하였다. 이상의 행태적 측면과 투자성과측면의 실

  • PDF