• Title/Summary/Keyword: 환자 선호도

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Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

Relationship between maximum bite force and facial skeletal pattern (최대 교합력과 안면 골격 형태에 관한 연구)

  • Choi, Won-Cheul;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.33 no.6 s.101
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    • pp.437-451
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    • 2003
  • The purpose of this study was to measure maximum bite force and to investigate its relationship with anteroposterior, vertical, and transverse facial skeletal measurements. From among the dental students at the College of Dentistry, forty subjects (26 male and 14 female) were selected. With two sets of strain gauge, maximum bite force at the right and left first molars and anterior teeth was measured in the morning and afternoon. After taking lateral and posteroanterior cephalograms, fifty and nineteen variables were evaluated, respectively Paired t-tests and an independent t-test were done and correlation coefficients were obtained. 1. The maximum bite force at the first molars was $68.0\pm13.9kg$. in males and $55.6\pm10.5kg$ in females (p<0.05) while the force at the anterior teeth was $8.4\pm4.9kg\;and\;1.1\pm3.4kg$ respectively (p<0.05). 2. Some tendency for a greater value of maximum bite force at the preferred side was observed but not statistically significant (p>0.05). 3. Significant difference was observed between the strong bite force group and the weak bite force group in some cephalometric and other measurements (p<0.05). N-S-Ar, S-Ar-Go, FH-Hl, IMPA and MMO showed a significant difference in posterior maximum bite force (P). N-S-Ar and FH-H1 also showed a significant difference in anterior maximum bite force (A). 4. Several cephalometric variables showed some correlation with maximum bite force (p<0.05). N-S-Ar, S-Ar-Go, UGA, FH-H6, FH-H1, body weight and MMO were significantly correlated with posterior maximum bite force (P). Go-Me, P-1 and IMPA were significantly correlated with anterior maximum bite force (A).

Survey of Caffeine levels in the Favorite Diets of Children (어린이 기호식품 중 카페인 함량에 대한 조사)

  • Lee, E-Na;Kim, Hee-Jin;Im, Ji-Young;Kim, Jeoung-A;Park, Hye-Young;Ryu, Ju-Young;Ko, Kwang-Rack;Kim, Hyung-Sik
    • Journal of Food Hygiene and Safety
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    • v.22 no.3
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    • pp.173-178
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    • 2007
  • Children may respond differently to the caffeine from adults because they have different physiologic makeup and are functionally immature in terms of hepatic and renal function; this leads to the slower clearance of caffeine in early life. Therefore, children are often assumed to be more susceptible to caffeine effects. Alarge number of food supplements may interfere with these processes, and therefore caffeine exposure may have more serious consequences for children than for adults, irrespective of sensitivity. However, there has never been a national dietary survey on caffeine intakes in children. The purpose of our study was to identify caffeine intakes and beverage sources of caffeine in a representative sample of children in Busan, Korea. Caffeine intakes were based only on beverages included in the Continuing Surveys of Food Intakes by individuals. The caffeine content of the beverages ranged from 2.8 to 65.2mg/100ml for cola, soft drinks, and teas. Caffeine was not completely absent from caffeine-free colas, juice, and milk. In this study, cola-type beverages were an important dietary source of caffeine in the children. Daily caffeine intake for children was estimated to range from 12.5 to 250 mg/day. In general, the acceptable daily intake (ADI) of caffeine should cover the entire population including children. Therefore, special considerations should be needed regarding the consumption of soft drinks containing caffeine to children below the 12 years of age.

Clinical Characteristics of Pulmonary Cryptococcosis (국내 폐효모균증의 임상적 특징)

  • Moon, Doo-Seop;Yoo, Jeong-Soo;Kim, Chung-Mi;Kim, Yeon-Soo;Kim, Seung-Min;Oh, Kwang-Taek;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Hahm, Shee-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1083-1093
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    • 1997
  • Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.

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Experimental and Clinical Study of Staple-Line Reinforcement Using Expanded Polytetrafluoroethylene in Thoracoscopic Bullectomy for Spontaneous Pneumothorax (자연 기흉 환자에서 봉합선 보강이 흉강경 폐부분 절제술에 미치는 영향: 동물실험 및 임상연구)

  • 문석환;심성보;왕영필;윤정섭;조건현;박재길;박만실;최시영;곽문섭
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.904-910
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    • 2003
  • Thoracoscopic bullectomy (VATS-B) is now the preferred treatment for spontaneous pneumothorax despite of higher recurrence rate than open thoracotomy. Several methods have been used to prevent this problem. The effectiveness of staple line reinforcement (SLR) in VATA-B using endostaplers was assessed by clinical and experimental study. Meterial and Method: In experimental study, canine lungs were harvested immediately (group I N=5) and 48 hours (group II N=5) after stapling. The pressures at which initial air leaks occurred were measured. In clinical study from February 1997 to March 1999, 106 procedures in 104 patients undergoing VATS-B for spontaneous pneumothorax were classified into two groups according to the presence of SLR and were compared. Result: The average pressure of the initial air leakage was significantly higher in SLR than that of staples alone (18$\pm$1.6 vs 48$\pm$3 mm Hg in group I; 23.8$\pm$1.9 vs 54$\pm$4.6 mm Hg in group II, p<0.001). In the clinical data, there were significant differences seen in the duration of drainage, the total length of endostaplers used, and the duration of the postoperative hospital stay between patients with staple alone and patients with SLR (4.4$\pm$1.4 vs 3.1$\pm$1.1 days in duration of drainage, 92.3$\pm$28.1 vs 71.1$\pm$30.6 mm in total length of endostaplers used, 5.9$\pm$1.9 vs 4.6$\pm$1.7 days in postoperative hospital stays, p<0.001). Conclusion: SLR was effective for preventing prolonged air leakage and responsible for shorter hospital stays after VATS-B for the treatment of spontaneous pneumothorax.

A Study on Quality Characteristics of Pleurospermum kamtschaticum as a Functional Food Resource (누룩치의 기능성 식품재료화를 위한 품질특성에 관한 연구)

  • 조순덕;최돈하;김건희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.7
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    • pp.1212-1217
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    • 2004
  • The aim of this study was to investigate Quality characteristics of Pleurospermum kamtschaticum to increase the value of functional food resources. To examine Quality characteristics of Pleurospermum kamtschaticum, various factors such as color, texture, fiber, minerals, tannin, crude proteins, crude lipids and sensory quality, were determined using physicochemical methods. The contents of dietary fiber were 0.57% and 0.54% in each 100 g of leaf and stem parts (freeze drying base). In mineral content, potassium was the highest value in both of leaf and stem parts (freeze drying base). The contents of tannin were 108.1 $\mu$g/mL and 20.9 $\mu$g/mL in leaf and stem parts (fresh base) respectively. Blanching stems showed significant difference in hardness from freeze-drying leaves. The antioxidative activity in ethanol extracts of Pleurospermum kamtschaticum was investigated using peroxide value and free radical scavenging activity. Free radical scavenging activity in ethanol extracts of Pleurospermum kamtschaticum was 43.5% in a 100 $\mu$g/mL level, and the antioxidative index was 1.09 in a 500 $\mu$g/mL level. For functional food using Pleurospermum kamtschaticum the contents of crude proteins and lipids were about 9% and 26%, respectively. The results from sensory evaluation of each treatment older age showed a better acceptability.

Circular Stapled Billroth I Anastomosis after Distal Subtotal Gastrectomy - Anastomotic Complications and Prevention - (원위부 위아전절제술 후 원형문합기를 이용한 위십이지장 문합술 - 문합부 합병증과 예방책 -)

  • Lee, Moon-Soo;Kang, Gil-Ho;Cho, Gyu-Seok;Kim, Yong-Jin;Kim, Hyung-Soo;Lee, Hwa-Soo;Kim, Sung-Yong;Baek, Moo-Jun;Kim, Chang-Ho;Cho, Moo-Sik
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.103-108
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    • 2006
  • Purpose: The circular stapled Billroth I gastrectomy has been gradually popularized because of several advantages. Thus, this study aims to identify what to be supplemented for the safety of this technique by examining the potential complication after the circular stapled Billroth I gastrectomy. Materials and Methods: This study selected 594 patients who underwent the circular stapled Billroth I gastrectomy because of the gastric cancer in our department of surgery from Jan. 1998 to Dec. 2004 as the subjects. As of Jan. 2001 when the bleeding on the anastomosis site was visually checked through the small incision at the opposite curvature to the lesion of the stomach to be resected and so the operation was completed, the patients were divided into the Group I (n=219) and Group II (n=375), which were the patients before and after Jan. 2001, respectively. Then, the clinical characteristics and postoperative anastomotic complications of both groups were compared. Results: For the comparison of complications between two groups, the anastomotic leakage was found in four cases in Group I and three cases in Group II (p=0.196). The stenosis on the anastomosis region was not observed in both groups. The bleeding on the anastomosis region illustrates the statistically significant difference between Group I and Group II, with 43 cases and 2 cases, respectively (P=0.0019). Conclusion: The circular stapled Billroth I gastrectomy is recommended because of several advantages of this technique. However, the bleeding on the anastomosis site may be indicated as the critical issue. Accordingly, the visual check on the bleeding on the anastomosis site during the operation will improve the safety of circular stapler.

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Development of a Occupation-Based Bilateral Upper Extremity Training Protocol in a Medical Setting for Stroke Patients (뇌졸중 환자를 대상으로 한 병원 환경에서의 작업 기반 양측성 상지 훈련 프로토콜 개발)

  • Kim, Sun-Ho;Kim, Jung Ran;Park, Hae Yean;Han, A-Reum;Kim, Jong-Bae;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.24-44
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    • 2020
  • Objective : To develop an occupation-based bilateral upper extremity training protocol that can be effectively applied in a medical setting Methods : The research process using the delphi technique was carried out in 3 stages. The first stage was an open questionnaire development stage, The first draft is prepared through literature review and open questions were developed through preliminary research based on the draft. The second stage was the delphi survey. Based on the responses of the experts obtained through the open Delphi survey, the adequacy of the training protocol was shown on a Likert 5 point scale. The items were edited and deleted, reconstructed by analyzing the mean and standard deviation, stability, convergence degree, consensus, and content validity ratio through the questionnaire. The third step was the completion of the protocol. After discussions between researchers, the finalized protocol contents were reorganized to complete the occupation-based bilateral upper extremity training protocol for medical setting. Results : The final protocol consisted of 9 items across 3 areas in the occupation-based intervention selection domain and 81 items across 4 areas in the bilateral upper extremity training domain, intervention period, and evaluation. Conclusions : This study suggests an evidence-based method that collects the opinions of occupational therapists in order to use occupation-based activities as interventions in a situation that currently sees occupational therapy primarily performed in hospitals. It is also meaningful that the bilateral upper extremity training can be applied effectively in clinical situations by concretely presenting.

A Study on the Standardization of QSCC II (Questionnaire for the Sasang Constitution Classification II) (사상체질분류검사지(四象體質分類檢査紙)(QSCC)II의 표준화(標準化) 연구(硏究) - 각 체질집단의 군집별(群集別) Profile 분석을 중심으로 -)

  • Kim, Sun-Ho;Ko, Byung-Hee;Song, Il-Byung
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.337-393
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    • 1996
  • The purpose of this study is to evaluate and standardize the four scales of Questionnaire for the Sasang Constitution Classification  II (QSCCII). QSCCII is newly prepared by statistical item analysis and is designed to examine its diagnostic discriminability. QSCCII is administered to 1366 random informants. From the survey, we could get the data for the standardization. The criteria of standardization are based on the data from 265 informants who are examined by professionals. Collectted data are analyzed by internal consistency, variation analysis(ANOVA), Duncan test and discrimination analysis of SPSS PC+ V4.0 program. The results are as follows reliability of four scales for QSCCII is relatively valid. The internal consistency of Tae-yang(太陽) (太陽) scale is Cronbach's a=0.5708. That of So-yang(少陽) scale is a=0.5708. That of Tae-eum(太陰) scale is a =0.5922. That of So-eum(少陰) scale is a=0.6319. 2. There is a significant difference between each group through variation analysis of four scales. 3. The process of standardization is based on the average value and standard deviation with respect to age and sex difference of each criteria 4. This study suggests a source of standardization of Sasang Constitution Classification by providing norms in which the differences of age, sex, and number of items are taken into deep consideration. QSCC Ⅱ, therefore, can be applied to every age(the 10's to the 60's) and sex groups. 5. The recalculation of the raw-score to standard value (T-score) shows that the diagnostic discriminability (Hit-ratio: 70.08%) of QSCC Ⅱ brings about 37% improvement than proportional chance criteria (33.33%). Especially, Hit-ratios of Tae-eum In(74.5%) and So-eum In(70.8%) are higher than that of So-yang In(60.0%). 6. QSCC has discriminability only to male informants. Compared with QSCC, however, QSCC II has relatively efficient discriminability both to male and female informants. 7. These results would be a demonstration of the fact that the QSCC II could be used as a tool for sasang constitution classification.

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Deduction and Verification of Optimal Factors for Stent Structure and Mechanical Reaction Using Finite Element Analysis (스텐트의 구조 및 기계적인 반응에 대한 최적인자 도출과 유한요소해석법을 통한 검증)

  • Jeon, Dong-Min;Jung, Won-Gyun;Kim, Han-Ki;Kim, Sang-Ho;Shin, Il-Gyun;Jang, Hong-Seok;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.201-208
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    • 2010
  • Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and $0.09\;mm^2$ for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.