• Title/Summary/Keyword: 우연성

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Congenital Left Atrial Appendage Aneurysm - A case report- (선천성 좌심방이류 - 1례 보고 -)

  • 김근직;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.827-830
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    • 1999
  • Congenital left atrial appendage aneurysm is a very rare congenital cardiac abnormality. That is postulated to arise from a developmental weakness in the atrial wall in utero. Clinically, patients are often asymptomatic and are diagnosed incidentally, but supraventricular arrhythmias and systemic thromboembolism have also been reported in some cases. Surgical resection at the time of diagnosis is recommended because of the propensity for thromboembolic complications. A 13-month-old female, who was suspected preoperatively as having partial absence of pericardium with left atrial herniation through the defect, underwent surgical resection of the left atrial appendage aneurysm. Exposure through a median sternotomy showed an intact pericardium. The postoperative course was uneventful.

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Evaluation of initial condition in rainfall-runoff model using the Satellite-based soil moisture data (위성 토양수분 데이터 기반 강우-유출모형 초기조건 산정)

  • Choi, Minha;SunWoo, Wooyeon
    • Proceedings of the Korea Water Resources Association Conference
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    • 2016.05a
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    • pp.109-109
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    • 2016
  • 유역의 물수지는 기상인자, 지형, 토양, 식생 등 여러 가지 인자들에 의해 결정된다. 물수지 분포를 평가하기 위해 수문모형의 모의 시 필요한 수문요소 조건들을 정보화하게 되며, 동시에 토양수분의 특성, 강우 입력자료, 유역의 지형학적 특성들은 불확실성에 기인하는 요소로 작용한다. 이러한 수문모형 모의 시 불확실성을 제거하기 위해 모형 초기조건에 대한 다각적인 분석이 선행이 필요하다. 특히 토양수분은 대기와 지표 사이의 상호작용에 작용하는 중요한 수문기상학적 인자로 평가되고 있다. 토양수분 데이터 자료를 이용하여 강우-유출모형의 입력자료를 구축하여 실제 토양수분의 변동성을 파악하는 연구가 활발히 진행되고 있으며, 유역기반의 유출현황을 산정하기 위해 매우 유용한 초기조건으로 그 역할이 기대된다. 현장에서 관측하는 토양수분 데이터는 넓은 유역의 토양수분을 대표하는 자료로 사용되기에는 한계점이 있으며, 위성기반 토양수분 데이터는 원격탐사를 통해 획득되기 때문에 토양수분의 시 공간적인 변동성 파악에 용의하며 경제성 또한 높다. 이에 따라, 본 연구에서는 유역의 수문순환 분석을 하고, 위성기반 토양수분의 적용 가능성을 평가하기 위해 Aqua위성에 탑재된 Advanced Mircowave Scanning Radiometer Earth Observing System(AMSR-E)와 Metop-A의 Advanced SCATterometer(ASCAT)의 토양수분 데이터를 이용하여 강우-유출모델의 초기조건을 산정하였다. 또한, 이에 대한 검증을 위해 기존 강우인자 초기조건 및 지점에서 관측된 토양수분 초기조건 등을 비교하여 통계분석을 실시하였다.

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Application of Westgard Multi-Rules for Improving Nuclear Medicine Blood Test Quality Control (핵의학 검체검사 정도관리의 개선을 위한 Westgard Multi-Rules의 적용)

  • Jung, Heung-Soo;Bae, Jin-Soo;Shin, Yong-Hwan;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.115-118
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    • 2012
  • Purpose: The Levey-Jennings chart controlled measurement values that deviated from the tolerance value (mean ${\pm}2SD$ or ${\pm}3SD$). On the other hand, the upgraded Westgard Multi-Rules are actively recommended as a more efficient, specialized form of hospital certification in relation to Internal Quality Control. To apply Westgard Multi-Rules in quality control, credible quality control substance and target value are required. However, as physical examinations commonly use quality control substances provided within the test kit, there are many difficulties presented in the calculation of target value in relation to frequent changes in concentration value and insufficient credibility of quality control substance. This study attempts to improve the professionalism and credibility of quality control by applying Westgard Multi-Rules and calculating credible target value by using a commercialized quality control substance. Materials and Methods : This study used Immunoassay Plus Control Level 1, 2, 3 of Company B as the quality control substance of Total T3, which is the thyroid test implemented at the relevant hospital. Target value was established as the mean value of 295 cases collected for 1 month, excluding values that deviated from ${\pm}2SD$. The hospital quality control calculation program was used to enter target value. 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T of Westgard Multi-Rules were applied in the Total T3 experiment, which was conducted 194 times for 20 days in August. Based on the applied rules, this study classified data into random error and systemic error for analysis. Results: Quality control substances 1, 2, and 3 were each established as 84.2 ng/$dl$, 156.7 ng/$dl$, 242.4 ng/$dl$ for target values of Total T3, with the standard deviation established as 11.22 ng/$dl$, 14.52 ng/$dl$, 14.52 ng/$dl$ respectively. According to error type analysis achieved after applying Westgard Multi-Rules based on established target values, the following results were obtained for Random error, 12s was analyzed 48 times, 13s was analyzed 13 times, R4s was analyzed 6 times, for Systemic error, 22s was analyzed 10 times, 41s was analyzed 11 times, 2 of 32s was analyzed 17 times, $10\bar{x}$ was analyzed 10 times, and 7T was not applied. For uncontrollable Random error types, the entire experimental process was rechecked and greater emphasis was placed on re-testing. For controllable Systemic error types, this study searched the cause of error, recorded the relevant cause in the action form and reported the information to the Internal Quality Control committee if necessary. Conclusions : This study applied Westgard Multi-Rules by using commercialized substance as quality control substance and establishing target values. In result, precise analysis of Random error and Systemic error was achieved through the analysis of 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T rules. Furthermore, ideal quality control was achieved through analysis conducted on all data presented within the range of ${\pm}3SD$. In this regard, it can be said that the quality control method formed based on the systematic application of Westgard Multi-Rules is more effective than the Levey-Jennings chart and can maximize error detection.

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Possibility of Clinical Philosophical Interpretation of Juyeok through Synchronicity (동시성을 통한 『주역』의 임상철학적 해석가능성)

  • Seok, Young-Jin
    • Journal of Korean Philosophical Society
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    • v.131
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    • pp.223-244
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    • 2014
  • In this paper, the author interprets Juyeok (The Book of Changes) as a philosophical book on self-culture instead of a book on divination. Juyeok, originally, was a book on divination written to tell fortunes; however, it has been a rich source producing the discourse of the humanities. This is because it has a unique system of linguistic symbols. Gwae-Hyo (Hexagrams and Horizontal Lines) system of Juyeok has a number of symbolic features, and there is too much room for new philosophical, cultural interpretations. Thus, Juyeok can be applied to any information and events, and it can, accordingly, help solve the problems of life we are facing. Moreover, Juyeok's unique characteristics are revealed very well in active intervention of persons who read and interpret it. Carl Gustav Jung is the very person who argued that one should interpret Juyeok through this active intervention. In the foreword of Juyeok translated by Richard Wilhelm, he mentions a possibility of the interpretation of Juyeok applying 'synchronicity.' According to him, Juyeok is a material not to predict the future or tell the fate ordained, but to look back on oneself or find the solutions of problems oneself. It allows the inquirer to interpret Gwae-Hyo-Sa (Explanations) not simply through the result of fortune-telling but the act of telling one's fortune. He applies 'synchronicity' to the finding of answers to one's problems in the given Gwae-Hyo-Sa. Synchronicity refers to 'the principle of non-causal relationship explaining a phenomenon of meaningful coincidence.' Here, simultaneity, unlike contingency the principle of causality refers to, means 'meaningful coincidence.' He presents a theory that the divination signs derived from Gwae-Hyo-Sang (Images) through synchronicity is a reflection of the psychology of the unconscious the fortune-teller or a man who receives the results of the divination signs has under certain circumstances on the outside. This is because Jung interprets it like this because the way of communication of Juyeok using symbolic language is not direct but indirect. Juyeok's system of symbolic language aims not at delivering objective knowledge, but the reader's self-transformation. This point can be applied in clinical philosophy. People who suffer from agony and pain in their daily lives may find meaningful and helpful advice for themselves no matter what Gwae-Hyo-Sa they choose in Juyeok. This is because it was originally hidden in their inner space and just revealed concretely through Gwae-Hyo-Sang or Gwae-Hyo-Sa in Juyeok. In this sense, we connect the meaning Gwae-Hyo-Sang or Sa contains from Juyeok to their circumstances, read counsel or advice needed ourselves and make it our own to be able to have power to change and help ourselves. And at this very point may be evaluated as an important role of Juyeok.

Surgical Repair of the Congenital Aneurysm of the Right Atrium (선천성 우심방 류의 수술치험 1례 보고)

  • 유양기;김정원;정성호;박정준;윤태진;서동만;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.56-59
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    • 2002
  • The four most common types of congenital malformations involving the right atrium(RA) and the coronary sinus(CS) are congenital enlargement of the RA, single RA diverticulum, multiple diverticula of the RA, and aneurysm of the RA or CS. A previously healthy 6year-old child was presented with signs of upper respiratory tract infection. Chest X-ray and echocardiogram revealed a severely isolated right atrial enlargement. The abnormally dilated right atrim was widely resected under cardiopulmonary bypass. Pathology revealed multifocal myocardial loss associated with mild fibrotic changes of the endocardium and epicardium Our experience on this rare congenital disease is presented along with a review of the literature.

An Inflammatory Myofibroblastic Tumor that Originated from the Posterior Mediastinum (후종격동에서 발생한 염증성 근섬유모세포종)

  • Song, Dong-Seop;Kim, Ji-Hoon;Chung, Won-Sang
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.145-148
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    • 2008
  • An inflammatory myofibroblastic tumor (IMT) is a rare disease and can occur in nearly every site of the body. The usual intrathoracic sites where an IMT has been recorded are the lung and bronchus. An IMT originating from the mediastinum has been rarely reported. A patient with a posterior mediastinal mass that was noticed incidentally on a chest X ray underwent mass extirpation. The pathologic diagnosis was an inflammatory myofibroblastic tumor. The tumor was positive for tuberculosis as determined by PCR. Tuberculosis can be thought to be the causative factor of the IMT in this case.

Clinical Significance of Focal Breast Lesions Incidentally Identified by $^{18}F-FDG$ PET/CT ($^{18}F-FDG$ PET/CT에서 우연히 발견된 국소 유방 병변의 임상적 의의)

  • Cho, Young-Seok;Choi, Joon-Young;Lee, Su-Jin;Hyun, Seung-Hyup;Lee, Ji-Young;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.456-463
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    • 2008
  • Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.

A Case of Multilocular Cystic Nephroma in Childhood (소아 다방성 낭포성 신종 1례)

  • Choi Min Sook;Lee Young-Mock;Kim Ji Hong;Kim Pyung Kil;Jeong Hyeon Joo;Kim Myung Joon
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.225-230
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    • 2001
  • Multilocular cystic nephroma is a rare disease, noninherited benign renal neoplasm occurring in both children and adults. It is necessary to make a differential diagnosis from all renal diseases with a cystic component, such as Wilms tumor, harmatoma or polycystic dysplastic kidney in childhood. There are about only 200 case reports in the world since Walter Edmunds had described it first. We report a case of multilocular cystic nephroma presented with painless abdominal mass, treated with nephrectomy and confirmed with pathology. (J. Korean Soc Pediatr Nephrol 2001 ;5 : 219-24)

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Congenital Intrapericardial Left Atrial Appendage Aneurysm Presenting with an Embolic Stroke - A case report - (뇌졸증을 병발한 선천성 심낭내 좌심방이류 - 1예 보고 -)

  • Suh, Jong-Hui;Kim, Yong-Hwan;Jeon, Hui-Kyung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.643-646
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    • 2008
  • Congenital intrapericardial left atrial appendage aneurysms (LAAA) are very rare. Most cases are asymptomatic and this malady is generally incidentally diagnosed in older patients. LAAAs are usually accompanied with supraventricular arrhythmias and life-threatening systemic embolism. Complete surgical correction is recommended immediately after the diagnosis to prevent significant complications, and even for the asymptomatic patients. We report here on the case of a 45-year-old man who presented with cerebral embolism due to LAAA. The patient was successfully treated with a resection of the aneurysm.

A case of vancomycin-induced drug hypersensitivity syndrome (반코마이신 투여 후 발생한 약물 과민성 증후군 1예)

  • Min, Kyung Sun;Choi, Woo Yeon;Song, Eun Song;Han, Dong Kyun;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1228-1231
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    • 2008
  • Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.