• Journal of Chest Surgery
• /
• v.32 no.12
• /
• pp.1093-1099
• /
• 1999

배경 : 류마티스성 승모판막 폐쇄부전증과 퇴행성 승모판막 폐쇄부전증에서 승모판막 성형술의 결과와 비교하여 류마티스성 승모판막 폐쇄부전증에서도 승모팍막성형술이 적합한 치료방법이 될 수 있는지를 알아보았다. 대상 및 방법 : 95년 1월부터 98년 12월 까지 승모판막 성형술을 시행받은 184명의 환자중에서 류마티스성 승모판막 폐쇄부전증 49례(1군)의 퇴행성 승모판막 폐쇄부전증 78례(2군)를 대상으로 하였다. 평균연령은 1군이 36.3$\pm$14.6(16-74세) 2군은 52.5$\pm$13.4(14-77)세였다 총 추적 관찰기간은 1군이 72.2인년 2군이77.2인년이었다 두군에서 수술후와 수술후 6개월 1년 및 이후 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과 : 두 군간에 수술전 혈류역학적인 차이를 보이지 않았고 수술전 평균 승모판막 폐쇄 부전의 정도는 1군이 3.0$\pm$0.4, 2군이 3.9$\pm$0.3였으나 수술후 추적 관찰에서 각각 0.9$\pm$0.9와 0.8$\pm$0.7정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의 변화나 승모판막에서의 평균압력차이 등 혈류역학적인 결과에도 차이를 보이고 있지 않았다 수술조기 사망과 후기 사망은 없었으며 재수술율은 1군이 인년대비 1.4% 2군이 인년대비 2.6%였고 색전발생율은 1군이 인년대비 2.8% 2군이 1.3%였다. 심내막염발생은 1군에서만 1례있었으며 상기 결과들에서 두군간에 의미있는 차이를 보이고 있지는 않았다 결론 : 향후 장기적인 추적 관찰이 필요하나 중기 성적에서 승모판막 성형술이 류마티스성 승모판막 폐쇄 부전증에서도 효과적인 치료방법임을 알수 있었다.다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.X>에서 $1,332.75{\mu}g/mL$으로 최 대값을 나타내었으며, 추출시간 4.24시간 및 시료에 대한 용매비 9.71 mL/g에서 가장 높게 나타났다. 추출온도가 높고, 추출시간이 증가할수록 총 polyphenol 함량이 증가하는 경향을 나타내었다. Gallic acid 함량은 $65.84^{\circ}C$에서 $30.51{\mu}g/mL$으로 최대값을 나타내 었으며, 추출시간 1.65시간 및 시료에 대한 용매비 17.17mL/g에서 가장 높은 추출율을 보였다. Gallic acid 함량에 대한 추출조건의 영향은 추출시간과 용매비에 영향을 받는 것으로 나타났으며, 설정된 범위 내에서 온도에 대한 영향은 거의 나타나지 않는 것으로 나타났다. 실험연구가 더 필요하리라 본다. 혈액학적 변화를 유도하고 환자의 연령, 혈소판 수, 대동맥 차단 시간, 체외 순환 시간, 술후 PT 및 aPTT와 같은 다인적 상황들이 술후 출혈에 영향을 미친다는 점들을 시사하고

• Journal of Chest Surgery
• /
• v.42 no.6
• /
• pp.732-737
• /
• 2009

Background: Many video-assisted thoracic surgery (VATS) lobectomies are performed as a potential alternative to thoracotomy despite the controversy about the safety and the associated morbidity/mortality rates. Material and Method: Between November 2006 and August 2008, we performed 87 lobectomies (VATS 36, Thoracotomy 51) and we retrospectively reviewed the surgical treatment results. A VATS lobectomy was performed by a 4~5 cm thoracotomy without rib spreading and this included anatomic hilar dissection, individual vessel and bronchus stapling and lymph node dissection. Result: We studied 52 male and 35 female patients whose age ranged from 6 to 79 (average age: $59.8{\pm}15.0$ years). The cases were diagnosed with lung cancer (66) (SQC 24, ADC 38, others 4), pulmonary metastasis (2), carcinoid (2) and benign diseases (17). There was no intraoperative death. Postoperative complications were seen in 5 (15.6%) VATS and 33 (64.7%) thoracotomies, and perioperative death caused by adult respiratory distress syndrome occurred in 1 (2.8%) VATS and 3 (5.9%) thoracotomies. Three patients Underwent conversion to thoracotomy (8.3%). The mean time to chest tube removal was 6 days for VATS and 9.4 days for thoracotomy (p<0.001), and the mean length of the hospital stay was 8 days for VATS and 12.8 days for thoracotomy (p<0.001). Conclusion: VATS lobectomy can be performed safely with low morbidity/mortality rates. Furthermore, all the patients benefited from earlier postoperative rehabilitation and less pain and they were candidates for an earlier return to normal activities.

• Journal of the Korean Society of Radiology
• /
• v.8 no.4
• /
• pp.181-187
• /
• 2014

The purpose of this study were to analyze the characteristic of the glow curves in order to the glow temperature of the thermoluminescent dosimeters (TLDs) for the absorbed dose measurement of the radiation therapy. In this study, we was used the TLDs of the LiF:Mg${\cdot}$Ti, LiF:Mg${\cdot}$Cu${\cdot}$P, $CaF_2$:Dy, $CaF_2$:Mn (Thermo Fisher Scientific Inc., USA). The source-to-solid dry phantom (RW3 slab, IBA Dosmetry, Germany) surface distance was set at 100 cm, and the exposure dose of 100 MU (monitor unit) was used 6- and 15-MV X-rays, and 6- and 12-MeV electron beams in the reference depth, respectively. After the radiations exposure, we were to analyze the glow curves by using the TL reader (Hashaw 3500, Thermo Fisher Scientific Inc., USA) at the fixed heating rate of $15^{\circ}C/sec$ from $50^{\circ}C$ to $260^{\circ}C$. The glow peaks, the trapping level in the captured electrons and holes combined with the emitted light, were discovered the two or three peak. When the definite increasing the temperature of the TLDs, the maximum glow peak representing the glow temperature was follow as; $LiF:Mg{\cdot}Ti$: $185.5{\pm}1.3^{\circ}C$, $LiF:Mg{\cdot}Ti$: $135.0{\pm}5.1^{\circ}C$, $CaF_2$:Dy: $144.0{\pm}1.6^{\circ}C$, $CaF_2$:Mn: $294.3{\pm}3.8^{\circ}C$, respectively. Because the glow emission probability of the captured electrons depend on the heating temperature after the exposure radiation, TLDs by applying the fixed heating rate, the accuracy of measurement will be able to improve within the absorbed dose measurement of the radiation therapy.

• Childhood Kidney Diseases
• /
• v.9 no.1
• /
• pp.64-68
• /
• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• Childhood Kidney Diseases
• /
• v.9 no.1
• /
• pp.15-20
• /
• 2005

Purpose : Nutcracker syndrome must be considered when hematuria or proteinuria occurs in a healthy child. The purpose of this study is to investigate the prevalence of nutcracker syndrome among children with asymptomatic hematuria or proteinuria, and to obtain the ratios of the peak velocity of the left renal vein between the aortomesenteric portion and the hilar portion in children with asymptomatic hematuna or protelnuria in which nutcracker syndrome was excluded and to observe whether the ratios are affected by sex, age or urinalysis findings. Methods : Using Doppler ultrasonography, we measured the flow velocity and obtained the peak velocity ratios of the left renal vein at the aortornesenteric portion and at the hilar Portion of the left kidney in children with asymptomatic hematuria or proteinuria who visited the Division of Pediatric Nephrology, Severance Hospital from May 2001 to March 2004. Results : Of 304 children with asymptomatic hematuna or proteinuria, 107 children(35.2%) were diagnosed with nutcracker syndrome. For 197 children with asymptomatic hematuria or proteinuria excluding nutcracker syndrome, the mean ratio of the peak velocity was 2.54 $\pm$0.73, which was not affected by sex, age or urinalysis findings. Conclusion : Nutcracker syndrome was the major cause of asymptomatic hematuria or proteinurla In children, comprising 35% of all cases. Doppler ultrasonography was helpful in the screening of nutcracker syndrome and prevention of its complications. For children with asymptomatic hematuria or proteinuria excluding nutcracker syndrome, the peak velocity ratio of the left renal vein did not differ from that of normal children and was not affected by sex, age or urinalysis findings. (J Korean Soc Pediatr Nephrol 2005;9:15-20)

• Childhood Kidney Diseases
• /
• v.10 no.1
• /
• pp.27-32
• /
• 2006

Purpose : Conservative management of multicystic dysplastic kidney(MCDK) without nephrectomy has recently been advocated. The purpose of this study was to determine the clinical course of conservatively managed MCDK and to find out possible predictive factors for involution of MCDK by ultrasonography(US). Methods : A retrospective analysis was made on 45 patients(26 boys and 20 girls) in whom MCDK was detected and had been traced by US between Dec. 1993 and Aug. 2005 at Severance Hospital. Results : Median follow-up time was 30 months(range 2-102 months). All patients under-went radionuclide scans and voiding eystourethrograms. The serial follow-up US showed complete involution in 11(24%), partial involution in 19(41%), and no interval change or increased in cyst size in 13(28%) patients. Nephrectomy was done in 3 patients(7%) due to relapsing urinary tract infection(UTI) and severe abdominal distension. The mean age of complete involution of MCDK was 37 months(range 12-84 months). Episodes of UTI were present in 17 patients(37%) and additional genitourinary(GU) abnormalities were found in 22 patients(44%). Hypertension and renal insufficiency was complicated in one patient. No child developed malignant tumor. Univariate analysis showed that five variables were associated with complete involution of the MCDK; gender, site, UTI episode, additional GU abnormalities, and renal length on initial US. After adjusting using the Pearson model, the presence of additional GU abnormalities was exclusively associated with complete involution among the 5 variables(P=0.034). Conclusion : In our review of 46 cases of MCDK, non-surgical approach for patients with MCDK was advisable and we could predict poor prognosis when MCDK is associated with other GU anomalies.

• Childhood Kidney Diseases
• /
• v.7 no.2
• /
• pp.157-165
• /
• 2003

Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management.

• Childhood Kidney Diseases
• /
• v.14 no.1
• /
• pp.22-31
• /
• 2010

Purpose : This study was performed to evaluate the relationship between glomerular basement membrane (GBM) alterations to epithelial cell (EpC) structure and renal function in Alport Syndrome (AS) patients. Methods : Fifteen patients diagnosed with AS (4-26yrs) were examined. The GBM in AS was categorized as : C1) normal, C2) minor alterations (widening of lamina rara interna or externa without lamina densa change), C3) nonspecific splitting of lamina densa, C4) basket-weaving pattern of lamina densa splitting. The length of each GBM portion along the epithelial side was measured on the systematically obtained electron microscopic photographs. Furthermore to obtain an objective assessment of the degree of glomerular EpC foot process change, the number of slit pores along $10\;{\mu}m$ of peripheral GBM in each category was obtained. Results : The percentage of normal GBM portion (C1) correlated inversely with daily protein excretion (g/day/$m^2$, P<0.05) and sum of the percentage of abnormal GBM portion (C2+C3+C4) had direct correlation with daily protein excretion (g/day/$m^2$, P<0.05). There were no significant relationships between the percentages of other categories of GBM alterations and creatinine clearance or protein excretion. There were no significant relationships between of creatinine clearance in relation to normal GBM(C1) portion as well as that in relation to sum of the percentage of abnormal GBM portion (C2+C3+C4). GBM abnormality did not correlate with age at biopsy. Conclusion : The extent of GBM structural abnormality is related to proteinuria in AS but the epithelial response is uniform even though the GBM ultrastructural lesions are not.

• Horticultural Science & Technology
• /
• v.28 no.3
• /
• pp.403-408
• /
• 2010

This study was carried out to investigate the physiological responses of $Rhododendron$ $mucronulatum$ Turcz. and $R.$ $indicum$ (L.) Sweet seedlings with 0%, 35%, 55% and 75% shading of full sunlight in polyethylene film house. The shading treatments were performed during the late growth season for each species (from Sept. 9 to Nov. 5, 2008). The shading treatment was effective in reducing the daily temperature by 0.9 to $1.7^{\circ}C$ during September and by 0.8 to $1.7^{\circ}C$ during October. Before the shading treatments, the water content of $R.$ $mucronulatum$ and $R.$ $indicum$ amounted to 68.5% and 66.3%, respectively. The water contents of two species after 75% shading treatment period decreased to 66.2% (3.4% reduction) and 65.9% (0.6% reduction), respectively. Notably, both species had a similar tendency indicating less reduction rate of water content with 75% shading. $R.$ $indicum$ showed higher photosynthetic capacity with higher level of shading, and its photosynthetic capacity reached the highest level ($9.63{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$). On the other hand, shading-treated $R.$ $indicum$ showed higher intercellular $CO_2$ concentration, stomatal conductance and transpiration rate (55% shading > 35% shading > 75% shading) than non-treated ones. In addition, non-treated seedlings showed higher water use efficiency than treated ones. In particular, it was found that the leaf color of $R.$ $mucronulatum$ turned equivalent to purple under full sunlight, while its leaf color kept equivalent more to green with higher level of shading, as evidenced even in naked eyes. According to comprehensive analysis using Munsell Color Chart on potential leaf color variations of $R.$ $mucronulatum$ depending on the level of shading, it was found that relatively many leaf colors under full sunlight were equivalent to R (red) and Y (yellow) chart, while relatively many leaf colors with higher level of shading were equivalent to G (green) and Y chart, where the latter still showed green color.

• Journal of KIISE:Databases
• /
• v.28 no.4
• /
• pp.742-757
• /
• 2001

Since database management systems(DBMSS) have limited lock resources, transactions requesting locks beyond the limit mutt be aborted. In the worst carte, if such transactions are aborted repeatedly, the DBMS can become paralyzed, i.e., transaction execute but cannot commit. Lock escalation is considered a solution to this problem. However, existing lock escalation methods do not provide a complete solution. In this paper, we prognose a new lock escalation method, adaptive lock escalation, that selves most of the problems. First, we propose a general model for lock escalation and present the concept of the unescalatable look, which is the major cause making the transactions to abort. Second, we propose the notions of semi lock escalation, lock blocking, and selective relief as the mechanisms to control the number of unescalatable locks. We then propose the adaptive lock escalation method using these notions. Adaptive lock escalation reduces needless aborts and guarantees that the DBMS is not paralyzed under excessive lock requests. It also allows graceful degradation of performance under those circumstances. Third, through extensive simulation, we show that adaptive lock escalation outperforms existing lock escalation methods. The results show that, compared to the existing methods, adaptive lock escalation reduces the number of aborts and the average response time, and increases the throughput to a great extent. Especially, it is shown that the number of concurrent transactions can be increased more than 16 ~256 fold. The contribution of this paper is significant in that it has formally analysed the role of lock escalation in lock resource management and identified the detailed underlying mechanisms. Existing lock escalation methods rely on users or system administrator to handle the problems of excessive lock requests. In contrast, adaptive lock escalation releases the users of this responsibility by providing graceful degradation and preventing system paralysis through automatic control of unescalatable locks Thus adaptive lock escalation can contribute to developing self-tuning: DBMSS that draw a lot of attention these days.