• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.42-48
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• 1994

Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patient associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.380-387
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• 1998

Background: Minimal pressure support(PSmin) is a level of pressure support which offset the imposed work of breathing(WOBimp) developed by endotracheal tube and ventilator circuits in pressure support ventilation While the lower applied level of pressure support compared to PSmin could induce respiratory muscle fatigue, the higher level than PSmin could keep respiratory muscle rest resulting in prolongation of weaning period during weaning from mechanical ventilation PSmin has been usually applied in the level of 5~10 cm$H_2O$, but the accurate level of PSmin is difficult to be determinated in individual cases. PSmin is known to be calculated by using the equation of "PSmin = peak inspiratory flow rate during spontaneus ventilation$\times$total ventilatory system resistance", but correlation of calculated PSmin and measured PSmin has not been known. The objects of this study were firstly to assess whether customarily applied pressure support level of 5~10 cm$H_2O$ would be appropriate to offset the imposed work of breathing among the patients under weaning process, and secondly to estimate the correlation between the measured PSmin and calculated PSmin. Method : 1) Measurement of PSmin : Intratracheal pressure changes were measured through Hi-Lo jet tracheal tube (8mm in diameter, Mallinckroft, USA) by using pulmonary monitor(CP-100 pulmonary monitor, Bicore, USA), and then pressure support level of mechanical ventilator were increased until WOBimp was reached to 0.01 J/L or less. Measured PSmin was defined as the lowest pressure to make WOBimp 0.01 J/L or less. 2) Calculation of PSmin : Peak airway pressure(Ppeak), plateau airway pressure(Pplat) and mean inspiratory flow rate of the subjects were measured on volume control mode of mechanical ventilation after sedation. Spontaneous peak inspiratory flow rates were measured on CPAP mode(O cm$H_2O$). Thereafter PSmin was calculated by using the equation "PSmin = peak inspiratory flow rate$\times$R, R = (Ppeak-Pplat)/mean inspiratory flow rate during volume control mode on mechanical ventilation". Results: Sixteen patients who were considered as the candidate for weaning from mechanical ventilation were included in the study. Mean age was 64(${\pm}14$) years, and the mean of total ventilation times was 9(${\pm}4$) days. All patients except one were males. The measured PSmin of the subjects ranged 4.0~12.5cm$H_2O$ in 14 patients. The mean level of PSmin was 7.6(${\pm}2.5\;cmH_2O$) in measured PSmin, 8.6 (${\pm}3.25\;cmH_2O$) in calculated PSmin Correlation between the measured PSmin and the calculated PSmin is significantly high(n=9, r=0.88, p=0.002). The calculated PSmin show a tendancy to be higher than the corresponding measured PSmin in 8 out of 9 subjects(p=0.09). The ratio of measured PSmin/calculated PSmin was 0.81(${\pm}0.05$). Conclusion: Minimal pressure support levels were different in individual cases in the range from 4 to 12.5 cm$H_2O$. Because the equation-driven calculated PSmin showed a good correlation with measured PSmin, the application of equation-driven PSmin would be then appropriate compared with conventional application of 5~10 cm$H_2O$ in patients under difficult weaning process with pressure support ventilation.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.5.3-6
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• 1981

There are too many kinds of esophageal corrosive agents, such as sodium hydrochloride, acetic acid, hydrochloric acid, etc. Esophageal burn due to above chemical agents are decreasing recently, but still many patients visited to the hospital because of swallowing corrosive agents for the purpose of suicide or accidentally. Among the treatment of corrosive injury of the esophagus, prevention of esophageal stricture is the key point. Recently various methods are using as the treatment of corrosive esophagitis and prevention of esophageal stricture. 51 cases of corrosive injury of the esophagus who had been admitted and treated at the Dept. of Otolaryngology, Han Yang University Hospital during past 9 years (from May 1972 to Dec. 1980) were evaluated and report the result about age distribution, sex incidence, monthly distribution, cause of swallowing, swallowing agents, arriving time at hospital after swallowing, changes on oral and pharyngeal mucosa, laboratory findings, emergency treatment and treatment during admission, treatment follow up results and complications with review of liter ature. Following results were obtained; 1. Female patients 27 cases (52.9%) were more than male patients 24 cases (47.1%) and its ratio was 1.13 : 1. 2. Age distribution showed predilection for age of 21-30 with 20 cases(39.2%), and 11-20 with 11 cases (21.6%), 31-40 with 7 cases(13.7%), over 50 with 7 cases (13.7%) were following. 3. Monthly distribution showed predilection for March with 8 cases(15.7%), and April, July with 7 cases (13.7%), September with 6 cases(l1.8%), October 5 cases(9.8%) were following. 4. For the purpose of suicide was the most cause of swallowing with 40 cases(78.4%), and accidentally swallowing 11 cases(21.6%). 5. Acetic acid was the most swallowing agent with 24 cases (47.0%), and hydrochloric acid 11 cases (21.5%), lye 8 cases(15.7%), iodine 2 cases(3.9%) were following. 6. Arriving time at the hospital after swallowing showed predilection for within 12 hours with 42 cases (82.4%), and from 12 hours to 24 hours with 4 cases(7.8%) was next. 7. Moderate change with injection and swelling was the prevalent change on oral and pharyngeal mucosa with 20 cases(39.2%) and severe cases with ulceration 18 cases (35.3%), mild cases with injection 10 cases (19.6%) were following. 8. Leukocytosis was seen on 40 cases (78.4%), and increased Hct. was seen 31 cases (60.8%). On urine analysis, 14 cases(27.5%) showed over 1.030 S.G., and proteinuria was seen on 25 cases(49.0%), glycosuria was seen on 5 cases(9.8%) and hematuria was seen on 6 cases(11.8). 9. Gastric lavage was done on 30 cases (58.8%) as emergency treatment and on 3 cases(5.9%) tracheostomy was done for the airway keeping. 10. As methods of treatment during admission, L-tube insertion was done on 50 cases (98.0%), antibiotics was given to 49 cases (96.1%), steroid and antacid were given to 46 cases(90.2%). 11. 36 cases(70.6%) were in favorable condition after proper treatment, but 2 cases (3.9%) were expired during admission, 4 cases (7.8%) showed esophageal stricture in-spite of treatment, and 1 case(2.0%) showed pyloric stenosis. 12. Complications were observed in 8 cases (17.7%). Renal failure (4 cases), aspiration pneumonia (2 cases), upper G-I bleeding (1 cases), and diabetic coma (1 cases) were seen in order of frequency.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.2
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• pp.228-239
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• 1999

In 1990 Home Care Education Programs started when legislation established certification for Home Care Nurses. The Ministry of Health and Welfare proposed a home care education curriculum which has 352 class hours and 248 hours of 'family nursing and practice'. Though Home Care Education Programs have been offered in 11 home care educational institutes, there has been no formal revision for the home care education programs. Also a first and second home care demonstration projects have been carried out, but there has been no research on outcomes for home care education as applied in home care practice. The purposes of this study were to identify the important content areas for home care nursing as perceived by home care nurses, and to identify their clinical competence in each of these areas, and from these to identify the education needs. The sample was 107 home care nurses who were working in home care demonstration hospitals and community-based institutions which have been offering home care services. Responses were received from 88 nurses, comprising a 82.2% return rate, and 86 were included in the final analysis. The instrument used was a modification of the instrument developed by Caie-Lawrence et(1995) and Moon's(1991) instrument on home care knowledge. The instrument's Cronbach's coefficient was 0.982. Among the respondents, 64% were working at home care demonstration hospitals and 36% were working at community-based institutions. Their home care experiences were from one month to six years, with a mean of 20.6 months. The importance rating for home care education content was 3.42 0.325, which means importance was rated relatively high. Technical aspects of home care were identified the most important. Five items 'education skill', 'counseling skill', 'interview skill', 'wound care skill', 'bed sore care skill' received 100% importance ratings. The competency rating was 2.87 0.367 and 'technical aspects of home care' was the highest, and 'application to home care skill' was the lowest. Home care nurses' education needs were identified and compared to the importance ratings and competency ratings. Eleven items were identified as the highest in the importance areas and eleven items were in the lowest competency areas. High importance ratings matched with low competency ratings determined training needs, but there was no matching items in this study. In the lowest competency areas four items were excluded, because of not being applicable in current home care practice. Therefore total eighteen items were identified as home care education needs. These items are 'bed sore care skill', 'malpractice', 'wound care skill', 'general infection control', 'change and management of tracheostomy tubes', 'CVA patient care', 'Hospice care', 'pain management', 'urinary catheterization and management', 'L-tube insertion and managements', 'Respirator use and management skill', 'infant care', 'prevention to burnout', 'child assessment', 'CAPD', 'infant assessment', 'computer literacy', and 'psychiatry patient care'.

• Korean Journal of Soil Science and Fertilizer
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• v.27 no.2
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• pp.136-146
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• 1994

To research the effect of chemotaxis of Rhizobia toward the root exudate on nitrogen fixing ability in soybean Rhizobia symbiosis system. Root exudate from seedlings of Glycine max. L was collected aseptic conditions. B. japonicum KCTC 2422 induced the formation of symbiotic nitrogen fixing nodules on the root of soybean plant and possessed motility and chemotaxis toward the 2mM proline. LPN-100 mutant was $Nod^-$, $Che^+$, and LPN-101 was $Che^-$, $Nod^+$ strains. Physiological properties of mutants were similar to parent strain. The crude root exudate was tested for its chemotactic ability using the capillary tube method. Chemotactic responses of RCR 3407 toward crude root exudate were 2.2, 2.6, 2.9, those of KCTC 2422 were 2.3, 2.9, 3.0, respectively. The crude root exudate was fractionated into neutral, cationic and anionic fractions. Chemotactic responses of KCTC 2422 was least with anionic fraction, most with neutral and intermediate with cationic fraction. B. japonicum KCTC 2422 was attracted by carbohydrates, amino acids and carboxylic acid. Carbohydrates and amino acids were good chemoattractants and carboxylic acids were intermediate chemoattractants. The peak concentration was $10^{-3}M$ for ribose, glucose, glutamine, aspartic acid and carboxylic acids, with exception of xylose, arabinose, tryptophan, which elicited maximum responses at $10^{-4}M$. The formation of nodules and nitrogenase activity of soybean inoculated with KCTC 2422 was determined in 7days after inoculation, and those of LPN-101 was detected in 15days after inoculation, but LPN-100 didn't form of nodules in soybean plants.

• Clinical and Experimental Reproductive Medicine
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• v.19 no.2
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• pp.133-141
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• 1992

We examined effects of co-culture with human oviduct epithelial cells (HOEC) on the development of mouse and human embryos from early embryonic· stage to late morula or blastocyst stage (LM or B). In human, embryos were transferred and pregnancy rate was investigated. The HOEC, collected from surgically removed fallopian tube, were cultured in medium-199 supplemented with 20 % fetal cord serum (FCS). The HOEC were characterized by using immunocytochemical staining with anticytokeratin antibody and then used for cultures of mouse and human embryos. Results obtained from co-culture system were as follows. Development rate of mouse embryos was improved by co-culture system at late developmental stage (p<0.025). Human supernumerary embryos remained after transfer, unsuitable for freezing because of their poor quality, were co-cultured for 72hrs. Co-culture (78.79%) or conditioned medium (78.26%) system improved the developmemt rate, significantly, in comparision with control (11.11%)(p<0.00l). Co-cultured (85.71%) human zygotes for 24hrs showed the better development rate in comparision with control (50.00%) (p<0.01). When we transferred embryos cultured with the HOEC to patients, we obtained one pregnancy. Co-cultured human zygotes for 24hrs showed the better quality and viability for the replacement in comparision with control (p<0.01). In addition, improved pregnancy rate was obtained. Our results suggest that the co-culture system can rescue early degenerating embryos by improving early development and yield a resonable number of blastocyst for the appropriate replacement. The effect provided by cultured HOEC is not species specific for the development of embryos and it can be used to overcome in vitro blocks for the development. And also the co-culture system offers the possibility to freeze embryos at blastocyst stage which is more sucessful stage for the freezing. The HOEC monolayer may provide some stimulus via specific factor, which is unknown, to the development of embryos. Our results showed that the co-culture system with HOEC can be an alternative to conventional culture system.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.1
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• pp.64-80
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• 1998

The risk of cross-contamination in dental clinic is very high. Those who are engaged in dental clinic are exposed to various microorganisms in saliva and blood of patient. Potential possibility of cross-contamination of patient to patient, patient to dentist, dentist to laboratory technician always exist, which is important in the view of public health. It is well known that microorganisms may cause cross-contamination by suck-back of microorganisms into the water supply line or air supply line of dental unit and sprayed back into the next patient's oral cavity. The majority of microorganisms coming from dental unit are water microorganisms from the main water supply which have colonized the tube within the units and multiplied in the relatively warm and stagnant conditions. The purpose of this study is to measure the extent of microbial contamination of dental unit and ultrasonic scaler, to evaluate that dental unit water supply is suitable for drinking water, and to assess the effect of flushing on reduction of microbial contamination of dental unit and ultrasonic scaler. In the first experiment, water samples(50ml) from 20 dental units and 10 ultrasonic scalers in Seoul National Univ. Hosp. were tested for the presence of coliform. The samples were filtered by membrane filtration technique.(Microfil system, Millipore Co. U. S. A.) The filter was then placed onto MacConkey agar plate and the plates with filter on it were incubated aerobically at $37^{\circ}C$ for 5 days. The colors and shapes of colonies were examined if those were coliform. To verify the presence of coliform, the colonies were inoculated into phenol red lactose broth and incubated aerobically at $37^{\circ}C$ for 2 days. The fomation of gas was observed. In the second experiment, water samples from 20 handpieces, 10 ultrasonic scalers and 30 A/W syringes after 0, 2, 4, 6 min. flushing respectively were taken. $200{\mu}l$ water samples were spreaded on Brain Heart Infusion agar plate and the plates were incubated aerobically at $37^{\circ}C$ for 5 days. The number of colony was counted. The results obtained were summarized as follows 1. The water from dental unit and ultrasonic scaler was not suitable for drinking water. 2. No coliform was founded in dental unit and ultrasonic scaler water supply. 3. The number of colony of dental unit and ultrasonic scaler was highest in the group of o min. flushing(p<0.05). 4. There was no statistically significant difference in the extent of microbial contamination among handpiece, ultrasonic scaler and A/W syringe (p>0.05). 5. The number of colony was lowest in the group of 4 min. flushing, but there was no statistically significant difference among 2, 4, 6 min. flushing groups.(p>0.05) 6. It is recommended to flush dental unit water line for 4 min. after use on each patient.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.230-241
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• 2018

Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.

• The Journal of Internal Korean Medicine
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• v.21 no.3
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• pp.377-388
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• 2000

Objective : This study was undertaken to evaluate the effect of Sunghyangchungisan (SHCS) on the regulation of vascular tone and $Ca^{2+}$ metabolism in arterial tissues. Vascular rings isolated from rabbit carotid artery were myographed isometrically in isolated organ baths and the effect of SHCS on contractile activities, endothelial function and $Ca^{2+}$ metabolism were determined. Methods : In phentobarbital sodium-anesthetized rabbits, SHCS administered through ear vein (100 mg/Kg body wt.) or intragastric dwelling tube (300 mg/Kg body wt.) attenuated phenylephrine (PE, 10 ${\mu}g$/Kg, i.v.)-induced increases in both systolic and diastolic cartoid arterial blood pressure. Results : In experiments with isolated arterial strips, SHCS relaxed arterial rings which were pre-contracted by phenylephrine (PE, 1 ${\mu}M$). The responses to SHCS were partially dose-dependent at concentrations lower than 0.5 mg/ml. When SHCS was applied prior to the exposure to PE, it inhibited the PE-induced contraction by a similar magnitude which was comparable to the relaxation of pre-contracted arterial rings. Washout of SHCS after observing its relaxant effect resulted in a full recovery of PE-induced contractions, indicating that the action mechanism is reversible. The observation that SHCS did not change the $ED_{50)$ of PE oh its dose-response curve ruled out the possible interaction of SHCS with ${\alpha}$-receptors. The relaxant effect of SHCS was not affected by removal of endothelium or a nitric oxide synthase inhibitor, L-NAME. Methylene blue, an inhibitor of the soluble guanylate cyclase, did not affect the relaxant effect of SHCS. These results suggest that the action of SHCS is not mediated by the endothelium nor soluble guanylate cyclase. Constant cGMP production determined in arterial strips in the presence or absence of SHCS is consistent with this conclusion. When contraction was induced by additive application of $Ca^{2+}$ in arterial rings which were pre-depolarized by high $K^+$ in a $Ca^{2+}$-free solution, the relaxant effect of SHCS was attenuated by increasing the $Ca^{2+}$ concentration. SHCS, when applied to the arterial rings pre-contracted by PE and then relaxed by nifedipine, a $Ca^{2+}$ channel blocker, did not show additive relaxation. SHCS partially blocked $Ca^{2+}$ influx stimulated by PE and high $K^+$ which was determined by 5-min ^{45}Ca$ uptake, while it did not affect $Ca^{2+}$ efflux. Conclusions : From above results, it is suggested that SHCS relax PE-induced contraction of rabbit carotid artery in an endothelium independent manner, andinhibition of $Ca^{2+}$ influx may contribute to the underling mechanism.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.8
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• pp.1348-1352
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• 2004

More than 200 Bifidobacterium sp. originated from human intestine were investigated for their ability to produce conjugated linoleic acid (CLA). Of the Bifidobacteria tested, 1 of culture type strain and 12 isolated strains from Korean infants showed CLA producing ability. cis-9, trans-11 octadecadienoic acid presented more than 90% of the total CLA isomers produced by the Bifidobacteria. CLA content in fermented milk by Bifidobacterium sp. KHU 141 increased by 39.6 mg/l00 g, which showed the potential use for producing fermented milk containing high content of CLA. In fermented milk, little changes showed in lauric acid, myristric acid, palmitic acid, oleic acid, and linolenic acid contents, whereas the content of linoleic acid (LA) decreased and the content of CLA increased. Bifidobacterium sp. KHU 141 converted 86.0% and 84.8% of LA consumed to CLA for 24 hr and 48 hr fermentation, respectively. Prolonging incubation from 24 to 48 hours did not appear to enhance CLA formation and CLA producing ability was stable whether bottle, test tube, or fermenter was used for making fermented milk by Bifidobacterium sp. KHU 141.