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Clinical Analysis of the Surgical Treatments for Large Primary Spontaneous Pneumothorax (외과적 치료를 시행한 대량 일차성 자연기흉의 임상분석)

  • Kim, Byung-Ho;Huh, Dong-Myung;Han, Won-Kyung
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.344-349
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    • 2009
  • Background: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and. so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. Material and Method: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients Should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1cm) seen on the computed tomography. Result: There were 50 men and 8 women with a mean age of 28.2 years (range: $14\sim54$ years). The mean length of hospitalization was 5.3 days (range: $2\sim10$ days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: $10\sim58$ months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intra-operative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1 % for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. Conclusion: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.

The Crystal and Molecular Structure of 25,26,27,28-Tetrnacetoxy[4]Arene${\cdot}$Monohydrate (25,26,27,28-테트라아세트오키시[4]에렌${\cdot}$일수화물의 결정 및 분자구조)

  • Choong Tai Ahn;Kwanghyun No
    • Journal of the Korean Chemical Society
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    • v.37 no.3
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    • pp.344-350
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    • 1993
  • 25,26,27,28-Tetraacetoxycalix[4]arene·monohydrate is orthorhombic, space group Pbca with a = 14.979(4), b = 15.154(4), c = 27.890(3) ${\AA}$, Z = 8, V = 6330.6 ${\AA}^{-3}$, D$_c$ = 1.28 $g{\cdot}cm^{-3}$, (Mo K${\alpha}$) = 0.71069 ${\AA}$, ${\mu}$ = 0.86 cm$^{-1}$, F(000) = 2600, and R = 0.069 for 3376 unique observed reflections with I > 1.0 ${\sigma}$(I). The structure was solved by direct methods and refined by cascade diagonal least-squares refinement. All the C-H bond lengths(= 0.96 ${\AA}$), the methyl groups and the methylene groups are fixed and refined as the rigid groups with ideal geometry. The macrocycle exists in the 1,3 alternate conformation (by Conforth) making the angles of 110.7, 684, 113.7 and 68.8$^{\circ}$ between the benzene rings and the methylenic mean plane, and four each acetoxy groups are twisted away from their own benzene rings with the angles of 68.2, 97.6, 78.9 and 71.3$^{\circ}$, respectively. The relative dihedral angles between two opposite side of the benzene rings are 135.6$^{\circ}$ for the rings (1) and (3) and 135.2$^{\circ}$ for (2) and (4). A water molecule which has nearly the same height of the methylenic plane of the macrocycle in the c-axis, is located within the distances of 2.942(5) ${\AA}$ from the O(8) atom of the carbonyl group and 2.901 ${\AA}$ from, another O(2)(1/2-x, -1/2+y, z). The shortest contact between the molecule is 3.193 ${\AA}$ from the O(4) to the C(3)(1/2+x, 1/2-y,-z).

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Predicting the Potential Habitat and Future Distribution of Brachydiplax chalybea flavovittata Ris, 1911 (Odonata: Libellulidae) (기후변화에 따른 남색이마잠자리 잠재적 서식지 및 미래 분포예측)

  • Soon Jik Kwon;Yung Chul Jun;Hyeok Yeong Kwon;In Chul Hwang;Chang Su Lee;Tae Geun Kim
    • Journal of Wetlands Research
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    • v.25 no.4
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    • pp.335-344
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    • 2023
  • Brachydiplax chalybea flavovittata, a climate-sensitive biological indicator species, was first observed and recorded at Jeju Island in Korea in 2010. Overwintering was recently confirmed in the Yeongsan River area. This study was aimed to predict the potential distribution patterns for the larvae of B. chalybea flavovittata and to understand its ecological characteristics as well as changes of population under global climate change circumstances. Data was collected both from the Global Biodiversity Information Facility (GBIF) and by field surveys from May 2019 to May 2023. We used for the distribution model among downloaded 19 variables from the WorldClim database. MaxEnt model was adopted for the prediction of potential and future distribution for B. chalybea flavovittata. Larval distribution ranged within a region delimited by northern latitude from Jeju-si, Jeju Special Self-Governing Province (33.318096°) to Yeoju-si, Gyeonggi-do (37.366734°) and eastern longitude from Jindo-gun, Jeollanam-do (126.054925°) to Yangsan-si, Gyeongsangnam-do (129.016472°). M type (permanent rivers, streams and creeks) wetlands were the most common habitat based on the Ramsar's wetland classification system, followed by Tp type (permanent freshwater marshes and pools) (45.8%) and F type (estuarine waters) (4.2%). MaxEnt model presented that potential distribution with high inhabiting probability included Ulsan and Daegu Metropolitan City in addition to the currently discovered habitats. Applying to the future scenarios by Intergovernmental Panel on Climate Change (IPCC), it was predicted that the possible distribution area would expand in the 2050s and 2090s, covering the southern and western coastal regions, the southern Daegu metropolitan area and the eastern coastal regions in the near future. This study suggests that B. chalybea flavovittata can be used as an effective indicator species for climate changes with a monitoring of their distribution ranges. Our findings will also help to provide basic information on the conservation and management of co-existing native species.

Development of Formulas for the Estimation of Renal Depth and Application in the Measurement of Glomerular Filtration Rate in Koreans (사구체 여과율 측정을 위한 한국인의 신장 깊이에 관한 방정식 도출과 이용)

  • Yoo, Ie-Ryung;Kim, Sung-Hoon;Chung, Yong-An;Jung, Hyun-Seok;Lee, Hae-Giu;Park, Young-Ha;Lee, Sung-Yong;Sohn, Hyung-Seon;Chung, Soo-Kyo;Kim, Hyun-Mi;Lee, Hyung-Goo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.418-425
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    • 2000
  • Purpose: There is no established formula for estimating renal depths in Korean. As a result, we undertook this study to develop a new formula, and to apply this formula in the calculation of glomerular filtration rate (GFR). Materials and Methods: We measured the renal depth (RD) on the abdominal CT obtained in 300 adults (M:F: 167:133, mean age 50.9 years) without known renal diseases. The RDs measured by CT were compared with the estimated RDs based on the Tonnesen and Taylor equations. New formulas were derived from the measured RDs in 200 out of 300 patients based on several variables such as sex, age, weight, and height by multiple regression analysis. The RDs estimated from the new formulas were compared with the measured RDs in the remaining 100 patients as a control. In 48 patients who underwent Tc-99m DTPA renal scintigraphy, GFR was measured with three equations (new formula, Tonnesen and Taylor equations), respectively, and compared with each other. Results: The mean values of the RDs measured from CT were 6.9 cm for right kidney of the men (MRK), 6.7 cm for left kidney of the men (MLK), 6.7 cm for right kidney of the women (WRK), and 6.6 cm for left kidney of the women (WLK). The RDs estimated from Tonnesen equation were shorter than the ones measured from CT significantly. The newly derived formulas were 12.813 (weight/height)+0.002 (age)+ 2.264 for MRK, 15.344 (weight/height)+0.011 (age)+0.557 for MLK, 12.936 (weight/height)+ 0.014 (age)+1.462 for WRK and 13.488 (weight/height)+0.019 (age)+0.762 for WLK. The correlation coefficients of the RD measured from CT and estimated from the new formula were 0.529 in MRK, 0.729 in MLK, 0.601 in WRK, and 0.724 in WLK, respectively. The GFRs from the new formula were significantly higher than those from the Tonnesen equation significantly, which was the most similar to normal GFR values. Conclusion: We generated new formulas for estimating RD in Korean from the data by CT. By adopting these formulas, we expect that GFR can be measured by the Gates method accurately in Korean.

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Reliability of Muscle Evaluation with a Tactile Sensor System (촉각센서를 이용한 근육평가의 신뢰도 조사)

  • Oh, Young-Rak;Lee, Dong-Ju;Kim, Sung-Hwan;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.337-344
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    • 2005
  • A tactile sensor employs a piezoelectric element to detect contact frequency shifts and thereby measure the stiffness or softness of material such as tissue, which allows the sensor to be used in many fields of research for urology, cardiology, gynecology, sports medicine and caner detection and especially for cosmetics and skin care. In this study, reliability of the tactile sensor system was investigated with its manual application to the muscles susceptible to temporomandibular disorders. Stiffness and elasticity of anterior temporalis, masseter and trapezius muscles were calibrated bilaterally from 5 healthy men with an average of 24.5$\pm$0.94 years. The tactile sensor used in this study had a computer-controlled and motor-driven sensor unit which automatically pressed down on the skin surface over the muscles being measured and retracted, thereby providing the hysteresis curve. The slope of the tangent of the hysteresis curve (${\Delta}f/{\Delta}x$) is defined as stiffness of the muscle being measured and the distance between the two parts of the curve as its elasticity. To determine inter-examiner reliability, all the measurements were performed by the two examiners A and B, respectively and the same examination were repeated with an interval of 2 days for intra-examiner reliability. The results from this study demonstrated high reliability in measuring stiffness and elasticity of anterior temporalis, masseter and upper trapezius muscles using a tactile sensor system. It is suggested that the tactile sensor system can be a highly reproducible and effective instrument for quantitative evaluation of the muscle in head and neck region.

Effects of Bisphenol A on the Placental Function and Reproduction in Rats (Bisphenol A가 흰쥐의 태반 기능과 출산에 미치는 영향)

  • Lee, Chae-Kwan;Kim, Seog-Hyun;Moon, Deog-Hwan;Kim, Jeong-Ho;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Kim, Hwi-Dong;Kim, Jung-Won;Kim, Jong-Eun;Lee, Chae-Un
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.3
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    • pp.330-336
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    • 2005
  • Objectives : The aim of this study was to investigate the effects of bisphenol A (BPA), an estrogen-like environmental endocrine disrupter, on the placental function and reproduction in rats. The mRNA levels of the placental prolactin-growth hormone(PRL-GH) gene family, placental trophoblast cell frequency and reproductive data were analyzed. Methods : The pregnancies of F344 Fisher rats ($160g{\pm}20g$) were detected by the presence of the copulatory plug or sperm in the vaginal smear, which marked Day 0 of pregnancy. Pregnant rats were divided into three groups. The control group was intraperitoneally injected with a sesame oil vehicle. The two remaining groups were injected with 50 or 500 mg/kg B.W/day of BPA, resuspended in sesame oil, on either days 7 to 11 or 16 to 20 of pregnancy, with the rats sacrificed on either day 11 or 20, respectively. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcription-polymerase chain reaction. The hormone concentrations were analyzed by radioimmunoassay, and the frequency of the placental trophoblast cells observed by a histochemical study. Reproductive data, such as the placental weight and litter size, were surveyed on day 20. The fetal weight was surveyed for 4 weeks after birth. A statistical analysis was carried out using the SAS program (version 8.1). Results : The mRNA levels of the PRL-GH gene family, such as placental lactogen I, Iv and II, prolactin like protein A, C and Cv, and decidual prolactin-related protein were significantly reduced due to BPA exposure. The mRNA levels of the Pit-1a and b isotype genes, which induce the expression of the PRL-GH gene family in the rat placenta, were also reduced due to BPA exposure. The PL-Iv and PL-II concentrations were reduced in the BPA exposed group. During the middle to last stage of pregnancy (Days 11-20), a high dose of BPA exposure reduced the frequency of spongiotrophoblast cells, which are responsible for the secretion of the PRL-GH hormones. Reproductive data, such as the placental and fetal weights and the litter size, were reduced, but that of the pregnancy period was extended in the BPA exposed compared to the control group. Conclusions : BPA disrupts the placental functions in rats, which leads to reproductive disorders.

Effects of Chromium (VI) Exposure on the Placental Function and Reproduction in Rats (6가 크롬 폭로가 랫트의 태반 기능과 출산에 미치는 영향)

  • Lee, Heun;Moon, Deog-Hwan;Lee, Chae-Un;Kang, Sung-Goo;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Kim, Jung-Won;Lee, Chae-Kwan;Chun, Jin-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.157-165
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    • 2004
  • Objectives : This study aimed to investigate the toxic effects of chromium (VI) on the placental function and reproduction in rats. For the study, the placental prolactin-growth hormone (PRL-GH) gene expression, placental trophoblast cell differentiation and reproductive data were analyzed. Methods : The pregnancies of F344 Fisher rats were checked by the presence of a copulatory plug or sperm in the vaginal smear, which was defined as day 0 of the pregnancy. Pregnant rats were divided into the three groups. The control group was given tap water (chromium level < 0.001 ppm) and the remaining groups were given 250 or 750 ppm of chromium (VI) [as potassium dichromate], from day 7 to 19 of the pregnancy. Rats were sacrificed at days 11 and 20 of pregnancy. The mRNA levels of PRL-GH and Pit-1a and b isotype genes were analyzed by Northern blot hybridization and reverse transcription-polymerase chain reaction (RT-PCR). The hormonal concentration was analyzed by radioimmunoassay, and the differentiation of placental trophoblast cells were observed by histochemical studies. Reproductive data, such as placental and fetal weights, pregnancy period, and litter size, were surveyed at day 20 of pregnancy and after birth. A statistical analysis was carried out using the SAS program (version 8.1). Results : The mRNA levels of the prolactin-growth hormone (PRL-GH) family of genes were dose dependently reduced by chromium exposure. The mRNA levels of Pit-1a and b isotype genes that induce the expression of the PRL-GH family of genes were also reduced by chromium exposure. The PRL-GH hormonal concentration in the rat placenta, fetus and maternal blood were decreased by chromium exposure. In the middle stage of pregnancy (day 11), a high dose of chromium suppressed the differentiation of spongiotrophoblast cells that secret the PRLGH hormones. In the last stage of pregnancy (day 20), a high dose of chromium induced apoptosis of placental cells. Reproductive data, such as placental and fetal weights, litter size, were reduced, but the pregnancy period was extended in the group exposed to chromium compared with the controls. Conclusion : Chromium (VI) disrupts the ordered functions of the placenta, which leads to reproductive disorders in rats.

Mitigation of Calcification in Bovine Pericardial Bioprosthesis after Amino Acids Posttreatment (아미노산 후처치의 이종 심낭보철편 석회화 완화 효과)

  • 안재호
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.131-135
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    • 2003
  • Bovine pericardium fixed in glutaraldehyde solution (GA) has been one of the most popular surgical bioprosthesis, however, late calcific degeneration after implantation remains to be solved. To mitigate calcific degeneration, we posttreated the bovine pericardium with amino acids after GA fixation. Material and Method: 40 small pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L $MgCl_26H_2O$as a control group (group 1). 40 pieces fixed in the same GA solution were posttreated with 2% chitosan solution (group 2) and the other 40 pieces posttreated with 8% glutamate (group 3). These were implanted into the belly of forty Fisher 344 rats subdermally and extracted at f month, 2 months, 3 months and 4 months after implantation. Result: With atomic absorption spectrophotometry we measured the deposited calcium amount and the results were as follows; 2.01 $\pm$0.13 mg/g in group 1, 2.34$\pm$0.73 mg/g in group 2, 2.49$\pm$0.15 mg/g in group 3 at 1 month after implantation, and 3.57$\pm$0.15 mg/g in group 1, 3.52$\pm$0.92 mg/g in group 2, 3.46$\pm$0.12 mg/g in group 3 at the second month. But 5.45$\pm$0.42 mg/g in group 1, 3.22 $\pm$1.31 mg/g in group 2 and 4.20$\pm$0.55 mg/g in group 3 at the 3rd month, which have statistical significance in group 2 (p<0.05). Finally at 4th month, 6.01$\pm$1.21 mg/g in group 1, 3.78$\pm$1.82 mg/g in group 2, 3.92$\pm$0.92 mg/g in group 3, which also have statistical significance (p < 0.05). Conclusion: This means posttreatment with 2% chitosan shows meaningful calcium mitigation effects after 3rd month on subcutaneously implanted bovine pericardium in the rat models but 8% glutamate shows mitigation effect after 4months in this experiment.

The Pulation Structure of the Pacific Cod (Gadus macrocephalus Tilesius) Based on Mitochondrial DNA Sequences (미토콘드리아 유전자 염기서열 분석에 의한 대구 계군 분석)

  • Seo, Young-Il;Kim, Joo-Il;Oh, Taeg-Yun;Lee, Sun-Kil;Park, Jong-Hwa;Kim, Hee-Yong;Cho, Eun-Seob
    • Journal of Life Science
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    • v.20 no.3
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    • pp.336-344
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    • 2010
  • To assess population structure and genetic diversity among the Pacific cod (Gadus macrocephalus), we investigated mtDNA COI gene sequences of 7 populations. Samples were obtained from Sokcho, Wolsung, Geojedo, Yeosu, Geomundo and Westsouth in 2008 and 2009 (n=28). The sequence analysis of 28 individual samples showed 8 haplotypes, ranging in sequence divergence by pairwise comparisons from 0.2 to 2.2% (1 bp-11 bp). The Gal haplotype was found in Wolsung, Geojedo, Yeosu, Geomundo and Westsouth, and was regarded as the main haplotype of Korean Pacific cod. Ga2, Ga3, Ga6 and Ga7 haplotypes were found only in Sokcho. In the PHYLIP analysis, 8 haplotypes formed two independent groups: cladeA consisted of Ga2, Ga3, Ga6 and Ga7 haplotypes, whereas cladeB contained Gal, Ga4, Ga5 and Ga8 haplotypes. The genetic relationship between the two groups was weakly supported by bootstrap analysis(<50%). In pairwise comparisons between 6 populations other than that from Sokcho, a very high per generation migration ratio ($N_m$=infinite) and a very low level of geographic distance ($F_{sr}=-0.0123-(-0.0423)$) were observed. The estimates of genetic distance between Sokcho and the other localities were all statistically significant (p<0.05, p<0.01, p<0.001), indicating a limited mtDNA-based gene flow between Sokcho and other regions. The finding of the lowest genetic diversity in the Sokcho population (nucleotide diversity=0.00589) may be a result of relatively small population size and interrupted gene flow to other localities. Consequently, the overall considerable migration of Pacific cod population in Korea caused a genetically homogeneous structure to form, although a distinct population was found in this study.

Comparison of Factors Associated With Agitation Among Youngest-Old, Middle-Old, and Oldest-Old Hospitalized Patients Referred to the Psychiatric Department (정신건강의학과에 협진의뢰된 연소노인, 고령노인, 초고령노인 입원환자의 초조의 연관요인 비교)

  • Min-Suk Jang;Seo-Hyun Choi;Se-ri Maeng;Yang-Sik Kim;Jae-Nam Bae;Jeong-Seop Lee;Won-Hyoung Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.89-99
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    • 2023
  • Objectives : In this study, elderly hospitalized patients aged 65 years or older who were admitted to a university hospital and referred to the department of psychiatry were classified into youngest-old, middle-old, and oldest-old. It was conducted to find out what factors contribute to the agitation pattern by age group, whether there is a difference in the factors, and whether there is a difference in the severity of the agitation pattern. Methods : From July 1, 2021 to December 31, 2021, the medical records of patients aged 65 years or older who were referred to the department of psychiatry were retrospectively reviewed. Age, gender, route of hospitalization, department of referral, reason for referral, treatment method, presence of internal and surgical diseases, and hematological test data were investigated. Results : There was a significant correlation with the RASS score in cases of surgery referral and high CRP levels for youngest-old aged 65 to 74 years, in cases of surgery referral, dementia and hyponatremia for middle-old aged 75 to 84 years, in case of dementia for oldest-old aged 85 years old or older. In addition, there were differences in the severity of agitation patterns between age groups. Conclusions : As the age group increases, the agitation of delirium patients becomes more severe, and various factors contributing to the agitation pattern also differ by age group. Therefore, when treating elderly patients with delirium, attention should be paid to factors that may affect agitation depending on age.