• Title/Summary/Keyword: 운동부

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The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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Pulmonary Thromboendarterectomy for Pulmonary Hypertension Caused by Chronic Pulmonary Thromboembolism (만성폐색전중으로 인한 폐동맥고혈압 환자에서 시행한 폐동맥내막절제술)

  • Song Seung-Hwan;Jun Tae-Gook;Lee Young-Tak;Sung Ki-Ick;Yang Ji-Hyuk;Choi Jin-Ho;Kim Jin-Sun;Kim Ho-Joong;Park Pyo-Won
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.626-632
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    • 2006
  • Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

Clinical features of children's brain tumors according to location (소아 뇌종양 발생위치에 따른 임상양상 고찰)

  • Han, Seung Jeong;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.76-81
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    • 2006
  • Purpose : This study evaluated the clinical characteristics of brain tumors in children according to their location, the parental delay and the doctor's delay between the onset of symptoms and the diagnosis of a pediatric brain tumor. In addition, this study compared the relationship between the pre-diagnostic symptomatic interval and the tumor location. Methods : A retrospective study was undertaken of 45 children with primary brain tumors admitted to Inha Hospital from July, 1986 to June, 2004. A diagnosis of the tumor location was made using brain MRI. Results : The male to female ratio was 1 : 0.67. The median age at diagnosis was 6.0 years in supratentorial tumors, 7.0 years in infratentorial tumors. Twenty four cases(53.3 percent) were located in the supratentorial area, 21 cases(46.6 percent) were located in the infratentorial area. The distribution of supratentorial tumors were 14(58.3 percent) in the cerebral hemisphere and temporal lobe, seven (29.1 percent) in the suprasellar area, and three(12.5 percent) in the pineal gland and posterial lateral ventricle. The distributions of the infratentorial tumors were 12(57.1 percent) in the cerebellar vermis and fourth ventricle, four(19.1 percent) in the brain stem, and five(23.8 percent) in the cerebellar hemisphere. The most common initial symptom was seizure(37.5 percent) in the supratentorial tumor and headache(38.0 percent) in infratentorial tumors. The median pre-diagnostic symptomatic interval (PSI) was 21 days(range 0-240 days). The median PSI with a parental delay in supratentorial tumor was six days(range 1-240 days), and 30 days(range 1-40 days) in the infratentorial tumor. We immediately diagnosed most cases after visiting the hospital. There was no significant relationship between the tumor location and the pre-diagnostic symptomatic interval. Conclusion : The most common symptom of supratentorial tumors and infratentorial tumors was seizure and headache, respectively. Although, the median pre-diagnostic symptomatic interval was shorter than in previous studies, a detailed medical history and a correctly interpreted neurological examination should lead to an earlier diagnosis of pediatric brain tumors.

A Study on the Improvement Plan through Current Status of Historical Park in Seoul (서울시 역사공원의 현황 고찰을 통한 개선 방안 도출)

  • Ko, Young-Kwon;So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.107-117
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    • 2016
  • In this study, six historical parks in Seoul is analyzed. Based on the analysis, the representative values of the historical parks in Seoul draw three criteria such as historicity, educational attributes, and sociality, and also the type of historic and cultural resources, spatial functions and arrangements, circulation and accessibility, and the type and usage of introduced facilities. Consequently the current status and improvement plan is suggested as follows. First, cultural assets oriented historical parks such as Sayuksin Bongeun and Seonnongdan historical Park focus on the management based on the preservation of historic and cultural resources. Non designated cultural heritages oriented historic parks such as Shingye Yanghwajin Itaewon-bugundang historic park should focus on the usages the symbolize and commemorate historic and cultural resources. Second, Careful attitudes on the historicity of the park are needed in the mixed type of historic and cultural resources that determine the identity such as Yanghwajin Itaewon-bugundang historic park. Third, the rate of facilities in Bongeun and Shingye historical park is increased due to the renovation of religion facilities, rather than the neighborhood parks. The autonomy of regulations that does not have the limits of the area of park facilities weaken the publicity of the historical parks. Fourth, Shingye historical park suggest changing its name into Danggogae martyrs' shrine historical park. because its historic and cultural resources are included as the historic park is named. Fifth, the current problems such as numerous uncontrolled entrances, mixed uses in circulation, and accessible failure due to the closure are recognized. Therefore, the entrances and circulations should be articulated clearly in order to increase opportunities of experience for visitors in the historic and cultural resources, and also neighborhood facility should be suitably divided. Sixth, the park facilities in the neighborhood parks are introduced equally in Seoul historical parks. The uses and arrangements that considered the circumstance of the historical parks should be determined in the cultural facilities such as outdoor music hall and sporting facilities. Seventh, historic facilities that named historic hall, culture hall, memorial hall, and promotion hall in the historic parks are utilized for convenience and religion facilities. Institutional framework should be examined to keep publicity in the historic parks by spatial privatization of the specific group.

Effects of Bombesin on Electrical and Mechanical Activities of Gastric Smooth Muscle Strips of Cats (적출한 고양이 위(胃) 평활근 절편의 전기적 및 기계적 활동에 미치는 Bombesin의 영향과 그 작용기전)

  • Park, Hyoung-Jin;Kwon, Hyeok-Yil;Suh, Sang-Won;Kim, Jeong-Mi;Lee, Tae-Hyung
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.39-49
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    • 1990
  • It has been reported that bombesin induces contraction of the smooth muscle of the gastrointestinal tract. Thus, the present investigation was undertaken to see an influence of bombesin on electrical activity of the gastric smooth muscle, since electrical activity is associated with contractile activity in the smooth muscle of the stomach. Smooth muscle strips $(5\;{\times}\;1.5\;cm)$ that included the corpus and antrum were prepared from the ventral and dorsal portion of the feline stomach along the greater curvature. Circular muscle strips $(1\;{\times}\;0.3\;cm)$ of the corpus were also obtained. Electrical activity of the corpus and antrum of the muscle strip was monophasically recorded by using Ag-AgCl capillary electrodes placed on the circular muscle layer. Contractile activity of the circular muscle strip was also recorded. The recordings were performed in Krebs-Ringer solution that was continuously aerated with $O_{2}$ containing 5% $Co_{2}$, and kept at $36^{\circ}C$. Dose-related responses of electrical activity and contractility to bombesin was studied after frequency of slow waves and contraction of each strip reached to a steady state. An action of $D-leu^{13}-{\psi}\;(CH_{2}NH)-D-leu^{14}-bombesin,\;D-pro^{2}-D-trp^{7,9}-substance\;P$, tetrodotoxin, hexamethonium, atropine, phentolamine or propranolol on the effect of bombesin was also observed. 1) Bombesin increased frequency of slow waves and contractions dose-dependently at concentrations from $10^{-9}\;M\;to\;3\;{\times}\;10^{-8}\;M$. 2) The bombesin analogue at a concentration of $3\;{\times}\;10^{-7}\;M$ antagonized the effect of bombesin on frequency of slow waves. 3) The effect of bombesin on frequency of slow waves was inhibited by tetrodotoxin $(10^{-6}\;M)$ and hexamethonium $(10^{-3}\;M)$ but unaffected by atropine $(10^{-6}\;M)$, phentolamine $(10^{-5}\;M)$ and propranolol $(10^{-5}\;M)$. 4) The effect of bombesin on frequency of slow waves was blocked by the substance P analogue at a concentration of $10^{-5}\;M$. 5) Substance P at a concentration of $10^{-5}\;M$ failed to change frequency of slow waves. It is concluded from the above results that bombesin increases the frequency of slow waves as well as contractions of the smooth muscle strip from the feline stomach, and the effect of bombesin might be mediated by non-cholinergic or non-adrenergic mechanism at neuromuscular junction. However, enteric nerves that have substance P as a neurotransmitter do not appear to participate in the action of bombesin on frequency of slow waves.

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Fusarium moniliforme Detected in Seeds of Corn and Its Pathological Significance (옥수수 종자(種子)에서 검출(檢出)된 Fusarium moniliforme와 그 병리학적(病理學的) 중요성(重要性))

  • Kim, Wan-Gyu;Oh, In-Seok;Yu, Seung-Hun;Park, Jong-Seong
    • The Korean Journal of Mycology
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    • v.12 no.3
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    • pp.105-110
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    • 1984
  • Seven seed samples of corn obtained from Kangweon Provincial Office of Rural Development, Kerea were tested for seed-borne fungi, and found that all the samples tested were infected with Fusarium moniliforme to an extent of $6.0{\sim}79.5%$. Severely infected seed samples showed poor germination on blotter. Seed component plating showed that the fungus present not only in tip caps, pericarps and endosperms, but also in embryos. Heavy infection of the fungus caused severe seed rot and seedling blight in soil, but the damage was not severe and many plants grew without any symptoms when the seeds with light infection were sown in soil. However the fungus was frequently detected from inside of the stems of healthy looking seedlings. The results indicate that the fungus transmit from seed to plant systemically. In inoculation experiments, the fungus produced stem rots on corn plants of 110 days old. The cultivar of Hwangok 3 was revealed more susceptible to the fungus than that of Suweon 19.

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A Study on the Nature-friendly Management Regarding the User Pattern of Yangjae Stream (양재천의 이용특성을 고려한 환경친화적 관리방안에 관한 연구)

  • Kim Sun-Hee;Hong Suk-Hwan;Bae Jung-Nam
    • Korean Journal of Environment and Ecology
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    • v.18 no.3
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    • pp.306-315
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    • 2004
  • Yangjae stream, stretching through Seocho-gu and Gangnam-gu, is a representative city stream with its environmentally friendly stream makeover project model, launched in 1995. The district of Gangnam-gu, the subject of this study, is under high pressure from the residents for its use as a huge residential areas close to the stream. The study has two main purposes. The first is to identify the condition and characteristic of utilization of Yangjae stream which is currently being increased in use by the stream restoration. Secondly, the study aims to suggest the environment-friendly management to accomplish arrangement of the naturally friendly stream based on the identification survey, The result from the user survey with 303 valid answer sheets show that the people from neighboring residential areas use this stream a lot doing exercising(51.8%) and taking a walk(24.4%) in their free time. Also regular use rate is high, and people are likely to use it alone(30.4%) or as a family(28.4%). With regard to the need of facility increase, even though the respondents required resting places in the shade(80.8%) most, overall, additional introduction of facilities was analyzed as unnecessary(78.8%). safety issue(22.0%) and a lack of convenience facilities(17.6%) and resting places in the shade(16.6%) are pointed as main problems while the users are generally satisfied(59.5%) with the stream. Improving walk-way and planting trees for shade on the slope were designed as a solution for these problems. For securing safety through improvement of walk-way, the scattering of pressure of current walk with building new walk using berms was presented. In order to increase safety on the walk-way(see above figure), the study proposes to build a new walk-way with berms to disperse excessive pressure. It also suggests the tree planting to provide shade in the stream and to make a provision for the planting of forest trees in the current law.

Laparoscopy-assisted Total Gastrectomy for Advanced Upper Gastric Cancer - Comparison with Open Total Gastrectomy - (진행위암의 복강경 보조 위 전절제술 - 개복 위 전절제술과의 후향적 비교 -)

  • Lee, Jun Hyun;Nam, Yoo Hee;Hur, Hoon;Jeon, Hae Myung;Kim, Wook
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.141-147
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    • 2008
  • Purpose: The aim of this study was to compare the short-term operative outcomes of laparoscopy-assisted total gastrectomy (LATG) with those of open total gastrectomy (OTG) for patients suffering with advanced upper gastric cancer. Materials and Methods: Of the 47 patients who underwent LATG with $D1+{\beta}$ or D2 lymphadenectomy from July 2004 to March 2008, 29 patients with pathologically proven advanced gastric cancer were compared with 35 patients who underwent conventional OTG during the same time period. The comparison was based on the clinicopathological characteristics, the surgical outcome, the follow-up survival and tumor recurrence. Results: The patients' age, gender and body mass index were similar between the two groups. However, there were statistically differences in tumor size ($9.2{\pm}3.9$ vs $6.1{\pm}3.6cm$, P=0.002) and the proximal resected margin ($2.1{\pm}2.0$ vs $3.6{\pm}2.1cm$ P=0.004). There was no significant difference in most of the peri- and post-operative courses such as the time to first flatus, the time to starting a solid diet and the length of the hospital stay, except for a longer operating time (289.0 vs. 361.3 minutes, P<0.001) in the LATG group. The complication rate was higher in the LATG group (13.8%) than that in the OTG group (5.7%). The mean overall survival and disease free survival times were 32 and 31 months, and 24 and 28 months, respectively, with an average 18.8 months follow-up duration. The main recurrent sites were peritoneum and lymph node in both groups. Conclusion: The early results of the current study suggest that LATG for AGC is technically feasible and it does not show any inferiorities of the postoperative outcomes as compared to those of conventional open total gastrectomy.

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Laparoscopy Assisted Total Gastrectomy with Lymph Node Dissection-77 Consecutive Cases (복강경 보조 위 전절제술-연속된 77예의 경험)

  • Lee, Joong-Ho;Song, Jye-Won;Oh, Sung-Jin;Kim, Sung-Soo;Choi, Won-Hyuk;Cheong, Jae-Ho;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.206-212
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    • 2007
  • Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

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Combined Effects of Biological Control Agent Two Native Shellfish on the Hibernal Diatom Bloom of Eutrophic Water (저온기 규조 발생억제를 위한 패류의 혼합적용)

  • Lee, Song-Hee;Hwang, Soon-Jin;Kim, Baik-Ho
    • Korean Journal of Ecology and Environment
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    • v.41 no.3
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    • pp.402-411
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    • 2008
  • Grazing effects of two freshwater shellfish, Unio douglasiae (UNIO) and Cipangoplaudina chinese malleata (CCM), on the hibernal diatom communities in eutrophic water was examined in a laboratory. Two animals having different feeding types used in the study were collected from Keum River (Boryeong, Korea), acclimatized in the artificial management system in a laboratory over at least one month, and starved in a laboratory for 2 days before the experiment. Experimental waters, which dominated by Synedra ulna-Scenedesmus sp. (ca. 80%), was collected from eutrophic lake, Lake Ilgam (Seoul) in Feb., 19, 2008 at AM 10:00, and used in the study after the filtration with 1 mm Nylon mesh. Feeding experiments were largely divided into three kinds of animal treatments; five densities of UNIO (U0, U1, U2, U3, U4) and CCM (C0, C1, C2, C3, C4), and four combined densities of two shellfish (M0, M1, M2, M3). U0 and C0 were control (no addition of UNIO or CCM), U1 or C1 (each animal density at 0.5 ind. $L^{-1}$), U2 or C2 (1.0 ind. $L^{-1}$), U3 or C3 (1.5 ind. $L^{-1}$), and U4 or C4 (2.0 ind. $L^{-1}$), respectively. Four combined treatments were consisted of M0 (no animals), M1 (U1+C3), M2 (U2+C2), and M3 (U4+C1), respectively. Under the presence of animal, the concentration of Chl-a and algal abundance were clearly decreased with the increase of UNIO density and the treated time, while in combined group a strong decrease of algal density showed with the increase of UNIO density. Total phytoplankton density shifted as the similar patterns to that of Chl-a concentration (r=0.6527, p<0.0001), however, there showed the differences following a species. There were strong decreases of dominant species Synedra ulna, Scenedesmus sp., Ankistrodesmus falcatus in UNIO treatment group, Diatoma vulgare in combined group, while Cryptomonas ovata in high density of CCM increased about 20% in algal density. Grazing rates (GRs) based on the concentration of Chl-a was depend on the kind of shellfish and treatment time; a strong feeding of CCM showed in the initial stage, and four hours later, UNIO and combined group with high UNIO density showed the high GRs. Interestingly, faeces production of shellfish was highest in combined group with high density of CCM, while their size over 60 ${\mu}m$ was much higher in production magnitude than that less 60 ${\mu}m$. Collectively, these results suggest that two domestic shellfish and its combined treatment have a strong potential as an effective biological controller of diatom bloom in cold eutrophic waters.