Kim, Hwan-Wook;Joo, Seok;Kim, Hee-Jung;Choo, Suk-Jung;Song, Hyun;Lee, Jae-Won;Chung, Cheol-Hyun
Journal of Chest Surgery
/
v.42
no.4
/
pp.447-455
/
2009
Background: Prosthetic valve endocarditis usually presents with clinical symptoms that are more severe than native valve endocarditis, and prosthetic valve endocarditis shows the spread of infection into the surrounding tissue as well as into the superficial endocardial layers. The postoperative prognosis is especially poor for valve re-replacement for the cases of active endocarditis that are unable to receive a full-course of pre-antibiotic therapy due to complications and the ensuing clinical aggravation. The aim of this study was to evaluate the clinical profiles, laboratory findings and mid-term surgical results of active prosthetic valve endocarditis. Material and Method: Among the 276 surgically treated infective endocarditis patients who were treated during the period from January 1998 to July 2008, 31 patients were treated for prosthetic valve endocarditis. Among these patients, 24 received surgical treatment for an 'active' state, and they were selected for evaluation. Result: The most frequently encountered symptom was a febrile sensation. Eight cases (33.3%) were accompanied by systemic thromboembolism, among which 5 cases (20.8%) had an affected central nervous system. 'Vegetations' were most commonly found on transesophageal echocardiography, and the 'Staphylococcus species' were the most frequent pathogens. There were 4 deaths in the immediate postoperative period, and an additional 4 patients died during the follow-up period (Mean$\pm$SD, 42.1$\pm$36.9 months). The cumulative survival rate was 79% at 1 year, 73% at 3 years, 66% at 5 year, and 49.5% at 7 years. Conclusion: The cases of active prosthetic valve endocarditis that were unable to receive a full course of preoperative antibiotics therapy generally have a poor prognosis. Nevertheless, early surgery and extensive resection of all the infected tissue is pivotal in improving the survival rate of patients with surgically treated active prosthetic valve endocarditis.
We have found the clusters of tiny spiny puffball-like mushrooms growing gregariously in fairy ring (arcs) rimmed by a zone of darker green grass in the golf courses. Macroscopic as well as microscopic characters were examined for the morphology of fruiting body. Exoperidium is thin and densely spiny with minute fibrillae at early stage. The connivent spines were soft and quite persistent. In age, the fibrillae scrumble away with a powdery coating, which leaves white endoperidium becoming pale brown. It's interior was white and fleshy at first, but turns into an olive-colored dust as the gleba, the spore-producing tissue, develops to maturity and loaded with olive-brown spore mass. Then, distinct apical pore developed on the endoperidium. Rudimentary subgleba(sterile base) was narrow, chambered, delineated from the gleba by a membrane in young material. These characters suggested this fungus is a Vascellum, a member of the family Lycoperdaceae. The shapes of the spores were globose, echinulate, $3{\sim}3.5{\mu}m$ in diameter, thick-walled, and olive brown. Capillitial threads were $8-9{\mu}m$ wide, mostly colorless in KOH solution and thin-walled, which designated as "paracapillitium". This is an another character that distinguishes this mushroom from Lycoperdon spp. The spines developed on exoperidium were characteristically connivent; their apices joined together in a point, leaving a space below, which gives the appearance of vault to each group of usually 5 to 6 fibrillae. Based on the above characters, this fungus is identified as Vascellum curtisii (Berkeley). The characters distinguishable this from Lycoperdon pulcherrimum, and Vascellum pretense are discussed in detail. Control trial was also attempted. Strong vertical raking(SVR) followed by applying 500x detergent solution (Spark, Aekyung Co. Seoul) resulted in excellent control over any other treatments. In this plot, fruiting body was not developed throughout the end of mushroom growing season.
This study presents matters of how to analyse the dance of artistic form on the course of transforming folk art to be separated from leisure to become the art form. In particular, the traditional art of dance in Korea has been of collective act like dureh, rather than of individual art, that it had to choose the repeated style of same form and rhythm. In this respect, before it can be said that the dance in its own form became more sophisticated and adopted the artistic segment in the time of modernisation, it is viewed that in the very heart of folk dance there was sufficient ability of artistic material to seek its own right. In this regard, the artistic transformation of seoljanggo nori into seoljanggo dance is an art form which is found in Korea, and expressing rhythm and playfulness is evident and sought attention. Therefore this study puts its importance in analysing how, in the aspect of the course of life of traditional arts, dance is formed in its own right and developed a form of art from fun entertainment. I have chosen, among them, seoljanggo, which used to be a form of fun entertainment and later transformed into a form of art on stage, in particular LeeGyeongh wa seoljanggo dance which maintains the style of Honam Udo farmers' music, and tried to read the text from it. It has resulted in that, Lee Gyeonghwa seoljanggo dance did a new try on tradition, in its development of expressing art through dance and onto more technical sophistication, found in the style of tune and choreography fused into its distinctive form. The art of traditional dance concerns here that seoljanggo has changed from agrarian entertainment to modern stage art, which shows how tradition can be adopted to the contemporary cultural life or to be reinvented to the needs of the aesthetic style that the current society consumes. Thus, it is necessary to think about its role in education and to represent cultural creativity from local developments.
Background: Spontaneous pneumomediastinum is an uncommon disorder with few cases reported. It usually occurs in young males and has benign self-limiting course without any apparent concomitant factor. It is seen after intrathoracic pressure changes leading to alveolar rupture. The clinical experiences of two medical centers were reviewed to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with spontaneous pneumomediastinum patients was performed. Result: 24 patients were identified with a diagnosis of spontaneous pneumomediastinum. These 24 patients were comprised of 18 men and 6 women with mean age 18.9 years (range 10 ~ 33). The major initial complaints were chest pain (79.2%), throat pain (62.5%), and subcutaneous emphysema (41.7%). The triggering events were exercise (16.7%), coughing (12.5%) and vomiting (12.5%). No apparent triggering event was noted in 54.2% of patients. In all cases, chest radiograph and computed tomography was done. Diagnostic computed tomography was required in 25%. White blood cell counts and C-reactive protein (CRP) were checked, and their initial mean values were $9,790{\pm}3,240/{\mu}L$ Land $1.31{\pm}1.71mg/dL$, final mean values were $5,440{\pm}1,665/{\mu}L$ Land $0.72{\pm}0.73mg/dL$, respectively. 23 patients were admitted (average $5.0{\pm}1.8$) and the symptoms were self-limiting in all cases without complications. Conclusion: Spontaneous pneumomediastinum is a benign condition with mild inflammatory signs that often presents with chest or throat pain. Secondary causes must be ruled out to avoid an unfavorable outcome with less invasive study. Because of very rare complications and recurrence, outpatient basis and shortened hospitalization may be feasible.
This thesis has an intention to examine how much Bobos, which has appeared as a new ruling class in the age of digital information economy, has had an influence on the fashion design and which aspect Bobos fashion assumes specifically. The existence of Bobos in Korea and its cultural disposition are examined. To do so, questionnaire survey has been performed for 400 persons. According to the result, it is shown that they control themselves thoroughly through exercise and have much interest in their health; for example, they prefer organic agricultural products and nonpolluting foods. They also consume goods reasonably, emphasizing on their own individuality, rather than purchase high-price articles for no good reason, and enjoy their life while seeking for success in the society. Such a disposition is almost same as that in the U.S, showing a small difference in the occupation or origins. It is examined which aspect Bobos fashion design, a new trend, assumes in more detail. Bobos seeks for a thing that is not cheap, has a recognized brand, and is not behind the fashion. They like the nature friendly, classical, and not vulgar thing. design should be casual and practical, and the quality of the material should be good. Especially, an individual disposition is emphasized in Bobos fashion, in which they disregard a brand and try to be the subject of a trend, by creating a fashion by themselves, to express their originality freely. Bobos fashion the first style it harmonizes the appear things not to be matching with each other and depending on pursuing the mix & match. The second style of Bobos fashion nature is friendship and fight. The hazard which it does like that the fact that it attempts is the composition characteristic of idea. The namely design is an utility cheap assuredly with high-class characteristic of subject matter is not a recognize cheap. The third style of Bobos fashion is expressed in nostalgic about the art. Of course Bobos style is not a possibility fashion as main stream of doing still today, but the effect of Bobos is magnified gradually from cultural, social, economic area. It analyzes style is a tendency where trend of the consumer is gradually converted marketing. This paper is meaningful in the sense that Bobos class, which has not been examined yet systematically, and the fashion are connected closely, and the fashion trend in the next is examined.
This study was conducted to analyze the relationships between terms, learning concepts and inquiries in ocean unit, the National Common Basic Curriculum. The several science textbooks were selected to use for study, written in accordance with the 7 current national curriculum for the fourth grade of elementary school, the seventh of middle school and the tenth of high school. The higher the school level becomes, the frequencies of using terms related with ocean region get. The explanation of terms, however, has a tendency to be less frequent in the high school level. In the perspective of learning concept, there are more concrete concepts than formal concepts regardless of school level. Pure scientific context appears most often in inquiry contest through the whole course of every school level. In respect to inquiry process, the frequency of integrative inquiry process is on the increase as the school level gets higher. From the viewpoint of inquiry activity, there have been a lot of discussions, experiments and investigations in every school level, while high school does not the present any field study and project. Through these result, it is considered that the explanation of main terms is inevitable in the textbooks as basic educational material without regard to school level. In learning concept and inquiry context, a well-rounded learning is needed in relation to students' cognitive development and science-technology-society. Especially for the inquiry activity of earth science education, the educational effect is remarkable through field study; its appropriate application is required, accordingly.
This study focuses on two points. First, I have examined the difference on combustion between flame-retardant and non flame-retardant products including vertical blinds and roll screens that are widely used as a substitute for fabric curtains. The second point is to see how long flame-retardant goods can be durable, that is, flame retardant durability after washing in liquid. the experiment on the flame-retardant ability before and after washing of vertical blinds and roll screens that have been used for a long time in fire protection construct. Comparing and analyzing domestic and foreign laws on flame-retardant after the experiment on durability of these products. I aim to draw necessity for increased application of internal laws and regulations on flame-retardant and show how to improve the point at issue. According to the result, clear differences in performance and safety were observed between flame-retardant and non flame-retardant products. flame-retardant materials can prevent things from fire spread without igniting but melting when they've met flame and burnt, In contrast, non flame-retardant material for experiment which size is 120cm long takes less than 3 minutes only to be completely destroyed by fire. However, it was expected for flame-retardant durability of flame-retardant blinds which are not washable to decrease flame-retardant durability after being washed with water, there was no sharp difference. so it is demonstrated that flame-retardant blinds can keep flame-retardant durability. accordingly through the strict course of product we are concerned about keeping durability.
The photochemistry of the derivatives of o-nitrobenzylcarboxyl esters or benzylsulfonyl derivatives has been well studied separately. But little attempt has been made to combine the fruits these two studies. Being photochemically active, benzylsulphonyl and intro groups should influence the reactivity of each other's, especially when the excited states are fully mixed due to the proximity of their location. The questions which should be clearly answered are; what kind of effect will be excerted to the other group, and whether these two functional groups are coupled in the course of the reaction. To answer the questions raised above, wer have synthesized two sulfonyl esters and four amides from the newly available starting material, 2-nitro-${\alpha}$-toluenesulfonyl chloride. The products identified from the exploratory solution photochemistry were cyclohexanol, phenol, cyclohexylamine, and sulfur dioxide. The results are not much different from the products originally anticipated. It has been temporarily concluded that there is little interaction between the benzyl sulfonyl group and ortho-nitro chromophore. The fact that a base (an amine) has been photochemically generated in solution photochemistry was further confirmed by and utilized in the solid phase quantitative photochemistry done on the film, so as to carry out the photochemical epoxide cure.
Acute aortic dissection associated with high mortality rate has an extremely poor prognosis if early diagnosis and treatment are not received. Recently, with advanced computed tomography and echocardiography, diagnostic rate is higher and early operation is possible. Therefore preoperative medical therapy at ER(emergency room) lowered the mortality rate. This study was done to analyze the results with preoperative management at ER and operations, retrospectively. Material and Method: A series of 42 patients treated surgically for acute aortic dissections from 1991 to 2001 were included in this study. There were 18 males and 24 females. Mean age was 51.1 years. The admission course through emergency and outpatient department(OPD) was 34 and 8 respectively. Result: 26 patients underwent ascending aorta replacement-7 combined aortic valve replacements, 7 patients underwent descending aorta replacements and 9 patients received Bentall's operation. At emergency department, 20 patients received antihypertensive drugs and $\beta$-receptor blockers and 6 patients died. 22 patients did not receive antihypertensive and $\beta$-receptor block drugs and 10 patients died. There were 16(38%) overall deaths. Conclusion: Early diagnosis at ER or OPD is essential for acute aortic dissection, and it is important to select the most appropriate noninvasive interventions as possible. Therefore, preoperative drug therapy at ER is suggested according the patient conditions.
Although traumatic thoracic aortic rupture is potentially a fatal condition requiring surgical attention, the presence of concomitant injury involving other parts of the body may greatly increase the risk of cardio-pulmonary bypass. We report our experience of treating associated injuries prior to the thoracic aortic rupture in these patients. Material and Method: From 1997 to 2003, the medical records of 24 traumatic aortic rupture patients were retrospectively reviewed and checked for the presence of associated injury, surgical method, postoperative course, and complications. Surgical technique comprised thoracotomy with proximal anastomosis under deep hypothermic circulatory arrest followed by side arm perfusion to reestablish cerebral circulation. CSF drainage was performed to prevent lower extremity paraplegia. Result: Major concomitant injuries (n=83) were noted in all of the reviewed patients, Of these, there were 49 thoracic injuries, 18 musculoskeletal injuries, and 13 abdominal injuries, Operations for associated injuries (n=16) were performed in 12 patients on mean 7.6$\pm$12.6 days following the injury. The diagnosis of aortic rupture at the time of injury was detected in only 18 patients. Delayed surgery of the thoracic aorta was performed on average 695$\pm$1350 days after injury and there were no deaths or progression of rupture in any of these patients during the observation period. There were no operative deaths and no major postoperative complications. Conclusion: Treating concomitant major injuries prior to the aortic injury in traumatic aortic rupture may reduce surgical mortality and morbidity.
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