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Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children (소아 급성 특발성 혈소판 감소성 자반증에서 골수흡인 검사의 적응)

  • Kim, Won-Duck;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.239-245
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    • 2001
  • Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

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Relationship of Fixation Disparity and Heterophoria According to Fixation Distance (원, 근거리에서 주시시차와 사위와의 관계)

  • Kim, Chang-Jin;Jeong, Ju-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.79-87
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    • 2008
  • Purpose: This study measured Y-intercept that means a fixation disparity, X-intercept that means a associated phoria and slope of a fixation disparity curve (FDC), which are variables of dissociated phoria and the FDC. We searched for the result value and examined the direction, distribution pattern and a variable that give an most affect on dissociated phoria and the FDC at distance and near. Also this study examined that there were statistically significant differences between distance and near, comparing the result value. Methods: We measured the dissociated phoria and the fixation disparity for 51 subjects at distance and near in June, 2007. All subjects ranged from 20 to 25 years of age (average 21.72${\pm}$1.88 years old) and had no eye disease. At distance the dissociated phoria measured with the distance MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the modified Mallett Far Unit (Bernell co., USA). At near the dissociated phoria measured with the near MIM card (muscle imbalance measure card, Bernell co., USA), and the fixation disparity measured with the Wesson fixation disparity card (American Optical co., USA). Results: The percentage distribution of types of fixation disparity curves was that at distance prevalence of Type I (74.6%) was the highest, followed by Type IV (17.6%) and Type II (3.9%), Type III (3.9%) and that at near prevalence of Type I (53.0%) was the highest, followed by Type III (29.4%), Type IV (13.7%) and Type II (3.9%). 2. There were significantly correlation in dissociated phoria, fixation disparity (Y-intercept) and associated phoria (X-intercept). 3. The fixation disparity at distance was most affected by associated phoria (X-intercept) (p=0.000). The distance dissociated phoria was most affected by fixation disparity (Y-intercept) (p=0.342), but the influence was weak. 4. The fixation disparity at near was most affected by associated phoria (X-intercept) (p=0.000). The near also dissociated phoria was most affected by associated phoria (X-intercept) (p=0.009). The result that compared the each variables with the same variables at distance and near had statistically significant on paired t-test for among dissociated phoria (t=7.529, p=0.000), X-intercept (t=5.860, p=0.000), the Y-intercept (t=4.640, p=0.000) but slope of the FDC did not differ significant (t=1.336 p=0.188). Conclusions: Relationship of fixation disparity and Heterophoria had close correlation at distance and near.

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A Study on the Characteristics of the Wealth and nobility Interpretation System of 『Japyeongjinjeon』, 『Jeokcheonsu』 (『자평진전』, 『적천수』의 부·귀 해석체계 특징 고찰)

  • Kim, Seung-Jong;Kim, Ki-Seung
    • Industry Promotion Research
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    • v.6 no.3
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    • pp.71-78
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    • 2021
  • The purpose of this paper is to examine the characteristics of the rich and noble interpretation system of 『Japyeongjinjeon』 and 『Jeokcheonsu』. Myungrihak is a study that began with the study of human wealth and nobility There are 『Japyeongjinjeon』 and 『Jeokcheonsu』 as two major classics of Myeongrihak. However, while these representative books are similar to each other in the interpretation system for the interpretation of wealth and nobility, they also have different aspects. Looking at this. In 『Jepyeong Jinjeon』, the success or failure of the Su-Ju is judged first. If it is Seong-Gyeog (成格), it becomes a good Su-ju (吉), and if it is a Pae-Gyeog (敗格), it becomes a bad Sa-Ju (凶). Even when it comes to Seong-Gyeog, among them there are Gui-Gyeong (貴格) and great Gui-Gyeong (大貴格). Representative great Gui-Gyeong include Jaein-Byeongtu (財印並透), Sigsin -Saengjae (食神生財), Sigsin-Hapsal (食神合煞), Sal-yongsigje (煞用食制) and Sanggwan-Yonggwan (傷官用官). In 『Jeokcheonsu』, there is Jaegi-tongmun (財氣通門) as a Su-Ju with wealth and Gwanseong-Ihoe as a Su-Ju with nobility (貴). Hyundai Group Chairman Chung Ju-young, the representative chaebol of Korea, becomes a Seong-Gyeog in the argument of Japyeong Jinjeon』 and is a Sigsin -Saengjae, and Jaegi-tongmun according to the argument of 『Jeokcheonsu』 are met The first, third, and seventh conditions. Samsung Group Chairman Lee Byung-cheol meets the seventh condition clearly in the argument of 『Jeepyeong Jinjeon』, which is Seong-Gyeog and Sal-yongsigje. In this study, we find out what kind of interpretation method there are and how they differ from the two classics through the original text. In addition, the suitability of the theoretical composition is examined by comparing and examining the characteristics of the rich and noble interpretation system through empirical examples of modern representatives. It is hoped that it will be of some help to related research in the future.

Initial Experience of the Emergency Bypass System ($EBS^{(R)}$) for the Patients with Cardiogenic Shock due to an Acute Myocardial Infarction (급성 심근경색으로 인한 심인성 쇼크 환자에 대한 경피적 순환 보조장치($EBS^{(R)}$) 적용의 초기경험)

  • Ryu, Kyoung-Min;Kim, Sam-Hyun;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon;Kim, Young-Hwa;Park, Seong-Sik
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.329-334
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    • 2008
  • Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

The Landscape Configuration and Semantic Landscape of Hamheo-pavilion in Gokseong (곡성 함허정(涵虛亭)의 경관짜임과 의미경관)

  • Lee, Hyun-Woo;Sim, Woo-Kyung;Rho, Jae-Hyun;Shin, Sang-Sup
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.1
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    • pp.52-64
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    • 2015
  • This research traced the characteristics of the semantic landscape, construction intent, landscape composition, and geomantic conditions of the area subject to the research based on the research methods of 'field investigation, document studies, and interviews,' centering around the entire area of Gokseong Hamheo-pavilion (Jeonnam Tangible Cultural Assets No. 160). The result of the research, specifically revealing the forms and methods by which the reciprocal view of nature and landscape composition appearing in the landscape of the entire area of Hamheo-pavilion, as part of the analysis and interpretation over the view-based construction characteristics and position of the entire area of Gokseong Hamheo-pavilion, can be summarized as follows. First, Hamheo-pavilion is a pavilion built as a resting area and as a venue for educational activities in 1543 in the nearby areas after Gwang-hyeon Sim founded Gunjichon-jeongsa for educational activities and dwelling purposes at Gunchon at the 30th year of King Jungjong. Gunchon, where Hamheo-pavilion and Gunjichon-jeongsa is located, exhibits the typical form having water in the front, facing Sunja-river(present Seomjin-river), and a mountain in the back side. Dongak-mountain, which is a guardian mountain, is in a snail-type form where cows leisurely ruminate and lie on the riverside, and the Hamheo-pavilion area is said to be an area bordering on one's way of enjoying peace and richness as it is a place with plentiful grass bushes available for cows to ruminate and lie down while sheppards may leisurely play their flutes at the riverside. The back hill of Hamheo-pavilion is a blood vessel that enters the water into the underwater palace of the turtle, and the building sitting on the turtle's back is Hamheo-pavilion, and the Guam-jodae(龜巖釣臺) and lava on the southern side below the cliff can be interpreted to be the underwater fairly land wanted by the turtle.6) Second, Hamheo-pavilion is the scenery viewpoint of Sungang-Cheongpung (3rd Scenery) and Seolsan-Nakjo(雪山落照, 9th Scenery) among the eight sceneries of Gokseong, while also the scenery viewpoint of Hamheo-Sunja(2nd Scenery) and Cheonma-Gwiam(天馬歸岩, 3rd Scenery) among the eight sceneries of Ipmyeon. On the other hand, the pavilion is reproduced through the aesthetics of bends through sensible penetration and transcendental landscape viewed based on the Confucian-topos and ethics as the four bends among the five bends of Sunja-river arranged in the 'Santaegeuk(山太極) and Sutaeguek(水太極, formation of the yin-yang symbol by the mountain and water)' form, which is alike the connection of yin and yang. In particular, when based on the description over Mujinjeong (3rd Bend), Hoyeonjeong(4th Bend), andHapgangjeong(2nd Bend) among the five bends of Sunja-river in the records of Bibyeonsainbangan-jido(duringthe 18th century) and Okgwahyeonji(1788), the scenery of the five bends of Sunja-river allow to glimpse into its reputation as an attraction-type connected scenery in the latter period of the Joseon era, instead of only being perceived of its place identity embracing the fairyland world by crossing in and out of the world of this world and nirvana. Third, Hamheo-pavilion, which exhibits exquisite aesthetics of vacancy, is where the 'forest landscape composed of old big trees such as oak trees, oriental oak trees, and pine trees,' 'rock landscape such as Guam-jodae, lava, and layered rocks' and 'cultural landscape of Gunchon village' is spread close by. In the middle, it has a mountain scenery composed of Sunja-river, Masan-peak, and Gori-peak, and it is a place where the scenery by Gori-peak, Masan-peak, Mudeung-mountain, and Seol-mountain is spread and open in $180^{\circ}$ from the east to west. Mangseo-jae, the sarangchae (men's room)of Gunjichon-jeongsa, means a 'house observing Seoseok-mountain,' which has realized the diverse view-oriented intent, such as by allowing to look up Seol-mountain or Mudeung-mountain, which are back mountains behind the front mountain, through landscape configuration. Fourth, the private home, place for educational activities, pavilion, memorial room, and graveyard of Gunji-village, where the existence and ideal is connected, is a semantic connected scenery relating to the life cycle of the gentry linking 'formation - abundance - transcendence - regression.' In particular, based on the fact that the descriptions over reciprocal views of nature regarding an easy and comfortable life and appreciations for a picturesque scene of the areas nearby Sunja-river composes most of the poetic phrases relating to Hamheo-pavilion, it can be known that Hamheo-pavilion is expressed as the key to the idea of 'understanding how to be satisfied while maintaining one's positon with a comfortable mind' and 'returning to nature,' while also being expressed of its pedantic character as a place for reclusion for training one's mind and training others through metaphysical semantic scenery.