• 생태와환경
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• 제34권4호통권96호
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• pp.298-309
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• 2001

영양상태가 다른 두 호수에서 식물플랑크톤 군집에 대한 담수산 패류의 섭식 효과를 2000년 6월부터 9월까지 조사하였다. 실험은 10 l 플라스틱 용기에 패류를 투입하지 않는 것과 투입한 것으로 처리되었고 2반복으로 수행되었다. 수체 내 존재하는 총질소와 총인 그리고 엽록소 a 농도는 소양호에 비해 일감호에서 월등히 높았다(p<0.01). 일감호에서 우점한 식물플랑크톤 군집은 거의 대부분 남조류 였던 반면 소양호에서는 편모조류가 우점하였다. 패류가 투입된 용기 내 총 식물플랑크톤의 감소율은 소양호와 일감호에서 각각 $1.70{\sim}7.39\;d^{-1}$그리고 $0.38{\sim}1.64\;d^{-1}$의 범위였다. 시간에 따른 식물플랑크톤의 변화를 바탕으로 한 패류의 유기물함량에 따른 여과율(FR; $ml\;mgAFDW^{1}\;h^{-1}$)은 일감호(0.24${\sim}$0.88)에서 보다 소양호(1.70${\sim}$3.06)에서 높았다. 조개 개체 당 여과율($l\;mussel^{-1}\;day^{-1}$)은 소양호에서 1.6${\sim}$7.8 l,일감호에서 1.7${\sim}$3.0 l로 나타났다(p<0.05).생물량에 대한 C-flux로 고려할 때, Corbicula leana는 소양호의 경우 식물플랑크톤 현존량의 0.8${\sim}$4.4배를, 일감호에서는 0.4${\sim}$l.6배를 섭식하는 것으로 조사되었다. 패류의 섭식 활동으로 인해 인의 농도가조개가 없는 용기에 비해 30${\sim}$50%증가하였다. 본 연구에서 나타난 결과들은 참재첩 (Corbicula leana)의 여과 섭식 잘동이 식물플랑크톤의 밀도와 군집구조에 따라 차이가 있음을 제시한다. 또한, 매우 부영양화된 호수에서도 참재첩은 높은 여과율을 나타냄으로써 국내 소규모의 부영양화된 호수에서 수질관리에 담수패류를 이용할 수 있는 가능성을 제시한다.

• Radiation Oncology Journal
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• 제33권1호
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• pp.12-20
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• 2015

Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

• Journal of Chest Surgery
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• 제21권6호
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• pp.1020-1029
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• 1988

The authors evaluated 153 patients who had undergone cardiac valve replacement between October 1979 and July 1988. The results are as follows: l. Out of 153 patients, there were 56 males and 97 females ranging from 15 to 62 years of age with a mean of 37 years. 2. Isolated mitral valve replacement took place in 82 patients, aortic valve replacement[AVR] in 16, double valve replacement[DVR] in 34, AVR combined with open mitral commissurotomy in 19, and tricuspid valve replacement[TVR] was done in 2 patients. 3. 153 patients had 187 prosthetic valves replaced with Ionescu-Shiley valves[16], Carpentier-Edwards[36], Bjork-Shiley[19], St. Jude Medical[108], and Duromedics[8]. 4. Our of 98 patients with atrial fibrillation[ 64% of a total 153 patients ] during the preoperative period, 22 patients recovered NSR[ 22/98, NSR recovery rate 22.4%] after valvular surgery and remaining 76 patients revealed persisting atrial fibrillation[76/153, 49.7% ]. 5. Preoperative episodes of systemic arterial embolization were attained in 9 patients[9/153, 6% ], and left atrial thrombi were confirmed in 22 patients intraoperatively[ 22/153, 14% ]. Of these, only one patient, however, demonstrated the correspondence of preoperative embolization and intraoperative existence of LA thrombi. 6. With mechanical prostheses, anticoagulant therapy was begun 48 hours after operation with sodium warfarin[2.5-5.0mg/day], maintaining the prothrombin time between 16 and 18 seconds or 30 to 50% of control values and continued for life. With tissue prostheses, sodium warfarin was continued for 3 to 6 months and converted into buffered ASA[ 325 mg/day ] for one year. 7. The mean follow-up for the survivors was 30.1 months, with a range from 3 months to 9 years. All suspected or confirmed thromboembolic episodes counted as events and occurred in 4 patients[ 1.04%/patient-year] with mechanical valve replacement. No persistent paralysis or death was noted. Late complications have not yet occurred in the patients with isolated MVR and AVR. 8. There were remarkable structural failures of tissue valves in 3 patients[ 1.9%/patient-year ], while no instance of failure of a mechanical valve. 9. There were 10 operative early deaths[10/153, 6.5%] and 5 late deaths[5/153, 3.3%]. Consequently, overall mortality was 9.8%[ 15/153] during follow-up period. 10. We currently favor using the St. Jude Medical valve in all patients requiring valve replacement except in those who can not take warfarin anticoagulation.

• 대한임상독성학회지
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• 제6권1호
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• pp.9-15
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• 2008

Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

• Journal of Korean Neurosurgical Society
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• 제30권6호
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• pp.729-733
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• 2001

Objective : Antifibrinolytic treatment after aneurysmal subarachnoid hemorrhage has been shown to have no significant effect on outcome since a reduction in the rate of rebleeding was offset by an increase in the incidence of hydrocephalus and ischemic events. As the results of early aneurysm surgery and a change of strategy in the intensive medical treatment, outcome in patients with cerebral ischemia has been improved. On the other hand, rebleeding still remains as a major cause of death. A short course of tranexamic acid(TA) was tried to study its efficacy and safety in reducing the incidence of rebleeding before aneurysm surgery. Methods : A total of 507 patients with ruptured cerebral aneurysm operated within 3 days after the attack from 1990 to 1999 were included in this study. Group A consisted of 302 consecutive patients treated from 1990 through 1995 served as control. Two hundred-five patients in group B were treated with TA from 1996 through 1999. Both groups were evaluated for comparability of demographic and clinical variables including age, Hunt-Hess grade, Fisher grade, aneurysm location, hypertension, day of surgery, and initial hydrocephalus. The relationships of TA with rebleeding, ischemia, and chronic hydrocephalus were also studied. Results : There was no significant difference in patient demographics and clinical characteristics between group A and group B. Sixteen patients(5.3%) suffered a recurrent hemorrhage in group A and three(1.5%) in group B(p<0.05). Chronic hydrocephalus requiring a shunt was found in a significantly greater proportion in group B than in group A(p<0.05). The incidence of cerebral ischemia was not elevated in group B compared with group A. Conclusion : Considering the fact that the reduction of fatal rebleeding outweighed the increased incidence of hydrocephalus, the authors believe that a short course of TA is beneficial in diminishing the risk of rebleeding prior to early surgical intervention.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2225-2228
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• 2012

Background: We assessed the efficacy and toxicity of ifosfamide and doxorubicin combination chemotherapy (CT) regimen retrospectively in Turkish patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) previously treated with platinum-based chemotherapy. Methods: A total of thirty patients who had received cisplatin based chemotherapy/chemoradiotherapy as a primary treatment received ifosfamide 2500 $mg/m^2$ days 1-3, mesna 2500 $mg/m^2$ days 1-3, doxorubicin 60 mg/m2 day 1 (IMA), repeated every 21 days. Eligible patients had ECOG PS< 2, measurable recurrent or metastatic disease, with adequate renal, hepatic and hematologic functions. Results: Median age was 47 (min-max; 17-60). Twenty six (86.7 %) were male. Median cycles of chemotherapy for each patient were 2 (range:1-6). Twenty patients were evaluable for toxicity and response. No patient achieved complete response, with nine partial responses for a response rate of 30.0% in evaluable patients. Stable disease, and disease progression were observed in five (16.7%) and six (20.0%) patients, respectively. Clinical benefit was 46.7%. Median time to progression was 4.0 months. Six patients had neutropenic fever after IMA regimen and there were one treatment-related death due to tumor lysis syndrome in first cycle of the CT. No cardiotoxicity was observed after CT and treatments were generally well tolerated. Conclusion: Ifosfomide and doxorubicin combination is an effective regimen for patients with recurrent and metastatic NPC. For NPC patients demonstrating failure of cisplatin based regimens, this CT combination may be considered as salvage therapy.

• Korean Circulation Journal
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• 제53권8호
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• pp.499-518
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• 2023

Cardiovascular diseases (CVDs), including coronary artery disease, stroke, heart failure, and hypertension, are the global leading causes of death, accounting for more than 30% of deaths worldwide. Although the risk factors of CVDs have been well understood and various treatment and preventive measures have been established, the mortality rate and the financial burden of CVDs are expected to grow exponentially over time due to the changes in lifestyles and increasing life expectancies of the present generation. Recent advancements in metagenomics and metabolomics analysis have identified gut microbiome and its associated metabolites as potential risk factors for CVDs, suggesting the possibility of developing more effective novel therapeutic strategies against CVD. In addition, increasing evidence has demonstrated the alterations in the ratio of Firmicutes to Bacteroidetes and the imbalance of microbial-dependent metabolites, including short-chain fatty acids and trimethylamine N-oxide, play a crucial role in the pathogenesis of CVD. However, the exact mechanism of action remains undefined to this day. In this review, we focus on the compositional changes in the gut microbiome and its related metabolites in various CVDs. Moreover, the potential treatment and preventive strategies targeting the gut microbiome and its metabolites are discussed.

• Tuberculosis and Respiratory Diseases
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• 제61권1호
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• pp.46-53
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• 2006

연구배경: IAP의 증가는 혈류량을 감소시켜 여러 장기에 영향을 준다. IAH는 IAP가 12 mmHg 이상 또는 APP가 60 mmHg 이하로, ACS는 IAP가 20 mmHg 이상이면서 동시에 하나 이상의 장기 손상이 있는 경우로 각각 정의한다. 저자들은 중환자에서 IAH 및 ACS의 유병률과 이들이 환자의 예후에 미치는 영향을 고찰하고자 하였다. 방 법: 고려대학교 의료원 중환자실에 입원하는 내과계 환자를 대상으로 하여, APACHE II 및 III 점수, SAPS II 점수를 기록하였다. IAP는 삼중관 요도관을 통하여, 입원 7일째까지 매일 3회 측정하였고, 환자가 사망하거나 일반 병실로 전실 또는 요도관을 제거할 때까지 계속하였다. 환자의 예후는 28일을 기준으로 판단하였다. 결 과: 총 111명 대상 환자들의 입원 1일 IAH 및 ACS의 유병률은 각각 47.7%, 15.3%였다. 사망군과 생존군 사이에 IAH의 유병률은 유의한 차이가 없었으나, ACS는 사망군에서 더 높았다 (p=0.004). 사망군에서 IAP는 더 높았고 (p=0.012), APP는 유의하게 낮았다 (p<0.001). 결 론: 중환자에서 입원 1일에 측정한 IAP의 증가, APP의 감소 및 ACS 발생은 환자의 사망과 연관이 있을 것으로 판단된다.

• Journal of Gastric Cancer
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• 제17권4호
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• pp.374-383
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• 2017

Purpose: Bleeding is one of the most serious complications of advanced gastric cancer (AGC) and is associated with a poor prognosis. This study aimed to evaluate the clinical outcomes of endoscopic hemostasis for bleeding in patients with unresectable AGC. Materials and Methods: This study included 106 patients with bleeding associated with gastric cancer who had undergone endoscopic hemostasis between January 2010 and December 2013. Clinical characteristics, treatment outcomes, including rates of successful endoscopic hemostasis and rebleeding, risk factors for rebleeding, and overall survival (OS) were investigated. Results: Successful initial hemostasis was achieved in 83% of patients. Rebleeding occurred in 28.3% of patients within 30 days. The median OS after initial hemostasis was lower in patients with rebleeding than in those without rebleeding (2.7 and 3.9 months, respectively, P=0.02). There were no significant differences in disease status and rebleeding rates among patients with partial response or stable disease (n=4), progressive disease (n=64), and first diagnosis of disease (n=38). Univariate and multivariate analyses (P=0.038 and 0.034, respectively) revealed that transfusion of ${\geq}5$ units of RBCs was a significant risk factor for rebleeding. Conclusions: Despite favorable success rates of endoscopic hemostasis for bleeding associated with gastric cancer, the 30-day rebleeding rate was 28.3% and the median OS was significantly lower in patients with rebleeding than in those without rebleeding. Massive transfusion (${\geq}5$ units of RBCs) was the only significant risk factor for rebleeding. Patients with bleeding associated with AGC who have undergone massive transfusion should be observed closely following endoscopic hemostasis. Further research on approaches to reduce rebleeding rate and prevent death is needed.

• 지역사회간호학회지
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• 제12권3호
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• pp.815-827
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• 2001

Accidents involving students are an important cause of death and disability. They also have enormous financial implications. In order to prevent childhood accidents. research and education for safety should be strengthened. The purpose of this study was to determine how often lower grade elementary students have accidents and what factors affect the accident rate. The study population consisted of 676 students who were in the 2nd, 3rd and 4th grades of twelve elementary schools located in Kun Wi Gun. The questionnaires were distributed to all of the 2nd to 4th grade student in the Kun Wi Gun to be completed by their parents about all the accidents which happened last one year and collected during the period of March 19, to March 30, 2001. The data were analyzed by using SPSS WIN 10.0 statistical package. The results of the study are as follow: 1. Among 676 students. 270 students had 540 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were April. Monday. and between 1 and 4 p. m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on school, around their homes and. then inside the home. 4. Most of accidents were caused by carelessness on the part of the students and the most frequent type of injury was an abrasion. 5. Students most injured part of the body was their legs. 6. They were treated at home most often and usually emergency treatment was performed by family members with disinfectant as first aid measure. Cost of the treatment of the accident ranged from 10.000 to 30,000 won in most cases. 7. Students' personality. type of family composition. mother's age and parents' education level were statistically significant. As a conclusion. 1st to 3rd grade rural elementary students need their assessment for accident involving condition. This study gave a very useful and important data to prepare accident prevention teaching program and to prepare accident prevention strategies.