• Title/Summary/Keyword: 유출

Search Result 9,748, Processing Time 0.053 seconds

Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
    • /
    • v.41 no.5
    • /
    • pp.598-604
    • /
    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

Studies on Genetics and Breeding in Rainbow Trout(Oncorhynchus mykiss) VII. Fertilization of Fresh Egg with Co-Preserved Sperm and Ultrastructural Changes (무지개 송어의 유전 육종학적 연구 VII. 동결보존시킨 정자와 신선한 난모세포의 수정 및 미세구조적 변화)

  • PARK Hong-Yang;YOON Jong-Man
    • Korean Journal of Fisheries and Aquatic Sciences
    • /
    • v.25 no.2
    • /
    • pp.79-92
    • /
    • 1992
  • This study was carried out to develop new techniques useful for cryopreservation, thawing and artificial insemination, and ultrastructural changes of cryopreserved spermatozoa in rainbow trout(Oncorhynchus mykiss) . Two extenders, such as Tyrode solution and Whittingham's $T_6$ solution, were used to preserve rainbow trout sperm in refrigerator $(-20,\;-40\;and\;-70^{\circ}C)$ or liquid nitrogen $%(-196^{\circ})$. Hand-stripped semen was diluted to 1:16 with two extenders, an then the semen were frozen after mixing semen and each extender containing 1M or 1.5M DMSO solution to 1:1. After 60 days cryopreserved semen was thawed in a $13^{\circ}$ water bath, and subsequently centrifugated. After centrifugation at 1,000 rpm for 5 min thawed semen was washed with extenders, and then fertilized with fresh eggs. The results obtained in these experiments were summarized as follows: After cryopreservation, over 75% of spermatozoa were appeared motile and the survival rate was high. Following cryopreservation by the addition of cryoprotectant such as DMSO, methanol and glycerol, the fertilization rate of the thawed spermatozoa appeared over $99\%$ compared with the control having $99\%$ of fertilization rate. There was no difference between the control and experimental groups such as $(-20^{\circ}C\;-40^{\circ}C\;and\;-70^{\circ}C)$ and $-196^{\circ}$ in fertilization rate. Following cryopreservation at $-196^{\circ}$ by the addition of 1M DMSO of cryoprotectant, each fertilization rate following 24 hours and hatching rate following 24 days showed $96\%$ and $8\%$ by the addition of BSA, but showed $98\%\;and\;10%$ by no addition of BSA. Following 2 months of cryopreservation by the addition of 1M DMSO of cryoprotectant, there were $10%$ of hatching rate at $-196^{\circ}\;and\;10\%\;and\;35\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C$. Following 2 months of cryopreservation by the addition of 1M methanol of cryoprotectant, there were $22\%$ of fertilization rate at $-20^{\circ}C,\;and\;28\%,\;at\;-70^{\circ}C$ Following 2 months of cryopreservation by the addition of 1M glycerol of cryoprotectant, there were $22\%$ of fertilization rate at $-20^{\circ}C$, and $33\%,\;at\;-70^{\circ}C$. pollowing 2 months of cryopreservation by the addition of 1.5M DMSO of cryoprotectant, there were $27\%$ of fertilization rate at $-20^{\circ}C,\;an\;36\%\;and \;35\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C$. Following 2 months of cryopreservation by the addition of 1.5M glycerol of cryoprotectant, there were $34\% \;of\;fertilization\;rate\;at\;-20^{\circ}C, \;and\;31\%\;and\;31\%,\;respectively,\;at \;-40^{\circ}C\;and\;-70^{\circ}$. Following 2 months of cryopreservation by the addition of 1.5M methanol of cryoprotectant, there were $28\%$ of fertilization rate at $-20^{\circ}C,\;and\;29\%\;and\;28\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C.$ From 10 days and 15 days following fertilization at $13^{\circ}C\;and\;10^{\circ}C$, respectively, the mortality rate of fertilized ova was markedly increased. The middle piece of spermatozoa had two set of central doublets, nine set of outer coarse fibres, and mitochondrial sheath. Spermatozoa went through morphological changes during storage, e.g. winding of flagella, detachment of the nuclear envelope and the plasma membrane from the nucleus of the sperm head. There were $1\%$ abnormal spermatozoa in fresh sperm and about $15\%$ during storage.

  • PDF

A Study on the Nonpoint Pollutant Loadings in Urban and Agricultural Areas (도시(都市)와 농촌(農村)에서의 비점원(非點源) 오염물(汚染物) 배출양상(排出樣相)에 관한 연구(硏究))

  • Lim, Bong Su;Lee, Byung Hyun;Choi, Eui So
    • KSCE Journal of Civil and Environmental Engineering Research
    • /
    • v.4 no.2
    • /
    • pp.45-53
    • /
    • 1984
  • This study was conducted to investigate characteristics of nonpoint pollutant discharges and concentrations in runoff from the urban and agricultural areas in Korea. The analytical parameters used for this study were COD, BOD and SS. This study was conducted during the period from May to August 1981. Nonpoint pollutant mass loadings from the urban area were influenced by the rainfall intensity and the duration of rainfall, and etc. The concentrations of pollutants in the first flush was higher as the discharges increased. It was, however, found that the concentrations of pollutants in the heavy storm runoff were decreased due to the dilution effect. When other rainfall followed a peak rainfall, the concentrations of pollutants were lower than expected, because the first flush conveyed the most of pollutants deposited on the combined sewers. However the concentrations were increased in proportion to the increased flow when a rainfall of higher intensity than the first flush was continued. Yearly area yield rates in kg/ha were estimated to be 690.5(489.9~1,328) of COD, 319.7(226.8~614.8) of BOD, and 831.2(589.7~1,598) of SS. Pollutant sources in agricultural area were of the domestic waste water, manure composting stack, and agricultural solid wastes and etc. In the paddy field, yearly area yield rates in kg/ha were estimated to be 623.4(21.7~114) of COD, 18.65(9.53~34.5) of BOD, and 91.9(46.3~171.8) of SS. In the crop land, however, yearly rates in kg/ha were estimated to be 91.9(46.3~171.8) of COD, 23.09(11.7~42.5) of BOD, and 23.09(11.4~43.4) of SS. Pollutant sources in the feedlot area were originating from the feces of cattle, the cleaning water, the wastes spilled from manure composting stack during rain. Yearly area yield rate in kg/ha was estimated to be 3.804(2,489~6,658) of COD, 2.047(464~2,900) of BOD, and 1.149 (729~1,442) of SS. Pollutant discharges in the forest area were resulted from the organic layer like leaves and others deposited on the surface. Yearly area yield rate in kg/ha was estimated to be 9.86(5.45~18.56) of COD, 3.48(1.67~7.54) of BOD, and 4.64(9.74~10.35) of SS.

  • PDF

Studies on the Physico-chemical Properties and Characterization of Soil Organic Matter in Jeju Volcanic Ash Soil (제주도(濟州道) 화산회토양(火山灰土壌)의 이화학적(理化学的) 특성(特性) 및 유기물(有機物) 성상(性状)에 관(関)한 연구(硏究))

  • Lee, Sang-Kyu;Cha, Kyu-Seuk;Kim, In-Tak
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.16 no.1
    • /
    • pp.20-27
    • /
    • 1983
  • A series of laboratory experiment was conducted to find out the chemical composition, characterization of humic substances by physical and chemical methods and reaction of Na-pyrophosphate, $Ca(OH)_2$ and rice straw with albumin on the degradation of soil organic matter in the volcanic ask soils of the Jeju Island. Results obtained were summarized as follows: 1. The contents of organic matter, available silicon, active iron and aluminum concentration in volcanic ash the soils were remarkably higher but available phosphorous was comparatively lower than the mineral soils. In volcanic ash soil, the contents of potassium, calcium and magnessium were higher in upland soil than that of forest soil. The ratios of active $Al^{{+}{+}{+}}/Fe^{{+}{+}}$, C/P and $K/Ca^+$ Mg were apparently high in volcanic ash soils while that of $SiO_2$/O.M. was high in mineral soil. 2. The carbon/nitrogen ratio in humin, humic acid content in organic matter, and carbon contents of humin in total carbon of soil organic matter were apparently higher in the volcanic ash soils than in the mineral soils, The total nitrogen and fractions of acid or alkali soluble nitrogen were remarkably high in volcanic ash soils while mineralizable nitrogen ($NH_4$-N and $NO_3$) contents were high in mineral soils. 3. The values of K600, RF and log K were also higher in volcanic ash soils than those in mineral soils, and the absorbance in the visible range were high and color was dark in the soil of which humification was progressed Extracted humic acid from volcanic ash soil was less reactive to the oxidizing chemical reagent and was persistance to the acid or alkali hydrolysises. 4. The major oxygen-containing functional groups in humic substances of volcanic ash soils were phenolic-OH alcoholic-OH and carboxyl groups while those in mineral soil were methoxyl and carbonyl groups. 5. Absorption spectra of alkaline solution of humic acid ranged from 200 nm to maxima 500 nm. Visible spectra peaks of from humic substances in the visible region were recognized at 350, 420, 450 and 480 nm. Only one single absorbance peak was observed in the visible region at 362 nm for Heugag series and two absorbance Peak were also at 360 nm and 390 nm for Yeungrag series. 6. Evolution of carbon as $Co_2$ was increased with addition of Na-pyrophosphate in Namweon and Heugag series, and "priming effects" took place on the soil organic matter decomposition by addition of rice straw with albumin in Ido series.

  • PDF

Environmental Characteristics and Catch Fluctuations of Set Net Ground in the Coastal Water of Hanlim in Cheju Island I. Properties of Temperature and Salinity (제주도 한림 연안 정치망어장의 환경특성과 어획량변동에 관한 연구 I. 수온 및 염분특성)

  • KIM Jun-Teck;JEONG Dong-Gun;RHO Hong-Kil
    • Korean Journal of Fisheries and Aquatic Sciences
    • /
    • v.31 no.6
    • /
    • pp.859-868
    • /
    • 1998
  • In order to investigate the relation between the marine environmental characteristics and the change of the catch in set net, the marine environment properties were analyzed by temperature and salinity observed in the western coastal area of Cheju Island from 1995 to 1996 and the results are as follows 1) Main axis of Tsushima Current appeared in the western coastal area of Cheju Island was off 2$\~$3 miles from November to May. Therefore the waters of high temperature over $14^{\circ}C$ and high salinity from $34.40\%_{\circ}$ to $34.60\%_{\circ}$ were distributed homogeneously from surface to bottom in this time. But China Coastal Waters of low salinity appeared in the Cheju Strait from June to October, surface waters became of high temperature and low salinity, and middle and bottom waters became of the temperature from 11 to $14^{\circ}C$ and the salinity over $33.50\%_{\circ}$ and then vertically sharp thermocline and halocline are formed in the western coastal area of Cheju Island. In summer, the water temperature and salinity of the surface waters in wstern coastal area of Cheju Island were lower and higher respectively than that in middle area of the Cheju Strait and the temperature and salinity of the bottom waters in this area were higher and lower, respectively than that in middle area of the Cheju Strait. Such a distribution shows a tidal front in this coastal area. On the whole year, surface temperature and salinity were from 14 to $23^{\circ}C$ and from 30.60 to $34.60\%_{\circ}$, respectively, and annual fluctuation range of temperature and salinity was within $9^{\circ}C$ and $4.00\%_{\circ}$, respectively, Thus, annual fluctuation range in this area is much narrower than that in the Cheju Strait. In bottom water, temperature ranges from 14 to $20^{\circ}C$ through the year. Thus, the fluctuation range of temperature is narrow. The low temperature of from $11^{\circ}C$ to $13^{\circ}C$ appeared in the west enterance of Cheju Strait was not shown in this coastal area. 2) The salinity of bottom water was from $33.60\%_{\circ}$ to $34.40\%_{\circ}$ in 1995, while low salinity wale. below $32.00\%_{\circ}$ appeared all depth from June in 1996. Thus, the variation of hydrographic conditions in this area is narrow in winter, and wide in summer due to the influence of China Coastal Waters. 3) In summer, surface cold water, local eddy and fronts of temperature and salinity were showed within 2 mile from the west coast of the Cheju Island due to vertical mixing by tidal current. Especially, temperature and salinity of bottom water are changed with the change of depth around Biyang-Do. Thus, the front of temperature and salinity appeared clearly between shallow area with the depth of under 10 m and deep area with of the depth of more than 50m. Surface water in outside area where high temperature and low salinity water appear intrudes between Worlreong-Ri and Geumreung-Ri. Thus, the front of temperature and salinity was made along the line that connects from this coast to Biyang-Do, The temperature of the bottom water is $2^{\circ}C$ to $4^{\circ}C$ lower than that of the surface water and its salinity is $0.02\%_{\circ}$ to $0.08\%_{\circ}$ higher than that of the surface water even in shallow area.

  • PDF

Removal Characteristics of Residual Hydrogen Peroxide (H2O2) according to Application of Peroxone Process in O3/BAC Process (O3/BAC 공정에서 Peroxone 공정 적용에 따른 잔류 과산화수소 제거 특성)

  • Yeom, Hoon-Sik;Son, Hee-Jong;Seo, Chang-Dong;Kim, Sang-Goo;Ryu, Dong-Choon
    • Journal of Korean Society of Environmental Engineers
    • /
    • v.35 no.12
    • /
    • pp.889-896
    • /
    • 2013
  • Advanced Oxidation Processes (AOP) have been interested for removing micropollutants in water. Most of water treatment plants (WTPs) located along the lower part of Nakdong River have adopted the $O_3/BAC$ process and have interesting in peroxone process a kind of AOP. This study evaluated the removal characteristics of residual hydrogen peroxide ($H_2O_2$) combining with the biofiltration process in the next BAC process when the hydrogen peroxide is applied for the WTP operating $O_3/BAC$ process. In the experiment, changing the temperature and the concentration of $H_2O_2$ of influent, the biofiltration process showed rapidly dropped the biodegradability when the $H_2O_2$ concentration was increased and lowered water temperature while BAC process maintained relatively stable efficiency. The influent fixed at $20^{\circ}C$ and the concentration of $H_2O_2$ at 300 mg/L was continuously input for 78 hours. Most of the $H_2O_2$ in the influent did not remove at the biofiltration process controlled 5 to 15 minutes EBCT condition after 24~71 hours operating time while BAC process controlled 5 to 15 minutes EBCT showed 38~91% removal efficiency condition after 78 hours operating time. Besides, after 78 hours continuously input experiment, the biomass and activity of attached bacterial on the biofilter and BAC were $6.0{\times}10^4CFU/g$, $0.54mg{\cdot}C/m^3{\cdot}hr$ and $0.4{\times}10^8CFU/g$, $1.42mg{\cdot}C/m^3{\cdot}hr$ respectively. These biomass and activity values were decreased 99% and 72% in biofilter and 68% and 53% in BAC compared with initial condition. The biodegradation rate constant ($k_{bio}$) and half-life ($t_{1/2}$) in BAC were decreased from $1.173min^{-1}$ to $0.183min^{-1}$ and 0.591 min to 3.787 min respectively according to increasing the $H_2O_2$ concentration from 10 mg/L to 300 mg/L at $5^{\circ}C$ water temperature and the $k_{bio}$ and $t_{1/2}$ were $1.510min^{-1}$ to $0.498min^{-1}$ and 0.459 min to 1.392 min at $25^{\circ}C$ water temperature. By increasing the water temperature from $5^{\circ}C$ to $15^{\circ}C$ or $25^{\circ}C$, the $k_{bio}$ were increased 1.1~2.1 times and 1.3~4.4 times. If a water treatment plant operating $O_3/BAC$ process is considering the hydrogen peroxide for the peroxone process, post BAC could effectively decrease the residual $H_2O_2$, moreover, in case of spilling the $H_2O_2$ into the water process line, these spilled $H_2O_2$ concentration can be able to decrease by increasing the EBCT at the BAC process.

Summer-Time Behaviour and Flux of Suspended Sediments at the Entrance to Semi-Closed Hampyung Bay, Southwestern Coast of Korea (만 입구에서 부유퇴적물 거동과 플럭스: 한반도 서해 남부 함평만의 여름철 특성)

  • Lee, Hee-Jun;Park, Eun-Sun;Lee, Yeon-Gyu;Jeong, Kap-Sik;Chu, Yong-Shik
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
    • /
    • v.5 no.2
    • /
    • pp.105-118
    • /
    • 2000
  • Anchored measurements (12.5 hr) of suspended sediment concentration and other hydrodynamic parameters were carried out at two stations located at the entrance to Hampyung Bay in summer (August 1999). Tidal variations in water temperature and salinity were in the range of 26.0-27.9$^{\circ}C$ and 30.9-31.5, respectively, indicating exchange offshore and offshore water mass. Active tidal mixing processes at the entrance appear to destroy the otherwise vertical stratification in temperature and salinity in spite of strong solar heating in summer. On the contrary, suspended sediment concentrations show a marked stratification with increasing concentrations toward bottom layer. Clastic particles in suspended sediments consist mostly of very fine to fine silt (4-16 ${\mu}$m) with a poorly-sorted value of 14.7-25.9 ${\mu}$m. However, at slack time with less turbulent energy, flocs larger than 40 ${\mu}$m are formed by cohesion and inter-collision of particles, resulting in a higher settling velocity. Strong ebb-dominated and weak flood dominated tidal currents, in the southwestern and the northeastern part, respectively, result in a seaward residual flow of -10${\sim}$-20 cm $s^{-1}$ at station H1 and a bayward residual flow less than 5.0 cm $s^{-1}$ at station H2. However, mean concentration of suspended sediments at station H1 is higher at flood (95.0-144.1 mg $1^{-1}$) than in ebb (75.8-120.9 mg $1^{-1}$). On the contrary, at the station H2, the trend is reversed with higher concentration at the ebb (84.7-158.4 mg $1^{-1}$) than that at the flood (53.0-107.9 mg $1^{-1}$). As a result, seaward net suspended sediment fluxes ($f_{s}$) are calculated to be -1.7 ${\sim}$-$15.610^{3}$ kg $m^{-2}$ $s^{-1}$ through the whole water column. However, the stations H1 and H2 show definitely different values of the flux with higher ones in the former than in the latter. Alternatively, depth-integrated net suspended sediment loads ($\c{Q}_{s}$) for one tidal cycle are also toward the offshore with ranges of 0.37${\times}$$10^{3}$ kg $m^{-1}$ and 0.21${\times}$$10^{3}$ kg $m^{-1}$, at station H1 and H2, respectively. This seaward transport of suspended sediment in summer suggests that summer-time erosion in the Hampyung muddy tidal flats is a rather exceptional phenomenon compared to the general deposition reported for many other tidal flats on the west coast of Korea.

  • PDF

Rural Migration and Changes of Agricultural Population (농민이촌(農民離村)과 농업인구(農業人口)의 변화(變化))

  • Wu, Tsong-Shien;Kim, Kuong-Ho
    • Korean Journal of Agricultural Science
    • /
    • v.1 no.1
    • /
    • pp.91-116
    • /
    • 1974
  • Taiwan agricultural development in the last decade has not been changed much since the accomplishment of land reform program. This is mainly due to the rapid development taken place within industry that agricultural development can not keep pace with. The increasing gap of rural-urban income discrepancy has caused socio-psychological unstability among rural people and inspire wants of out-migration. From 1961 to 1970, population of the ten largest cities showed an annual growth rate of 4.05%, while the population of the remainder of Taiwan showed 2.06%. Assuming the natural increase rate of these two population sections are similar, the difference of rural and urban annual growth rate can be at tributed to the flow of people from rural to urban sectors. The main objective of this paper is to identify the amount of agricultural out-migration and its impact on agricultural development and agricultural extension programs. Specifically, the objectives are to examine (1) rural-urban population composition (2) rural out-migration estimation (3) changes of agricultural population, and (4) implications for agricultural development and extension programs Some of the important findings are listed below; (1) The average agricultural out migration of the period 1960-1969 is estimated at around 60,000 per year. Take Tainan prefecture for example, the Male-Female Migration Ratio is 0.39 for age 20-24, 0.55 for age 25-29, 0.90 for 30-34. It is understood between age 20 and 34, the rural female migration rate is higher than the rural male. (2) Based on the population growth rate of 1950-1969, agricultural population is projected for the period of 1953 to 1989. By 1978, the agricultural population will reach its peak and begin to dedaine from 1980. The projected agricultural population in 1989 is 5,847,566 which occupies 29% of the Taiwan total population. (3) Assuming area of cultivated land keep unchanged as 905,263 ha. in 1970, and tif we can eliminate all 72% of part-time farms, then the average farm acreage for hose full-time farms will be increased to 3.6 hactares. This is unlikely to happen before 1989 without the government interference. (4) Less than 10% of adult farmer s of age 25-64 in 1969 enrolled in Farm Discussion Club, only 5% of adult farm women enrolled in Home Economics Club, and 5% of rural youth enrolled in 4-H Club. These statistics show a fact that only few farmers are reached by extension workers. Based on findings in this paper, some important suggestions are listed for future agricultural development. (1) Improve agricultural structure by decreasing agricultural population (a) Encourage farmers with less than 0.5 ha. of land to seek jobs outside of agriculture (b) Encourage joint cultivation and farm mechanization (c) Discourage rural migrants to Keep farm land (d) Provide occupational guidance program through extension education programs (2) Establish future farmers settlement project to assure rural youth have enough resources for farming. (3) An optimum Population policy should be integrated into rural socio-economic development and national development programs.

  • PDF

The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.6
    • /
    • pp.724-732
    • /
    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

  • PDF

Long Term Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암 환자에서의 기관지 소매 절제술의 장기 성적)

  • Cho, Suk-Ki;Sung, Ki-Ick;Lee, Cheul;Lee, Jae-Ik;Kim, Joo-Hyun;Kim, Young-Tae;Sung, Sook-Whan
    • Journal of Chest Surgery
    • /
    • v.34 no.12
    • /
    • pp.917-923
    • /
    • 2001
  • Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

  • PDF