• Title/Summary/Keyword: 자연경과

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Characterization of deterioration of concrete lining in tunnel structures (터널 콘크리트 라이닝 구조물의 성능저하 특성)

  • Kim, Dong-Gyou;Jung, Ho-Seop;Bae, Gyu-Jin;Shin, Hyu-Soung
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.11 no.4
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    • pp.387-394
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    • 2009
  • The objective of this study is to evaluate the durability and deterioration of concrete lining in the seven conventional tunnels. These tunnels were constructed about 40~70 years ago, and closed about 10~40 years ago. The field investigation and various laboratory testings were performed for this study. It was observed from the visual, examinations that the concrete linings of 7 tunnels were severely deteriorated, such as, cracks, leakages, desquamation, and exploitations. The compressive strengths obtained from rebound hardness method and uniaxial compressive strength test on core specimens largely differed depending on the locations in the tunnel. The maximum compressive strength of concrete lining was greater about 2 times than the minimum compressive strength of concrete lining in the same tunnel. The results of micro-structural analysis showed that the substances deteriorating the concrete lining, such as ettringite and thaumasite, were detected in the concrete lining of tunnel.

Effect of Beraprost Sodium in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 Beraprost sodium의 효과에 대한 연구: 이중 맹검 무작위 임상시험)

  • Lee, Sang-Do;Seo, Kwang Won;Lee, Jung Yeon;Huh, Jin Won;Choi, Ik Su;Park, Jae Sun;Shim, Tae Sun;Oh, Yeon-Mok;Park, In Won;Ryu, Wang-Seong;Choi, Byoung Whui
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.320-328
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    • 2004
  • Background : Pulmonary vascular changes which occur early in the course of chronic obstructive pulmonary disease (COPD) are prevalent manifestation and later cause pulmonary hypertension, which is a bad prognostic factor in COPD. Beraprost sodium (BPS), an orally active prostacyclin analogue, has been shown to improve survival in patients with primary pulmonary hypertension. This study investigated the effect of BPS in the patients with COPD. Methods : This is a double-blind randomized placebo-controlled, two center clinical trial. Twenty one consecutive patients with COPD were enrolled from June 2003 to June 2004 (patients treated with BPS for 3 months, BPS group, n=11; those with placebo, placebo group, n=10). The baseline demographic, pulmonary function and hemodynamic data were not significantly different between two groups. Results : On echocardiographic examination, trans tricuspid valve pressure gradient has decreased significantly after 3 months with beraprost in the BPS group [17.7(${\pm}11.4$) to 8.2(${\pm}8.9$) mm Hg, p-value<0.05], while there was no significant change in the control group. Six-minute walking distance has decreased in the control group and increased in the BPS group, but there was no statistical significance. Conclusion : In patients with COPD oral administration of BPS reduced the pulmonary arterial pressure. The clinical significance of this finding, that is improving symptoms and natural course of the disease, needs further study.

Analysis of Children with Unilateral Multicystic Dysplastic Kidney(MCDK) (편측성 다낭포성 신이형성증 (Unilateral multicystic dysplastic kidney)의 임상 경과)

  • Yoo Ji Hyung;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Han Sang Won;Kim Myung Joon
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.63-68
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    • 2000
  • Purpose: MCDK is regarded as a common cause of abdominal masses in children. And the presentation of the MCDK is usually a unilateral flank mass in the a newborn. Bialteral disease results in either fetal demise or necessity fer renal replacement therapy at birth. This study is designed to assess the clinical features and natural history of the unilateral multicystic dysplastic kidney. Patients and Methods: From January 1987 to January 2000 data were obtained retrospectively on 57 patients (28 boys and 29 girls, age ranged 1day-11years) who had a diagnosis of multicystic dysplastic kidney. The diagnosis of multicystic dysplastic kidney was confirmed by a combination of ultrasonography and radionuclide scan. Voiding cystourethrogram study in 31 patients were done to determine the condition of the contalateral kidney. Restllts: $84\%$ of the patients were diagnosed before birth by antenatal ultrasonography Clinical manifestations of children with postnatal diagnoses were palpable abdominal mass($3.5\%$), abdominal distension($17\%$), and incidental($10.5\%$). The abnormalities in contralateral kidney were hydronephrosis($21\%$), compensatory hypertrophy($12\%$), simple cyst($2\%$), bifid pelvis($2\%$). Surgical management was performed in 20 patients($35\%$) due to recurrent infection, for diagnostic purpose to differentiate from malignancy and abdominal distention. Follow-up in the remaining 37 patients continued (mean 18 months) and results of sonogram findings were involution change in 23 patients($40\%$) and no interval changes in 13 patient($23\%$). Conclusions : The apparent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rather than operative intervention except in associated severe complications such as urinary tract infection or rupture of cysts.

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1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age (산전 초음파로 발견된 일측성 수신증의 생후 1개월 때의 초음파 소견에 따른 1년 추적 결과)

  • Yoon, Hoe-Soo;Yum, Mi Sun;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Yoon, Chong Hyun;Moon, Dae Hyuk;Hahn, Hyewon
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.64-70
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    • 2006
  • Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.

Changes in Mean Platelet Volume and Platelet Distribution Width after Therapy in Childhood Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소성 자반증 환아에서 치료경과에 따른 평균 혈소판용적과 혈소판용적 분포폭의 변동)

  • Kim, Jong Tai;Lee, Kyung Won;Kim, Soon Nam;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.505-511
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    • 2002
  • Purpose : Mean platelet volume(MPV) and platelet distribution width(PDW) are useful parameters in evaluating disorders of platelets. In cases with idiopathic thrombocytopenic purpura(ITP), they change as platelet count increases. In this study, we compared the values of MPV and PDW in ITP patients at diagnosis with those of normal children. We also studied whether the early changes in MPV may predict the clinical course. Methods : From December 1995 to May 2001, 71 patients with ITP were admitted to Ajou University Hospital. They were treated with IVIg 400 mg/kg for five days and MPV, PDW, platelet count were analysed. Normal control group(n=38) was compared. The study group was divided into acute and chronic forms, and also divided into group A, good early responders whose platelets increased more than $100,000/{\mu}L$ within 5 days and group B who did not. Results : Mean value of MPV at diagnosis in ITP patients was lower than the normal control group(P<0.05). In group A, MPV was abruptly increased on the first day after IVIg and then started to decrease. But in group B, MPV was steadily increased until the fourth day after IVIg. In the normal control group, there were inverse correlations between platelet count and MPV(r=-0.415, P<0.05), but in ITP patients, there were positive relationships between platelet count and MPV(r=0.646, P<0.05) at diagnosis. Conclusions : MPV at diagnosis of ITP was lower than the normal control. MPV and PDW could not predict the course of ITP patients, but MPV could distinguish good early responders. More research is needed to find out the reasons of decreased MPV at diagnosis of ITP.

Clinical Features of Dietary Protein Induced Proctocolitis (식이 단백 유발 직결장염의 임상적 고찰)

  • Im, Sun Ju;Kim, Seong Heon;Bae, Sang Nam;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.157-163
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    • 2005
  • Purpose: Dietary protein induced proctocolitis (DPIPC) can be considered as a cause of rectal bleeding or blood streaked stool in otherwise healthy-looking infants in the first several months of life. Failure to appreciate this entity may lead to inappropriate diagnostic or therapeutic intervention. This study aimed to ascertain the clinical features, treatment and prognosis of DPIPC. Methods: We reviewed 13 infants retrospectively, presented with bloody stool in early infancy. They were diagnosed as DPIPC clinically in Pusan National University Hospital from May 2002 to June 2004. Results: Seven males and six females were included. The mean age at onset of bleeding was $96.8{\pm}58.8days$. The mean frequency of hematochezia was $2.6{\pm}2.5$ times a day. Duration from onset of symptom to diagnosis was $35.5{\pm}55.0days$ and duration from onset of symptom to resolution of bleeding was $58.7{\pm}67.0days$. Nine (69.2%) were exclusively breast-fed infants and two (15.4%) were formula-fed infants. All but one infant did not have family history of other allergic diseases. A dietary history of ingestion of cow's milk, nut or shellfish was present in three mothers. Peripheral eosinophil count was normal to slightly elevated (total WBC count $10,555{\pm}3,145/mm^3$, relative eosinophil count $6.3{\pm}3.0%$, absolute eosinophil count $659.0{\pm}532.2/mm^3$). Sigmoidoscopy revealed lymphonodular hyperplasia with surrounding hemorrhagic spots in the rectosigmoid colon in 6 infants. Histopathologic finding of colonic biopsies in 5 infants showed chronic inflammation with lymphoid follicular hyperplasia (5 infants), crypt abscess (3 infants), or mild infiltration of eosinophils (less than 20/high power field) in the lamina propria. Spontaneous resolution of rectal bleeding occurred in all infants without dietary change or medicine. Conclusion: Most infants with DPIPC experience a very benign course and have spontaneous resolution of rectal bleeding without changes in the mother's diet. In the case of strong evidence for DPIPC we suggest deferring further invasive investigation and continuing breast feeding.

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Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia (소아 골반저 근실조에서 바이오피드백 치료의 유용성)

  • Park, Kie-Young;Chang, Soo-Hee;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.51-59
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    • 2007
  • Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

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Effects of Raising Seeding by Cold Water, Low Night Temperature, and Using Abandoned Mine on Flower Bud Differentiation, Growth and Yield of Forcing Cultured Strawberry (Fragaria x ananassa Duch.) (냉수경, 야냉 및 폐광육묘가 촉성딸기의 화아분화와 생육 및 수량에 미치는 영향)

  • Kim, Woon-Seop;Yoon, Wha-Mo
    • The Journal of Natural Sciences
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    • v.8 no.1
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    • pp.71-80
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    • 1995
  • This experiment was conducted to investigate the effect of raising seedling methods of cold water, low night temperature, and abandoned mine on forcing culture of strawberry. The results were as follows ;1. $17^{\circ}C$ cold water alone and cold water plus 8-hour short day treatments significantly accelerated the flower bud differentiation of Nyoho cultivar to 11 and 15 days, respectively, comparing to common soil raising seedling.2. The date of flower bud differentiation of Nyoho cultivar as influenced by cold water treatment the 17th, the 13th and the 10th of September, respectively, when the seedlings were treated on the 10th of September and on the 25th and the 10th of August in 1991. In 1992, data showed that the flower bud differentiation dates were the 4th and the 2nd of September and the 29th of August when cold water treatment was done on the 10th of August and on the 25th and the 10th of July.3. The first harvest date when Nyoho cultivar was treated by cold water for 30days from Jul. 25 was Nov. 10, this implying that the harvesting day could advanced to 19 days comparing to that by the common soil raising seedling method. The resulting yield was recorded to 21.94 ton per hectare.4. Regardless of the starting date of the treatment, $13^{\circ}C$ low night temperature plus 8-plus short day treatments for 20 days required 17 days to differentiate the flower bud of Nyoho cultivar. Harvesting day could be advanced to 59 days comparing to that by the common raising seedling method when the seedling was treated on July 25, this resulting in increasing the total yield obtained by April 14 of following year to 8.25 ton per hectare.5. When the seedlings of both Nyoho and Hokowase cultivars were raised under the condition of abandoned mine, flowering and harvest date were earlier by the treatment for 20 days than that for 30 days or 40 days. The highest yiesd obtained was recorded in Nyoho cultivar or 1.88 ton per hectare.

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Erosion Control Effect by Soil ansi Vegetation Transition in Mountainous Area after Soil Erosion Measures were Initiated (토양 및 식생변화에 따른 토지 사방 공사의 효과에 관한 연구)

  • 이천용
    • Journal of the Korean Institute of Landscape Architecture
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    • v.14 no.2
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    • pp.7-16
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    • 1986
  • This study was carried out to investigate the effects of such erosion control measures as sowing, planting and small earth structures on the soil and vegetation. In order to study the changes in soil and vegetation, 36 plots were surveyed from 1981 to 1982 in the large erosion control area which is restored last 20 years. The factors which were measured included vegetation coverage, tree growth, number of species, soil depth, soil consistancy, and Chemical properties of soil. The results were as follows; 1) Maximum coverage of the overstory and understory was attained 7 years after the initiation of erosion control. So the overstory need to be tended and pruned. 2) Diversity of species increased until age 6 after which it began to decrease. 3) In order of tree growth, black locust was the fastest, followed by siberian alder and pitch pine. The initial growth of black locust, though the best among the 3 tree stop., decreased rapidly year by year. At the same time, siberian alder and pitch pine grew well until 12 and 6 years after the initiation of erosion control respectively. 4) Fifty percent of the initially planted trees died within 8 yeard. The mortality of siberian alder occurred until the 20th year while the mortality of pitch pine stopped after 10 years. Thereafter 500 trees per hectare were maintained. 5) The soil depth in A and B horision increased by 2cm annually during 20 years. The soil consistency also decreased rapidly until 7th year. The physical soil properties of the rehabilitated areas were improved after the 14th year. 6) The soil pH tend to decrease from 5.3 during the first year to 5.1 during the twentieth year. 7) The organic matter and nitrogen content in the soil were increased by fertilization but after 20 years these nutrients are still deficient for normal tree growth. 8) The phosphorous content in the soil was high in the first year but the longer the period after the initiation of erosion control the lese the content of phosphorous. 9) The biomass of black locust was the highest and increased continuously. The biomass of siberian alder on the contrary decreased from the 15th year because the number of trees in this place was very low. The total biomass in the twentieth year after erosion control initiation was 105.7 ton per hectare.

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Hybrid Natural Orifice Transluminal Endoscopic Cholecystectomy in Dogs: Transgastric, Transcolonic and Transvaginal Approaches (개에서 자연개구부를 통한 하이브리드 내시경적 담낭절제술: 경위장관, 경결장 및 경질 접근법)

  • Kim, Soo-Hyun;Jeong, Seong-Mok;Shin, Sa-Kyeng;Kim, Seong-Su;Shin, Beom-Jun;Lee, Jae-Yeon;Park, Ji-Yeong;Kim, Myung-Cheol;Kim, Young-Il;Lee, Sang-Il;Kim, Ji-Yeon
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.497-505
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    • 2011
  • Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.