• Title/Summary/Keyword: 총 삽입 시간

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Treatment of Deep Venous Thromboses of Lower Leg with Thrombolysis (혈전용해술을 이용한 하지 심부정맥 혈전증의 치료)

  • 이재원
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.711-715
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    • 2001
  • Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

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In Vivo Embryo Production and Embryo Transfer in Hanwoo and Jeju Black Cattle Using CIDR (CIDR를 이용한 제주 한우 및 흑우의 체내 수정란 생산과 이식)

  • Kim, Y.H.;Koo, J.C.;Oh, C.W.;Kang, S.Y.;Yang, B.S.;Oh, S.J.;Kim, C.N.;Song, J.Y.;Kim, I.H.
    • Journal of Embryo Transfer
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    • v.21 no.3
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    • pp.191-198
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    • 2006
  • The objectives of this study was to produce valuable offsprings of Hanwoo and Jeju black cattle using in vivo embryo production and embryo transfer techniques during 5 years ($2001{\sim}2005$) in Jeju. Two hundred and eighty six Hanwoo and sixty nine Jeju black cattles, at random stages of the estrous cycle, received a CIDR. Seven days later, the animals were superovulated with a total of 400 mg pFSH ($Folltropin^{(R)}-V$) administered twice daily in constant doses (each 50 mg) over 4 days. On the 6th administration of FSH, CIDR was withdrawn and 25 mg $PGF_{2{\alpha}}$ was administered. Cows were artificially inseminated thrice after estrous detection at 12 hr intervals. The cows received $250{\mu}g$ GnRH at the time of 2nd insemination. Embryos were recovered 7 or 8 days after the 1st insemination. Recipients were synchronized with donors by insertion of a CIDR for 7 days and administration of 25 mg $PGF_{2{\alpha}}$ at the time of CIDR removal. The collected embryos were transferred to 1,219 recipients by 6 transfer persons. The mean numbers of total ova and transferable embryos from Hanwoo and Jeju black cattle donors were 7.4 and 4.7, respectively The number of transferable embryos differed between Hanwoo (5.0) and Jeju black cattle (3.5, p<0.05), while that of total ova did not differ. Repeated superovulation treatments decreased (p<0.05) the ratio of numbers of the flushed animals vs. superovulated animals in Jeju black cattle, and the numbers of total ova and transferable embryos in Hanwoo. More transferable embryos were collected at summer (5.6) than winter (2.9, p<0.01). The mean pregnancy rate was 40%. The pregnancy.ate was affected by transfer year (2001<2004, p<0.05) and transfer person ($33.0{\sim}41.9%$, p<0.01), while not by donor (embryo) breed. These results showed that in vivo embryo preduction and embryo transfer techniques using CIDR for Hanwoo and Jeju black cattle donors as well as recipient, regardless of their estrous cycle, may enable a stable embryo production and recipient preparation.

Cost-Effectiveness of VATS Versus Open Thoracotomy for Primary Spontaneous Pneumothorax (일차성 자연기흉의 수술 방법에 따른 비용효용 비교)

  • 장운하;오태윤;김미혜;최주원
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.898-903
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    • 2000
  • 배경 및 목적: 최근 비디오 흉강경술은 최소 침습적인 수술 방법으로서 자연 기흉의 일반적 치료법으로 인정되고 있으나 비교적 높은 재발율과 비용-효용 관계에 대해서는 논란이 있다. 비디오 흉강경을 이용한 기포 절제술 후의 재발율은 평균 5-10%정도로 보고되고 있으며 이는 개흉술에 비해 상당히 높은 것이다. 또한 국내 의료 실정에서의 개흉술과 비디오 흉강경술의 비용효용에 대한 비교 통계는 없는 상황이다. 대상 및 방법: 1997년 1월부터 1999년 7월까지 일차성 자연기흉으로 성균관 의대 강북삼성병원 흉부외과에서 수술을 시행한 173예를 대상으로 후향적 조사하였다. 비디오 흉강경술로 시행한 104예와 개흉술로 시행한 69예를 양군으로 나누어 성별 및 연령, 발병부위, 수술의 적응증, 수술시간, 술 후 흉관 삽입기간 및 재원 일수, 술후 합병증, 재발율, 수술 경비 및 총치료경비 등을 비교하였다. 결과: 양군의 성별, 연령, 발병부위 등에는 차이가 없었다. 수술 시간은 흉강경군이 73.1$\pm$29.5분, 개흉군이 141$\pm$52분이었다.(p<0.05). 술 후 평균 흉관의 거치기간 및 재원일수는 흉강경군이 각각 3.93일 및 7.5일, 개흉군이 7.0일 및 13.4일이었다.(P<0.05, P<0.05). 술 후 재발한 경우가 비디오 흉강경군에서 6예(5.6%), 개흉군에서 1예(1.4%) 있었다(P<0.05). 본원에서 시행한 비디오 흉강경술과 개흉술의 비교에서 수술로 발생하는 비용은 비디오 흉강경군이 유의하게 높았으나 (1,202,192$\pm$178,992원, 1,005,669$\pm$311,531원; P<0.05) 총 치료비의 비교에서는 유의한 차이가 없었다.(1,946,110$\pm$487,440원, 1,793,912$\pm$308,079원; P=0.18). 결론: 비용 효용관계 및 재발율은 병원마다의 수술 수기 및 퇴원 정책등에 따라서 다소간의 차이가 있을 수 있으나 본원의 조사 결과에서는 비디오 흉강경술이 개흉술에 비해 비용-효과가 있다고 볼 수 없으며 재발율도 높았다.

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Transformation of Chinese Cabbage Glutathione Reductase (GR) gene into Lettuce (Lactuca sativa L.) with Particle Bombardment (유전자총을 이용한 상추 내로의 배추 Glutathione Reductase (GR)유전자의 도입)

  • 정재동;이부자;이효신;김창길
    • Korean Journal of Plant Tissue Culture
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    • v.27 no.6
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    • pp.475-478
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    • 2000
  • The cytosolic glutathione reductase(GR) gene of chinese cabbage was introduced into Lettuce (Lactuca sativa L.) with particle bombardment method. When cotyledon explants were treated with osmoticum-conditioning medium (0.6 M sorbitol/mannitol) 4 hours prior to and 16 hours after bombardment, it was identified by GUS assay that this condition was the most efficient one for introduction of foreign genes into cotyledon tissue of lettuce with particle bombardment. The stable integration of a GR gene was confirmed by the PCR analysis. 0.3, 0.6, 1.5 kbp PCR fragments of transgenes were obtained by three types of primers designed on the basis of GR sequence. To know whether the expression of the GR gene of pBKs-GR 1 can be stably maintained in the next generation, T$_2$selfing seeds obtained from the transformed mother plants were sowed on MS medium supplemented with 200 mg/L kanamycin sulfate. 70% of seedlings showed resistance to kanamycin.

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Membranous PTEE Monocusp Vlave on the Right Ventricular Outflow Tract (막형 PTEE 단엽판막을 이용한 우심실 유출로 확장수술)

  • 박영환;홍유선;이현성;이종균;조범구
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.322-328
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    • 2001
  • 배경: 우심실 유출로 재건술후에는 폐동맥판막부전이 우심실기능에 나쁜 영향을 미친다. 이를 막기 위해 여러 재료로 판막을 제조하여 사용하는데 가피 형성이 적은 막형 ePTEE(expanded polytetrafluoroethylene, Goretex) 단엽판막의 효과를 알아보고자 연구를 시행하였다. 대상 및 방법; 1996년 3월부터 1997년 2월까지 우심실유출로 재건술을 시행받고 수술 1일까지 우심실 압력을 측정할 수 있었던 47명중 막형 Goretex단엽판막을 사용한 환자(비교군) 19명, 사용하지 않은 환자(대조군) 28명에서 단엽판막의 유용성을 조사하였다. 두 군간에는 나이, 체중 그리고 McGoon ratio 등에는 통계학적 차이가 없었다.(p>0.05) 이전의 수술은 대조군에서 19번, 비교군에서 22번을 시행하였다. 우심실 유출로에 대한 수술은 대조군에서 REV수술 2예, 우심실폐동맥 연결수술 8예, 우심실 유출로 재개건술 2예, 우심실 유출로에 대한 수술은 대조군에서 16예였으며, 비교군에서는 REV 수술 5예, Rastelli 씨 수술 6예, 재우심실 유출로 재건술 5예, 그리고 우심실 재건술 3예였다. 결과: 대동맥 차단 시간이나 총심폐순환시간에는 두군간의 차이는 없었다. 또한 수술직후와 수술후 1일째 측정한 우심실 압력 및 좌심방압력의 차이도 두군간에는 차이가 없었으며 수술후 7일째 시행한 심에코도 결과 ejection fraction., 우심실/ 좌심실 압력비 , 그리고 우심실 유출로의 압력차, 강심제 투여일수, 호흡기 사용 기간 등에서도 두군간의 차이는 없었으나 흉관 삽입기간이 비교군에서 의미있게 짧았다. 추적 조사 기간 중 비교군 1예에서 사망을 하였으나. Goretex 단엽판막에 의한 것은 아니였으며 심초음파검사상 우심실 유출로 압력차이나 재수술은 두군간에 차이는 없었으나 폐동맥 폐쇄부전은 비교군에서 의미 있게 낮은 것을 보이고 있다. 결론; 막형 Goretex 단엽판막의 조기성적은 우수하였으며 폐동맥 폐쇄분전의 정도를 적게 하는 효과를 보이나 앞으로 이들이 성장함에 따라 우심실 유출로에 폐쇄를 일으키는지는 계속적인 추적관찰이 요구된다.

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Comparison and evaluation of volumetric modulated arc therapy and intensity modulated radiation therapy plans for postoperative radiation therapy of prostate cancer patient using a rectal balloon (직장풍선을 삽입한 전립선암 환자의 수술 후 방사선 치료 시 용적변조와 세기변조방사선치료계획 비교 평가)

  • Jung, hae youn;Seok, jin yong;Hong, joo wan;Chang, nam jun;Choi, byeong don;Park, jin hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.45-52
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    • 2015
  • Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

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The Evaluation of SUV Variations According to the Errors of Entering Parameters in the PET-CT Examinations (PET/CT 검사에서 매개변수 입력오류에 따른 표준섭취계수 평가)

  • Kim, Jia;Hong, Gun Chul;Lee, Hyeok;Choi, Seong Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.43-48
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    • 2014
  • Purpose: In the PET/CT images, The SUV (standardized uptake value) enables the quantitative assessment according to the biological changes of organs as the index of distinction whether lesion is malignant or not. Therefore, It is too important to enter parameters correctly that affect to the SUV. The purpose of this study is to evaluate an allowable error range of SUV as measuring the difference of results according to input errors of Activity, Weight, uptake Time among the parameters. Materials and Methods: Three inserts, Hot, Teflon and Air, were situated in the 1994 NEMA Phantom. Phantom was filled with 27.3 MBq/mL of 18F-FDG. The ratio of hotspot area activity to background area activity was regulated as 4:1. After scanning, Image was re-reconstructed after incurring input errors in Activity, Weight, uptake Time parameters as ${\pm}5%$, 10%, 15%, 30%, 50% from original data. ROIs (region of interests) were set one in the each insert areas and four in the background areas. $SUV_{mean}$ and percentage differences were calculated and compared in each areas. Results: $SUV_{mean}$ of Hot. Teflon, Air and BKG (Background) areas of original images were 4.5, 0.02. 0.1 and 1.0. The min and max value of $SUV_{mean}$ according to change of Activity error were 3.0 and 9.0 in Hot, 0.01 and 0.04 in Teflon, 0.1 and 0.3 in Air, 0.6 and 2.0 in BKG areas. And percentage differences were equally from -33% to 100%. In case of Weight error showed $SUV_{mean}$ as 2.2 and 6.7 in Hot, 0.01 and 0.03 in Tefron, 0.09 and 0.28 in Air, 0.5 and 1.5 in BKG areas. And percentage differences were equally from -50% to 50% except Teflon area's percentage deference that was from -50% to 52%. In case of uptake Time error showed $SUV_{mean}$ as 3.8 and 5.3 in Hot, 0.01 and 0.02 in Teflon, 0.1 and 0.2 in Air, 0.8 and 1.2 in BKG areas. And percentage differences were equally from 17% to -14% in Hot and BKG areas. Teflon area's percentage difference was from -50% to 52% and Air area's one was from -12% to 20%. Conclusion: As shown in the results, It was applied within ${\pm}5%$ of Activity and Weight errors if the allowable error range was configured within 5%. So, The calibration of dose calibrator and weighing machine has to conduct within ${\pm}5%$ error range because they can affect to Activity and Weight rates. In case of Time error, it showed separate error ranges according to the type of inserts. It showed within 5% error when Hot and BKG areas error were within ${\pm}15%$. So we have to consider each time errors if we use more than two clocks included scanner's one during the examinations.

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The Central Venous Catheter-related Infection of Chlorhexidine-silver Sulfadiazine Coated Catheters in Medical ICU (내과계 중환자실 환자에서 Chlorhexidine-silver Sulfadiazine Coated Catheter의 중심정맥관 감염에 대한 연구)

  • Jung, Young Ju;Koh, Younsuck;Lim, Chae-Man;Lee, Jae Seung;Yu, Mi Hyun;Oh, Yeon Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.389-396
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    • 2005
  • Background : Central venous catheters(CVCs) area major source of nosocomial infection. Chlorhexidine-silver sulfadiazine coated catheters (CHSS) were developed to reduce the rate of CVC infection. However, the clinical effectiveness of CHSS in comparison wth non-coated catheter (NCC) remains to be evaluated. Methods : From January 2004 to December 2004 in medical intensive care unit (ICU) of Asan Medical Center, CVCs were inserted in 446 cases. We retrospectively analyzed characteristics of patients and catheterization,the catheter-related infection rate and colonization, microbiologic findings, and insertion sites (subclavian, jugular, femoral) according to the type of inserted CVCs (NCC: 187 cases, CHSS: 259 cases). Catheter related infection is defined as catheter related bacteremia and catheter related non-bacteremic sepsis. Results : 1) The mean age of the patients in each group was $62{\pm}16$ years, $63{\pm}15$ years (p=0.42), and sex ratio 94:50, 141:69 (p=0.9) in NCC and CHSS. Duration of ICU admission ($29{\pm}37$, $26{\pm}44$ p=0.42), duration of mechanical ventilation ($17{\pm}22$, $15{\pm}19$ p=0.17), and APACHE III score at the time of CVC insertion ($81{\pm}34$, $82{\pm}37$ p=0.61) were not different between both groups. 2) Mean duration of catheterization was 118 in NCC and 119 in CHSS (p=0.98). Number of catheter-days was 2176 days in NCC and 3035 days in CHSS. Catheter-related infection occurred in 9 (4.8%) cases receiving NCC and 4 cases (1.5%) receiving CHSS. Catheterrelated infection incidence per 1000 catheter-days was 4.1 and 1.3, respectively (p=0.04). CHSS was associated with a significant reduction of infection in jugular catheters regarding to insertion sites (p=0.01). 3) Microorganisms causing infection were Staphylococcus aureus (n=3), Candida (n=3), coagulase-negative Staphylococci (n=2), and Klebsiella (n=1) in NCC, and Candida species (n=2), coagulase-negative Staphylococci (n=2), Proteus (n=1) in CHSS. Conclusion : CHSS has significantly reduced the episodes of infection compared to NCC in jugular catheterization in medical ICU.

Effects of Parity and Season on Production of Embryos in Superovulated Hanwoo (과배란 처리된 한우의 수정란 생산에 미치는 산차와 계절의 효과)

  • Song, Sang-Hyun;Jang, Duk-II;Min, Chan-Sik;Park, Jyun-Kyu;Joo, Young-Kuk;Lee, Jyung-Gyu;Chung, Ki-Hwa
    • Journal of Embryo Transfer
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    • v.27 no.3
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    • pp.127-131
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    • 2012
  • This study was performed to investigate the effects of parity and season on the embryo production in superovulated Hanwoo cows. Superovulation was performed from 1 to 8 times by repeated superovulation treatment of Hanwoo cows (n = 22). Irrespective of estrous cycle, donor cows were received a CIDR, progesterone (50 mg) and estradiol benzoate (2.5 mg). After 4.5 days, the donor cows were superovulated with total 28AU FSH (Antorin R-10) administrated twice daily in a decreasing dose for 4 days. On $6^{th}$ and $7^{th}$ of FSH injection, 2.5 mg and 15 mg $PGF_2{\alpha}$ were injected i.m, respectively. CIDR was removed at the $7^{th}$ FSH injection. The donor cows received $200{\mu}g$GnRH at 48 hrs after $1^{st}$ $PGF_2{\alpha}$ injection. The donor cows were artificially inseminated three times after estrous detection at 12 hr intervals and embryos were recovered 7 days after estrous detection. The mean number of total ova, transferrable embryos, degenerated embryos and unfertilized oocytes were $11.6{\pm}7.9$, $5.5{\pm}4.4$, $3.0{\pm}3.3$ and $2.6{\pm}4.1$ per donor cows, respectively. A higher number of total ova were recovered in parity 3~5 ($14.3{\pm}1.3$) than 1~2 ($8.9{\pm}1.9$, P<0.05). The number of recovered normal embryos is significantly higher in parity 3~5 ($7.3{\pm}0.8$) than that of over 6 ($3.7{\pm}1.5$). Significantly higher number of total ova and normal embryos were recovered in summer ($16.4{\pm}2.3$, $8.1{\pm}1.4$) than in autumn ($10.1{\pm}1.8$, $4.5{\pm}1.1$) and winter ($6.3{\pm}1.8$, $3.3{\pm}1.1$), respectively (P<0.05). Transferable embryos were significantly higher in summer ($7.6{\pm}1.3$) than in winter ($3.0{\pm}1.0$, P< 0.05). The results were showed that parity and season affecting on the production of embryos in superovulated Hanwoo.

Evaluation on Thermal Performance Along with Constructability and Economic Feasibility of Large-diameter Cast-in-place Energy Pile (대구경 현장타설 에너지파일의 열교환 성능과 시공성 및 경제성 분석)

  • Park, Sangwoo;Sung, Chihun;Lee, Dongseop;Jung, Kyoungsik;Choi, Hangseok
    • Journal of the Korean Geotechnical Society
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    • v.31 no.5
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    • pp.5-21
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    • 2015
  • An energy pile is a novel type of ground heat exchangers (GHEX's) which sets up heat exchange pipes inside a pile foundation, and allows to circulate a working fluid through the pipe for exchanging thermal energy with the surrounding ground stratum. Using existing foundation structure, the energy pile can function not only as a structural foundation but also as a GHEX. In this paper, six full-scale energy piles were constructed in a test bed with various configurations of the heat exchange pipe inside large-diameter cast-in-place piles, that is, three parallel U-type heat exchangers (5, 8 and 10 pairs), two coil type heat exchangers (with a 500 mm and 200 mm pitch), and one S-type heat exchanger. During constructing the energy piles, the constructability of each energy pile was evaluated with consideration of the installation time, the number of workers and any difficulty for installing. In order to evaluate the thermal performance of energy piles, the thermal performance tests were carried out by applying intermittent (8 hours operating-16 hours pause) artificial cooling operation to simulate a cooling load for commercial buildings. Through the thermal performance tests, the heat exchange rates of the six energy piles were evaluated in terms of the heat exchange amount normalized with the length of energy pile and/or the length of heat exchange pipe. Finally, the economic feasibility of energy pile was evaluated according to the various types of heat exchange pipe by calculating demanded expenses per 1 W/m based on the thermal performance test results along with the market value of heat exchange pipes and labor cost.