• Title/Summary/Keyword: 요로 폐쇄

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Study on the Growth of the Aortic Aannulus. Root, and Anastomosis After Arterial Switch Operation in Infancy (영아기에 시행한 동맥전환술 후의 대동맥판륜, 근부, 및 문합부위 성장에 관한 연구)

  • 이정렬;박정준
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.479-485
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    • 1997
  • We investigated changes of the size of neoaortic annulus, root, and aortic anastomosis after arterial switch operation for complete transposition of the great arteries performed in infancy. A total of 23 patients were included in this study. Age ranged from 6 to 153 days. Body weight averaged 3.9$\pm$0.8kg and 17 patients were male. The preoperative angiocardiographic dimensions of the pulmonary annulus, the pulmonary root, and the sinotubular junction, standardized to the diameter of descending aorta at the level of diaphragm, were compared to the size of postoperative measurements of the neoaortic annulus, the neoaortic root, and the aortic an stomosis at a mean interval of 17.2$\pm$ 9.4 months. Mean dimensions of the neoaortic annulus and the neoaortic root were significantly increased postoperatively(n=23, annulus; p<0.01, root; p<0.01), however, those of the aortic anastomosis did not reveal significant change(n=23, p=0.06). There were no significant differences in changes of diameters of the neoaortic annulus, the root, and the aortic anastomosis between patients with(n=8) and without(n=15) postoperative neoaortic regurgitation(annulus; p=0.32, root; p=0.29, anastomosis; p=0.86). Postoperative dimensions of the neoaortic root and annulus between patients with ventricular septal defect(n: 10) and without ventricular septal defect(ni 13) were not significantly changed compared to the preoperative measurements(annulus; p=0.09, root; p=0.07) but mean diameters of the aortic anastomosis decreased significantly after operation in patients with ventricular septal defect(p=0.04). This study revealed that the site of the aortic an stomosis grows in proportion to patient's somatic growth after arterial switch operation. Although we could not demonstrate the relation between the aortic root dilatation and the postoperative neoaortic regurgitation in this study, a continuous close follow-up might be necessary to detect a possible progression of the aortic root dilatation and the resulting significant aortic valve regurgitation.

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Angiographic Results of Radial Artery Grafts that are Used for Myocardial Revascularization (관상동맥 우회술 후 혈관조영술을 이용한 요골동맥의 개통률 분석)

  • Yie, Kil-Soo;Oh, Sam-Sae;Kim, Jae-Hyun;Shinn, Sung-Ho;Kim, Soo-Cheol;Seo, Hong-Joo;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.546-551
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    • 2007
  • Background: The radial artery is gaining widespread acceptance as complementary arterial conduits for surgical myocardial revascularization, but there have been limited reports about its angiographic patency compared with that of internal thoracic artery or saphenous vein. We tried to evaluate angiographic patency of radial artery graft and to compare that of radial artery and other gratis with retrospective manner. Material and Method: From January 2001 to Jure 2006, totally 132 patients (male 92, female 40) who underwent coronary artery bypass graft using radial artery were re-admitted to our hospital for follow up angiographic examination. Mean age was 58.2+8.87 and mean follow up duration was 32 month ($2{\sim}110$ month). Off pump and on pump bypass surgery were performed 74 and 58 patients respectively. Along with radial artery, left internal thoracic arteries were used in 57 cases, concomitant left internal thoracic artery and saphenous veins were used in 47 cases and bilateral internal thoracic arteries were used in 20 cases. Result: Totally 412 distal anastomosis were performed and 376 anastomosis remained patent (91.2%). Left internal thoracic artery showed the most excellent patency in all of the conduits (98.5%). Radial artery graft patency was 90.8% (169/186). There was no statistical difference of the patency by conduit between on-pump and off-pump group. But radial artery showed more higher patency rate (98/110, 89%) in the severe stenotic lesion that preoperatively revealed more than 90% stenosis than in the lesser severe (<90%) stenotic lesion (60/76, 78%)(p < 0.005). Radial artery conduit represented the worst result when it was grafted in the right coronary system. But when it was positioned in the left heart especially diagonal or obtuse marginal area, patency was comparable with left internal thoracic artery. Conclusion: Radial artery graft showed good midterm patency when it was used in the severe stenotic lesion more than 90% and left coronary system. But great notice should be taken when it is grafted in the right coronary system or less severe stenotic lesion.

An Improved Online Algorithm to Minimize Total Error of the Imprecise Tasks with 0/1 Constraint (0/1 제약조건을 갖는 부정확한 태스크들의 총오류를 최소화시키기 위한 개선된 온라인 알고리즘)

  • Song, Gi-Hyeon
    • Journal of KIISE:Computer Systems and Theory
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    • v.34 no.10
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    • pp.493-501
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    • 2007
  • The imprecise real-time system provides flexibility in scheduling time-critical tasks. Most scheduling problems of satisfying both 0/1 constraint and timing constraints, while the total error is minimized, are NP-complete when the optional tasks have arbitrary processing times. Liu suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on uniprocessors for minimizing the total error. Song et at suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on multiprocessors for minimizing the total error. But, these algorithms are all off-line algorithms. In the online scheduling, the NORA algorithm can find a schedule with the minimum total error for the imprecise online task system. In NORA algorithm, EDF strategy is adopted in the optional scheduling. On the other hand, for the task system with 0/1 constraint, EDF_Scheduling may not be optimal in the sense that the total error is minimized. Furthermore, when the optional tasks are scheduled in the ascending order of their required processing times, NORA algorithm which EDF strategy is adopted may not produce minimum total error. Therefore, in this paper, an online algorithm is proposed to minimize total error for the imprecise task system with 0/1 constraint. Then, to compare the performance between the proposed algorithm and NORA algorithm, a series of experiments are performed. As a conseqence of the performance comparison between two algorithms, it has been concluded that the proposed algorithm can produce similar total error to NORA algorithm when the optional tasks are scheduled in the random order of their required processing times but, the proposed algorithm can produce less total error than NORA algorithm especially when the optional tasks are scheduled in the ascending order of their required processing times.

Clinical Analysis of Ectopic Kidney in Children (소아 이소성 신장의 임상적 고찰)

  • Yook Jin-Won;Kim Ji-Hong;Kim Myung-Joon;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.196-202
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    • 1999
  • Purpose : When the mature kidney fails to reach its norml location in the renal fossa, the condition is known as ectopic kidney. Presenting symtoms can be various and it generally depend on the associated anomaly. Beside urologic anomalies such as hydronephrosis and vesicoureteral reflux, various anomalous vascular net work, skeletal anomaly or genital anomaly can be observed in this condition. Methods : Sixteen children with ectopic kidney was studied retrospectively to analyse initial presentation, accompanied anomaly and prognosis. Results : 56% of the children were accompanied with other urologic anomalies such as true incontinence and vesicoureteral reflux that required surgical treatment. 31% of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : Ectopic kidney can be often misdiagnosed as tumorous condition or as a surgical condition depend on the abnormal location of the kidney. Careful evaluation using abdominal sonogram, DMSA, VCUG and abdominal CT scan should be performed in order to search for associated anomalous condition and for proper management.

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Local Environments of Li in the Interlayer of Clay Minerals at Room and High Temperatures (상온 및 고온에서 점토광물 층간의 Li 환경)

  • Kim, Yeong-Kyoo;Lee, Ji-Eun
    • Journal of the Mineralogical Society of Korea
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    • v.20 no.3
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    • pp.193-201
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    • 2007
  • We used $^6Li$ and $^7Li$ MAS NMR to investigate the fate and local environments of Li in the interlayer of clay minerals such as hectorite, Woming-montmorillonite, beidellite, and lepidollite at room and high ($250^{\circ}C$) temperature. Although $^6Li$ NMR spectra show narrower peaks than those of $^7Li$ NMR, S/N ratio is low and there are no obvious differences in chemical shifts suggesting that it is difficult to apply $^6Li$ NMR to have information on the local environments of Li in the clay interlayers. $^7Li$ NMR spectra, however, show changes in the peak width and quadrupole patterns providing information on the local environments of Li in the interlayer even though changes in the chemical shift are not observed. In montmorillonite, two different local environments of Li are observed; one has a narrow peak with typical quadrupole patterns whereas another has a broad peak without those of the patterns. Changes in the peak width is also observed from broad to narrow in the $^7Li$ NMR spectra for beidellite but not for hectorite at high temperature. Our results suggest that the peak width change in the broad peak is attributed to the coordination changes in the water molecules around Li which is tightly bonded on the basal oxygen of Si tetrahedra as inner-sphere complexes. The narrow peak in montmorillnoite can be assigned to the Li bended as outer-sphere complexes.

A Case of Urologic Manifestation of IARS2-associated Leigh Syndrome (IARS2 유전자 연관 리 증후군(Leigh syndrome) 여아에서 방광기능장애 증례)

  • Hyunjoo Lee;Ji-Hoon Na;Young-Mock Lee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.1
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    • pp.25-30
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    • 2023
  • Leigh syndrome is a rare progressive neurodegenerative mitochondrial disorder with clinical and genetic heterogeneity. Recently, balletic IARS2 variants have been identified in a number of patients presenting broad clinical phenotypes from Leigh and West syndrome to a rare syndrome CAGSSS characterized by cataracts, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, and skeletal dysplasia syndrome (OMIM#616007). We describe a child with Korean Leigh syndrome with urologic manifestations resulting from a compound heterozygote mutation in IARS2. A 5-year-old girl visited the emergency room with a complaint of abdominal pain accompanied by abdominal distension. Abdominal-pelvic CT showed a markedly distended urinary bladder without definite obstructive lesions. She was diagnosed with neurogenic bladder dysfunction based on a urodynamic study. She had global delayed development due to neurologic regression after 6 months of age and a history of bilateral cataract surgery at the age of 2 years. Her brain magnetic resonance imaging showed symmetrically increased signal intensities in the bilateral putamen and caudate nuclei with diffuse cerebral atrophy. No gene variants were identified through whole-mitochondrial genome analysis. Whole exome sequencing was performed for diagnosis, and compound heterozygous pathogenic variants were identified in IARS2: c.2446C>T (p. Arg816Ter) and c.2450G>A (p. Arg817His). To the best of our knowledge, this is the first case report of bladder dysfunction manifestation in a patient with IARS2-related Leigh syndrome. Thus, it broadens the clinical and genetic spectrum of IARS2-associated diseases.

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Surgical Outcome of Tetralogy of Fallot in Adolt -Implication of Preoperative Cyanosis- (수술 전 청색증 정도에 따른 성인 활로씨 4징증의 임상 양상)

  • Kim Sang-hwa;Park Soon-Ik;Park Jung-Jun;Song Hyun;Lee Jae-Won;Seo Dong-Man;Song Meong-Gun;Song Jong-Min;Kang Duck-Hyun;Song Jae-Kwan;Jang Wan-Sook;Kim Young-Hwue;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.271-276
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    • 2005
  • We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.

Analysis of 1,000 Cases of Abdominal Ultrasonography Performed by a Pediatrician (소아과 의사에 의해 시행된 복부 초음파 검사 1,000예에 대한 분석)

  • Bae, Sang-In;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.28-35
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    • 2007
  • Purpose: The aim of this study was to evaluate the clinical usefulness of ultrasound examination of children performed by a pediatrician. Methods: One thousand children who presented with symptoms of a gastrointestinal disorder and underwent abdominal ultrasound evaluation in the Department of Pediatrics, between January 2003 and June 2006, were included in this study. We analyzed the patient's medical records and ultrasound results retrospectively. Results: Among the 1,000 patients, 58.4% were male and 41.6% were female. The mean age of the patients was $4.7{\pm}4.0$ years. The main reasons for ultrasound were abdominal pain (43.9%), vomiting (17.3%), elevated liver enzymes (11.8%), and jaundice (9.8%). Abnormal ultrasound findings were present in 57.9% of cases. The major abnormal findings were mesenteric lymphadenitis (29.2%), fatty liver (12.1%), hepatitis (6.4%), hepatosplenomegaly (6.2%), and acute appendicitis (4.8%). The time interval between the initial medical evaluation and the ultrasound evaluation was within 24 hours in most cases (78.5%). The main findings in children with abdominal pain were mesenteric lymphadenitis (32.6%), fatty liver (5.9%), intussusception (2.7%), and acute appendicitis (2.7%). The main findings in children with vomiting were mesenteric lymphadenitis (12.7%), hypertrophic pyloric stenosis (10.4%), and acute appendicitis (3.5%). The major ultrasound findings in children with urinary tract diseases were hydronephrosis (45.4%), urolithiasis (21.5%) and cystic renal disease (18.1%). Conclusion: Ultrasound examination played an important role as a non-invasive and prompt screening examination for detection of abdominal diseases. Ultrasound was an important tool for pediatricians to determine timely information for patient management.

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Cross-border Interaction and Cross-border City's Development in North Korea-China Borderland: A Case study of Dandong, Liaoning, China (월경적 상호작용과 북중 접경도시의 발전: 중국 랴오닝성 단둥시를 중심으로)

  • Joh, Young-Kug
    • Journal of the Economic Geographical Society of Korea
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    • v.20 no.3
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    • pp.307-330
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    • 2017
  • This paper attempts to elaborate on features of cross-border interaction conducted on Dan-dong, the main city of China-North Korea trade. Through the deep interview with some trader or firms and also questionnaire survey, this paper can reveal the supremacy of informal or non-market mechanism in the cross-border trade and inter-firm linkages, and also trader and firm's rent-seeking behaviour. These features show the uniqueness of border regime between China and North Korea. Even though it is getting more porous than before, I argue that China keeps the stance toward quite controlled borderland. As the proof of this argument, I show that main tenet of China's bordland policies is the borderland stability rather than the development. The striking one is the 'Prosperous Borders, Wealthy Minorities Program(??富民行???)'. In spite of the program's title, its utmost purpose is to secure the 'borderland stability and territorial integrity' rather than to enhance the border's openness and borderland's development.

Experimental Study of Performance of PEMFC Operated in Dead-End Mode (수소극 Dead-End 모드 고분자 전해질 연료전지의 실험적 연구)

  • Ji, Sang-Hoon;Hwang, Yong-Sheen;Choi, Jong-Won;Lee, Dae-Young;Park, Joon-Ho;Jang, Jae-Hyuk;Kim, Min-Soo;Cha, Suk-Won
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.34 no.6
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    • pp.643-648
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    • 2010
  • Portable fuel cells are commonly operated in the dead-end mode because of such as high fuel utilization. However, the performance of such systems deteriorates continuously with an increase in the amount of by-products such as water vapor and nitrogen. In this study, to verify the effect of water vapor on Proton Exchange Membrane Fuel Cells (PEMFCs), constant-load experiments were carried out for a current density of 600 mA/cm2 and a voltage of 0.4 V, respectively. The performance of the cell was more stable under constant voltage conditions than under constant current density conditions. Condensed water accumulated in the anode channel near the cell outlet. The experimental results show how the relative humidity (RH = 0.15, 0.4 and 0.75) of air at the cathode side affect the performance of PEMFCs with dead-end anode. At RH values higher than 0.15, the mean power density increased by up to 51% and the mean purge duration decreased by up to 25% compared to the corresponding initial values.