• Title/Summary/Keyword: 추적기

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Surgical Correction of Total Anomalous Pulmonary Venous Connection in Early Infancy (조기 영아에서 전폐정맥연결이상의 외과적 교정)

  • 성시찬;방정희;전희재;조광조;최필조;우종수;이인규;이형두
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.510-517
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    • 1999
  • Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

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Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum -Effect of the size of tricuspid valve annulus on the surgical outcome- (영아기에 발견된 심실중격이 온전한 폐동맥 폐쇄증의 외과적 수술요법 술전 삼첨판륜 크기 가 수술 결과에 미치는 영향)

  • 이정렬;윤태진
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1081-1089
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    • 1996
  • Pulmonary atresia with intact ventricular septum has continued to have a high surgical mortality and morbidity. This mAy attribute to the non-uniformity of the anomaly. We reviewed a total of 34 infants with pulmonary atresla and intact ventricular septum managed in this hospital between 1987 and 1995. Mean age and body weight were 57.2 (range, 3-208) days and 4.1 (range, B.3∼6.8) kg. The preoperative Z-value of the diameter of the tricuspid valve was less than -2 in 85.2% of patients and less than -4 in 33. 3% . It is well correlated w th right ventricular cavity size (n=27. r10.68, p< 0.05). Coronary artery-right ventricular fistulas were identified in 3 patients, and right ventricular dependency was suspected in 1 Over All hospital mortality was 23.5%(8/34), although it decreased to 16.6%(4124) in 1990s. Subsequent procedures were performed in 6 patients between 3 days and 58 months after Initial palliation : one bidirectional cavopulmonary shunt and 1 Fontan operation after systemic-pulmonary shunt, 3 transannular patch + atrial septal defect closure and 1 additional systemic-pulmonary shunt after polmonary valvectomy or valvotomy. Changes of Z-values of the diameter of tricuspid valve have been followed up in 11 patients between 1 and 66 months postoperatively. Z-values were increased In 5 out of 8 transannular right ventriculAr outflow tract enlargement group and in 1 out of 3 pulmonary valvectomy or valvotomy group. Our data suggest that tailoring a treatment to right ventricular cavity size and coronary anom lies may improve the surgical outcome. A Z-value of the tricuspid valve diameter could be used.

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Fluvial Deposits Distributed along the Seomjin River (섬진강 유역의 하성 퇴적층에 관한 연구)

  • You, Hoen-Su;Cho, Seok-Hee;Koh, Yeong-Koo
    • Journal of the Korean earth science society
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    • v.21 no.2
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    • pp.174-187
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    • 2000
  • The Quaternary coarse-grained sandy sediments are distributed along the channels of Seomjin River. The fluvial sediments were sedimentologically studied in horizontal and vertical distributions. To analyze depositional environments and facies changes in the sediments, sediment sampling from river mouth to upper stream and desctriptive approaches to the sediment profiles outcropped near Kurye were carried out. The sediments along the stream lines of the river are assigned to very coarse to coarse sand in grain size. The sediment grains are widely scattered in sorting and moderately sorted in average. For skewness and kurtosis, the sediments ranges from very fine to very coarse skewed and from very lepto-kurtic to extremelyl epto-kurtic states, respectively. The sediments are divided into slightly gravelly sand, gravelly sand and sandy gravel in sediment type. The pain shape in the sandy sediments are dominant in equant and tabular forms showing wide varieties. The sandy sediments are mostly poorly sorted and are highly variable in surface texture with SEM. Some smaller grains in the sediments ordinarily show polished surfaces. Of those grains, quartz ones are commonly angular to surounded. On the basis of facies changes and sedimentary structures, outcropped fluvial sediment profiles in Kurye are classified into xGyS, mGyS, gGyS, xSM, xS, mS, mGyM, IgM in facies. These eight facies are reformed as facies assemblage I and ll. The facies assemblage I and II are interpreted as the products of the channel deposits in braided stream and flood plain ones besides channels, respectively. The change facies assemblage I with facies assemblage ll imply that depositional environments hadbeen migrated from braied sream to flood plain ones.

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Changes in Body Composition after a Radical Gastrectomy for a Gastric Adenocarcinoma using Bioelectrical Impedance Analysis during the First Year following Surgery (위암의 근치적 위절제술 후 생체 전기 임피던스법을 이용한 체성분 변화의 1년간 추적관찰)

  • Hwang, Si-Eun;Kim, Chan-Young;Yang, Doo-Hyun
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.228-236
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    • 2007
  • Purpose: We have evaluated changes of body composition for patients that underwent a radical gastrectomy for stomach cancer by the use of available bioelectrical impedance analysis during the first year following surgery. We plan to utilize these findings in nutritional and physiological studies. Materials and Methods: We evaluated clinical changes in body composition in patients using the bioelectrical impedance method (Inbody 4.0, Biospace, Korea), between November 2003 to November 2004. A total of 98 patients agreed to enroll in this study among all of the patients that underwent a radical gastrectomy. Results: The average weight decreased by 6.7%, and 9.4%, within the first and 6 months after surgery, respectively (P<0.01). The fat free mass (FFM) dropped by 4.9% within the first month and there were no more changes after this period (P<0.01). The fat mass (FM) and visceral fat area (VFA) decreased 24.3% and 14.1% within the first 6 months (P<0.01), respectively. The reduction effects for female patients were greater than for male patients for weight, FFM and VFA (P<0.05). The edema index was higher in patients with stage III-IV disease than in patients with stage I-II disease (P<0.05). There were significant differences for Billroth I and Billrothl II patients as compared to patients that underwent an esophagojejunostomy for a reduction of the FM, as measured in the in the 12th month after surgery (27.6%, 22.1%, and 41.2%, respectively; P<0.05). Conclusion: Since nutritional supplementation and an improvement in body weight loss after a radical gastrectomy is significantly related with quality of life, nutritional and physiological studies should be greatly considered. In this study, bioelectrical impedance analysis was very useful in analyzing the diminution of body composition and we hope this study on the nutritional and physiological aspects related to a radical gastrectomy will be useful for later studies.

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Which of Baby Boom Generation Can Get the Benefit of Extension of the Retirement Age Obligation? (베이비붐세대와 정년연장 혜택의 귀착)

  • Seok, Jae Eun;Yi, Gi Joo
    • Korean Journal of Social Welfare
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    • v.68 no.2
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    • pp.107-130
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    • 2016
  • This study is aimed at the exploratory research on the influence of the obligation of extension of the retirement age on the baby boom generation. The basic question of this study is about which of the baby boom generation can get how much benefit according as the extension of the retirement age becomes compulsory. The extension of the retirement age is the system that can be applied to regular full-time workers. Accordingly, this study is intending to analyze the characteristics of the workers having a high likelihood for benefits from extension of the retirement age by tracing the economic activity state and labor history of the baby boomers. For this purpose, this study looked into the change of the economic activity state by age cohort of the male baby boomers based on the data for the Korea Labor Panel's 4th(2001) & 17th(2014)year. Using Survival analysis, this study also analyzed who will continue to remain as a regular full-time wage earner. As the result of the analysis, it was found that the more the cohort ages of baby boomers increased, the smaller the probability of remaining as a regular full-time wage earner, and the group who can get benefits from extension of the retirement age was predicted to account for only 11.4% level among the baby boomers. In addition, the result showed that there was a high likelihood of getting more benefits from extension of the retirement age when the baby boomers worked for the government-invested institution, corporate bodies, and government organizations rather than working for private enterprises. Thus, it can be safely said that there might appear a generational conflict due to extension of the retirement age in that such jobs coincide with the ones favored by the rising generation.

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Clinical Experience of Long-term Home Oxygen Therapy (재택산소요법을 받고 있는 환자들에 대한 임상 관찰)

  • Lee, Young-Suk;Cha, Seung-Ick;Han, Chun-Duk;Kim, Chang-Ho;Kim, Yeun-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.283-291
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    • 1993
  • Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

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The Effect of Steroid on the Treatment of Endobronchial Tuberculosis (기관지 결핵 치료에 있어서 스테로이드의 효과)

  • Sung, Yun-Up;Kim, Sang-Hoon;Shin, Jong-Wook;Lim, Seong-Yong;Kang, Yun-Jung;Koh, Hyung-Gee;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.130-141
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    • 1995
  • Background: Endobronchial tuberculosis is one of the serious complications of pulmonary tuberculosis. Without early diagnosis and proper treatment of endobronchial tuberculosis, bronchostenosis can leave and lead to the collapse of distal lung parenchyme, bronchiectasis, and secondary pneumonia accompanied with moderate to severe dyspnea, cough, hemoptysis, and localized wheezing. Therefore steroid therapy has been tried to prevent bronchostenosis. But the effect of steroid therapy on the endobronchial tuberculosis is not definite at present. We tried to elucidate the effect of steroid on the treatment of endobronchial tuberculosis for prevention of bronchostenosis. Methods: We observed the initial and sequential bronchoscopic findings, pulmonary function tests and simple chest roentgenograms in 58 patients diagnosed as endobronchial tuberculosis and admitted to Chung-Ang university hospital from 1988 to 1992. The patients in nonsteroid group (n=39) were treated with anti-tuberculosis chemotherapy only and steroid group(n=17) with combined steroid therapy. Sequential bronchoscopic findings, pulmonary function tests, and chest roentgenograms were comparatively analyzed between the two groups. Results: 1) The endobronchial tuberculosis was highly prevalent in young females especially in third decade. 2) Both actively caseating type and the stenotic type without fibrosis was the most common in the bronchoscopic classification. 3) The sequential bronchoscopic findings in steroid group 2 months after treatment showed no significant improvements compared with nonsteroid group. 4) There was no significant difference between the two groups in the sequential bronchoscopic improvements according to bronchoscopic types. 5) We did not find any significant difference in improvements on follow-up pulmonary function tests and simple chest roentgenograms between the two groups 2 month after treatment. 6) There was no significant adverse effect of steroid during the treatment. Conclusion: Combined steroid therapy provably would not influence outcome of the treatment of endobronchial tuberculosis.

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Helicobacter pylori reinfection rate by a 13C-urea breath test and endoscopic biopsy tests in Korean children (한국 소아에서 Helicobacter pylori 박멸 후 13C-요소 호기 검사와 내시경적 생검을 이용한 재감염률 연구)

  • Shim, Jeong Ok;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.268-272
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    • 2006
  • Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

Application of SP Monitoring in the Pohang Geothermal Field (포항 지열 개발지역에서의 SP 장기 관측)

  • Lim Seong Keun;Lee Tae Jong;Song Yoonho;Song Sung-Ho;Yasukawa Kasumi;Cho Byong Wook;Song Young Soo
    • Geophysics and Geophysical Exploration
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    • v.7 no.3
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    • pp.164-173
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    • 2004
  • To delineate geothermal water movement at the Pohang geothermal development site, Self-Potential (SP) survey and monitoring were carried out during pumping tests. Before drilling, background SP data have been gathered to figure out overall potential distribution of the site. The pumping test was performed in two separate periods: 24 hours in December 2003 and 72 hours in March 2004. SP monitoring started several days before the pumping tests with a 128-channel automatic recording system. The background SP survey showed a clear positive anomaly at the northern part of the boreholes, which may be interpreted as an up-flow Bone of the deep geothermal water due to electrokinetic potential generated by hydrothermal circulation. The first and second SP monitoring during the pumping tests performed to figure out the fluid flow in the geothermal reservoir but it was not easy to see clear variations of SP due to pumping and pumping stop. Since the area is covered by some 360 m-thick tertiary sediments with very low electrical resistivity (less than 10 ohm-m), the electrokinetic potential due to deep groundwater flow resulted in being seriously attenuated on the surface. However, when we compared the variation of SP with that of groundwater level and temperature of pumping water, we could identify some areas responsible to the pumping. Dominant SP changes are observed in the south-west part of the boreholes during both the preliminary and long-term pumping periods, where 3-D magnetotelluric survey showed low-resistivity anomaly at the depth of $600m\~1,000m$. Overall analysis suggests that there exist hydraulic connection through the southwestern part to the pumping well.

Improvement of Patient Safety and Inspection Satisfaction by Developing Pretreatment Process System with the Patients Who Reserved CT Enhance Examination (CT 조영검사 예약환자의 전처치 프로세스 시스템 개발을 통한 환자안전 및 검사 만족도 향상)

  • Beom, Hyinam;Han, Jaebok;Song, Jongnam;Kim, Wook;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.10 no.1
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    • pp.29-37
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    • 2016
  • This study aims to improve the satisfaction level of the patient who undergoes CT contrast examination by developing and applying pretreatment process system, which not only can reduce the side effects caused by the test but also can help carry out the test smoothly. The subjects were 214 patients who booked CT contrast examination from January 2014 to February 2014 but could not carry out their test on schedule. We analyzed the reasons for the delay and conducted follow-up survey on them. We analyzed the usefulness of pretreatment process system by contemplating and developing pretreatment process system and applying it to the patients for whom follow-up survey was conducted from January 2015 to February 2015. The number of outpatients who came to the hospital form January to February 2014 was 2,846 and the number of patients who could not undergo the test was 214, accounting for 7.52% of the total. The specific reason for the delay includes 214 cases of unknown creatinine 98 with 120 minutes of average delay time, 40 cases of creatinine over 1.3(19%) with 30minutes of average delay time, 34 cases of past contrast media side effect 6% with 40 minutes of average delay time and 25 cases of lack of pretreatment such as fasting, etc. 11% with 120minutes of average delay time. The number of CT scan has been increasing ever since the development of CT and the frequency of using the contrast media is expected to increase. If we can employ pretreatment process system in order to effectively control the side effect of contrast media and help the CT contrast examination to be smoothly conducted on schedule, I'm sure we could improve the quality of our medical service and increase our patients' satisfaction who come to our CT scan room.