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Analysis of Postoperative Coronary Angiography in Symptomatic Patients (관상동맥 우회술 시행 후 증상이 있는 환자에서 시행한 관상동맥 조영술의 분석)

  • Kim Young-Hak;Han San-Woong;Kang Jeong-Ho;Kim Hyuck;Lee Chul-Burm;Chon Soon-Ho;Nam Seung-Hyuk;Chung Won-Sang
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.759-764
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    • 2006
  • Background: We analyzed post-operative angiography performed in symptomatic patients to evaluate the patency rates and the roles of grafts. Material and Method: We reviewed 52 (15%) coronary angiograms performed for recurrent angina after prior coronary artery bypass surgery from January 1995 to June 2005. A total of 345 patients underwent coronary artery bypass surgery during this period. There were 41 men and 11 women and the mean age was $64.07{\pm}15.58$ years. The median period from operation to re-angiogram was 68.5 months (range, 1 to 126 months). The numbers of grafts and peripheral anastomoses were 42 and 43 for internal thoracic artery (ITA), 14 and 20 for radial artery (RA), and 49 and 89 for saphenous vein. The mean number of anastomosis was 2.9 per patient, Result: The patency rates of ITA, RA and saphenous vein graft (SVG) were 37/43 (86%), 17/20 (85%) and 34/89 (38.2%). The patency rate of arterial grafts was significantly higher than that of SVG (p< 0.001) and the patency rate of the RA was comparable to that of ITA (p=0.942). The patency rate of sequential SVGs was higher than that of single SVG (40.3% vs 31.8%, p=0.478) and the patency rate of proximal segments in sequential anastomosis was higher than that in single anastomsis (55.6% vs 31.8%, p=0.097), but statistically not significant. Conclusion: Arterial grafts have markedly superior patency rates than SVGs, so consideration should be given to the vigorous use of arterial grafts. The patency rate of the RA was comparable to that of ITA.

Efficiency Test for Surface Protecting Agents for the Chemical Resistance of Concrete Structures Using Sulfur Polymers (Sulfur Polymer를 사용한 콘크리트 구조물용 내화학성 표면보호재의 성능 평가)

  • Lee, Byung-Jae;Lee, Eue-Sung;Chung, Woo-Jung;Kim, Yun-Yong
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.18 no.5
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    • pp.1-8
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    • 2014
  • Structures requiring chemical resistance are usually coated with surface protecting agents, but the cost for maintenance and re-construction is incurred due to the low durability. Therefore, in this study, sulfur was polymerized and the performance was examined so that it could be used as the concrete surface protecting agents for structures requiring chemical resistance. The evaluation results indicated that for the spray of the sulfur polymer surface coating agents, the application of the gravity type was appropriate; and for the number of coating times, about 3 cycle spray gave the best results. For the surface condition of the concrete to be coated with the surface protecting agents, outstanding quality was obtained above room temperature ($20{\sim}30^{\circ}C$), and the bond strength increased as the temperature increased. The evaluation results of the strength characteristics depending on the filler content of the surface protecting agents indicated that about 20~40% filler mixing contributed to the strength improvement as it reduced the shrinkage of the sulfur polymer. Also, the mixing of silica showed larger increase in the bond strength than the mixing of fly ash, and the most outstanding bond strength characteristics could be obtained by the mixing of both silica and fly ash. In the case of the chemical resistance, the strength reduction was minimized and outstanding chemical resistance was obtained when the fly ash and silica were substituted by 20%, respectively. The performance evaluation of the chloride ion penetration indicated that for the specimens coated with the sulfur polymer surface protecting agents, the chloride ion penetration resistance increased by 29~48% compared to the specimen without the coating of the surface protecting agent. The examination of the coating condition of the surface protecting agents, compressive strength, bond strength, chemical resistance, and salt damage resistance indicated that in the range of this study, the optimal level was when the silica and fly ash were substituted by 20%, respectively, as the filler for the sulfur polymer.

Biliary Atresia -A Survey by the Korean Association of Pediatric Surgeons in 2011- (담도폐쇄증 -대한소아외과학회 회원 대상 전국 조사-)

  • Oh, J.T.;Kim, D.Y.;Kim, S.C.;Kim, I.K.;Kim, H.Y.;Kim, H.Y.;Nam, S.H.;Park, K.W.;Park, W.H.;Park, J.Y.;Seo, J.M.;Lee, N.H.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chung, S.Y.;Jung, S.E.;Chung, J.H.;Choi, K.J.;Choi, S.O.;Choi, S.H.;Choi, Y.M.;Han, S.J.;Hong, J.
    • Advances in pediatric surgery
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    • v.19 no.1
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    • pp.1-13
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    • 2013
  • The Korean Association of Pediatric Surgeons (KAPS) performed the second nationwide survey on biliary atresia in 2011. It was a follow-up study to the first survey, which was performed in 2001 for the retrospective analysis of biliary atresia between 1980 and 2000. In the second survey, the authors reviewed and analyzed the clinical data of patients who were treated for biliary atresia by the members of KAPS from 2001 to 2010. A total of 459 patients were registered. Among them, 435 patients primarily underwent the Kasai operation. The mean age of patients who underwent the Kasai operation was $66.2{\pm}28.7$ days, and 89.7% of those patients had type III biliary atresia. Only five patients (1.4%) had complications related to the Kasai operation. After the Kasai operation, 269 (61.8%) of the patients were re-admitted because of cholangitis (79.9%) and varices (20.4%). One hundred and fifty-nine (36.6%) of the patients who underwent the Kasai operation subsequently underwent liver transplantation. The most common cause of subsequent liver transplantation was persistent hyperbilirubinemia. The mean interval between the Kasai operation and liver transplantation was $1.1{\pm}1.3$ years. Overall the 10-year survival rate after the Kasai operation was 92.9% and the 10-year native liver survival rate was 59.8%. We had 23 patients for primary liver transplantation without the Kasai operation. The mean age patients who underwent primary liver transplantation was $8.6{\pm}2.9$ months. In summary, among the 458 Kasai-operation and liver-transplantation patients, 373 lived, 31 died, and 54 were unavailable for follow up. One-third of the patient who survived have had complications correlated with biliary atresia. In comparison with the first survey, this study showed a higher survival rate and a greater number of liver transplantation.

A Study of Nursing Manpower Requirements based on the Nursing Times spent in Operating Room of an University Hospital (수술실 간호인력의 수요측정 및 간호제공량분석 - 수술대기시간과 수술시간을 중심으로 -)

  • YooN Ke Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.45-61
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    • 1987
  • This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

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The Clinical Significance of STAT-PAK ULTRA FAST$^{(R)}$ and ICT Tuberculosis$^{(R)}$ for Serologic Diagnosis of Tuberculosis (폐결핵 진단을 위한 STAT-PAK ULTRA FAST$^{(R)}$와 ICT Tuberculosis$^{(R)}$의 유용성에 관한 연구)

  • Kim, Geun-Hwa;Park, Hee-Sun;Kim, Myung-Hoon;Kang, Dong-Won;Lee, Kyu-Seung;Ko, Dong-Seok;Suh, Jae-Chul;Jeong, Seong-Su;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.311-320
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    • 1999
  • Background: In recent years, tuberculosis has re-emerged as a major health problem in both industrialized & developing countries. Recent advances in identifying & purifying antigens secreted in active tuberculosis infection have lead to the development of serological assays based on a number of immunodominant antigens. To date, the most sensitive and specific of these antigens has been the 38-kDa antigen. Method: Two rapid membrane-based serologic assays using antigen(38-kDa) from mycobacterium tuberculosis for the diagnosis of tuberculosis were evaluated in 22 patients with smear-positive pulmonary tuberculosis, 14 patients with inactive pulmonary tuberculosis, and 9 patients with non-tuberculous lung disease. Result: The evaluation of validity(sensitivity, specificity, positive predictive value, negative predictive value, false positivity and false negativity) of STAT-PAK ULTRA FAST$^{(R)}$ were 77.3%, 28.6%, 63.0%, 44.4%, 71.4 %, and 22.7% for differential diagnosis of active pulmonary tuberculosis and inactive pulmonary tuberculosis, respectively. The evaluation of validity of STAT-PAK ULTRA FAST$^{(R)}$ were 77.3%, 33.3%, 73.9%, 37.5%, 66.7%, and 22.7% for differential diagnosis of active pulmonary tuberculosis and non-tuberculosis. The evaluation of validity of ICT Tuberculosis$^{(R)}$ were 54.5%, 57%, 66.7%, 44.4%, 42.9%, and 45.5% for differential diagnosis of active pulmonary tuberculosis and inactive pulmonary tuberculosis. The evaluation of validity of ICT Tuberculosis$^{(R)}$ were 54.5%, 100%, 100%, 47.4%, 0%, and 45.4% for differential diagnosis of active pulmonary tuberculosis and non-tuberculosis. Conclusion: We concluded no effectiveness of STAT-PAK ULTRA FAST$^{(R)}$ & ICT tuberculosis$^{(R)}$on serologic diagnosis of pulmonary tuberculosis. In the future, further large-scale study should be needed for serologic diagnosis of pulmonary tuberculosis.

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Effect of Cryopreservation Day on Pregnancy Outcomes in Frozen-thawed Blastocyst Transfer (동결 해동한 포배 이식에 있어서 동결시기가 임신결과에 미치는 영향)

  • Kim, Hyun-Jung;Kim, Chung-Hyon;Lee, Joong-Yeup;Kwon, Jae-Hee;Hwang, Do-Yeong;Kim, Ki-Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.57-64
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    • 2010
  • Objectives: Likewise fresh cycle, it is also important to select right blastocysts for transfer in purpose of improving the pregnancy and implantation rates in frozen-thawed embryo transfer (ET) cycles. To investigate the relationship between the developmental velocity at the time of cryopreservation and pregnancy rates, we compared pregnancy rates between the day 5 cryopreservation group and the day 6 cryopreservation group. Methods: Transfers of frozen-thawed blastocysts which had been cryopreserved by vitrification on day 5 or day 6 were performed between January 2006 and June 2007. Ethylene glycol, DMSO, and pull and cut straws were used for vitrification and artificial shrinkage was done in expanded blastocysts. Thawing was performed on the day before transfer and thawed blastocysts were cultured in for 15~18 hrs in Quinn's blastocyct media. Blastocyst survival was assessed before transfer and post-thaw survival was defined as >50% of cells remaining intact and blastocoele re-expansion by the time of transfer. Results: Transfers of thawed blastocyst had been cryopreserved on day 5 were 52 cycles and 41 transfer cycles were cryopreserved on day 6. Patient characteristics, the number of transferred embryos and the survival rate of thawed blastocysts were not different in each cryopreservation day. But the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and implantation rate were significantly high in transfer of frozen-thawed blastocyst which were cryopreserved on day 5. Conclusions: The clinical pregnancy and implantation rate of day-5 blastocyst showed significantly higher than those of day-6 blastocyst in frozen-ET cycles. This result indicated that developmental rate of blastocyst at cryopreservation time in frozen-thawed cycle is discriminative marker of pregnancy outcome as like in fresh cycle.

A Study on the Characteristic and Manufacture Technique for the Gold wire of Phoenix-Shaped Glass Ewer by National Treasure No. 193 (국보 제193호 봉수형유리병 금사의 특성과 제작기법 연구)

  • Hwang, Hyun Sung;Yun, Eun Young
    • Journal of Conservation Science
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    • v.31 no.1
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    • pp.21-27
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    • 2015
  • The Phoenix-shaped Glass Ewer, which is No. 193 National Treasure, was seriously damaged by a unique form of green glass pieces when excavated among a number of burial accessories of Hwangnamdaechong known to have been formed in the 5th century. While it has long been exhibited at the National Museum of Korea since its treatment for conservation treatment at conservation science laboratory in 1984, the existing adhesive materials seriously deteriorated for the 30 years, and the condition was quite unstable. The epoxy resin used as a restorative materials turned yellowing due to the light and heat so much that it was no longer able to exhibit it in a stable and effective manner. As a result, a re-treatment for conservation was conducted lately. This study focuses on the three pieces of Gold wires used to carefully wrap up the handle of the Phoenix-shaped Glass Ewer broken into three pieces, which has not been studied so far. As for the analysis method for Gold wires, SEM-EDS and Stereo Microscope were used for nondestructive analysis. First of all, the result of the SEM-EDS analysis shows that the composition was Au 91.9 wt.%-Au 92.8 w.t% and Ag 5.9 wt.%-Ag 6.5 wt.%, which indicates that it was an alloy made of Au and Ag. The production technique of Gold wires was also observed by means of optical microscopes. In general, Gold wires were manufactured by a drawing process in which a lump of gold was beaten or pulled out of a hole or by a process of twisting a gold plate. However, Gold wires separated from the handle of the Phoenix-shaped Glass Ewer did not involve any trace of twisting on the surface. Rather, fine vertical stripes were observed with the sections filled up. Hence, it is thought that this Ewer went through a drawing process and then was mended. As a result, no certain relation with the golden mending material used for the Phoenix-shaped Glass Ewer was verified. The findings above indicate that most of the existing researches on Gold wires recognized them, not as separate remains, but merely as a component of other golden remains. Thus, there has been little systematic study on the manufacturing techniques of Gold wires. The future study on Gold wires may verify the correlation between the Gold wires used to fix the handle of the Phoenix-shaped Glass Ewer, which is examined in this study, with that of golden remains in the Silla era.

Coronary Artery Bypass Graft in Patient with Advanced Left Ventricular Dysfunction (중등도 이상의 좌심실 기능 부전 환자에서의 관상동 우회술의 임상 분석)

  • 정종필;김승우;신제균
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.901-908
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    • 2001
  • Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1%) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98%) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84%) and first degree of Rentrop classification(16 cases, 52%) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

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A study on drainage characteristics and load amount evaluation by crop type in a hydroponic cultivation facility of horticultural complex (수경재배 시설원예단지 작물 유형별 배액 특성 및 부하량 평가 연구)

  • Jin, Yujeong;Kang, Taegyoung;Lim, Ryugab;Kim, Hyunwoo;Kang, Donghyeon;Park, Minjung;Son, Jinkwan
    • Journal of Wetlands Research
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    • v.23 no.4
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    • pp.352-363
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    • 2021
  • The purpose of this study was to evaluate the load of nutrients contained in the drainage discharged from the facility horticultural complex and to use them for re-use of fluids and design for introduction of water treatment plants. Representative hydroponic cultivation crops were selected as tomato, paprika, cucumber, and strawberry, and the total number of samples analyzed for water quality was 80. As a result of the analysis, since various fertilizer components such as N, P, K+, Na+, Mg2+, Ca2+, Si4+, HCO3-, Cl-, S2-, Fe, Mn, Cu, Zn, Mo and B are contained at very high concentrations in the drainage, the need for water treatment was confirmed. Through statistical analysis, it was analyzed that the drainage concentration of strawberries was lower than that of tomatoes, paprika, and cucumbers. In the case of tomatoes, these essential ion concentrations are the highest, so it was confirmed that they are subject to valuable resources in terms of reuse of fertilizers. The load of N and P of the drainage discharged from the facility horticultural complex 1m2 was analyzed. For N, the daily processing capacity of 4.0 kg of tomatoes, 3.3 kg of paprika, 3.0 kg of cucumbers, and 1.5 kg of strawberries was calculated based on 1 ha. It was suggested that the P concentration needs a scale and capacity that can handle 0.5 kg of tomatoes, 0.6 kg of paprika, 0.4 kg of cucumber, and 0.2 kg of strawberries per day. Through this study, the amount of nitrogen and phosphorus contained in the drainage discharged from the greenhouse of each crop was evaluated to analyze the economy. In addition, it was expected to be used as basic data that can be used to calculate the treatment capacity to be reflected when introducing water treatment facilities in facility horticultural complexes for sustainable agriculture.

What Is a Monster Narrative? Seven Fragments on the Relationship between a Monster Narrative and a Catastrophic Narrative (괴물서사란 무엇인가? - 괴물서사에서 파국서사로 나아가기 위한 일곱 개의 단편 -)

  • Moon, Hyong-jun
    • Cross-Cultural Studies
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    • v.50
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    • pp.31-51
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    • 2018
  • The concept of 'monsters' have become popular, again, in recent times. A number of 'monster narratives' that discuss monsters such as zombies, humanoids, viruses, extraterrestrials, and serial killers have been made and re-made in popular media. Noting such an interesting cultural context, this article attempts, first, to find out some essential prototypical elements of a monster narrative and, second, to relate it with a catastrophic narrative. Correspondingly, the word 'monster' has been used as a conceptual prototype category that denies universal and clear definition, which makes it as one of the most widely used and familiar subjects of the use of metaphor. The prototypical meanings of various monster figures can be converged on a certain creature of being in this way held out as bizarre, curious, and abnormal. The monster figure that surpasses existing normality is also connected to 'abjection,' such as something that is cast aside from the body such as the bodily functions seen in its associated blood, tears, vomit, excrement, or semen, and so on. Nevertheless, both the monster figure and abjection produce disgust and horror in the minds of ordinary spectators or readers of media using this metaphor to heighten excitement for the viewers. The abject characteristic of the monster figure also has something in common with the posthuman figure, meaning to apply to a category of inhuman others who are held outside of the normal category of human beings. In the similar vein, it is natural that the most typical monster figures in our times are posthuman creatures embodied in such forms as seen with zombies, humanoids, cyborgs, robots, and so on. In short, the monster figure includes all of the creatures and beings that disarray normalized humanist categories and values. The monster narrative, in the same sense, is a type of story that tells about others outside modern, anthropocentric, male-centered, and Westernized categories of thought. It can be argued that a catastrophic narrative, a literary genre which depicts the world where a series of catastrophic events demolish the existing human civilization, ought to be seen as a typical modern-day monster narrative, because it also discounts and criticizes normalized humanist categories and values as is the result of the monster narrative. Going beyond the prevailing humanist realist narrative that are so familiar with existing values, the catastrophic narrative is not only a monster narrative per se, but also a monstrous narrative which disrupts and reinvents currently mainstream narratives and ways of thinking.