• Title/Summary/Keyword: Drainage method

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Clinecal Investigation and Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum (전흉벽 늑연골의 리모델링 성형술을 이용한 누두흉수술의 임상적 고찰 초기합병증)

  • Her, Keun;Song, Cheol-Min;Jeon, Cheol-Woo;Jang, Won-Ho;Kim, Hyun-Jo;Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.882-889
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    • 2002
  • Acute Complications of Remodelling Plasty of Costochondral Rib Cage For Pectus excavatum Recently, Remodelling Plasty of Costochondral Rib Cage has been introduced as an minimally invasive procedure and expanded its application for pectus excavatum. Outcomes and acute complications were reviewed Material and Method: A retrospective survey of 55 patients who underwent Remodelling Plasty of Costochondral Rib Cage from September, 1999 to February, 2002 was conducted to review complications, postoperative treatments, and outcomes. Result: Age ranged from 1 to 27 years(mean 11.4 $\pm$ 7.1). 35(64%) were less than 15-year old and 20(36%) were more than 15-year old. There were 44(80%) Male patients and 11(20%) female patients. Length of hospital stay was 7.8 $\pm$ 2.1 days for less than 15-Y-old group, 10.6 $\pm$ 6.2 days for more than 15-Y-old group(p = 0.042) One substernal bar was inserted in 52 patients and two substernal bars were inserted in 3 patients. As for stabilizer, one lateral side was fastened in 15 patients and both lateral sides were fastened in 6 patients. In the less than 15-Y-old group, 4 patients needed stabilizer, whereas in the more than 15-Y-old group, 18 patients needed stebilizer(s)(p = 0.000). Including all kinds of complications, 28(51 %)patients had postoperative complications. Of them, only 7 patients were treated for complications(C-tube insertion was done in 7 patients and reoperation for bar refixation or removal was done in 3 patients of them). Conclusion: Most complications after Remodelling Plasty of Costochondral Rib Cage For Pectus Excavatum were trivial without treatment although C-tube drainage was needed in some patients. However bar displacement such as rotation and lateral sliding should be corrected as soon as detected in order not to remove the bar(the worst situation).

Effects of Intraoperative Doxycycline Pleurodesis with Concomitant Video-assisted Thoracoscopic Bullectomy (흉강경을 이용한 폐기포절제 수술과 동시에 시행한 Doxycycline Pleurodesis의 효과)

  • Kim, Hyeong-Guk;Han, Jae-Yeol;Kim, Gwang-Ho;Kim, Jeong-Taek
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.59-62
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    • 1996
  • Chemical pleurodesis with doxycycline has been used during video-assisted thoracoscopic surgery (VATS) as an auxiliary method to enhance therapeutic goal in patients with pneumothorax. However, the therapeutic effect of doxycycline pleurodesis (DP) has not been clearly defined yet. To evaluate the effect of DP, we compared two groups of patients who were given VATS bullectomy from October 1993 to June 1995. Group I composed of 21 patients who received DP and group II composed of 20 patients who did not received DP Doxycycline 500mg with saline 200ml were instilled into the pleural cavity upon a completion of bullec omy, and retained there for 0.5-1 hour and then drained out. The age of group I was 30.9 $\pm$ 20.0 and that of group II was 24.3 $\pm$ 9.49 years. Male to female ratio was 20: I in group I and 20 : 0 in group II. The postoperative indwelling time of chest tube was 5.86 $\pm$ 4.69 days in group I and 3.80 $\pm$ 2.28 days in group II. Seven patients had more than 100m1/day of chest tube drainage on the postoperative third day in group I compared to one patient in group II. Five patients had postoperative indwelling time of chest tube greater than 7 days in group I compared to two in group II. The number of patients who had postoperative fever were 3 in both group, analgesic requirements were 2.19 $\pm$ 2.77 amples in group I and 2.30 $\pm$ 1.95 ambles in group II. Follow-up was done from 2 months to 16 months after surgery. During the follow up periods, four patients had recurrence 2 (9.5%) in group I and 2 (10%) in group II. We conclude that concomitant doxycycline pleurodesis with video-assisted thor coscopic bullectomy In patients with pneumothorax is not necessary.

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Rewetting Strategies for the Drained Tropical Peatlands in Indonesia (인도네시아의 배수된 열대 이탄지에 대한 재습지화 전략)

  • Roh, Yujin;Kim, Seongjun;Han, Seung Hyun;Lee, Jongyeol;Son, Yowhan
    • Korean Journal of Environmental Biology
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    • v.36 no.1
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    • pp.33-42
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    • 2018
  • The tropical peatlands have been deforested and converted to agricultural and plantation areas in Indonesia. To manage water levels and increase the overall productivity of crops, canals have been constructed in tropical peatlands. The canals destructed the structure of the tropical peatlands, and increased the subsidence and fire hazard risks in the region. The Indonesian government enacted regulations and a moratorium on tropical peatlands, in order to reduce degradation. A practical method under the regulations of rewetting tropical peatlands was to permit a canal blocking. In this study, four canal blocking projects were investigated regarding their planning, construction priority, design, building material, construction, monitoring, time and costs associated with the canal blockings. In the protected areas, regulations restricted the development of the tropical peatlands areas that were noted as deeper than 3 m, and the administration stopped issuing new concessions for future work projects for this noted criteria of land use. A noted purpose of canal blockings in these areas was to effectuate the restoration of the lands in the region. The main considerations of the restoration efforts were to maintain a durability of the blockings, and to encourage the participation of the area stakeholders. In the case of a concession area, regulations were set into place to restrict clear-cutting and shifting cultivation, and to maintain groundwater level in the tropical peatland. The most significant priorities identified in the canal blocking project were the efficiency and cost-effectiveness of the project. Nevertheless, the drainage of tropical peatlands has been continued. On the basis of a literature review on regulations and rewetting methods in tropical peatlands of Indonesia, we discussed the improvements of the regulations, and adequate canal blockings to serve the function to rewet the tropical peatlands in Indonesia. Our results would help establishing an adequate direction and recommended guideline on viable rewetting methods for the restoration of drained tropical peatlands in Southeast Asia.

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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Production of Organic Rice (Oryza sativa L.) using Organic Cultivation Manual (유기재배매뉴얼을 활용한 유기쌀 생산)

  • Cha, Kwang-Hong;Oh, Hwan-Jung;Seo, Dong-Jun;Song, Yong-Su;Ahn, Joon-Seob;An, Kyu-Nam;Jung, Woo-Jin
    • Korean Journal of Organic Agriculture
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    • v.22 no.1
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    • pp.97-113
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    • 2014
  • An actual proof experiment was carried out to establish the production of high quality organic rice at farm household in Gwangjin, Junnam, Korea 2011. Experimental plot was designed with conventional organic cultivation and manual organic cultivation in both Hopeongbyeo and Onnuri varities. Experimental field was consisted with suitable drainage loam soil, anryong series, and normal paddy field. Chemical characteristics of the soil were investigated from initial soil and soil after harvest in experimental sites. Seed disinfection was treated with hot water dipping method at $60^{\circ}C$ for 10 min. Rice transplanting was carried out at 17 June with 25 days seedling using machine transplanting. Golden apple snail was used to prevent weed growth as middle size (1.5~1.7 kg/10a) at one week after rice transplanting. Amount of applied fertilizer in experimental plot was supplied with organic fertilizer for the shortage after harvest of hairy vetch (1,100 kg/10a). Bordeaux mixture was used to control of sheath blight and neck blast disease in all experimental plot at 19 Aug. Application of chitin culture solution was treated in manual organic cultivation at 2 and 15 Aug. At late growth stage, incidence rate of neck blast was the highest level at Hopyeongbyeo in conventional organic cultivation. Incidence rate of sheath blight in both Hopyeongbyeo and Onnuri was higher in conventional organic cultivation than in manual organic cultivation. Incidence of rice leaf folder was the highest level at Onnuri in conventional organic cultivation. Yield index in manual organic cultivation was increased by 13% and 38% at Onnuri and Hopyeongbyeo, respectively, compared with conventional organic cultivation. Head rice percentage in both Hopyeongbyeo and Onnuri was slightly increased in manual organic cultivation. These results indicate that high quality production of rice organic cultivation could be depending on management of safe fertilization with nutrient content in soil.

Role of the Inferior Thyroid Vein after Left Brachiocephalic Vein Division During Aortic Surgery

  • Park, Hyung-Ho;Kim, Bo-Young;Oh, Bong-Suk;Yang, Ki-Wan;Seo, Hong-Joo;Lim, Young-Hyuk;Kim, Jeong-Jung
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.530-534
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    • 2002
  • Background: In aortic surgery, division and ligation of the left brachiocephalic vein(LBV) may improve exposure of the aortic arch but controversy continues about the safety of this division and whether a divided vein should be reanastomosed after arch replacement was completed. The safety of LBV division and the fate of the left subclavian venous drainage after LBV division were studied. Material and Method: From November 1998 to January 2001, planned division and ligation of the LBV on the mid-line after median sternotomy was peformed in 10 patients during the aortic surgery with the consideration of local anatomy and distal aortic anastomosis. Assessment for upper extremity edema and neurologic symptoms, measurement of venous pressure in the right atrium and left internal jugular vein, and digital subtraction venography(DSV) of the left arm were made postoperatively. Result: In 10 patients there was improvement in access to the aortic arch for procedures on the ascending aorta or aortic arch. The mean age of patients was 62 years(range 24 to 70). Follow-up ranged from 3 weeks to 13 months. One patient died because of mediastinitis from methicilline-resistant staphylococcus aureus strain. All patients had edema on the left upper extremity, but resolved by the postoperative day 4. No patient had any residual edema or difficulty in using the left upper extremity during the entire follow-up period. No patient had postoperative stroke. Pressure difference between the right atrium and left internal jugular vein was peaked on the immediate postoperative period(mean peak pressure difference = 25mmHg), but gradually decreased, then plated by the postoperative day 4. In all DSV studies left subclavian vein flowed across the midline through the inferior thyroid venous plexus. Conclusion: We conclude that division of LBV is safe and reanastomosis is not necessary if inferior thyroid vein, which is developed as a main bridge connecting the left subclavian vein with right venous system, is preserved.

Comparative Study of 2 mm Video-thoracoscopic Examination and High-resolution Computed Tomography for Spontaneous Pneumothoarx Patients (자연기흉에서 고해상 전산화단층촬영술과 2 mm 비디오 흉강경검사의 비교 연구)

  • Lee, Song-Am;Chee, Hyun-Keun;Hwang, Jae-Joon;Cho, Seong-Joon;Lee, Sung-Ho;Kim, Kwang-Taik
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.362-368
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    • 2007
  • Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.

The Role of Chest CT Scans in the Management of Empyema (농흉에서 전산화 단층촬영의 의의)

  • Heo, Jeong-Suk;Kwun, Oh-Yong;Sohn, Jeong-Ho;Choi, Won-Il;Hwang, Jae-Seok;Han, Seung-Beom;Jeon, Young-June;Kim, Jung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.397-404
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    • 1994
  • Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

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Effect of Soil Environment on Diversity and Population of Aerobic Soil Bacteria from Baekdudaegan Mountain Forests in Gyeongsangbuk-do, Korea (경상북도 산림지역의 토양 환경이 호기성 토양 세균의 다양성과 밀도에 미치는 영향)

  • Park, Chul Yeong;Lee, Sun Keun;Kim, Ji Hong;Lee, Sang Yong;Lee, Jong Kyu
    • Journal of Korean Society of Forest Science
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    • v.101 no.3
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    • pp.501-508
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    • 2012
  • This study was carried out to compare species diversity of soil bacteria from Baekdudaegan mountain forests (Bonghwa-gun, Mungyeong-si and Sangju-si) in Gyeongsangbuk-do and to analyze the effects of soil environments on diversity and population of soil bacteria. Soil bacteria were isolated from soil samples by streak plate method, and identified by DNA extaction and 16S rDNA sequence analyses. The population of soil bacteria from the soil samples of Bonghwa-gun was the highest with $5.1{\times}10^5cfu/g$, and followed by those from Mungyeong-si and Sangju-si with $1.9{\times}10^5cfu/g$ and $1.1{\times}10^5cfu/g$, respectively. The population of soil bacteria from surface layer soil was the highest, and then gradually decreased according to soil depth. The increase in population of soil bacteria from soil samples of different sites was correlated with the increase of the altitude of soil sampling site, depth of A horizon, liquid phase among three phases of soil, water content and bulk density of soil. Two hundreds and sixty eight bacterial colonies from Bonghwa-gun were classified into 10 species, 8 genera. One hundred and thirty four bacterial colonies from Mungyeong-si were classified into 15 species, 9 genera. Forty four bacterial colonies from Sangju-si were classified into 5 species, 2 genera. The dominant species (occupancy rate) from Bonghwa-gun and Mungyeong-si were Bacillus weihenstephanensis (36% and 40%, respectively), and Sangju-si was Bacillus cereus (39%). The relationships between soil environment and community structure of soil bacteria were analyzed statistically by using ecological indices. The diversity, evenness and dominance indices of soil bacteria were 6.30, 2.04 and 0.59 in Bonghwa-gun, 9.09, 2.94 and 0.51 in Mungyeong-si, and 4.55, 2.34 and 0.71 in Sangju-si, respectively. The diversity and evenness indices were increased by the increase of water content, drainage condition and gravel content of soil, while the dominance index was decreased.

Eosinophilic Peritonitis (EP) Complicated with Continuous Ambulatory Peritoneal Dialysis (CAPD) (지속적 외래 복막투석 직후 발생하는 비감염성 호산구성 복막염)

  • Paek Kyung-Hoon;Jeon Yun-Ae;Min Jae-Hong;Park Kyung-Mi;Kim Jung-Su;Ha Il-Soo;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.117-122
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    • 1997
  • Purpose : To clarify the clinical findings, laboratory findings and disease course of EP complicated with CAPD and to find out possible predisposing factors to EP. Methods : The medical records of 34 children who underwent CAPD at our hospital between Jan. '94 and Dec. '96 were retrospectively reviewed. The clinical features and laboratory findings of EP were analyzed, and several parameters were evaluated as predisposing factors of EP. Results : EP developed in 7(21%) out of 34 patients. The major symptom of EP was turbid peritoneal fluid without fever, abdominal pain or disturbance of drainage in all cases. The microbiologic culture studies of the peritoneal fluid resulted negative in all cases. Patients with peripheral blood eosinophilia before insertion of CAPD catheter had higher risk of EP than those without eosinophilia (P=0.002). And peripheral blood eosinophilia, noted after insertion of hemodialysis catheter in cases with previous hemodialysis before CAPD, showed significant correlation with the occurrence of EP (P=0.016), too. However, there was no significant correlation between peripheral blood eosinophilia noted after insertion of CAPD cathter and the occurrence of EP. Identification of eosinophils in peritoneal fluids was more accurate with cytospin analysis. Conclusions : An early and accurate diagnosis of EP in patients with CAPD can prevent unnecessary treatment of antibiotics. Peripheral blood eosinophilia before insertion of CAPD catheter is one of the predisposing factors of EP. And, cytospin analysis of peritoneal fluid is an accurate method for diagnosis of EP.

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