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Determination of Short Term Prognosis Among Chronic Obstructive Lung Disease with Acute Respiratory Failure According to Simplified Acute Physiology Score (만성 폐쇄성 폐질환에서 급성 호흡부전 발생시 Simplifed Acute Physiology Score에 따른 단기예후의 평가)

  • Lee, Sang-Pyo;Sung, Yun-Up;Kim, Sang-Hoon;Kim, Bong-Sik;Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.532-539
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    • 1993
  • Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

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Teachers' Conceptions about the Genetic Determinism of Human Behaviors (교사들이 가지는 사람의 행동적 특징에 대한 유전자 결정론적 인식)

  • Youn, Se Jin;Seo, Hae-Ae
    • Journal of The Korean Association For Science Education
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    • v.34 no.4
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    • pp.407-415
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    • 2014
  • Genetic determinism of human behaviors is considered as a philosophical perspective that genes in humans determine biological as well as social traits. However, many biologists agree that human traits are determined by interactions between genes and genes, as well as between genes and environments. In this context, genetic determinism still affect ideas of the general public as well as research directions of biologists. According to Cl$\acute{e}$ment's KVP model (Cast$\acute{e}$ra & Cl$\acute{e}$ment, 2012), teachers' conceptions of genetic determinism influence students' concepts of genetics. This study intends to investigate teachers' conceptions on genetic determinism of human behaviors. For this end, a questionnaire adopted from a previous research (Cast$\acute{e}$ra & Cl$\acute{e}$ment, 2012) has been administered to 308 teachers including 151 pre-service and 157 in-service. Factor analysis has been conducted to extract major factors and one-way ANOVA has been employed to find out differences in extracted factors among different groups of teachers. Four factors have been extracted from 14 items of questionnaire, including factor 1, a perspective of genetic determinism of gender differences in intellectual ability, social status, and emotional traits; factor 2, a perspective of genetic determinism of individual differences in intellectual ability; factor 3, a perspective of genetic determinism of individual differences in biological immune function and behavioral trait; and factor 4, a perspective of genetic determinism of ethnic differences. From the results of One-way ANOVA among teacher groups on four factors, first, it has shown a significant difference in factor 1 (F=3.325, p=.006), factor 3 (F=3.320, p=.006) and factor 4 (F=4.325, p=.001) due to their subject matters. In post-hoc comparison there have been no significant difference between biology teachers and other teachers. It has also been found that there was a significant difference between pre-service and in-service teachers in factor 1 (t=-3.938, p=.000) and factor 4 (t=-3.121, p=.002) and in-service teachers are more genetic deterministic than pre-service teachers. Finally, different religions have no influence on teachers' conceptions of genetic determinism of human behaviors.

Potential Biotypes in Korean Isolates of Bipolaris cactivora Associated with Stem Rot of Cactus

  • Kim, Jeong-Ho;Jeoung, Myoung-Il;Hyun, Ick-Hwa;Kim, Young-Ho
    • The Plant Pathology Journal
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    • v.20 no.3
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    • pp.165-171
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    • 2004
  • A total of 62 isolates of Bipolaris cactivora causing cactus stem rots were isolated from major cactus-growing areas in Korea. Colony morphology of the isolates on potato-dextrose agar was differentiated into aerial (CA) and non-aerial mycelial types (CB). CA had profound aerial mycelium with grayish brown (CA-l), light brownish (CA-2), and brownish (CA-3) pigmentations; respectively, while CB had dark brownish pigmentations. CA had conidia of less dark pigmentation and acute terminal end. CB had darker and more round-end conidia. Twenty-eight amplified fragments were produced by polymerase chain reaction (PCR) with a set of 2 random primers. The sizes of amplified DNA fragments ranged approximately from 0.1 to 2.3 kb. The isolates were classified into 2 major genomic DNA random amplified polymorphic DNA (RAPD) groups at the genomic similarity of 97.7% and 95.1%, respectively. Cluster analysis of genetic similarity among the isolates generated a dendrogram that clearly separated all isolates into SA or SB. This result suggests that there may be two morphotypes of B. cactivora in Korea that may differ in their genetic constitutes.

Surgical Treatment of Peroneus Longus Tendon Rupture after Ostectomy of Peroneus Tubercle of Calcaneus: A Case Report (종골의 비골 결절 골절제술 후 발생한 장비골건 파열에 대한 수술적 치료: 증례 보고)

  • Lee, Jin-Young;Kim, Gab-Lae;Jung, Min;Lee, Eui-Soo;Kwon, Jae-Woo;Seo, Dong-Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.72-75
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    • 2014
  • We experienced a patient in whom rupture of the peroneus longus tendon occurred after ostectomy of the peroneus tubercle of the calcaneus. Acute rupture of the peroneus tendon can be managed by end-to-end anastomosis, while neglected cases can be treated by tenodesis, tendon transfer, or tendon graft. In the current patient, the tendon ends were mildly retracted, yielding a small gap. We successfully repaired the retracted tendon ends after lengthening by Z-plasty.

Hemodynamic Influences of Positive End-Expiratory Pressure Ventilation in Patients with Pulmonary Insufficiency (호기말 양압호흡이 혈류역학 및 심기능에 미치는 영향)

  • 장병철
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.79-85
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    • 1985
  • The effect of graded increments in positive end-expiratory pressure [PEEP] on hemodynamics required to ventilate 8 critically ill patients is reported. Acute respiratory insufficiency was a cause of death in only one patient of drug inoxication among the 8 patients studied. The cardiac output was not changed significantly after the increment of PEEP to the level of 20 cm H2O. The heart rate was increased significantly from 15 cm H2O PEEP [P<0.01] as compared to 0 cm H2O PEEP; and the stroke volume was decreased significantly from 15 cm H2O PEEP [P<0.05]. The blood pressure was not affected at any level of PEEP, but the pulmonary artery pressure was elevated significantly at 10 cm H2O PEEP [P<0.01]. The right ventricular transmural filling pressure was not affected at the level of 10 cm H2O PEEP, but from 15 cm H2O PEEP it was increased significantly. With the increment of PEEP, the left ventricular stroke work index was decreased slightly; and at 20 cm H2O PEEP, it was decreased significantly. The right ventricular stroke work index was increased only at 10 cm H2O PEEP. The systemic vascular resistance was decreased significantly from 15 cm H2O PEEP [P<0.01].

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Oral Glutamine Supplementation Reduces Radiotherapy-induced Esophagitis in Lung Cancer Patients

  • Gul, Kanyilmaz;Muge, Akmansu;Taner, Atasever;Sehri, Elbag
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.53-58
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    • 2015
  • Background: The purpose of this study was to assess the the efficacy of oral glutamine (GLN) in prevention of acute radiation-induced esophagitis in patients with lung cancer and determine the predictive role of clinical and dosimetric parameters. Materials and Methods: Thirty-two patients diagnosed with lung cancer were studied prospectively. Sixteen patients (50%) received prophylactic powdered GLN orally in doses of 10g/8h. Patients were treated 2 Gy per fraction daily, 5 days a week. We evaluated the grading of esophagitis daily at the end of each fraction of each treatment day until a cumulative dose of 50 Gy was reached. The primary end point was radiation-induced esophagitis. Results: All patients tolerated GLN well. Toxicity grade, weight loss, serum cytokine levels and esophageal transit times exhibited statistically significant improvement in the GLN receiving group. GLN suppressed the inflammation related to the disease and treatment and reduced toxicity with statistical significance. Conclusions: This study suggests a benefical role of oral GLN use in prevention and/or delay of radiation-induced esophagitis, in terms of esophageal transit time and serum immunological parameters, as well as weight loss.

Remodeling of Infarcted Myocardium with Contrast-Enhanced Magnetic Resonance Imaging

  • 최병욱;최규옥;김영진;정남식;임세중
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.45-45
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    • 2003
  • To evaluate remodeling of infarcted myocardium with contrast-enhanced MRI (co-MRI) at true end-diastole (ED) MRI was performed with a Gyroscan Intera (1.5 Tesla, Philips, Netherlands) in 13 patients with acute subendocardial myocardial infarction. The First exam was done 0-15 days (mean 5.2days) after symptom onset and the second exam 28-88days (mean 49 days) after the first exam. Ce-MRI encompassing the entire left ventricle was performed with a multi-shot, turbo-field-echo, breath-hold sequence and a non-selective, inversion prepulse 10 minutes after the intravenous injection of Gd-DTPA at a dose of 0.2 mmol/kg body weight. To allow the long TD, ECG synchronization should use two RR-intervals for one acquisition of a segment of k-space by setting the heart rate to half that of the true heart rate. Trigger delay time (TD) was adjusted to the RR-interval for true end-diastolic imaging. The other typical parameters were TR=5.4ms, TE=1.6ms, voxel size=1.37${\times}$1.37${\times}$10mm, k-space data segmented into 8 segments with 32 lines of segment per two cycles over 16 cardiac circles. The thickness of hyperenhanced myocardium and epicardially nonenhanced myocardium were followed.

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Remodeling of Infarcted Myocardium with Contrast-Enhanced Magnetic Resonance Imaging

  • 최병욱;최규옥;김영진;정남식;임세중
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.92-92
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    • 2003
  • To evaluate remodeling of infarcted myocardium with contrast-enhanced MRI (co-MRI) at true end-diastole (ED) MRI was performed with a Gyroscan Intera (1.5 Tesla, Philips, Netherlands) in 13 patients with acute subendocardial myocardial infarction. The First exam was done 0-15 days (mean 5.2days) after symptom onset and the second exam 28-88days (mean 49 days) after the first exam. Ce-MRI encompassing the entire left ventricle was peformed with a multi-shot, turbo-field-echo, breath-hold sequence and a non-selective, inversion prepulse 10 minutes after the intravenous injection of Gd-DTPA at a dose of 0.2 mmol/kg body weight. To allow the long TD, ECG synchronization should use two RR-intervals for one acquisition of a segment of k-space by setting the heart rate to half that of the true heart rate. Trigger delay time (TD) was adjusted to the RR-interval for true end-diastolic imaging. The other typical parameters were TR=5.4ms, TE=1.6ms, voxel size=1.37$\times$1.37$\times$10mm, k-space data segmented into 8 segments with 32 lines of segment per two cycles over 16 cardiac cycles. The thickness of hyperenhanced myocardium and epicardially nonenhanced myocardium were followed.

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A rare case of childhood-onset systemic lupus erythematosus associated end-stage renal disease with cerebral abscess and hemorrhage

  • Jee Hyun Kim;Jae Il Shin; Ji Hong Kim;Keum Hwa Lee
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.44-50
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    • 2024
  • Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

Establishment of the Heart Failure Model in Swine for the Experiment of the Pneumatic Ventricular Assist Device (공압식 심실보조기의 실험을 위한 돼지에서의 심부전 모델의 개발)

  • 박성식;서필원;이상훈;강봉진;문상호;김삼현
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.123-130
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    • 2003
  • Background: In order to develop the acute heart failure model for the animal experiment of the pneumatic ventricular assist device, we decided to use young pig whose coronary artery distribution is almost the same as humans and also very cheap in price. The purpose of this study is to develop stable, reproducible acute ischemic heart failure model in swine using coronary artery ligation method. Material and Method: Five young pigs whose weights are the same as adult humans are under experiment. Each pig was under endotracheal intubation and connected to a mechanical ventilator. Through left lateral thoracotomy, we exposed the heart and induced ischemic heart failure by coronary artery ligation. The ligation began at the distal part of the left anterior descending coronary artery. After 5 minutes of initial ligation we reperfused the artery and then re-ligated. Before and after each ligation-reperfusion procedure we assessed the left ventricular end-diastolic pressure, arterial pressure, and cardiac index. We also measured left ventricular end-diastolic dimension, end-systolic dimension, fractional shortening, ejection fraction using intraoperative epicardial echocardiography. After appropriate heart failure was established with sequential (from distal part of LAD to proximal location) ligation-reperfusion-ligation procedure, we inserted the ventricular assist device and operated. Result: We established stable acute ischemic heart failure in 3 of 5 young pigs with this sequential ligation-reperfusion-ligation procedure, and could maintained 50% less ejection fraction before the procedure according to intraoperative epicardial echocardiography. We also observed no ventricular arrhythmia usually associated with simple coronary artery ligation in large animals and no cardiac arrest associated with ventricular arrhythmia or myocardial stunning. In pathologic specimen, we observed scattered ischemic myocardium in all around the ischemic field induced by coronary artery ligation. Conclusion: Under the concept of ischemic preconditioning, we developed safe and reproducible acute ischemic heart failure model in swine using sequential coronary artery ligation-reperfusion-ligation method.