• Title/Summary/Keyword: 안전확보

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Minimally invasive cardiac surgery with the partial mini-sternotomy in children (소아연령군에서의 부분흉골소절개를 통한 최소침투적심장수술)

  • 이정렬;임홍국;성숙환;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.466-471
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    • 1998
  • Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

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An Influence of Modified Robicsek Sternal Wiring after Median Sternotomy on the Postoperative Sternal Wound Infection (정중 흉골 절개 후 시행한 변형 Robicsek 흉골 봉합법이 수술 후 흉골감염에 미치는 영향)

  • Chang, Won-Ho;Youm, Wook;Kim, Dong-Hyun;Oh, Hong-Chul;Han, Jung-Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.763-769
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    • 2009
  • Background: In the majority of cases, sternal instability and wound infection concomitantly present after a cardiac operation following conventional median sternotomy, and these complications have a major influence on the postoperative course. The aim of this study is to compare the results of the different sternal wiring techniques of sternal infection. Material and Method: Between April 2004 and December 2008, 157 adult patients underwent cardiac in group A, whereas 71 patients who had undergone modified Robicsek sternal wiring were included in group B. The incidences of sternal wound complications in the two groups were assessed. Result: The mean age of the group B patients was older than that of the group A patients ($61{\pm}10$ years vs $57{\pm}13$ years). The incidence of preoperative left ventricular dysfunction (ejection fraction <30%), chronic obstructive pulmonary disease, renal failure requiring dialysis and diabetes mellitus were significantly higher in Group B, whereas the other perioperative risk factors for infection were not significantly different between the two groups. Two patients in group A experienced superficial wound infection, whereas 4 patients in group B displayed superficial wound infection, but the difference was not statistically significant (p=0.255). Yet poststernotomy deep sternal wound infection appeared in 6 patients of group A, whereas none of the patients in group B displayed this malady. Conclusion: The modified Robicsek sternal wiring technique showed greater sternal stability even for the patient with a high risk for infection, and the technique caused a lower incidence of deep sternal wound infection.

Molecular Characterization and Toxin Profile of Bacillus cereus Strains Isolated from Ready-to-eat Foods (유통 중인 즉석·편의식품류에서 분리한 Bacillus cereus의 산생 Toxin 및 분자유전학적 특성 조사)

  • Kim, Tae Sun;Kim, Min Ji;Kang, Yu Mi;Oh, Geune;Choi, Su Yeon;Oh, Mu Sul;Yang, Yong Shik;Seo, Jung-Mi;Ryu, Mi-Geum;Kim, Eun-Sun;Ha, Dong-Ryong;Cho, Bae Sik
    • Korean Journal of Food Science and Technology
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    • v.46 no.3
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    • pp.334-340
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    • 2014
  • Toxin-producing Bacillus cereus is the causative agent of two different types of food poisoning: the emetic and the diarrheal types. This study was conducted to investigate the presence of enterotoxin and emetic toxin genes in 263 B. cereus isolated from 619 different ready-to-eat food items. Hemolytic enterotoxins hblA, hblC, and hblD were detected in 85.6, 41.1, and 76.8%, respectively, of the B. cereus isolates. About 67.0% (175/263) of the isolates presented all of three genes. Non-hemolytic enterotoxins nheA, nheB, and nheC were detected in 100, 97.0, and 68.4% of the isolates, respectively. Approximately 90.0% (236/263) of the isolates presented all of these three non-hemolytic enterotoxin genes. Emetic toxin gene, CER, was detected in 132 of 263 (50.2%) isolates. Computer-assisted cluster analysis of Rep-PCR profiles showed a high genetic diversity among the isolates. All B. cereus isolates from food samples tested in this study carried at least 6 of 10 toxin genes.

Optimization of sterilization conditions for the production of retorted steamed egg using response surface methodology (반응표면분석을 이용한 레토르트 계란찜의 살균조건 최적화)

  • Cheigh, Chan-Ick;Mun, Ji-Hye;Chung, Myong-Soo
    • Korean Journal of Food Science and Technology
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    • v.50 no.3
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    • pp.331-338
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    • 2018
  • The purpose of this study was to determine the optimum sterilization conditions for the production of retorted steamed egg using response surface methodology. Sterilization processes for eighteen conditions using varying sterilization temperature ($X_1$), time ($X_2$), and method ($X_3$) as the independent variables were carried out through a $3^2{\times}2$ experimental factorial design. Quality evaluations after sterilization included measurements of $F_0$ value ($Y_1$), peak stress ($Y_2$), pH ($Y_3$), color value ($Y_{4-6}$), and organoleptic test [preference for appearance ($Y_7$), overall acceptability ($Y_8$), and preference for texture ($Y_9$) and egg taste ($Y_{10}$)]. Dependent variables ($Y_{1-10}$) of eighteen conditions were more affected by temperature and time than by the sterilization method. Eight factors were selected among the dependent variables as significant factors related to the quality of the steamed egg. Finally, by establishing an optimum range of each dependent variable and contour analysis, the optimum sterilization conditions for the production of steamed egg were determined to be $120^{\circ}C$ for 25 min using a 2-step sterilization process.

Establishments of Lead Standards through Monitoring Heavy Metals in Calcium, Chitosan, and Propolis Health Foods (칼슘, 키토산, 프로폴리스 건강보조식품중 중금속 모니터링을 통한 납기준 제정)

  • Kim, Mee-Hye;Chung, So-Young;Sho, You-Sub;Kim, Myung-Chul;Kim, Chang-Min
    • Korean Journal of Food Science and Technology
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    • v.33 no.5
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    • pp.525-528
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    • 2001
  • This study was conducted to estimate the contents of heavy metals in some health foods available on Korean markets. The samples were digested with microwave system, then analyzed using GF-AAS for the contents of lead (Pb), cadmium (Cd) and arsenic (As). The contents of mercury (Hg) were determined using a mercury analyzer. The average values of Hg, Pb, Cd and As in calcium (Ca) health foods were 0.007, 1.08, 0.02 and 0.48 mg/kg respectively. Those values in chitosan health foods were 0.001, 0.36, 0.01 and 0.03 mg/kg respectively. Those values in propolis health foods were 0.013, 4.96, 0.01 and 0.13 mg/kg, respectively. The health foods that contained cow bone powders had the highest lead contents. Based on the variation in lead contents of those products, it could be possible that they might be contaminated through raw materials and/or manufacuring process. Some propolis products were also very high in lead contents. There could be risks for some population, especially the aged who overtake those health foods, to have heavy intake of lead. Therefore, we established the lead standards of 3.0, 2.0 and 5.0mg/kg less than for Ca, chitosan and propolis health foods respectively, based on the Codex method.

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Morphometric Analysis of Distances between Sacral Hiatus and Conus Medullaris Using Magnetic Resonance Image in Korean Adult (자기공명영상을 이용한 한국 성인의 엉치뼈틈새와 척수원뿔 사이 거리 연구)

  • Park, Tai Soo;Hwang, Byeong-Wook;Park, Sang-Joon;Baek, Sun-Yong;Yoon, Sik
    • Anatomy & Biological Anthropology
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    • v.29 no.4
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    • pp.145-154
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    • 2016
  • The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients(88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was $62.8{\pm}9.4mm$ and the mean distance between SH and CM was $232.2{\pm}21.8mm$. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients(p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height(p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.

Hazard Analysis for the Cultivation Stage of Strawberry Farms for Securing Preliminary Data to Establish the Good Agricultural Practices (농산물우수관리제도 확립의 기초자료 확보를 위한 딸기농장 재배단계의 위해요소 분석)

  • Lee, Chi-Yeop;Lee, Won-Gyeong;Song, Jeong-Eon;Kim, Kyeong-Yeol;Shim, Won-Bo;Yoon, Yo-Han;Kim, Yun-Shik;Chung, Duck-Hwa
    • Journal of agriculture & life science
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    • v.46 no.3
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    • pp.97-108
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    • 2012
  • Physical, chemical and biological hazards of strawberry farms at the cultivation stage were analyzed to establish the GAP(Good Agricultural Practice) system. Samples were collected from the plants, cultivation environments(water, soil and air), and personal hygiene (hand, glove, and clothes) of three strawberry farms(A, B, and C) and were tested to analyze physical, chemical (heavy metals and pesticide residues), and biological(sanitary indications and foodborne pathogens) hazards. Physical hazards such as insects and pieces of metal and glass were found in the strawberry farms and can be potential bow for strawberry products. Heavy metal and pesticide residue as chemical hazards were detected at levels lower than the regulation limit. In case of biological hazards, total bacteria and coliform were detected at the levels of 1.6~7.3 and 1.3~5.6 log CFU/g, leaf, mL, hand or $100cm^2$. However, Escherichia coli was not detected in all samples. Bacillus cereus and Staphylococuus aureus were detected at levels of ${\leq}$ 1.1~6.1 log CFU and 4.7~5.4 log CFU/g, mL, hand or $100cm^2$, whereas Listeria monocytogenes, E. coli O157 and Salmonella spp. were not detected in all samples. This study demonstrates that various harzards were in strawberry farms at the growing stage. Therefore proper management such as GAP is needed to prevent the occurrence of food poisoning associated with the hazards revealed in this study.

Microbiological Hazard Analysis of Hot Pepper Farms for the Application of Good Agricultural Practices (GAP) System (농산물우수관리제도 (GAP) 적용을 위한 고추농가의 미생물학적 위해도 평가)

  • Nam, Min-ji;Heo, Rok-Won;Lee, Won-Gyeong;Kim, Kyeong-Yeol;Chung, Do-Yeong;Kim, Jeong-Sook;Shim, Won-Bo;Chung, Duck-Hwa
    • Journal of agriculture & life science
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    • v.45 no.6
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    • pp.163-173
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    • 2011
  • The objective of this study was to determine microbiological risk factors in hot pepper farms for the application of good agricultural practices (GAP). Samples were collected from cultivation environments and utensils, plants, workers, and air at 3 hot pepper farms located in Cheongsong, Korea and were tested to detect sanitary indications [aerobic plate bacteria (APC), coliform, and Escherichia coli], foodborne pathogens, and fungi. APC, coliform, and fungi were detected at the levels of 0.7~6.2, 0.2~4.7, and 0.4~4.3 log CFU, respectively, in the three farms. Four (4.4%; l leaf, l irrigation water, and 2 soil) of 90 samples collected were revealed to be E. coli positives. For foodborne pathogens, Staphylococcus aureus was only detected at $1.0log\;CFU/100cm^2$ in the worker's cloth of B farm, and Bacillus cereus was detected at the levels 1.0~2.5 log CFU in the cultivation environments and utensils and worker of B and C farms. However, other pathogens were not detected. The results demonstrated potential microbiological risks for hot pepper cultivated in the farms. Therefore, a management system to minimize the microbial risk such as GAP is required to ensure the safety of hot pepper.

Soil Management Techniques for High Quality Cucumber Cultivation in Plastic Film Greenhouse (고품질 시설하우스 오이재배를 위한 토양 종합관리 기술)

  • Hyun, Byung-Keun;Jung, Sug-Jae;Jung, Yeon-Jae;Lee, Ju-Young;Lee, Jae-Kook;Jang, Byoung-Choon;Chio, Nag-Doo
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.5
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    • pp.717-721
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    • 2011
  • In case of plastic film greenhouses cultivating fresh vegetables on paddy soil, soil characteristics must be considered as more important factor than any other factors. Generally after the four years of cultivation, soils tend to increase electrical conductivity value, nutrient unbalance and soil pests. As a result, degradation of agricultural products occurred, therefore it is necessary to improve soil conditions. In this study, yield and economic cost of cucumber were analyzed. The best soil conditions for cucumber cultivation were alluvial or valley in soil topology, moderately or poorly drainage in soil drainage classes, coarse loamy soil in texture. In addition, rich-sunlight and-deep groundwater would be proper for the cucumber cultivation. Good environmental managements of plastic film greenhouse were as follows. The temperature needed to be adjusted three times. The optimal daytime temperature could be $22{\sim}28^{\circ}C$, the one from 12 until night could be $14{\sim}15^{\circ}C$, and the temperature from 24 to sunrise could be $10{\sim}12^{\circ}C$. During plant growth period, soil moisture content was as low as 10~15%, and it needed to be maintained as 15~20% during reproductive growth period. To control pests, catch crop cultivation and solar treatment were carried out, after those EC was reduced and the root-knot nematode was controled too. Cucumber yield from the plot with improved soil managements increased to $158.4Mg\;ha^{-1}$, but plot with successive cropping injury yielded $140.3Mg\;ha^{-1}$. The income from the plot with improved soil managements was 215,676 thousand won $ha^{-1}$, the plot with successive cropping injury was 131,649 thousand won $ha^{-1}$. Income rate of each plot was 51.8% and 38.4%, respectively.

Establishment on Fertilizer Recommendation and Soil Characteristics of Rice Paddy with Environment-friendly Cultivation (농가실천 친환경 벼재배 논의 토양특성 및 시비추천량)

  • Yang, Chang-Hyu;An, Seung-Hyun;Kim, Taek-Kyum;Kim, Sun;Baek, Nam-Hyun;Choi, Weon-Young;Lee, Jang-Hee;Jeong, Jae-Hyeok;Kim, Si-Ju
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.3
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    • pp.347-352
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    • 2011
  • Environment-friendly agriculture (EFA) are aimed to reduce use of chemical inputs as possible the recycling of resources and the environment while preserving the local resources in the long term to ensure a constant productivity and profitability for producing safe food. This study was conducted to investigate characteristics on soil environment at paddy field of environment-friendly agriculture regions (EFARs) in Honam area. Survey point of EFARs Chungnam, Jeonbuk and Jeonnam, rice bran farming method in two districts, rice bran + snail farming method in eight districts, snail farming method in five districts and ducks farming method in three districts a total of 18 districts were selected. Annual of farming method, friendly-environment certification, amount of applied fertilizer, and history of cultivation to the farm household were surveyed. The content of available phosphate and silicate among the soil chemical properties in EFA paddy field were a little lower than optimum level, and those of agricultural methods fertilized with rice bran were a little lower than those of others. Hardness among the soil physical properties in EFA paddy field were a little lower than conventional practices, and that of agricultural methods fertilized with rice bran were a little lower than those of others. We showed fertilizer recommendation dose about soil nutritional shortages according to fertilization prescriptions index by crops.