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Surgical outcome of severe pulmonary arterial hypertension secondary to left-to-right shunt lesions (심한 폐동맥 고혈압을 동반한 좌우 단락 질환 환자의 수술 후 경과)

  • Lee, Cha Gon;Jeong, Su-In;Huh, June;Kang, I-Seok;Lee, Heung Jae;Yang, Ji-Hyuk;Jun, Tae Gook
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.195-202
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    • 2010
  • Purpose : Despite recent advances in pulmonary hypertension management and surgery, appropriate guidelines remain to be developed for operability in congenital heart disease with pulmonary artery hypertension (PAH). Our aim was to evaluate clinical outcomes of patients with severe PAH who underwent surgical closure of left-to-right shunt lesions (LRSL) on the basis of pulmonary reactivity. Methods : We retrospectively reviewed 21 patients who underwent surgical closure of LRSL with severe PAH (${\geq}8$ Wood unit) from January 1995 to April 2009. The median age at operation was 26 years. Atrial septal defect, ventricular septal defect (VSD), VSD and patent ductus arteriosus (PDA), and PDA was present in 11, 4, 4, and 2 patients, respectively. Results : Operability was based on vasoreactivity of PAH. Of the 21 patients, 5 showed response to pulmonary vasodilator therapy and 8 showed vasoreactivity after balloon occlusion of defects. The remaining 8 patients were considered operable because of significant left-to-right shunt (Qp/Qs ${\geq}1.5$). Five patients underwent total closure of defects and 16 were left with small residual shunts. The median follow-up duration was 32 months. There was no significant postoperative mortality or morbidity. Systolic pulmonary artery pressure (PAP) decreased in all but 2 patients. All patients except 1 showed improvement of New York Heart Association functional class. Conclusion : Closure of LRSL in patients with severe PAH on the basis of pulmonary vasoreactivity seems reasonable. PAP and clinical symptoms improved in most patients. Further research is needed for the evaluation of long-term results.

Health Conditions and Health Behaviors of Merchants at Traditional Markets (전통시장 상인의 건강상태와 건강행태)

  • Hwang, Seong-Ho;Kwon, O-Hyun;Jeon, Mi-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.237-245
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    • 2017
  • This cross-sectional descriptive study was conducted to determine the health conditions and health behaviors of merchants at traditional markets and compare them with members of the general population[ED highlight - do you mean "members of the general population"?]. The data were collected from 307 merchants at N traditional market in C City from 1-20 June 2015 at D Health Center of C City after physical measurement and blood collection and then analyzed using SPSS WIN 21.0. The male, female, and overall smoking rates of merchants at the traditional market were 34.2%, 3.5% and 11.1%, the annual drinking rates were 68.4%, 38.5%, and 45.9%, and the rates of subjects under stress and the rates of experiencing depression were 23.7%, 28.5%, and 27.4% and 5.3%, 6.1%, and 5.9%, respectively, which were all relatively lower than members of the general population[ED highlight - please ensure that my changes here are in keeping with your intended meaning.]. The male, female and overall rates of medium-level physical activities and walking were 32.9%, 19.9%, and 23.1% and 85.5%, 79.2%, and 80.8%, respectively, to have relatively good health behaviors, and the mental health is relatively fine than members of the general population[ED highlight - please clarify this, I cannot infer your intended meaning.]. However, test group[ED highlight - the test group? Please specify.] had high prevalence rates of hypertension, diabetes, hypercholesterolemia, and metabolic syndrome. Moreover, as the duration of work increased, the abdominal circumference as well as the prevalence rates of low HDL-cholesterol, hypertension, metabolic syndrome, and arthritis increased. Therefore, the specific causes of these shall be determined, and the long-term daily life improvement program shall be prepared and applied continuously for merchants at traditional markets.[ED highlight - please specify what these refer to; however, the entire sentence can probably be deleted.

The effect of rooming-in care on the emotional stability of newborn infants (모자동실이 신생아의 정서적 안정에 미치는 영향)

  • Ahn, So Yoon;Ko, Sun Young;Kim, Kyung Ah;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1315-1319
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    • 2008
  • Purpose : We aimed to examine the effect of rooming-in care on newborn infants emotional stability by comparing them with those cared for in a nursery. Methods : Forty-eight full-term newborn infants born at Cheil General Hospital between July 1 and October 31, 2007, were enrolled. Twenty-four newborn infants were roomed-in in their mothers rooms (rooming-in group), and 24 newborns were cared for in the hospital nursery (the nursery group) for the first 3 days of their lives. Those with perinatal problems that required medical treatment were excluded. By using Brazeltons neonatal behavior assessment scale, we measured irritability and self-quieting as well as the duration of crying after heel-stick puncture for the newborn metabolic screening test. Results : The rooming-in group had a higher irritability score than the nursery group ($6.8{\pm}1.7$ vs. $4.2{\pm}2.1$, P<0.001), thereby suggesting stable behavior against external irritation; the former also had a higher self-quieting activity score ($5.9{\pm}0.3$ vs. $4.5{\pm}1.8$, P=0.001), thereby suggesting that stability was reached quickly from the irritated state. Time taken to stop crying after the heel-stick puncture was significantly shorter in the rooming-in group than in the nursery group ($17{\pm}15.1$ seconds vs. $115.3{\pm}98.5$ seconds, P<0.001). Conclusion : These results show that newborn infants in the rooming-in group exhibit more stable behavior against external irritation and can be stabilized from an irritated state more quickly than infants cared for in the nursery, even after a few days of rooming-in care.

Radiotherapy Results of Midline Malignant Reticulosis (MMR) (중심선 악성 세망증의 방사선 치료 결과)

  • Yun, Sang-Mo;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.14 no.4
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    • pp.291-297
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    • 1996
  • Purpose : This study was performed to evaluate survival, failure patterns, and prognostic factors of MMR patients after radiation therapy. We also discussed the need for chemotherapy. Materials and Methods : A retrospective analysis was done for 23 patients with MMR who were treated with radiation therapy from June 1985 to November 1992. There were 19 male and 4 female patients, The patients' age ranged from 17 to 71 years (median 39 years). Systemic symptoms including fever, weight loss, or malaise were found in $30\%$ of the patients. The nasal cavity was most frequently involved No patients had nodal involvement at diagnosis. There were 2 patients with distant metastasis at presentation. Radiation therapy was delivered five times a week, 1.8 Gy daily, total $45\~54$ Gy (median 50.4 Gy) using 6 MV X-ray No patients received chemotherapy as initial treatment. Results : Overall 5-year and 10-year survival rates were $52.4\%$ and $44.1\%$, respectively. Seventy Percent(12/17) of the patients achieved complete response to radiotherapy, and $29.4\%$ (5/17) achieved partial response. The Patients with complete response showed a better 5-year survival rate than those with partial response ($66.9\%$ vs. $20\%$. p=0.004). Symptom duration before diagnosis, the presence of systemic symptom, and the number of primary sites had no influence on survival. The patterns of failure were as follows: local failure(1), failure in adjacent site(1), local and distant failure(1) distant metastasis(2). and conversion to malignant lymphoma(1). We could not find factors associated with the patterns of failure. Conclusion : The most important facto associated with survival was the response to radiotherapy. Seventeen percent of the patients had distant metastasis, and the salvage after distant metastasis was not successful. However. about $50\%$ of the patients could achieve long-term survival with local radiation therapy alone. Therefore, chemotherapy of MMR should be done after a prospective randomized study for the factors associated with distant metastasis.

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Lipoprotein and Lipid Abnormalities in Uremic Children with Maintenance Dialysis (투석 치료중인 만성 신부전 소아에서의 지질 및 지질단백 이상)

  • Kim Jung-Sue;Song Jung-Han;Park Hye-Won;Cheong Hae-Il;Kim Jin-Q;Choi Yong;Ko Kwang-Wook
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.109-116
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    • 1997
  • Purpose : Chronic renal failure is often accompanied by severe dyslipidemia, a known risk factor for cardiovascular disease. Lipoprotein(a) [Lp(a)] has recently been characterized as a risk factor for atherosclerosis and thrombosis. Cardiovascular disease is the leading cause of death in adult patients on dialysis. However, there are only limited data available concerning risk factors for atherosclerosis in uremic children. We have measured serum levels of lipids, lipoproteins, apolipoproteins and Lp(a) in uremic children with maintenance dialysis. Methods : Ten uremic children with hemodialysis (HD) and 14 with peritoneal dialysis (PD) in our dialysis unit were included in this study. The mean age of HD patients was $162{\pm}59$ months and the male to female ratio was 7:3. The mean age and sex ratio of PD patients were $123{\pm}63$ months and 6:8, respectively. The levels of cholesterol, triglyceride, lipoproteins, apolipoproteins and Lp(a) were measured from serum sampled after 14 hours of fasting. The normal control levels were cited from 2 articles presenting the normal blood lipid and lipoprotein levels of primary school and middle school children in Korea. Results : There was no difference in age, sex ratio, body mass index and duration of dialysis between the HD and the PD group. The serum concentration of the cholesterol, triglyceride and apolipoprotein B were significantly elevated in dialysis patients compared with normal subjects. The serum level of Lp(a) was significantly elevated in only PD group. The serum Lp(a) level was below 30 mg/dl in 13 and above 30 mg/dl in 11 patients. The serum albumin level was significantly decreased in high Lp(a) group than in low Lp(a) group. Conclusion : The uremic children receiving dialysis reveal abnormal serum lipid and lipoprotein profiles. These results suggest that they have a higher risk for coronary heart disease, although there has been no clinical evidence of coronary heart disease at present. A long-term follow-up study of these children to clarify the suggestion should be started now.

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Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria (단백뇨를 동반한 IgA 신병증 및 HSP 신염을 가진 소아에서 메틸프레드니솔론 충격요법과 경구 스테로이드 요법의 비교)

  • Ahn, Ji Young;Moon, Jung Eun;Hwang, Young Ju;Choi, Bong Seok;Ko, Cheol Woo;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

Surgical Outcome of Biventricular Repair for Double-outlet Right Ventricle: A 18-Year Experience (양대혈관우심실기시증에 대한 양심실 교정의 수술 성적: 18년 치험)

  • 이정렬;황호영;임홍국;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.566-575
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    • 2003
  • We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.

Effect of Film Layers and Storing Period on the Fermentation Quality of Whole Crop Barley Silage (청보리 사일리지의 비닐겹수 및 저장기간에 따른 발효품질)

  • Song, Tae-Hwa;Park, Tae-Il;Park, Hyong-Ho;Yoon, Chang;Kim, Yang-Kil;Park, Jong-Chul;Kang, Chon-Sik;Son, Jae-Han;Kim, Kyong-Ho;Cheong, Young-Keun;Oh, Young-Jin
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.35 no.1
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    • pp.6-11
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    • 2015
  • This study was undertaken to characterize feed value and silage quality according to storage period and film layers for whole-crop barley silage. The crude protein (CP) content increased in all silage during the storage periods compared to those before silage, this content slightly increased over the prolonged storage period but it was not significant (p>0.05). Depending on the film layers of silage, 6 layers were higher than 4 layers. The neutral detergent fiber (NDF) and acid detergent fiber (ADF) contents also increased in all silage during storage periods compared to those before silage (P<0.05), but they were maintained at similar levels during the storage period. Depending on the film layers of silage, 6 layers were higher than 4 layers. The total digestible nutrients (TDN) content decreased in all silage during the storage periods. However, it was maintained at a similar level for the duration of each storage period. Depending on the film layers of silage, 6 layers were lower than 4 layers. The pH value was decreased during the prolonged storage period and depending on the film layers, 6 layers were lower than 4 layers. In the organic acid contents during the prolonged storage period, lactic acid increased, acetic acid was lower, and butyric acid was significantly higher (p<0.05). Depending on the film layers, 6 layers showed higher levels of lactic acid and lower levels of butyric acid (p<0.05). Therefore, these results showed that 6 layer wrapping was advantageous for long term storage of whole crop barley silage, while also indicating that it is desirable to use 4 layer wrapping within a six month period.

Establishment of Safe Management Guideline Based on Uptake Pattern of Pesticide Residue from Soil by Radish (토양잔류 농약의 무 흡수양상 및 토양 안전관리기준 설정)

  • Hwang, Jeong-In;Kwak, Se-Yeon;Lee, Sang-Hyeob;Kang, Min-Su;Ryu, Jun-Sang;Kang, Ja-Gun;Jung, Hye-Hyeon;Hong, Sung-Hyeon;Kim, Jang-Eok
    • Korean Journal of Environmental Agriculture
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    • v.35 no.4
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    • pp.278-285
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    • 2016
  • BACKGROUND: Uptake patterns of ${\alpha}$-, ${\beta}$-isomers and sulfate metabolite of endosulfan (ED) by radishes grown in treated soils with ED concentrations of 2 and 10 mg/kg were investigated to establish soil management guidelines for ensuring the safety of radishes from ED residues. METHODS AND RESULTS: All samples of soils and radish plants separated into shoot and root parts were analyzed for ED residues using a gas-chromatography mass spectrophotometer, and the results were used to calculate the bioconcentration factor (BCF), indicating the ratio of ED concentrations between radishes and soils. During the experimental period, uptake and distribution rates of ED-sulfate in radishes were the highest, followed by ${\alpha}$- and ${\beta}$-ED. The BCF values to initial ED concentrations in soils were greater for root parts (0.0077 to 0.2345) than for shoot parts (0.0002 to 0.0429) and used to obtain regression equations by time. Long-term BCFs estimated by the obtained equations ($R^2$ of 0.86 to 1.00) were evaluated with the maximum residue limit (0.1 mg/kg) of ED for radishes, in order to suggest safe management guidelines of ED for radish-cultivating soils. CONCLUSION: Suggested guidelines showed the significant dependency on duration for radish cultivation and exposed concentration of ED in soil.

Clinical Report of 46 Intracranial Tumors with LINAC Based Stereotactic Radiosurgery (선형가속기를 이용한 뇌종양 46예의 뇌정위다방향방사선치료 성적)

  • Yoon Sei C;Suh Tge S;Kim Sung W;Kang Ki M;Kim Yun S;Choi Byung O;Jang Hong S;Choi Kyo H;Kim Moon C;Shinn Kyung S
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.241-247
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    • 1993
  • Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors (n=15), acoustic neurinomas (n=8), meningiomas (n=7), gliomas (n=6), craniopharyngiomas (n=4), pinealomas (n=3), hemangioblastomas (n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 $cm^3\;(mean;\;7.26\;cm^3)$. The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age (a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18 $(39.1\%)$ of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16 $(34.8\%)$ were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34 $(73.9\%)$ of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8 $(17.4\%)$ of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases (pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two $(4.4\%)$ Patients who were anaplastic astrocytoma (n=1) and metastatic brain tumor (n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up inall cases.

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