• Title/Summary/Keyword: Old aged

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Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.172-178
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    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

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Analysis of Risk Factors in Coronary Artery Bypass Surgery (관동맥우회술의 위험인자 분석)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1049-1055
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    • 1998
  • Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

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Effects of Dietary Yeast Culture Containing Recombinant Porcine Somatotropin on Growth Performances in Broiler Chickens (Recombinant Porcine Somatotropin 함유 Yeast Culture의 사료 내 첨가가 육계의 생산성에 미치는 영향)

  • Ko Y. M.;Kim D. W.;Kim K. E.;Shin S. C.;You S. J.;Ahn B. K.;Kang C. W.
    • Korean Journal of Poultry Science
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    • v.31 no.4
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    • pp.245-253
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    • 2004
  • This study was conducted to investigate the effects of dietary yeast culture containing rPST on growth performances and the characteristics of body compositions in broiler chickens. A total of 460 Ross male broiler chicks aged 2-day-old were fed one of five experimental diets; Control(devoid of all), TI (with $0.1\%$ antibiotics; chlorotetracycline), T2 (with $0.1\%$ rPST-yeast culture), T3 (with $0.2\%$ rPST-yeast culture) or T4 (with $0.2\%$ SC yeast culture) for 6 weeks. Feed consumption and body weights were measured weekly. At week 5 of the experiment, 10 chicks were randomly selected and sacrificed. The relative weights of each organ and the chemical composition of edible meat were measured. The enzyme activity, total cholesterol, Ca and P were also determined. Tibial weight, bone strength and chemical composition were investigated. There were no significant differences in feed intake and feed conversion ratios among the treatments throughout the experimental period. Body weight gains tended to be increased by feeding of diets containing rPST-yeast culture. The relative weight of breast muscle in T3 group was significantly higher than that of the control (P<0.05). The moisture contents of breast meat in groups fed diets containing rPST-yeast culture or SC yeast culture were significantly increased as compared with those of the control and n. However, the contents of crude protein and ether extract were not affected by feeding of rPST-yeast culture. There were no significant differences in GOT, total cholesterol, Ca and P. The relative weight and strength and proximal composition of the tibia were also not affected by dietary treatments. These results indicated that dietary rPST-yeast culture may be a valuable alternative for optimizing growth performances, particularly for improving the yield of breast muscle.

Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis (비결핵성 기관지탄분섬유화증의 임상 양상)

  • Lee, Hee-Seub;Maeng, Joo-Hee;Park, Pae-Gun;Jang, Jin-Gun;Park, Wan;Ryu, Dae-Sik;Kang, Gil-Hyun;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.510-518
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    • 2002
  • Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

Characteristics of Exposure to Humidifier Disinfectant by Lung Injury Patients (가습기 살균제 폐 손상 피해자의 살균제 노출 특성 -태아와 임산부 노출을 중심으로 -)

  • Park, Dong-Uk;Ryu, Seung-Hun;Lim, Heung-Kyu;Kim, Sun-Kyung;Ahn, Jongju;Roh, Hyun-Suk;Choi, Ye-Yong;Cha, Won-Seok;Lee, Eun;Hong, Sang-Bum;Do, Kyung-Hyun;Cho, Jae-lim;Bae, Mun-Joo;Shin, Dong-Chun;Paek, Domyung;Hong, Soo-Jong
    • Journal of Environmental Health Sciences
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    • v.42 no.3
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    • pp.147-159
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    • 2016
  • In South Korea, many cases of humidifier disinfectant-associated lung injury (HDLI) have been reported among people who used humidifier products containing humidifier disinfectant (HD). The objective of this study is to characterize exposure to HD among a total of 221 HDLI patients who used HD. Information and data on the HDs used were collected through a structured questionnaire and home environmental investigations. The conditions of these 221 HDLI patients were clinically confirmed to be caused by the use of HD. Children aged under 5 years old made up the highest proportion of HDLI cases (n=125, 56.6 %), followed by pregnant women (n=35, 15.8%). Forty-three percent (n=95) of the victims died. There were three cases of fetuses and 35 pregnant women among the victims. The number of HDLI patients who used only the Oxy Saksak brand of HD was found to be 85 (38.5%), followed by the HD brands Cefu (n=24, 10.9%), Lottemart Wiselect (n=9, 4.1%) and Aekyung (n=3). Patients who exclusively used HD brands containing polyhexamethylene guanidine phosphate (PHMG) (n=13, 55.7%) as an active ingredient made up the largest share, followed by those who exclusively used HD containing only oligo(2-(2-ethoxy) ethoxyethyl guanidinium (PGH) (n=24, 10.9%) and by those who only used a mixture of chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) (n=3, 1.4%). HD products containing PHMG were found to be the most commonly used among the confirmed HDLI patients. Three exposed fetuses who never used HD after birth developed lung injuries, indicating a probability of exposure to HD during gestation. All HDLI patients responded that they used HD while sleeping and for longer than 10 hours per day. In conclusion, the development of HDLI was clinically found to be associated with the use of several HD products containing PHMG, PGH and CMIT/MIT.

Pattern of Occurrence of Mycoplasma pneumoniae Pneumonia in Admitted Children : Southern Central Korea, from 1989 to 2002 (소아 입원 환자에서 관찰된 Mycoplasma pneumoniae 폐렴의 발생 양상 : 최근 13년간(1989-2002년) 경남 서부지역)

  • Kang, Ki Su;Woo, Hyang-Ok
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.474-479
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    • 2003
  • Purpose : The determination of exposure and prevalence of Mycoplasma pneumoniae pneumonia of any region should be helpful for clinical diagnosis. We studied the pattern of occurrence of M. pneumoniae pneumonia among children living in southern central Korea during the last 13 years. This area has a relatively small population and less mobility compared with metropolitan areas. Methods : We performed a retrospective descriptive study of 143 patients admitted to the pediatrics ward among all the patients aged less than 15 years old diagnosed with M. pneumoniae pneumonia at our hospital, from July 1989 to June 2002. Results : The percentiles of incidence per year compared to the total patients admitted to a pediatric ward per year were 0.52% in 1989, 0.48% in 1990, 0.13% in 1991, 0% in 1992, 1.85% in 1993, 1.00% in 1994, 0.15% in 1995, 0.53% in 1996, 1.75% in 1997, 0.65% in 1998, 0.24% in 1999, 1.14% in 2000, 1.30% in 2001, 0.53% in 2002. In the peak incidence of monthly distribution for two consecutive years with outbreaks, its outbreak in the first year was concentrated in late fall and winter, but its outbreak in the following year was earlier than first year. There was peak incidence of age distribution in 4-5 years. It is shown gradually that age distributions per year of outbreak became earlier in age. Conclusion : The occurrences of M. pneumoniae pneumonia in southern central Korea occurred at 3-4 year intervals, 1-2 years in duration, compared to three year intervals, one year in duration, according to reports from metropolitan areas before 1997.

The Effect of Stocking Density and Strain on the Performance and Physiological Adaptive Responses in Broiler Chickens (육계에서 품종 및 사육 밀도가 생산성 및 생리적 적응성 지표에 미치는 영향)

  • Jang, In-Surk;Yun, Seo-Hyun;Ko, Young-Hyun;Kim, Se-Yun;Song, Min-Hye;Kim, Jong-Sun;Sohn, Sea-Hwan;Moon, Yang-Soo
    • Korean Journal of Poultry Science
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    • v.41 no.3
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    • pp.205-215
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    • 2014
  • The aim of this study was to determine the effects of stocking density and strain on the performance and physiological adaptive responses including the plasma corticosterone content and the level of mRNA expression of pro-inflammatory cytokines and antioxidant enzymes in broiler chicks. A total of 300 birds of two strains (150 Ross strain vs. 150 Cobb strain) aged 3-d old were allotted into two stocking densities (standard stocking density,$0.046m^2/bird$ vs. high stocking density, $0.023m^2/bird$) in battery cages by $2{\times}2$ factorial designs with ten replicates until 35 d of age. There was no significant strain effect on body weight, feed intakes and feed to gain ratio and the relative organ weights. However body weight, feed intakes and relative organ weight were found to be significantly (P<0.05) affected by the effect of stocking density. Plasma corticosterone level was not affected by both stocking density and strain effects. Hepatic mRNA expression of pro-inflammatory cytokines including interleukin-$1{\beta}$ (IL-$1{\beta}$), IL-6, IL-18 and interferon-gamma (IFN-${\gamma}$) was not significantly changed by the effects of strain and stocking density. However, the mRNA expression of glutathione peroxidase (GPX) was affected by strain, showing that Ross strain decreased (P<0.05) the GPX expression. With respect to the effect of stocking density, there was a significant (P<0.05) increase in superoxide dismutase (SOD) and catalase (CAT) and GPX mRNA expression in the liver from high stocking density group. Splenic pro-inflammatory cytokine expression was not also affected by stocking density and strain, except that IL-18 mRNA significantly (P<0.05) decreased in Cobb strain under high stocking density. The mRNA expression of SOD and CAT was significantly (P<0.05) affected by the effects of stocking density and strain. In conclusion, growth performance was not affected by strain but stocking density. Although mRNA expression of major pro-inflammatory cytokines was not changed by stocking density and strain, antioxidant enzyme was significantly affected by stocking density, strain or even organ in birds under summer conditions. More detailed studies still needed to be explored to elucidate the effects of environmental conditions and genetic background on physiological responses in birds.

Coronary Artery Bypass Graft Surgery in the Elderly (고령환자의 관상동맥 우회로 조성술)

  • 김학제;황재준;김현구;신재승;손영상;최영호
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.715-721
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    • 1999
  • Background:The number of old patients receiving coronary artery bypass grafting(CABG) is increasing. With the more recent advances in operative techniques, the age at which CABG is indicated has also increased. This study evaluated the risk factors associated with the hospital mortality and the morbidity following CABG in elderly patients. Material and Method: Between March 1991 and June 1998, we retrospectively reviewed 45 consecutive patients aged 65 years or older who underwent CABG. We compared the data with the results of 179 patients under the age 65 years operated during the same period. Result: Mean age was 68${\pm}$1.41 years(range 65 to 74 years). Emergency surgery was required in 4, and elective surgery in 41 patients. The mean number of distal anastomosis per patient was 3.62 ${\pm}$0.81 and mean aortic cross-cramp time was 69.84${\pm}$18.5 minutes. Thirty patients had Canadian class III or IV preoperatively, but 43 patients had class I or II postoperatively. The left ventricular ejection fraction increased significantly from 54.23${\pm}$10.62% preoperatively to 58.14${\pm}$9.88% postoperatively(p<0.05). Postoperative complication was pneumonia in 2 patients, acute renal failure in 2 patients, sternal wound infection in 1 patient, and postoperative myocardial infarction in 1 patient. There were two postoperative deaths. The causes of deaths were low output syndrome in one patient, and sepsis due to pneumonia in the other patient. The hospital mortality was higher in the elderly group(4.4 versus 2.86%) but was not statistically significant(p>0.05). Incremental risk factors for hospital deaths in the elderly were emergent operation, preoperative PTCA, postoperative use of IABP and postoperative ARF(p<0.05). The duration of hospital stay after operation was significantly longer for the elderly group than the younger group(19.27${\pm}$12.51 vs 15.55${\pm}$6.99 days; p< 0.05). Follow-up was complete for 34 of the hospital survivors and ranged from 1 to 73 months(mean: 23.58${\pm}$19.56 months). There was no late mortality of cardiac origin. Conclusion: Age is an important factor in selecting optimal management for elderly patients with coronary compromise, but age alone should not dictate the choice of therapy. Coronary artery bypass surgery in the elderly is associated with acceptable early mortality and excellent long-term results.

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The Influence of Accommodation on Watching Home 3D TV at Close Distance (가정용 3D TV의 근거리 시청이 조절기능에 미치는 영향)

  • Kim, Jung-Ho;Hwang, Hae-Young;Kang, Ji-Hun;Yu, Dong-Sik;Kim, Jae-Do;Son, Jeong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.2
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    • pp.157-163
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    • 2013
  • Purpose: This study was investigated weather watching 2D and 3D images effecting on accommodative function (AF), and differences between changes of AF by 2D and 3D. Methods: 50 subjects (male 30, female 20) aged 20's to 40's years old ($22.9{\pm}3.93$ years) who are available to watching 3D images were participated for this study. Accommodative amplitude (AA) by near point of accommodation (NPA), accommodative response (AR), positive and negative relative accommodation (PRA, NRA), accommodative facility (AF) were measured before, after watching 2D and 3D images at 1 m distance for 30 minutes respectively. Results: Accommodative amplitude after both watching 2D and 3D images decreased comparing to before watching images, and AA after watching 3D images was significantly lower than after watching 2D images. AR after both watching 2D and 3D images increased comparing to before watching images, but there was no difference between 2D and 3D. PRA and NRA were not significantly different between before, after watching 2D and 3D images. Accommodation speed by AF was increased for before watching ($13.52{\pm}3.32$ cpm) following by for after watching 2D images ($14.28{\pm}3.21$ cpm) and for watching 3D images ($14.90{\pm}3.27$ cpm). Conclusions: Watching images at close distance is effect to accommodation functions, and sequence of AA decrease of before watching images following by after watching 2D images and after watching 3D images may effect to asthenopia with same sequence as AA decrease. The results of increase of AF after watching images, specially 3D images show a possibility of vision therapy and further detail VT studies using 3D images are required in the future.

A Study on Developing a Model for Cancer Damage Cost Due to Risk from Benzene in Ulsan Metropolitan City (울산 지역에서 대기중 벤젠으로 인한 암 사망 손실비용 추정 모형에 관한 연구)

  • Lee, Yong-Jin;Kim, Ye-Shin;Shin, Dong-Chun;Shin, Young-Chul
    • Environmental and Resource Economics Review
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    • v.13 no.1
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    • pp.49-82
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    • 2004
  • The study aimed to evaluate cancer damage cost due to risk from benzene inhalation. We performed health risk assessment based on US EPA guideline to estimate annual population risk in Ulsan metropolitan city. Also, we estimated a willingness-to-pay amount for reducing a cancer mortality rate to evaluate a value of statistical life. We combined the annual population risk and the value of statistical life to calculate the cancer damage cost. In the health risk assessment, we applied the benzene unit risk ($2.2{\times}10^{-6}{\sim}7.8{\times}10^{-6}$) in the US EPA'S Integrated Risk Information System to assess the annual population risk. Average concentration of benzene in ambient air is $7.88{\mu}g/m^3$(min: 1.16~max: $23.32{\mu}g/m^3$). We targeted an exposure population of 516,641 persons who aged over 30 years old. Using a Monte-Carlo simulation for uncertainty analysis, we evaluated that the population risk of benzene during ten years in Ulsan city is 2.90 persons (5 percentile: 0.32~95 percentile: 9.11persons). And the monthly average WTP for 5/1,000 cancer mortality reduction during ten years is 14,852 Won(95% C.I: 13,135~16,794 Won) and the implied VSL is 36 million Won(95% C.I: 30~40 million Won). Cancer damage cost due to risk from benzene inhalation during 10 years in Ulsan city is about 104 million Won(5 percentile: 13~95 percentile: 328 million Won). Health benefit cost to reduce a cancer mortality risk of benzene is about 50 million Won is Ulsan metropolitann city. But, it is very important that this cost is not for all health damage cost of cancer mortality in some area. We just recommended a model for evaluating a cancer risk reduction, so we must re-evaluate an integrated application of total VOCs damage cost including benzene.

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