• Title/Summary/Keyword: Defect factors

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Clinical Characteristics and Prognostic Factors of Vesicoureteral Reflux (방광요관역류의 임상적 특징 및 예후인자)

  • Kim, Wun-Kon;Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.29-35
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    • 2014
  • Introduction: Persistent vesicoureteral reflux (VUR), a major cause of urinary tract infection (UTI) in children, can result in serious renal complications, such as reflux nephropathy and chronic renal failure. We evaluated the clinical characteristics and prognostic factors of VUR. Methods: From December 1993 to May 2011, we examined 117 children with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Chungbuk National University hospital for a UTI. The patients were managed medically or surgically. Results: Male patients had a slightly higher prevalence of VUR than female patients (55%). The degrees of the 161 refluxing ureters, as classified by the International Reflux Study Committee, were as follows: grade I, 15 ureters; grade II, 32 ureters; grade III, 54 ureters; grade IV, 26 ureters; grade V, 34 ureters. One hundred and sixty-one renal units (115 cases) underwent a 99m TC-DMSA renal scan, and 62% showed abnormal findings. The incidence of renal cortical defects showed a direct correlation with the severity of VUR. Ninety-four refluxing ureters were followed up medically, and 66 ureters (67%) either disappeared or improved. However, 9 refluxing ureters persisted. The spontaneous resolution rate of VUR seemed to be higher in younger patients with lower grades of reflux, and without renal cortical defects. Sixty-seven refluxing ureters (41%) were treated surgically, 62 refluxing ureters (92%) disappeared, and 5 refluxing ureters (8%) persisted. Conclusion: The incidence of renal cortical defects in patients with UTIs was 62% (in a 99m TC-DMSA renal scan), and showed a direct correlation with the severity of VUR. The spontaneous resolution rate seemed to be lower in the patients with higher grades of VUR, older age (over 4 years old) and diffuse renal cortical defects.

Intraoperative Measurement and Analysis of Coronary Artery Bypass Graft Flow (수술중 측정한 관상동맥 우회도관 혈류량의 분석)

  • Park, Kye-Hyun;Chae, Hurn;Yun, Yang-Ku;Lee, Jae-Woong;Kim, Kwhan-Mien;Jun, Tae-Gook;Kim, Jhin-Gook;Shim, Young-Mog;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.760-769
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    • 1997
  • This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.

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아동의 잠재된 영재성 개발 프로그램

  • Lee, Sun-Ju
    • Journal of Gifted/Talented Education
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    • v.10 no.2
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    • pp.71-86
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    • 2000
  • According to Torrance, it is said that about 30% of feeble-headed children are bearing potential brilliant quality. Such potential gifted children exist really much more than children who appear to show their own brilliant quality. Nevertheless, research activity to reveal children's potential giftedness has not been relatively actively progressed. Renzulli, Smith and so on progresses research activity to reveal children's potential giftedness and strategies developed by them are being used widely all over the world, but these strategies show the defect that children can not overcome by themselves the interfered factors influenced negatively on their gift revelation. Russian scholar Babaeva made the effective education program to develop children's potential giftedness. Her program includes various activity methods or mental correct activity and psychological training activity and such training activity is realized through some steps and each step has it's own purpose and realization method. With the result that children discriminated as common children by the experimental study which is progressed by the present program participate, their standard of intelligence and originality showed the improved effect of the similar standard to children factors not a little influencing on children's giftedness development process but she also developed the leading concrete study method for the children to overcome this by themselves. In this paper, the present writer will examine potential giftedness development program researched in Russia and discuss their theoretic background and concrete activity course, activity result. Through this, children's have the excellent abilities in various spheres, this writer will obtain significant suggestions to educate the potential gifted children who do not display their own potentialities and do not receive a favor from gifted children program.

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Evaluation of Standing Tree Characteristics by Development of the Criteria on Grading Hardwood Quality for Oaks Forests in Central Region of Korea (활엽수 입목형질등급 기준 개발을 통한 중부지역 참나무림의 입목특성 평가)

  • Lee, Young Geun;Lee, Sang Tae;Chung, Sang Hoon
    • Journal of Korean Society of Forest Science
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    • v.107 no.4
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    • pp.344-350
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    • 2018
  • This study was carried out to improve the forest management method considering the use of high value added timber in the natural broadleaf forests. For this purpose, the criteria for evaluating the quality grade of standing trees were established and applied to the oak stand in the central region of Korea. The evaluation factors of the grade were bending of stem, branch, stem damage, and other defects. If the logs are divided into 2.1 m units and three logs up to 6.3 m are available, they are classified as Grade I (G-I). If two logs are available, they are classified as Grade II (G-II), If only one log is available, it is classified as Grade III (G-III). When any log is not available as timber, it is classified as Grade IV (G-IV). As a result of applying the grade to the oak stand, G-I was 6.7 %, G-II was 28.0 %, G-III was 38.3 %, and G-IV was 27.0 %. The ratio of standing trees by oak species of higher than G-III was 88.2 % for Quercus acutissima, 88.1 % for Q. variabilis, 83.5 % for Q. serrata, 56.3 % for Q. aliena, and 50.3 % for Q. mongolica, respectively. The G-IV ratio for Q. variabilis and Q. mongolica tended to decrease with increasing diameter at breast height. The order of major defect affecting the grading level was bending of stem > branch > stem damage > other defects. Considering the grade level and oak species distribution, it was concluded possible to produce high quality hardwood timber when we concentrate forest tending techniques on Q. acutissima and Q. variabilis stand. In order to improve the accuracy of grading, it is necessary to continuous complement through the monitoring research for evaluation factors.

Risk Factor Analysis and Surgical Indications for Pulmonary Artery Banding (폐동맥 밴딩의 위험인자 분석과 수술적응중)

  • Lee Jeong Ryul;Choi Chang Hyu;Min Sun Kyung;Kim Woong Han;Kim Yong Jin;Rho Joon Ryang;Bae Eun Jung;Noh Chung I1;Yun Yong Soo
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.538-544
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    • 2005
  • Background: Pulmonary artery banding (PAB) is an initial palliative procedure for a diverse group of patients with congenital cardiac anomalies and unrestricted pulmonary blood flow. We proved the usefulness of PAB through retrospective investigation of the surgical indication and risk analysis retrospectively. Material and Method: One hundred and fifty four consecutive patients (99 males and 55 females) who underwent PAB between January 1986 and December 2003 were included. We analysed the risk factors for early mortality and actuarial survival rate. Mean age was $2.5\pm12.8\;(0.2\sim92.7)$ months and mean weight was $4.5\pm2.7\;(0.9\sim18.0)\;kg$. Preoperative diagnosis included functional single ventricle $(88,\;57.1\%)$, double outlet right ventricle $(22,\;14.2\%)$, transposition of the great arteries $(26,\;16.8\%)$, and atrioventricular septal defect $(11,\;7.1\%)$. Coarctation of the aorta or interrupted aortic arch $(32,\;20.7\%)$, subaortic stenosis $(13,\;8.4\%)$ and total anomalous pulmonary venous connection $(13,\;8.4\%)$ were associated. Result: The overall early mortality was $22.1\%\;(34\;of\;154)$, The recent series from 1996 include patients with lower age $(3.8\pm15.9\;vs.\;1.5\pm12.7,\;p=0.04)$ and lower body weight $(4.8\pm3.1\;vs.\;4.0\pm2.7,\;p=0.02)$. The early mortality was lower in the recent group $(17.5\%;\;16/75)$ than the earlier group $(28.5\%;\;18/45)$. Aortic arch anomaly (p=0.004), subaortic stenosis (p=0.004), operation for subaortic stenosis (p=0.007), and cardiopulmonary bypass (p=0.007) were proven to be risk factors for early death in univariate analysis, while time of surgery (<1996) (p=0.026) was the only significant risk factor in multivariate analysis. The mean time interval from PAB to the second-stage operation was $12.8\pm10.9$ months. Among 96 patients who survived PAB, 40 patients completed Fontan operation, 21 patients underwent bidirectional cavopulmonary shunt, and 35 patients underwent biventricular repair including 25 arterial switch operations. Median follow-up was $40.1\pm48.9$ months. Overall survival rates at 1 year, 5 years and 10 years were $81.2\%\;65.0\%,\;and\;63.5\%$ respectively. Conclusion: Although it improved in recent series, early mortality was still high despite the advances in perioperative management. As for conventional indications, early primary repair may be more beneficial. However, PA banding still has a role in the initial palliative step in selective groups.

A Study on Oriental Medical Diagnosis of Musculoskeletal Disorders using Moire Image (Moire 영상을 이용한 근골격계 질환의 한의학적 진단에 관한 연구)

  • Lee Eun-Kyoung;Yu Seung-Hyun;Lee Su-Kyung;Kang Sung-Ho;Han Jong-Min;Chong Myong-Soo;Chun Eun-Joo;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.72-92
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    • 2000
  • This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.

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Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting (관상동맥 우회술 292례의 중기 성적)

  • 김태윤;김응중;이원용;지현근;신윤철;김건일
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.643-652
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    • 2002
  • As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF<40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

Clinical Analysis of Mitral Valve Repair with Artificial Chordae (인공 건삭을 이용한 승모판성형술의 임상적 고찰)

  • 이석기;김정중;오삼세;백만종;나찬영;김욱성
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.768-773
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    • 2004
  • Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.

A Study on the Stiffness of CBA(Corner Block with Anchor Bolt) Joint in Knockdown Type Table Furniture (조립식(組立式) 탁자(卓子)의 CBA접합부(接合部) 강성(剛性)에 관(關)한 연구(硏究))

  • Chung, Woo-Yang;Lee, Phil-Woo
    • Journal of the Korean Wood Science and Technology
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    • v.17 no.2
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    • pp.34-64
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    • 1989
  • Corner block with anchor bolt(CBA) joint method used in knock-down type table furniture manufacturing can reduce the packing and transporting cost. Unfortunately. it also has the disastrous defect to be loosend and unstable during the service life mainly due to fatigue and creep(repeated and prolonged loading). So 22 joint groups constructed were tested to evaluate the effect of some design factors related to the size of side rail(apron). block attachment to side rail. and the number of anchor bolt as well as the effect of the type of corner block(mitered type vs. rectangular type) Usable strength from the stiffness coefficients of each joint group were analysed with SPSS /PC+ and described as the criteria of CBA joint construction. The conclusions were as follows: The height of side rail(50, 75 and 100 mm) and the addition of polyvinyl acetate(PVAc) emulsion in the corner block attactment to side rail had the effect on raising the usable strength of CBA joint with remarkable high significance. And the effect of 2 - anchor bolts was also superior to that of 1 - bolt significantly. However. the thickness of side rail(22 mm vs. 25 mm) had no effect on the strengthening the table joint rigidity. Mitered type corner block joint appeared to he recommendable for CBA jointed table construction rather than the rectangular type one regardless of the method of block attachment to side rail. The best result identified from Duncan's multiple comparison was in the construction with 25 mm thick and 100 mm height of side rail fastened using 2 - anchor bolts in mitered type corner block. But it would be reasonable to use 22 mm thick & 75 mm high side rail and mitered corner block with PVAc emulsion & 2 bolts considering the productivity and production cost down in the MDF furniture manufacturing industries.

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Ultrastructure of nasal cilia in children with recurrent or persistent respiratory diseases (반복 지속성 호흡기 질환 소아에서 비강 섬모의 미세구조 검사의 의의)

  • Shin, Su-A;Yang, Seung;Oh, Jae-Won;Lee, Ha-Baik;Park, Cheol-Eon;Kwan, Jung-Kyun
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.410-416
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    • 2006
  • Purpose : Ciliary abnormalities of the respiratory system usually accompany recurrent or persistent respiratory diseases such as paranasal sinusitis, bronchiectasis, rhinitis, and/or otitis media, since they cause certain derangements in ciliary cleaning activities. This disease is usually inherited by autosomal recessive trait, but may also be found to be acquired or transient in rare cases after heavy exposure to pollutants, cigarette smoking or severe infection. We performed this study in children with frequently recurrent or persistent respiratory diseases to clarify if the ciliary abnormalities are preceding factors. Methods : We enrolled 17 children with suspected respiratory ciliary abnormalities. The indications for evaluation of ciliary ultrastructure were recurrent or persistent respiratory infections. Children with immunologic abnormalities were excluded. From August 2000 to July 2003, we performed a biopsy on nasal mucosa and examined the structure of ciliary status by using an electron microscope. Results : Of the subjects, there were seven males and 10 females, aged 2 to 10 years. Out of the 17 subjects, 12 cases of chronic paranasal sinusitis, nine chronic coughs, nine frequent upper respiratory infections, seven cases of recurrent otitis media, four cases of recurrent pneumonia, and four cases of bronchial asthma were found. Out of the 17 cases on which histologic examinations were conducted, four cases showed pathologic findings, including one case of inner dynein arm defect, one of microtubular transposition, one of supernumerous tubules, and one singlet, respectively. Conclusion : It is essential for differential diagnosis and effective treatment to identify the abnormalities of ultrastructure of nasal cilia in children with symptoms of frequently recurrent or persistent respiratory diseases, if immunodeficiency or respiratory allergy could be excluded.