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Comparison of VATS with Thoracotomy for the Treatment of Spontaneous Pneumothorax (자발성 기흉의 치료에서의 비디오 흉강경 수술과 개흉술의 비교)

  • 김문수;김영태;김기봉;김원곤;성숙환;김주현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.294-298
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    • 1999
  • Background: Video-assisted thoracoscopic surgery(VATS) has been established as a new method for treatment of spontaneous pneumothorax. We compared the clinical results of VATS with those of thoracotomy performed during the recent 5 years. Material and Method: We analyzed 126 patients whose medical records were available among the 154 patients who underwent operations for spontaneous pneumothorax from 1992 to 1996. The mean age was 27.1 years(15 to 75 years). 87 patients were operated on by VATS(Group A) and the other 39 by thoracotomy(Group B). The mean follow-up period was 14.7 months. Result: The operation time was shorter in group A than in group B(90.6${\pm}$38.6minutes: 117.2${\pm}$58.9minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than in group B(6.7${\pm}$4.2: 9.4${\pm}$3.3 days, p<0.05). The amount of analgesics(nalbuphin HCl, ketoprofen) used postoperatively were 2.4${\pm}$2.8 ampules in group A, which is less than the 6.5${\pm}$5.6 ampules in group B(p<0.05). The number of staples used in group A was smaller(2.7${\pm}$1.3 in group A, 1.76${\pm}$1.1 in group B, p<0.05). The duration of chest tube indwelling(4.3${\pm}$4.0 days in group A, and 5.6${\pm}$3.0 days in group B, NS), the recurrence rate(13.8% in group A, 2.6% in group B, NS), and the duration of air leakage(1.3${\pm}$3.3 days in group A, and 1.0${\pm}$2.5days in group B, NS) were not statistically different between the two groups. Conclusion: The application of VATS for the treatment of spontaneous pneumothorax has brought in better clinical results(shorter operation time, shorter hospital stay, less pain, and better cosmetic merits) than the thoracotomy without increasing any morbidity. However no advantages in recurrence rates and duration of postoperative air leakages are revealed.

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Neurobehavioral Performance Test of Workers Exposed to Mixed Organic Solvents (복합유기용제에 폭로된 근로자들에 대한 신경행동학적 기능의 평가)

  • Kim, Chang-Youn;SaKong, Joon;Chung, Jong-Hak;Joo, Ree;Jeon, Man-Joong;Sung, Nag-Jung;Kim, Sang-Kyu
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.314-328
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    • 1997
  • A cross-sectional study was performed to evaluate the effects of chronic exposure to low-dose solvent on neurobehavioral performance of 48 male workers exposed to organic solvents. A control group of 50 workers was selected from same factories. Each worker completed a medical and occupational questionnaire and four tests of Neurobehavioral Core Test Battery. These included Benton visual retention test, digit symbol, digit span, and pursuit aiming. Comparison of mean performance showed a significantly poorer performance on digit symbol, digit span, and pursuit aiming. In univariate analysis, age contributed to poor performance on Benton visual retention test and educational level was found to reduce the performance on symbol digit in both groups. Amount of alcohol intake was found to reduce the performance on digit symbol and smoking appeared to slow pursuit aiming in the exposure group. In multiple regression analysis, controlling for age, educational level, alcohol, and smoking, Solvent exposure was found to be associated with performance of digit span, and number of correct dot of pursuit aiming. Age on Benton visual retention, educational level on digit symbol, arid smoking on pursuit aiming were found to be a significant factors on each test items. This study suggest that short-term memory, and perception can be affected easily by chronic exposure of organic solvents which air concentration levels were under the Threshold Limit Value.

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A Study of Surface Electromyography Measurement of Facial Muscles in Normal Person (정상인의 안면부 운동 시 표면근전도 측정 연구)

  • Lee, Hyung Geol;Jung, Da Jung;Choi, Yoo Min;Kim, Suk Hee;Yook, Tae Han;Song, Beom Yong;Kim, Jong Uk
    • Journal of Acupuncture Research
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    • v.31 no.2
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    • pp.51-63
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    • 2014
  • Background or Objectives : The purpose of this study is to measure surface Electromyography(sEMG) of facial muscles in normal person and to find method for standardizing of sEMG's value. Methods : We measured 3points on face, frontalis muscle($GB_{14}$), zygomaticus muscle($SI_{18}$), orbicularis oris muscle($LI_{19}$) of 40 normal person by sEMG. 40 normal person consist with two groups, each 20 male, 20 female. Average age of subject was $26.50{\pm}4.79$. SEMG instrument QEMG-4 XL was used. After training exercise of facial muscles, sEMG's root mean square value was measured once. Results : 1. In whole experimental group, frontalis muscle's both side average was $78.36{\pm}40.87$, zygomaticus muscle's both side average was $84.70{\pm}49.81$, orbicularis oris's both side average was $104.83{\pm}38.81$. 2. Left side of Frontalis muscle, both side of zygomaticus muscle are high marked in male than female in statistically. 3. In whole experimental group, average of ratio comparing smaller value with bigger value in difference between left side and right side was $19.60{\pm}12.88$ %. 4. Average of asymmetry index(AI) was $11.46{\pm}8.36$ %. orbicularis oris muscle's average of AI had least difference was $8.95{\pm}7.50$ %. zygomaticus muscle's average of AI had most difference was $13.95{\pm}8.90$ %. Conclusions : The result of this study could provide useful information of field of sEMG is used in oriental medicine treatment of facial muscles. To assess efficacy of treatment in facial muscles, we need to standardize facial muscle's sEMG values by using AI, ratio comparing values and etc.

Relationship on the lead exposure indices and symptoms by ALAD genotype in lead worker (연 노출 근로자들의 ALAD genotype에 따른 연 노출지표 및 증상과의 관련성)

  • Ahn, Kyu Dong;Lee, Jong Chun;Cho, Kwang Sung;Kim, Jin Ho;Lee, Sung Soo;Lee, Byung Kook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.11 no.2
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    • pp.111-117
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    • 2001
  • A cross-sectional study was performed to evaluate associations between lead biomarkers, lead-related symptoms, and ${\delta}$-aminolevulinic acid dehydratase (ALAD) genotype among 598 lead workers and 144 control office workers in storage battery industries, secondary smelting and litharge making industries. Lead inhibits the second enzymes, ALAD, in the heme synthesis pathway. ALAD gene, which codes for one of three isozymic proteins (termed ALAD1-1, ALAD1-2, and ALAD2-2), seems to modify the toxicokinetics of lead. The result as follows; The percents of total workers whose genotype of ALAD1-1 and ALAD1-2 were 88.4% and 11.6%, respectively. The zinc protoporphyrin in blood (ZPP) and ${\delta}$-aminolevulinic acid in urine (ALAU) of lead workers with ALAD1-2 were significantly lower than those of lead workers with ALAD1-1, but there were no significant difference between two genotype for blood lead, age, and work duration. The proportion of ALAD1-2 genotype in control office workers was 13.2%. The proportions of ALAD1-2 genotype of lead workers were 14.0%(their mean air lead level below $0.024mg/m^3$), 10.4%($0.025-0.049mg/m^3$), 11.8%($0.050-0.099mg/m^3$), and 9.4%(above $0.100mg/m^3$), respectively. In the logistic analysis of 15 lead related symptoms, 'arthralgia'(S7) symptom of ALAD1-2 was significantly lower (OR=0.481; 95% CI=0.248-0.932) than that of ALAD1-1, but 'feeling of irritation'(S11) of ALAD1-2 was significantly higher(OR=1.636; 95% CI=1.035-2.586) than that of ALAD1-1 after controlling possible confounder (blood lead, work duration, smoking and drinking habit).

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Basic Study on the Hearing-threshold Levels of Workers with Noise-induced Hearing Loss in Korea (1996년도 소음성난청 유소견 근로자들의 청력역치 관련 기초조사)

  • Moon, Young-Han;Lee, Sang-Yeal;Lee, Kyung-Nam;Ahn, Yeon-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.1
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    • pp.17-29
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    • 1999
  • Objectives. This study was carried out to analyze the hearingthreshold levels and relating factors of 1,048 workers with noiseinduced hearing loss$(D_1)$. Methods. We analyzed the hearing-threshold levels and relating factors of 1,048 workers with noise-induced hearing loss$(D_1)$ examined by the summary reports of specific health examination results of industries and personal reports of specific health examination results reported by 58 specific health examination institutes and 8 secondary pneumoconiosis examination institutes in 1996. Results. Among 1,048 workers at 510 workplaces, male workers were 1,009 (96.3%) and female workers were 39 (3.7%). The mean ages of workers initially exposed to noise and at present were 28.7 and 47.2, respectively. The duration of total exposure was 16.5 years. Average hearing-threshold levels analyzed by three-divided classification of the study subjects were 43.7dB(Lt) and 42.6dB(Rt). Those analyzed by six-divided classification were 50.5dB(Lt) and 48.6d8(Rt). Among workers with noise-induced shearing loss$(D_1)$, 16.3% was unilateral hearing loss and 84.6% was classified to compensation case. 8.8%(Rt) and 10.2%(Lt) of them were suspected to be conductive hearing loss by differences of air-bone hearing-threshold levels. Hearing-threshold levels of workers in manufacturing industry were significantly increased during the short exposure compared with the levels in mining industry. Among manufacturing industries, hearing-threshold levels of workers in trailer and other transportation equipment manufacturing industry were significantly increased. Age and duration of total noise exposure were not significantly related to the average hearing-threshold levels analyzed by three-divided classification. Hearing-threshold levels of female workers were significantly increased during the short exposure compared with those of male workers. Hearing-threshold levels of workers at the high risk group, ages of 20s, 30s and total exposure duration of less than 10 years, were not significantly increased compared with those of the other groups. However, they were exposed at young ages. The 3 leading industries of workers at high risk group were trailer and other transportation equipment manufacturing, automobile manufacturing and assemble-metal manufacturing industries. Conclusions. This study was the first nationwide analysis of the hearing-threshold levels and relating factors of workers with noise. induced hearing loss$(D_1)$. We found the differences of the real number by the statistics of the department of labour and the expected number of worker' s compensations for occupationally-induced hearing loss estimated by this study. According to the results of this study, we should carefully examine the methods to narrow this difference.

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Meteorological Condition and Pest Management (기상환경과 병해충 발생 및 그 대책)

  • 현재선
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.27 no.4
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    • pp.361-370
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    • 1982
  • The effects of climatic factors on organisms lire variable and complex, and it, however, can be interpreted in terms of those on the distribution and those on the population densities. The distribution of an organism may largely be determined by the temperatures, except some temporal organisms which are depended on the air mass movements. Population density of an organism is determined by various climatic factors, such as previous winter temperature, temperature of growing season and rainfall. The start of growing season of the rice plants has been shifted to earlier since last decade in Korea. This may mean that the overall climatic condition during the growing season might be considerably different from those in past years, and such a difference in climatic conditions might have close relation with the recent status of the diseases and insect pests through direct effects on the physiology and population dynamics of the organisms, as well as through on the biotic associations of the pest organisms. The white back planthopper and brown planthopper have become the key insect pests in Korea in recent years. They are migratory and have high reproductive pontentials and more generations than average residential insects. The synchronization of the migrants and physiological condition of the rice plants seems to be the important factors in relation to the recent outbreaks of these insects; the high reproductive rate can be obtained with the growth stage of rice being 30-50 days after transplanting. The modication of the microclimate associated with high plant density and some other introduced new cultural techniques also have some relation with the outbreak. The key diseases of the rice are the blast disease, sheath blight and the bacterial leaf blight. For the rice blast, the seedling blast and leaf blast during the early growing season and the neck blast, have become more serious, the former may be related to hotbed nursery and the later may be related to the high humidity in early August, and synchronization of the heading time which has been shifted to early part from middle or late part of August. In general, for the rice diseases, the development of the new races have been the most serious which are largely resulted from the introduction of the new varieties, but it also seems to be related with the prolonged periods of the favorable condition associated with the shifted growing seasons. In general, the diseases and insect pest problems have become much more variable and complex, and control measures should be based on the thorough knowledge of the ecology of the pest organisms, that is, effects of various environmental factors on the disease cycle; spore release, spore deposition, infection, colonization and sporulation of the disease organisms, and those on the development, reproductive potentials, dispersal, age specific responses of the insects. The well organized real-time pest management systems, such as alfalfa weevil management system developed at the Purdue University in U.S., is the prime importance for the implementation of the pest management principles.

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DEHP, DEP and DBP Exposure Analysis using Urinary Metabolites of Gyonggi Province University Students

  • Lee, JangWoo;Kho, YoungLim;Kim, SungKyoon;Choi, Kyungho;Hwang, SeongHee;Jeong, Jeeyeon;Kim, Pangyi
    • Journal of Environmental Health Sciences
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    • v.39 no.5
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    • pp.408-417
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    • 2013
  • Objectives: Phthalates are used as plasticizers in polyvinyl chloride (PVC) plastics. As phthalate plasticizers are not chemically bound to the PVC, they can leach, migrate or evaporate into indoor air and atmosphere, foodstuffs, other materials, etc. Therefore, humans are exposed through ingestion, inhalation, and dermal exposure over their entire lifetime, including during intrauterine development. In particular, university students have a great number of opportunities to contact products including phthalates during campus life (food packaging, body care products, cosmetic, lotions, aftershave, perfume etc.). The purpose of this study was to examine levels of phthalate exposure as undergraduate students begin to use pharmaceuticals and personal care products including phthalates. Methods: Phthalate metabolites, mono-ethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-2- ethylhexyl phthalate (MEHP), {(mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP}, and mono-(2-ethlyl-5-oxohexyl) phthalate (MEOHP} were examined. 80 urine samples collected from university students were analyzed using LC/MS/MS(API 4000, Applied Bioscience) with on-line enrichment and columnswitching techniques. This study was carried out at Y university located in Gyonggi Province from 2008 to 2011. Results: The detection limit of phthalate metabolites were 0.03 ng/mL for MEP, 0.11 ng/mL for MnBP, 0.08 ng/mL for MiBP, 0.93 ng/mL for MEHP, 0.19 ng/mL for MEOHP and 0.16ng/mL for MEHHP. MnBP showed the highest urinary levels (median: 31.6 ug/L, 24.8 ug/g creatinine (cr)). Concentrations were also high for MEHHP (median: 24.1 ug/L, 19.0 ug/g cr), followed by MEOHP (median: 22.8 ug/L, 17.9 ug/g cr). In individual cases, the maximum level reached up to 348 ug/L, and 291 ug/g cr, respectively. The urinary and creatinine adjusted levels of MEP were lower than those for DBP and DEHP metabolites, but were higher in 95th percentiles. As a result, the mean daily DEP intake value was 2.3 ${\mu}g/kg$ bw/day, 3.5 ${\mu}g/kg$ bw/day for DEHP and 4.9 ${\mu}g/kg$ bw/day for DBP. Conclusion: These students' phthalate exposure levels were below the international safe level set by the EU, but higher than the 2012 KFDA survey of the age group from 3 to 18.

Surgical Management of Multidrug Resistant Pulmonary Tuberculosis (다제내성 폐결핵 환자에서의 수술적 치료)

  • 성숙환;강창현;김영태;김주현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.287-293
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    • 1999
  • Background: Medical treatment of multiple drug resistant(MDR) pulmonary tuberculosis has been quite unsuccessful. We analyzed our experience to identify the benefits and complications of the pulmonary resection in MDR pulmonary tuberculosis. Material and Method: A retrospective review was performed in 27 patients who unerwent pulmonary resection for MDR pulmonary tuberculosis between January 1994 and March 1998. Mean age was 40 years and the average history of diagnosis prior to surgery was 3.1 years. All had resistance to an average of 4.4 drugs, and received second line drugs selected according to the drug sensitivity test. Most patients (93%) had cavitary lesions as the main focus. Bilateral lesions were identified in 19 patients (70%), however, the main focus was recognized in one side of the lung. Eleven patients (41%) were converted to negative sputum smear and/or culture before surgery. Result: Pneumonectomy was performed in 9 patients, lobectomy in 16 and segmentectomy in 2. There was no operative mortality. Morbidity had occurred in 7 patients (26%), prolonged air leak in 3 patients, reoperation due to bleeding in 2, bronchopleural fistula in 1, and reversible neurologic defect in 1. Median follow up period was 15 months (3-45 months). Sputum negative conversion was initially achieved in 22 patients (82%), and with continuous postopertive chemotherapy negative conversion was achieved in other 4 patients (14%). Only one pneumonectized patient (4%) failed due to considerable contralateral cavity. Conclusion: For patients with localized MDR pulmonary tuberculosis and with adequate pulmonary reserve function, surgical pulmonary resection combined with appropriate pre and postoperative anti-tuberculosis chemotherapy can achieve high success rate with acceptable morbidity.

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Clinical Factors Influencing the Trial and Purchase of Bilateral Microphones with Contralateral Routing of Signal in Patients with Asymmetric Sensorineural Hearing Loss

  • Seong, Jeon;Yang, Seung Koo;Jang, Pilkeun;Lee, Sang-Yeon;Carandang, Marge;Choi, Byung-Yoon
    • Korean Journal of Audiology
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    • v.24 no.1
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    • pp.29-34
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    • 2020
  • Background and Objectives: Bilateral microphones with contralateral routing of signal (BiCROS) hearing aid is an option for hearing rehabilitation in individuals with asymmetric sensorineural hearing loss (ASNHL). The clinical factors influencing the trial and purchase of BiCROS were investigated. Subjects and Methods: We reviewed the medical records of 78 patients with ASNHL who were recommended to use BiCROS and analyzed the demographic and audiological factors influencing the trial and purchase of BiCROS. Results: Among the 78 patients, 52 (66.7%) availed of the free BiCROS trial and 21 (26.9%) purchased BiCROS. The mean pure tone audiometry (PTA) air conduction (AC) threshold of the better- and worse-hearing ears were 44.2±12.8 dB and 90.7±22.5 dB HL, respectively. The decision for trial or purchase of BiCROS was not influenced by age, sex, duration of hearing loss of the worse-hearing ear, or PTA AC threshold or speech discrimination score of both ears. The first and third quartiles of the PTA AC thresholds for the better-hearing ear of BiCROS buyers were 38.75 dB and 53.75 dB HL, respectively. The counterpart values for the worse-hearing ear were 72.50 dB and 118.75 dB HL, respectively. Conclusions: The clinical factors analyzed in this study were found to be irrelevant to the trial and purchase of BiCROS in patients with ASNHL. Nevertheless, the distribution range of the auditory thresholds of the subjects using BiCROS can be a useful basis for the counseling of patients with ASNHL and selection of candidates for BiCROS use.

Association between High Diffusion-Weighted Imaging-Derived Functional Tumor Burden of Peritoneal Carcinomatosis and Overall Survival in Patients with Advanced Ovarian Carcinoma

  • He An;Jose AU Perucho;Keith WH Chiu;Edward S Hui;Mandy MY Chu;Siew Fei Ngu;Hextan YS Ngan;Elaine YP Lee
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.539-547
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    • 2022
  • Objective: To investigate the association between functional tumor burden of peritoneal carcinomatosis (PC) derived from diffusion-weighted imaging (DWI) and overall survival in patients with advanced ovarian carcinoma (OC). Materials and Methods: This prospective study was approved by the local research ethics committee, and informed consent was obtained. Fifty patients (mean age ± standard deviation, 57 ± 12 years) with stage III-IV OC scheduled for primary or interval debulking surgery (IDS) were recruited between June 2016 and December 2021. DWI (b values: 0, 400, and 800 s/mm2) was acquired with a 16-channel phased-array torso coil. The functional PC burden on DWI was derived based on K-means clustering to discard fat, air, and normal tissue. A score similar to the surgical peritoneal cancer index was assigned to each abdominopelvic region, with additional scores assigned to the involvement of critical sites, denoted as the functional peritoneal cancer index (fPCI). The apparent diffusion coefficient (ADC) of the largest lesion was calculated. Patients were dichotomized by immediate surgical outcome into high- and low-risk groups (with and without residual disease, respectively) with subsequent survival analysis using the Kaplan-Meier curve and log-rank test. Multivariable Cox proportional hazards regression was used to evaluate the association between DWI-derived results and overall survival. Results: Fifteen (30.0%) patients underwent primary debulking surgery, and 35 (70.0%) patients received neoadjuvant chemotherapy followed by IDS. Complete tumor debulking was achieved in 32 patients. Patients with residual disease after debulking surgery had reduced overall survival (p = 0.043). The fPCI/ADC was negatively associated with overall survival when accounted for clinicopathological information with a hazard ratio of 1.254 for high fPCI/ADC (95% confidence interval, 1.007-1.560; p = 0.043). Conclusion: A high DWI-derived functional tumor burden was associated with decreased overall survival in patients with advanced OC.