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Occurrence Pattern of Intussusception according to the Introduction of Rotavirus Vaccine: An Observational Study at a University Hospital (로타바이러스 백신 도입에 따른 장겹침증 발생 경향: 한 대학병원 관찰 연구)

  • Nam, Hye Na;Lim, Kyung In;Tchah, Hann;Ryoo, Eell;Sun, Yong Han;Cho, Hye-Kyung
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.202-208
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    • 2016
  • Purpose: Rotavirus vaccine (RV) was introduced in Korea since 2007, and intussusception (IS) remains an important safety concern. This study investigated the trend of IS occurrence related to RV as well as the temporal relevance between vaccination and IS in children. Methods: We collected data of the patient aged ${\leq}18$ years with IS admitted to Gachon University Gil Medical Center, 2003 to 2015. For the patients that have occurred since 2008, the immunization records of RV were collected. The proportion of cases <1 year was calculated by the year and the temporal relationship between vaccination and IS occurrence was analyzed. Results: A total of 696 IS cases were noted. The cases <1 year were 30.7% (214/696). Although the incidence of all IS has increased over the 13-year period (from 74.1 in 2003 to 89.5 in 2015, linear by linear association, P=0.003), the incidence of IS <1 year has not increased (from 56.9 in 2003 to 53.3 in 2015, P=0.910), and the proportion of cases <1 year has decreased (from 35.4 in 2003 to 18.8 in 2015, P=0.000). Of 128 cases <1 year since 2008, 53.9% received RV. In the vaccinated group, 10 cases of IS occurred within 30 days, and eight cases did within 31 to 60 days. Numbers of IS after first, second, and third dose were three, 10, and five cases, respectively. Conclusions: Occurrence of IS in children <1 year of age did not increase since the introduction of RV. Further monitoring is essential for evaluation of vaccine safety.

Genesis and Characteristics of the Soil Clay Minerals Derived from Major Parent Rocks in Korea -III. Soil Mineralogy of Sand and Silt Size Fractions in the Soils (한국(韓國)의 주요(主要) 모암(母岩)에서 발달(發達)된 토양점토광물(土壤粘土鑛物)의 특성(特性)과 생성학적(生成學的) 연구(硏究) -III. 모래와 미사중(微砂中)에 토양광물(土壤鑛物)의 특성비교(特性比較))

  • Um, Myung-Ho;Um, Ki-Tae;Lim, Hyung-Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.25 no.1
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    • pp.1-7
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    • 1992
  • Sand and silt size fractions of soils which were derived from five major rocks of granite, granite-geniss, limestone, shale, and basalt in Korea were studied. Determination of the mineralogical and chemical composition of rock-forming mineral breakdown which is accompanied by the formation of secondary minerals. The chemical composition of the fraction was largely changed with the content of weatherable and resistant soil minerals such as ferromagenesian minerals, carbonates, and guartz. In the sand fractions of the soils from the granite and granite-gneiss, chlorite-vermiculite mixed layers seem to be an intermediate weathering product prior to the weathering state of the formation of vermiculite from chlorite. Kaolin minerals in the silt fractions of the soils from the granite-gneiss are considered to be formed by the pseudomorphic transformation of plagioclase. In the sand and silt fractions of the soils derived from the limestone, large amount of calcite and dolomite seems to have been inherited from the parent rocks. The primary chloritc, micas, and feldspars are considered to be formed from the weathering remains after leaching of carbonate minerals during the soil formation. In the residual soils(Gueom series) developed from the basalt, quartz and micas were coexisted with plagioclase and augite inherited from the parent rock.

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Effects of pH and Redox Conditon on Silica Sorption in Submerged soils (담수조건(湛水條件)에서 토양산도(土壤酸度)와 산화환원(酸化還元) 전위(電位)가 토양(土壤)의 규산흡착(珪酸吸着)에 미치는 영향(影響))

  • Lee, Sang-Eun;Neue, Heins Ulitz
    • Korean Journal of Soil Science and Fertilizer
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    • v.25 no.2
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    • pp.111-126
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    • 1992
  • Silica sorption isotherm belonged to the C-type with weak L-type characteristics according to the classification system of adsorption isotherm. Silica sorption isothem fitted well to the Freundlich and Tempkin equation but not to the Langmuir equation. The color interference probably due to $Fe^{2+}$ during spectrometric silca determination by Molybdenum-blue method affected the sorption isotherm in reduced soils or low pH. Four parameters such as the intercept of Freundlich equation, the slope of Tempkin equation, the "Silica reactivity", and the "C-type slope", where the last two parameters were termed in the current study, were examined to assess treatment effects on silica sorption. Among them the "C-type slope" was found out to be the best parameter. The C-type isotherms showed the same high correlation coefficient as Freundlich and Tempkin equation when regressed to the sorption isothem. Plotting the C-type slope on a logarithmic scale vs. the pH showed high linearity. Using the "C-type slope" as a perameter, the pH and soil type affected the silica sorption while the effect of redox condtion was not significant. All Fe and Al extracted by the various reagents, and OM were highly correlated to silica sorption. Among them $Fe_d$ was identified as the highest influencing soil property. Since there is no equivalent reliable method to discriminate the forms of the soil Al-oxides their likely importance remains unclear.

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Evaluation of Pretreatment Moisture Content and Fixation Characteristics of Treated Wood for Pressure Treatment of Japanese Red Pine and Japanese Larch Skin Timber with ACQ, CUAZ and CuHDO (소나무와 낙엽송 스킨팀버의 ACQ, CUAZ, CuHDO 가압처리를 위한 처리용 목재의 적정 함수율 및 처리목재의 정착 특성 평가)

  • Choi, Yong-Seok;Oh, Se-Min;Kim, Gyu-Hyeok
    • Journal of the Korean Wood Science and Technology
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    • v.39 no.6
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    • pp.481-489
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    • 2011
  • This study was conducted to evaluate the pressure treatment characteristics of Japanese red pine and Japanese larch skin timber with ACQ-2, CUAZ-2 and CuHDO-1. The effect of moisture content (MC) on preservative treatability was investigated for Japanese red pine sapwood and Japanese larch heartwood, and fixation characteristics of CCA alternatives was also evaluated. Japanese red pine sapwood, which was dried below 30 percent MC, was fully penetrated with preservatives, and minimum requirement of preservative retention for the hazard class H3 was achieved. Through measuring preservative retention gradient in Japanese red pine sapwood, it was confirmed that the retention gradient of CuHDO-1 was steeper than that of both ACQ-2 and CUAZ-2. In particular, it was intensified at a higher MCs of wood samples (25∼30%). Japanese larch heartwood did not meet the minimum requirement of penetration and retention for the hazard class H3 over the range of pretreatment MCs tested. With presteaming under $121^{\circ}C$ for 12 hours, the treatability of Japanese larch heartwood was enhanced to meet the minimum requirement for the hazard class H3. The fixation rate of copper was much more faster under drying condition compared with nondrying condition; more than 95% of copper were fixed in 3~6 days and 1 day under drying conditions in Japanese red pine sapwood and Japanese larch heartwood, respectively. After 3-week fixation period at ambient temperature, the amount of mobile copper in treated wood sample that remains available for leaching from treated wood was the highest in the wood samples treated with ACQ-2, followed by CuHDO-1 and CUAZ-2. It was proportional to the amount of copper in treating solution.

Efficacy of Mitral Valve Surgery in Moderate Ischemic Mitral Regurgitation (MR) (중등도의 허혈성 승모판막 폐쇄부전증 환자에서 승모판막 수술의 유용성)

  • Jung Sung Ho;Lee Jae Won;Choi Jun Young
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.357-365
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    • 2005
  • Background: Patients with mitral regurgitation (MR) in the setting of coronary artery disease have a dismal long-term prognosis whether treated medically or surgically. Moreover, the optimal management of moderate ischemic MR at the time of coronary artery bypass grafting (CABG) remains the subjects of controversy. Thus, the present retrospective study was undertaken to determine whether mitral valve surgery for moderate ischemic MR at the time of CABG would be preferable to CABG alone in terms of clinical outcome. Material and Method: Between January 1997 and December 2003, 34 patients with moderate (Gr 3/4) ischemic MR underwent CABG alone (Group I, n=23) or CABG plus mitral valve surgery (Group II, n=11). Operative mortality, long-term survival and echocardiographic parameters were used to evaluate the efficacy of mitral valve surgery in patients with moderate ischemic MR. The mean follow-up durations of each group were $69.3\pm4.3$ months and $53.1\pm4.9$ months respectively. Result: There was no hospital mortality in both groups. There was one case of late mortality in Group I. The mean number of bypass graft was similar ($3.8\pm1.2\;vs\;3.7\pm1.3$ respectively). Cardiopulmonary bypass time was longer in group II (p=0.014). In group II, all of the patients received mitral annuloplasty using ring. On immediate postoperative echo-cardiogram, mitral regurgitation was reduced more in group II (p=0.002). Echocardiogram performed at last follow-up state showed no difference except the grade of MR between the two groups. Actuarial survival of both groups at 5 years was similar ($95.5\%\;vs\;100\%$, p=0.48). Conclusion: This study shows that in selected patients with moderate ischemic MR, CABG without mitral valve surgery might be sufficient. However, patients with low EF and NYHA functional class pre-operatively had tendency of significant residual MR, so mitral valve surgery should be necessary in these patients, and moreover, MR severity and left ventricle volume decreased more in mitral valve surgery group. Therefore, more large-scale studies are necessary to determine these effects on the ventricular function and long-term survival.

The Changes of Cerebral Metabolic Parameters, Serum Levels of Neuron-Specific Enolase and S-100$\beta$ Protein During Retrograde Cerebral Perfusion Under Profound Hypothermic Total Circulatory Arrest (초저체온하 완전순환정지 시에 이용되는 역행성 뇌관류의 시간에 따른 뇌대사 지표, 혈청 내 neuron-specific enolase, 및 S-100 베타단백의 변화)

  • 김경환
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.653-661
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    • 2001
  • Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

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Long-Term Outcomes and Risk factor Analysis after Pneumonectomy for the Sequelae of Pulmonary Tuberculosis (폐결핵의 후유증에 대한 전폐절제술의 장기 성적 및 위험인자 분석)

  • 김영태;김홍관;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.535-541
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    • 2002
  • Background: The prevalence of pulmonary tuberculosis remains high in several areas of the world, and pneumonectomy is often necessary to treat the sequelae of the disease. We retrospectively analyzed the morbidities, mortalities, and long-term outcomes after pneumonectomy for the treatment of tuberculous sequelae. Material and Method: Between 1981 and 2001, 94 patients underwent either pneumonectomy or extrapleural pneumonectomy for the treatment of tuberculous sequelae. There were 44 males and 50 females. The mean age was 40(16~68) years. The pathology included destroyed lung in 80, main bronchus stenosis in 10, and both lesions in 4. Surgical procedures were pneumonectomy in 47, extrapleural pneumonectomy in 43, and completion pneumonectomy in 4. Results: One patient died postoperatively due to empyema. Twenty-three complications occurred in 20 patients; empyema in 15(including 7 bronchopleural fistulas), wound infection in 5, and others in 3. Univariate analysis revealed presence of empyema, extrapleural pneumonectomy, prolonged operation time, and old age as risk factors of postpneumonectomy empyema. In multivariate analysis, old age and low preoperative FEV1 were risk factors of empyema. Low preoperative FEV1 was the risk factor of bronchopleural fistula(BPF) in univariate analysis. Low preoperative FEV1, positive sputum AFB, and presence of aspergilloma were risk factors of BPF in multivariate analysis. There were twelve late deaths. Actuarial 5-and 10-year survival rates were 94$\pm$3% and 87$\pm$4%, respectively. Conclusion: Pneumonectomy could be performed with acceptable mortality and morbidity, and could achieve good long-term survival for the treatment of tuberculous sequelae. In patients with risk factors, special care is recommended to prevent postoperative empyema or bronchopleural fistula.

Surgical Technique for Korean Artificial Heart(AnyHeart) Implantation Using a Right Thoracotomy Approach (우측 개흉술을 이용한 한국형 인공심장(AnyHeart)의 이식기법)

  • Son. Ho-Sung;Sun, Kyung;Shin, Jae-Seung;Lee, Sung-Ho;Jung, Jae-Seung;Lee, Hye-Won;Kim, Kwang-Taik;Kim, Seung-Chul;Won, Yong-Soon;Min, Byoung-Goo;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.329-335
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    • 2002
  • Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.