Background: Spontaneous hemopneumothorax is a rare disease and can be life threatening; it occurs in $1{\sim}12%$ of patients with spontaneous pneumothorax. We analyzed clinical reviews and treatments, as well as complications of spontaneous hemopneumothorax patients that were treated to aid in the optimal management. Material and Method: We studied retrospectively 30 cases with spontaneous hemopneumothorax for 11 years, from 1995 to 2006, at our hospital. Result: All the patients were male and most of the patients were under 30 years. The sides with the disorder were as follows: right in 15 cases and left in 15 cases. Patients showed mostly initial symptoms of chest pain, dyspnea and hypovolemic shock. All patients underwent a closed thoracostomy and 27 patients underwent surgery. Chemical pleurodesis was peformed because of postoperative persistent air leakage and one case was treated in the ICU due to re-expansion pulmonary edema, There were no other complications such as fibrothorax seen during the follow-up periods. Conclusion: The most important finding is proper initial management, as the spontaneous hemopneumothorax can potentially lead to a life-threatening condition. Recently, video assisted thoracoscopic surgery (VATS) is common procedure for general thoracic surgery and overcomes the weak points of performing a thoracotomy. The results of VATS are encouraging.
Understanding the light environment in greenhouse cultivation and the light utilization characteristics of crops is important in the study of photosynthesis and transpiration. Also, as the plant grows, the form of light utilization changes. Therefore, this study aims to develop a light extinction coefficient model reflecting the plant growth. To measure the extinction coefficient, five pyranometers were installed vertically according to the height of the plant, and the light intensity by height was collected every second during the entire growing season. According to each growth stage in the early, middle, and late stages, the difference between the top and bottom light intensity tended to increase to 69%, 72%, and 81%. When leaf area index and plant height increased, the extinction coefficient decreased, and it showed an exponential decay relationship. Three-dimensional model reflecting the two growth indexes, the paraboloid had the lowest RMSE of 1.340 and the highest regression constant of 0.968. Through this study, it was possible to predict the more precise light extinction coefficient during the growing period of plants. Furthermore, it is judged that this can be utilized for predicting and analyzing photosynthesis and transpiration according to the plant height.
Alzheimer's disease (AD) represents a major public health concern and has been identified as a research priority. Clinical research evidence supports that the core cerebrospinal fluid (CSF) biomarkers for AD, including amyloid-β (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau), reflect key elements of AD pathophysiology. Nevertheless, advances in the clinical identification of new indicators will be critical not only for the discovery of sensitive, specific, and reliable biomarkers of preclinical AD pathology, but also for the development of tests that facilitate the early detection and differential diagnosis of dementia and disease progression monitoring. The early detection of AD in its presymptomatic stages would represent a great opportunity for earlier therapeutic intervention. The chance of successful treatment would be increased since interventions would be performed before extensive synaptic damage and neuronal loss would have occurred. In this study, the importance of developing an early diagnostic method using cognitive decline biomarkers that can discriminate between normal, mild cognitive impairment (MCI), and AD preclinical stages has been emphasized.
Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.
The results of study on planting and cultivate of Hong Man-Seon(1643~1715)'s 'Salimkyungjae(The Economy of Forest)' the first summative textbook of agricultural skill of South Korea, are as follows. First, 'Salimkyungjae' suggests that one can enrich oneself, eat fruits in fall, enjoy the shade of trees in summer, and enjoy flowers in spring if one plants tree with 10 year plan with knowledge of ecology. Second, the number of plants had increased continuously from the early Chosun Dynasty to the mid Chosun Dynasty. The 52 plants in the book are classified into 31 trees, 8 shrubs, 3 others, and 10 herbs, and 28 of them are fruit trees. Hence, we can see that the book is for the promotion of welfare. Third, planting(transplantation) is the best on January of the lunar calendar, and the second on February, and fertile soil should be added much. Trees must be planted as deep as once it was planted, and buttressed. It will sprout well if it is planted at the depth of one inch, and planting a cutting should be carried out at the early March with 5 inch and finger-thick branches. Grafting is the best when it begins to sprout. Fruit trees will bear many fruits if they are grafted at the direction of South, and fruits will be greater if the trees' branches are cutting off on January. Especially, January was selected for the best season of planting traditionally. Fourth, flower trees are planted or sowed with manure around January and February of the lunar calendar, and it is recommended to replant them into flowerpots with manure when having flower buds around March and April of the lunar calendar. It would bloom earlier when using water mixed with stable manure, and sulfur smoke can be used in order to change the flower color from red to white. Flowerpots would be placed at half shaded lot with being supported by bricks. Pomegranate, gardenia, camellia and four-season flower should be planted after flowers fallen. When flower trees are beside walls, they need to be rotated frequently since their branches all point toward house. Seeds need to be preserved in a sunny hut, where its entrance and ventilating openings would be at south because it is convenient to manage pots. Fifth, insects hidden at fruit trees would be destroyed by torch smoke when roosters cry on New year's day of the lunar calendar. Insects would be decoyed into straw hanged at dawn of Cheongmyeongday(淸明日). Insects on fruit trees would be controlled using sulfur powder to close up holes or sulfur smoke to fumigate. Particularly, it suggests that utilization of fertile soil would be the best solution for growing health plants and preventing pest.
The structural failure of the glutaraldehyde-treated xenograft valves has been the primary concern about the limited durability as predicted from the begimling of clinical use, and long-term follow-up has shown a significant incidence of primary tissue failure(PTF) from both biological and mechanical reasons. Twenty-seven patients with the low-profile lonescu-Shiley valves explanted from mitral position for PTF(Group III) were studied on the patient characteristics and valve pathology, and the results were compared with the matched observations of the Haycock(Group I) and of the standard-profile lonesiu-Shiley valves(Group II). Patients were aged 16 to 56 years(mean, 38.0$\pm$ 11.0 years), and the size of the failed mitral bioprosthesis was 30.8$\pm$ 1.3 mm. The hemodynamic consequences were stenosis in 29.6%, insufficiency in 44.4%, mixed steno-insufficiency in 14.8%, together with normal function for the rest of patients of prophylactic re-replacement. Pathology revealed calcification with or without tissue damage in 63.0% and tissue damage with or without calcification in 58.l%, in contrast with the observations of predominant tissue damage(76.8%) over calcification in Group I and of calcification(76.1%) over tissue damage in group II. Although dystrophic calcification has long and repeatedly dealt with patient's young age as a determinant of valve durability, such a characteristic evidence was not reached even in patients with calcified valves. Moreover, the prolonged explantation p riods from the studied on the previous report suggested strongly yet possibly evolving destructive processes among the valves in the remaining patients, and awaits further follow-up. In conclusion, PTF of the xenograft valves seems to result from more complicated biologic and metabolic reasons as well as more complex mecharical factors than the reported, and newer generation prostheses, with tissue preservation with glutaraldehyde, do not likely to provide decisive improvement in the occurrence of structural failurebioprostheses is generally limited to the highly aged.
Kim, Hyeong-Ryul;Cho, Jeong-Su;Jang, Hee-Jin;Lee, Sang-Cheol;Choi, Eun-Suk;Jheon, Sang-Hoon;Sung, Soak-Whan
Journal of Chest Surgery
/
v.42
no.5
/
pp.615-623
/
2009
Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.
Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
Radiation Oncology Journal
/
v.18
no.3
/
pp.194-199
/
2000
Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.
Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.
Since the world's economic and political structures have changed, the term 'globlization' has shown up as a dominant power and as a necessity for regional and national development. Each nation is responding to the globalization process economically and politically in various ways. In general, however, the economic response to the globalization is economic restructuring from the Fordist industries to 'flexible specialization'. And the political response to the globalization is 'global localization' as a new type of local politics(i.e., local policy activism or growth-enhancing local development policies). The crisis of Fordism shifted the role of local governments towards more involovement with local economic development. Local governments are mobilizing for loca economic development, they are taken into a process of institutional change that tends to redefine their responsibilities inside the state. Local governments thus tend to act as an entrepreneur in order to restructure theiir local economies and to compete with other national and international regions. State restructuring towards enerepreneurialism and efficient regional policy pursuing a pro-growth coalition trategy is chosen as a new mode of regulation for the post-Fordism at the local level. The flexible specialization as the post-Fordist economy and the local government as an entrepreneur are the global choice for globalization and a post-Fordist society. The paper focuses on the regulation theory which comprises the political economic perspective on resturcturing. Economic restructuring and state restructuring will be discussed in detail. And the paper tries to combine the economic globalization and the global localization as economic and political responses to globalization.
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