• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.619-624
• /
• 2008

Background: Secondary spontaneous pneumothorax is caused by various underlying lung diseases, and this is despite that primary spontaneous pneumotherax is caused by rupture of subpleural blebs. The treatment algorithm for secondary pneumothorax is different from that for primary pneumothorax. We studied the recurrence rate, the characteristics of recurrence and the treatment outcomes of the patients with secondary spontaneous pneumothorax. Material and Method: Between March 2005 to March 2007, 85 patients were treated for their first episodes of secondary spontaneous pneumothorax. We analyzed the characteristics and factors for recurrence of secondary spontaneous pneumothorax by conducting a retrospective review of the medical records. Result: The most common underlying lung disease was pulmonary tuberculosis (49.4%), and the second was chronic obstructive lung disease (27.6%), The recurrence rate was 47.1% (40/85). The second and third recurrence rates were 10.9% and 3.5%, respectively. The mean follow up period was $21.1{\pm}6.7$ months (range: $0{\sim}36$ month). For the recurrence cases, 70.5% of them occurred within a year after the first episode. The success rates according to the treatment modalities were thoracostomy 47.6%, chemical pleurodesis 74.4%, blob resection 71% and Heimlich valve application 50%. Chemical pleurodesis through the chest tube was the most effective method of treatment. The factor that was most predictive of recurrence was 'an air-leak of 7 days or more' at the first episode. (p=0.002) Conclusion: The patients who have a prolonged air-leak at the first episode of pneumothorax tend to have a higher incidence of recurrence. Further studies with more patients are necessary to determine the standard treatment protocol for secondary spontaneous pneumothorax.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.2
• /
• pp.125-131
• /
• 2011

Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

• Journal of Chest Surgery
• /
• v.38 no.7 s.252
• /
• pp.518-521
• /
• 2005

Pneumothorax associated with thoracic endometriosis is a rare clinical entity and it is called catamenial pneumothorax if the recurrence of pneumothorax is related to the period of menstruation. Several hypotheses about its pathogenesis are suggested including spontaneous rupture of the bulla, endometrial implants of the visceral pleura, and passage of air from the genital tract through endometrial fenestration of the diaphragm. Pneumothorax is associated with chest pain and dyspnea within 72 hours of the onset of menses in young women and developed usually at right side. We report a case of 32-year-old woman who had bilateral pneumothorax and thoracic endometriosis confirmed histopathologically in the visceral pleura by thoracotomy.

• Tunnel and Underground Space
• /
• v.31 no.4
• /
• pp.211-220
• /
• 2021

Tunnel collapse often occurs during deep underground tunneling (> 40 m depth) in South Korea. Natural cavities as well as water supply pipes, sewer pipes, electric power cables, artificial cavities created by subway construction are complexly distributed in the artificial ground in the shallow depths of the urban area. For deep tunnel excavation, it is necessary to understand the properties of the ground which is characterized by porous elements and various geological structures, and their influence on the stability of the ground. This study analyzed geological factors for risk assessment in deep excavation in South Korea based on domestic and overseas case study. As a result, a total of 7 categories and 38 factors were derived. Factors with high weights were fault and fault clay, differential stress, rock type, groundwater and mud inrush, uniaxial compressive strength, cross-sectional area of tunnel, overburden thickness, karst and valley terrain, fold, limestone alternation, fluctuation of groundwater table, tunnel depth, dyke, RQD, joint characteristics, anisotropy, rockburst and so forth.

• Clinical and Experimental Pediatrics
• /
• v.46 no.3
• /
• pp.224-229
• /
• 2003

Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

• Journal of Chest Surgery
• /
• v.32 no.6
• /
• pp.556-560
• /
• 1999

Background: The cause of spontaneous pneumothorax is not yet but it is certain that intrathoracic air comes from ruptured bulla. Video-assisted thoracoscopic surgery(VATS) or open thoracotomy is recommended for thoracic incision in recurrent pneumothorax. However, recurrent rate after bullectomy with the VATS is very high compared to mini-thoracotomy, 3% to 20% and below 2%, respectively. Material and Method: This retrospective analysis was performed on 16 re-operated cases among 446 surgically treated pneumothorax of the 737 cases of spontaneous pneumothorax diagnosed at Yongdong Severance Hospital from Nov. 1992 to June 1997. Result: Among the 446 surgically-treated patients in 737 case of spontaneous pneumothorax, 16 patients underwent re-operation, showing a 3.5% re-operation rate. Male-to-female ratio was 15 to 1 and mean age at initial attack was 20.2 years(ranging from 15 to 50). Mean hospital stay was 6.34 days(ranging from 2 to 20 days) and mean chest tube indwelling period was 4.2 days(ranging from 1-10 days). Median follow-up was 46 months(range 10-66 months). Three different surgical methods were applied : video-assisted thoracoscopic surgery(VAST) in 281 cases, of whom 2 underwent local anesthesia; subaxillary mini-thoracotomy in 159 cases and limited lateral thoracotomy in the remaining 6 cases. Three different re-operative surgical methods were applied ; video-assisted thoracoscopic surgery (VAST) in 6 cases, subaxillary mini-thoracotomy in 9 cases, and limited lateral thoracotomy in the remaining 1 case. The underlying etiological factors of the recurrent pneumothorax after bullectomy were o erlooking type(9) and new growing type(7). Mean recurrent period from previous operation was 1 month for overlooking type and 18 months for new growing type. Conclusion: The underlying etiological factors of recurrent pneumothorax lead to re-operation were new-growing and over-looking type. We need additional treatments besides resecting blebs of prevent the recurrence rate and more gentle handling with forceps due to less damage to the pleura.

• Journal of Chest Surgery
• /
• v.39 no.12 s.269
• /
• pp.949-952
• /
• 2006

Spontaneous pneumothorax is rarely occurred as an initial sign of primary lung cancer. As a lot of these cases have already advanced, even then surgical resection is performed, the prognosis is often undesirable, We happened to find a ruptured cavity on a 65-year-old male patient who had suffered from pulmonary tuberculosis in the past, while performing VATS bullectomy for simple spontaneous pneumothorax, Then, as a result of frozen biopsy, it was diagnosed as squamous cell cancer Because the tumor was infiltrated from the upper lobe into the lower lobe passing by fissure, we should remove by pneumonectomy and the pathologic stage was found stage I(T2N0M0). When we made an follow-up observation for one year and a half, there was neither relapse nor complication. When there appears spontaneous pneumothorax to the high risk group for lung cancer who were smokers over forty-year old, with chronic bronchitis or pulmonary emphysema, it needs to have a closer observation on a base lung disease such as lung cancer through chest CT, and it is also necessary to make more active approach by performing the surgical operation through a thoracoscopy when there is a continued air release.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.2 no.1
• /
• pp.13-17
• /
• 2009

Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

• Proceedings of the Korean Society for Food Science of Animal Resources Conference
• /
• 2006.05a
• /
• pp.128-132
• /
• 2006

관절염이 일어나는 정확한 기전은 아직까지 잘 규명되어 있지 않으나 일반적으로 cytokine, chemokine을 비롯한 여러 가지 조절 물질들 사이의 미묘한 균형이 깨어지는 일이 주된 요인으로 추정되고 있다. 사람의 경우 염증이 일어난 관절 조직에서 활막 세포(synovial fibroblast)는 여러 염증성 사이토카인들을 분비하기도 하며 또 한편 이들 cytokine의 target 세포로 이들의 자극에 대하여 정상인의 그것과 다른 증식 및 활성화 반응을 보이는 등, 다양한 측면에서 관절염증의 유발에 기여하는 것으로 보여진다. 따라서 활막세포 활성화 경로를 DNA Microarray chip을 이용하여 세포 및 분자 수준에서 밝혀 이를 차단할 수 있는 자연물질(natural product)를 선별함으로써 항생제나 스테로이드를 사용하지 않고 돼지의 관절염을 효과적으로 치료 또는 예방할 수 있는 방법을 모색하고자 한다. 6.6kg의 암컷 Yorkshire와 수컷 Landrace의 교배잡으로 왼쪽 뒷다리 슬관절에 십자인대를 파열하여 관절염을 유발하고 8주간 성장을 시킨 후 정상 슬관절과 관절염이 유발된 슬관절의 활막세포로부터 total RNA를 추출한 후 affymetrix Gene chip을 제작하여 Geneplex소프트웨어를 이용하여 데이터를 분석하였다. 분석 결과 unknown 유전자 962개를 포함하여 유전자 발현이 증가된 유전자는 총 1,059개 였으며, unknown 유전자 564개를 포함하여 유전자 발현이 증가된 유전자는 총 639개를 얻었다. 이러한 돼지 관절염에서의 활막세포에 의한 유전적 발현 양상으로부터 molecular function, biological process, pathway등을 이용하여 관절염 지표를 작성할 수 있다.분별을 성공적으로 수행하였다.(p<0.05), 맛, 연도, 다즙성 및 전체적인 기호성은 유의한 차이가 없었다.자체를 악하다고 볼 수 없고 더구나 구원을 이 세상에서의 이탈로 볼 수 없다. 진정한 구원이란 원래 하나님이 보시기에 아름다웠던 그 세상으로의 회복을 포함한다. 이런 면에서 하나님 주권 신앙 하에서 구원이란 전 인격적인 구원, 전 우주적인 구원이 된다. 그렇기 때문에 성도는 세상의 삶과 학문, 예술, 정치, 경제, 사회를 포함한 모든 분야를 하나님의 뜻 가운데서 그 원래의 목적에 부합할 수 있도록 회복시키는 일에 적극 참여해야 한다.자체가 이를 주도하기는 사실 어려움이 있다. 그리고 대형유통점이 영업행위를 영업시간제한에서부터 출점제한에 이르기까지 규제하는 건은 심사숙고하여야 한다. 대형유통점이 국가경제 및 지역사회에 미치는 영향이 부정적인가 긍정적인가에 대해 국내외 학계와 업계에서 여전히 많은 논란이 있기 때문이다. 정부와 지자체에 의한 시장개입은 반드시 필요한 경우에 한해 합당한 방법에 의해 이루어져야 한다. 대형유통점에 대한 규제는 지역사회에 미치는 영향을 다면적으로 평가한 결과에 근거하여 이루어져야 할 것이다. 대부분의 지자체는 체계적인 평가시스템과 객관적인 통계 자료를 갖고 있지 못한 실정이다. 향후 가장 시급한 과제는 시장개방 이후 지난 10년간 대형유통점이 지역사회에 미친 영향에 관한 광범위한 통계자료를 수집하고 이를 체계적으로 분석하여 정책방향을 올바르게 설정하는 것이라 할 수 있다.i와 K. pneumoniae가 존재하며 확산 중임을 시사한다. 앞으로 CTX-M형 ESBL의 만연과 변종 CTX-M형 ESBL의 출연을 감시하기 위한 정기적인 연구와 조사가 필요한 것으로 생각한다., A2-1, B1-1, B2-1의 경우, 강우 일수 감소 이전과

• Pediatric Infection and Vaccine
• /
• v.16 no.1
• /
• pp.80-86
• /
• 2009

Purpose : This study was performed to determine the clinical course of BCG lymphadenitis. Methods : Between May 2005 and April 2009, the medical records of 33 patients with BCG lymphadenitis were retrospectively reviewed. If needed, needle aspiration was recommended without surgical resection or antituberculous medication. Results : Of the 33 patients who were identified, 21 were males and 12 were females. Among the 33 patients, 32 were full-term babies. The mean age was 6 months (range, 2-35 months) and the most prevalent site of the lesion was the left axilla. BCG lymphadenitis was observed 1-34 months after BCG vaccination, mostly 1-6 months after vaccination. The size of the enlargement was generally 1-3 cm. The strains were identified as French (n=14), Danish (n=7), and Tokyo (n=12). BCG lymphadenitis regressed spontaneously in 19 patients. After 1-5 needle aspirations, 14 patients recovered completely. Complete regression of lymphadenitis was recorded over an average period of 4 months. Conclusion : Clinicians need to be aware of the clinical features of BCG lymphadenitis. For management of BCG lymphadenitis, regular follow-up with observation should be the mainstay. Needle aspiration is a safe and easy treatment for suppurative BCG lymphadenitis.