• Title/Summary/Keyword: 장애우

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Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index (만성 폐쇄성 폐질환 환자에서 Tei 지수를 이용한 우심실기능 평가)

  • Oh, Yoon-Jung;Shin, Joon-Han;Kim, Deog-Ki;Choi, Young-Hwa;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.343-352
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    • 2001
  • Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

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Long Term Results of Rastelli Operation with a Mechanical Valve (기계 판막을 이용한 라스텔리 수술의 장기 성적)

  • Choi, Se-Hoon;Kim, Kwan-Chang;Kwak, Jae-Gun;Kim, Chang-Young;Lee, Jeong-Ryul;Kim, Yong-Jin;Rho, Joon-Ryang;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.900-905
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    • 2006
  • Background: Homografts and bioprostheses are most commonly used for Rastelli operation in congenital heart disease, but the limited durability is responsible for multiple reoperations associated with increased morbidity This study evaluated long-term results after Rastelli operation with a mechanical valved conduit. Material and Method: A total of 20 patients underwent Rastelli operation with mechanical valved conduit from January 1990 to July 1992. Operative mortality was 1 of 20 patients, and a retrospective review of 19 patients(10 males, 9 females) was done. Initial diagnosis was congenitally corrected transposition of great arteries(cc-TGA, n=4), complete TGA (n=2), ventricular septal defect with pulmonary atresia(VSD with PA, n=9), truncus arteriosus(n=2), double outlet right ventricle with pulmonary stenosis(DORV with PS, n=2). The mean age at Rastelli operation was $4.6{\pm}3.4$ years, and mean follow-up period was $12.8{\pm}2.7$ years. Patients underwent Rastelli opearation using 16 CarboMedics mechanical valve, and 3 Bjork-Shiley mechanical valve($17{\pm}2$ mm). Result: There were 15 reoperations for failed mechanical valved conduit. The freedom from reoperation at 5 and 10 years was 53% and 37%. Most patients were received oral anticoagulation with warfarin, and maintained the international normalized ratio(INR) of 1.5 to 2.0. There was no anticoagulation or thromboembolism related complication. There was a significant difference in the causes of a conduit failure between early(within 3 years) and late(after 3 years) failure groups. The six patients reported early prosthetic valve failure, mainly due to valvular dysfunction by thrombosis or pannus formation. The other nine patients reported late prosthetic valve failure, mainly due to dacron conduit stenosis at anastomosis sites, whereas their valvar motion was normal except 1 patient. Conclusion: To avoid early prosthetic valve failure, strict anticoagulation therapy would be helpful. About the late development of obstructive intimal fibrocalcific peels within the Dacron conduit, an improvement of conduit material is necessary to reduce late prosthetic valve failure. In selected patients, the long term results were satisfactory.

A Study on the Model Regulation's Improvement for Control of Aeronautical Obstacles in Korea (항공장애물관리규정 개선을 위한 연구)

  • Lee, Kang-Seok
    • Journal of Korean Society of Transportation
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    • v.23 no.3 s.81
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    • pp.21-34
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    • 2005
  • To control the obstacles surrounding aerodrome is significant for preventing air accident and ensuring the long sustaining of aerodromes. On the other hand, within a scope of ensuring safe flight operations, the application of Shielding is one of the issues to be importantly considered to manage efficiently the obstacles limitation around aerodromes, to dissolute the private asset privilege limitation from regulation on aerodrome circumference, and to decrease the pains to manage the obstacles, in terms of not only operating safely but also utilizing efficiently the airspace around aerodromes. The ICAO and other aviation-advanced states mitigate the construction limitation or exempt the obligation of obstacle sign by applying the shielding theory that the obstacles are not regarded as obstacles where are below the shadow surface. The Republic of Korea inserted the new regulation including the applying shielding similar to ICAO on Aviation Act and regulations. It is, however, hard to manage the aviation obstacles around aerodrome efficiently with these new regulation. Particularly, there exists much rooms to dispute because it cannot suggest the specific standard which is necessary to apply shielding theory at airspace of aerodromes. Therefore, in this study, the international standards on aviation obstacles were reviewed, analyzed and compared with those of domestic status. The direction of which guideline for control of aeronautical obstacles applicable within domestic circumstances as well as correspondent with international standard was suggested. Particularly, as far as the disputable application of shielding theory is concerned, the alternatives for aviation safety and efficient airspace operation by suggesting the clear standards alternatives were suggested.

Analysis of $^{99m}Tc-ECD$ Brain SPECT Images for ADHD in Children Using Statistical Parametric Mapping (SPM) (주의력 결핍 과잉행동장애(ADHD) 어린이 $^{99m}Tc-ECD$ Brain SPECT Image의 SPM을 이용한 분석)

  • 박성옥;신동호;권수일;이명훈;조철우;윤석남;오은영
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.141-148
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    • 2003
  • The purpose of this study is to evaluate the distribution of clusters and blood flow rate in ADHD SPECT brain blood flow images of children using statistical parametric mapping (SPM99). We studied 64 ADHD children (4-15 y, $8.03{\pm}2.57$ y. male/female:52/12) and compared them with a control group of 12 children (6-l7 y, $9.42{\pm}3.37$ y, male/female:8/4). We injected blood flow tracer $^{99m}Tc$-ethylcysteinate dimer (ECD) as a rCBF agent and took blood flow images after 30 min. by SPECT camera. In the case of hyperperfusion of rCBF in the ADHD group, we found 3 clusters clearly separated at the cingulate gyrus, Rt.cerebral occipital lobe and Lt.cerebellar post. lobe, on probability level 0.05 (P<0.05). Thirty-six ADHD patients with average hyperfusion rates between 18.72-19.30% in each cluster had more increase in blood flow than the average perfusion rate at the Rt. cerebral occipital lobe. These levels were influenced by P-value. In the case of hypoperfusion in the ADHD children, 4 decreased clusters on Lt. and Rt. cerebral frontal lobe, Lt. cerebral claustrum and Rt. cerebral, sup. temporal gyrus at P<0.01 can be seen. The average hypoperfusion rates for the ADHD children were 18.41-18.69% in each cluster, which showed more hypopefusion than the average perfusion rate at the Lt. Cerebrum inf. Frontal gyrus. The perfusion rates and the number of patients were not affected by P-value. The result of this study shows significant hyperpefusion clusters at the probability level of P:0.05 and hypoperfusion clusters at P:0.01. The number of ADHD patients in each clusters and the perfusion rate were not affected by P-value.

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STANDARDIZATION STUDY FOR THE KOREAN VERSION OF THE LURIA-NEBRASKA NEUROPSYCHOLOGICAL BATTERY FOR CHILDREN II : EVALUATION OF THE VALIDITY & CLINICAL UTILITY OF THE KOREAN VERSION OF LNNB-C (한국판 아동용 Luria-Nebraska 신경심리 검사의 표준화 연구 II : 타당도 및 임상적 유용성 검증)

  • Shin, Min-Sup;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.70-82
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    • 1994
  • Present study was to evaluate the validity and the clinical utility of the Korean version of Luria-Nebraska Neuropsychological Battery for Children(LNNB-C) in various groups including normal, brain damaged attention deficit hyperactivity disordered(ADHD), and psychiatrically disordered. The Korean version of LNNB-C and BGT were administered to clinical groups consisted of 51 patients(19 brain damaged, 16 ADHD. and 16 psychiatric controls), and to normal group composed of 147 children between the age of 8 and It Also KEDI-WISC was administered D clinical groups as a part of comprehensive psychological assessment There were significant differences between the brain damaged and the normals on all scales of LNNB-C, and between the normals and the ADHD on 11 clinical scales and 3 summary scales, which indicate the clinical validity for the scales of the Korean version of LNNB-C. The significant differences between the ADHD and the brain damaged on 3 summary scales were found, suggesting that the summary scales might play an important role id discriminating between two groups. Multiple discriminant analysis showed that the Korean version of LNNB-C significantly discriminates 3 groups - normals, ADHD, and brain damaged. Percentages of correct classification were ranged from 62.5% in the ADHD to 98.6Ta in the normals. For further evaluating the discriminant validity of the LNNB-C, the discriminant power of each items were calculated, and 131 of the 147 items discriminated significantly between the brain damaged and the normals. The scales of LNNB-C significantly correlated with the error scores of BGT and the most of scales of KEDI-WISC. These results put together : strongly support the concurrent and the discriminant validity of the Korean version of LNNB-C in diagnosing brain damage. The limitations of present study and several issues for the luther study were discussed.

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Short-term Effect of Botulinum Toxin Injection on the Surface EMG of Masticatory Muscles and Jaw Function (교근 부위의 보툴리눔 독소 주사가 저작근의 근전도 및 악기능에 미치는 영향)

  • Lee, Jeong-Yun;Park, Hee-Kyung;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.69-77
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    • 2006
  • Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

Temperament and Character Patterns of ADHD Children in a Community (지역사회 주의력결핍 과잉행동장애 아동의 기질 및 성격 특성)

  • Cho Soo-Churl;Kim Boong-Nyun;Jung Dong-Sun;Hwang Jun-Won;Shin Min-Sup;Lyoo In-Kyoon;Kim Jae-Won;Go Bock-Ja;Lee Sang-Eun;Jung Sun-Woo;Kim Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.2
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    • pp.124-130
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    • 2006
  • Objectives : The objective of this study was to evaluate the differences in patterns of temperament and character, as assessed by the Junior Temperament and Character Inventory (JTCI), between the children with attention-deficit/hyperactivity disorder (ADHD) and the control group in a community sample. In addition, we examined the potential differences on JTCI profiles according to the ADHD subtypes. Methods : Parents of 185 ADHD subjects (mean age $9.0{\pm}1.7$ years), as diagnosed by the DISC-IV, and 185 age- and gender-matched comparison children have completed the parent's version of the JTCI. Results : The ADHD group scored significantly higher in Novelty Seeking and lower in Persistence than the comparison group on JTCI. However, there were no significant differences in the temperament or character profiles by the ADHD subtypes. Conclusion : The results of this study suggest that the temperamental factors of higher Novelty Seeking and lower Persistence are related to ADHD. The temperament or character profiles in this study do not provide support for the distinctiveness of the ADHD subtypes.

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Home hospice palliative care service in Korea: Based on focus group interview (가정 호스피스완화의료 서비스 현황 조사: 실무자 포커스 그룹 인터뷰를 중심으로)

  • Koh, Su-Jin;Kim, Yeol;Song, Mi Ok;Choi, Youngsim;Choi, Sung Eun;Jho, Hyun Jung;Huh, Yun Jung;Park, Myung-Hee;Park, Seon Ju;Kwon, So-Hi
    • Journal of the Korean Data and Information Science Society
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    • v.25 no.1
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    • pp.37-52
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    • 2014
  • The aim of this study was to understand home hospice care status and problem in Korea, and ultimately to develop the home hospice standard. This study was conducted as a part of a study on the institutionalization of the home hospice in Korea. A focus group interview with representatives of seven home hospice agency where have provided home hospice service for years was conducted. All of the participants agreed to the essential components for home hospice service including 24 hour on call service, multidisciplinary team visiting, and periodical team meeting. Visiting frequency was 1-3 times per week mostly by nurses. And they agreed requisitely to fulfill an office for home visiting nurses, storage space, and home visiting bags. The obstacles of providing home hospice were 1) no reimbursement system, 2) difficulties to change medication at home, 3) lack of inpatient beds for symptom control. Standardization of home hospice is critical to improve service quality and to develop reimbursement system. The findings of this study could be used as a basic data to develop home hospice standards and guidelines.

A Study on Load Current and Temperature to Expect Lifetime of High-Power Cables (고전력 케이블의 잔여 수명 예측을 위한 부하 전류 및 온도 연구)

  • Um, Kee-Hong;Lee, Kwan-Woo
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.15 no.4
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    • pp.199-203
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    • 2015
  • With the development of industry these days, the demand for electric power increases and the larger capacity for power transfer is required. The scales of facilities should become larger; and the relative systems are required to operate with a higher degree of reliability. Therefore, stabilization of electric power systems is an important issue. The high degree of reliability required in the process of production and supply of electric power is an essential part of industrial society. Accident such as blackouts causes a hugh amount of economic losses to the high-tech industrial society dependent upon electric power. This paper is about the basic study of the relations between the load current and lifetime of power cables in operation. In order to do the research, we installed a current transformer and an equipment for measuring temperature at the 6.6. kV cables in operation. The two equipments have been installed on the cable systems in operation for the last 20 years. Since the insulation resistance of most of the cables showed the value larger than the threshold, it was not easy to tell the remaining lifetime of cables. The load current of the cables was almost constant. The surrunding temperature was $15{\sim}25^{\circ}C$, little variation of temperature values.

Botulinum Toxin type A injection Versus Lidocaine Injection for Myofascial Pain Involving upper Trapezius (승모근 근막동통에 대한 보툴리눔 독소와 리도카인 주사의 치료효과 비교)

  • Ahn, Sung-Woo;Park, Eun-Hee;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.345-351
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    • 2005
  • The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.