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Postoperative Progress and Influencing Factors in Patients after Rastelli Procedure (Rastelli 술식후 임상경과의 평가 및 영향인자)

  • Kim, Se Heui;Kim, Kyeong Sik;Lee, Jong Kyun;Choi, Jae Young;Sul, Jun Hee;Lee, Sung Kyu;Park, Young Whan;Cho, Bum Koo
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.259-264
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    • 2003
  • Purpose : We have performed an analysis on patients who received Rastelli operation in our institute and reviewed their progress postoperatively. Various factors with suspected relationship to the outcome have been considered to help in future treatment and follow-up. Methods : We analyzed retrospectively 43 patients who either received Rastelli operation in Yonsei University Cardiovascular Center from March 1995 to April 1997 or who received post-procedural cardiac catheterization and follow-up echocardiography in the out-patient department after the procedure. Results : No statistically valid relationships were found between the age of the patient, their body weight, preoperative pulmonary arterial index and pressure, presence of pulmonary branchial stenosis and postoperative results. Cases with atrioventricular concordance showed lower age and body weight, and discordant cases exhibited lower ejection fraction 3 days postoperatively. Upon follow up, lower NYHA score was seen in patients with severe residual stenosis. In the group that received cardiac catheterization after the procedure, residual stenosis and right ventricular pressure measurement in echocardiography showed good correlation with the catheterization data. Conclusion : In cases where conduit insertions of the right ventricular outflow tract are required to achieve total correction in complex cardiac deformity, early operation does not seem to provide a clear risk to the patient. In patients with atrioventricular discordance, careful postoperative observation of the ventricular function seems to be needed. Also, echocardiography appears to be a sound method in follow-up of patients after the correctional procedure.

Comparison of Nutritional Status of the Daejeon Metropolitan Citizens by Frequency of Eating Out (외식 빈도에 따른 대전시민의 영양상태 비교)

  • Suh, Yoon-Suk;Kang, Ji-Hyun;Kim, Han-Sook;Chung, Young-Jin
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.171-180
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    • 2010
  • This study aims at investigating the health and nutritional status of the adults according to frequency of eating out. One day food intake data were collected by 24 hr recall dietary survey and body size, blood pressure and some blood lipids and other constituents were measured on 137 Daejeon metropolitan citizens 20 yrs old and above who visited Chungnam National University Hospital for physical examination during the period of December 6, to December 15, 2008. The frequency of eating out were categorized into four levels: less than once a week, once a week, 2-3 times a week, 4 times a week and above. Body mass Index, waist circumference, blood pressure, blood lipid, blood glucose, GPT and GOT did not showed any significant difference according to the frequency of eating out of the subjects. Though, systolic blood pressures and serum levels of total cholesterol and LDL-cholesterol showed a little tendency to be high in the subjects eating out 2-3 times a week. In the contrary, serum triglyceride level tended to be low in the same group. The subjects eating out 4 times a week and over took more total protein, animal protein, animal fat, phosphorus and vitamin $B_2$ than any other group. Also protein energy ratio was the highest in the group eating out 4 times a week and above and they took more animal food group, other food group, beverages teas and alcohols than other groups eating out. These results showed that higher frequency of eating out leads to higher intake of protein, fat, phosphorus, animal food groups and other food groups (oils, beverages, seasonings) and to lower intake of vitamin C and plant food groups. It, thus, suggested that the strategy for restaurant business is required to provide the menu substituted animal food by more plant food.

A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years (최근 4년간 극소 저출생 체중아의 인공 호흡기 치료율과 경과 변화에 관한 연구)

  • Jung, Byun Kyung;Kim, Yeoung Ju;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1073-1079
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    • 2003
  • Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

Changes in the Lung after Pulmonary Hypertension Induced by Obstruction of the Pulmonary Vein in Rats (흰쥐에서 폐정맥 폐쇄에 의해 유도된 폐동맥고혈압 발생 후의 폐장의 변화)

  • Jang Won-Chae;Jeong In-Suk;Cho Kyu-Sung;Oh Bong-Suk
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.659-667
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    • 2006
  • Background: Experimental studies of vascular remodeling in the pulmonary arteries have been performed actively. These models required a persistent vascular insult for intimal injury induced by chronic hypoxia, monocrotaline intoxication or chronic air embolism and characterized medial hypertrophy and neointimal formation by active synthesis of the extracellular matrix protein. The purpose of this study was to determine the pattern of pulmonary vascular remodeling after obstruction of the pulmonary vein. Material and Method: Obstruction of the right pulmonary vein with a metal clip was performed in Sprague-Dawley rats $(352{\pm}18g,\;n=10)$ to cause pulmonary vascular disease. Fifteen days later, experimental studies were done and finally the both lungs and hearts were extirpated for experimental measurement. Pulmonary arterial pressure, weight ratio of right ventricle (RV) to left ventricle (LV) and ventricular septum (S) (RV/LV +S weight ratio), and pulmonary artery morphology (percent wall thickness, %WT) were evaluated and compared with normal control groups. Result: Pulmonary hypertension $(38{\pm}12mmHg\;vs\;13{\pm}4mmHg;\;p<0.05)$ and right ventricular hypertrophy (right ventricular/left ventricular and septal weight ratio, $0.52{\pm}0.07\;vs\;0.35{\pm}0.04;\;p<0.05$) with hypertrophy of the muscular layer of the pulmonary arterial wall (percent wall thickness, $22.4{\pm}6.7%\;vs\;6.7{\pm}3.4%;\;p<0.05$) were developed by 15 days after obstruction of the pulmonary vein. Conclusion: Obstruction of the pulmonary vein developed elevation of pulmonary blood pressure and medial hypertrophy of the pulmonary artery. These results are a part of the characteristic vascular remodeling. Theses results demonstrate that obstruction of the pulmonary vein can develope not only high pulmoanry blood flow of contralateral lung but also intima injury inducing vascular remodeling.

The Effect of Midazolam As Sedative Agent in Bronchoscopy (기관지내시경 검사시 전처치로서 Midazolam의 효과)

  • Lee, Sang-Haak;Hyun, Dae-Sing;Lee, Sook-Young;Kim, Seok-Chan;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.612-618
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    • 2002
  • Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.

Comparative Study on the Estimation of CO2 absorption Equilibrium in Methanol using PC-SAFT equation of state and Two-model approach. (메탄올의 이산화탄소 흡수평형 추산에 대한 PC-SAFT모델식과 Two-model approach 모델식의 비교연구)

  • Noh, Jaehyun;Park, Hoey Kyung;Kim, Dongsun;Cho, Jungho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.136-152
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    • 2017
  • The thermodynamic models, PC-SAFT (Perturbed-Chain Statistical Associated Fluid Theory) state equation and the Two-model approach liquid activity coefficient model NRTL (Non Random Two Liquid) + Henry + Peng-Robinson, for modeling the Rectisol process using methanol aqueous solution as the $CO_2$ removal solvent were compared. In addition, to determine the new binary interaction parameters of the PC-SAFT state equations and the Henry's constant of the two-model approach, absorption equilibrium experiments between carbon dioxide and methanol at 273.25K and 262.35K were carried out and regression analysis was performed. The accuracy of the newly determined parameters was verified through the regression results of the experimental data. These model equations and validated parameters were used to model the carbon dioxide removal process. In the case of using the two-model approach, the methanol solvent flow rate required to remove 99.00% of $CO_2$ was estimated to be approximately 43.72% higher, the cooling water consumption in the distillation tower was 39.22% higher, and the steam consumption was 43.09% higher than that using PC-SAFT EOS. In conclusion, the Rectisol process operating under high pressure was designed to be larger than that using the PC-SAFT state equation when modeled using the liquid activity coefficient model equation with Henry's relation. For this reason, if the quantity of low-solubility gas components dissolved in a liquid at a constant temperature is proportional to the partial pressure of the gas phase, the carbon dioxide with high solubility in methanol does not predict the absorption characteristics between methanol and carbon dioxide.

Measurement and Quality Control of MIROS Wave Radar Data at Dokdo (독도 MIROS Wave Radar를 이용한 파랑관측 및 품질관리)

  • Jun, Hyunjung;Min, Yongchim;Jeong, Jin-Yong;Do, Kideok
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.32 no.2
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    • pp.135-145
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    • 2020
  • Wave observation is widely used to direct observation method for observing the water surface elevation using wave buoy or pressure gauge and remote-sensing wave observation method. The wave buoy and pressure gauge can produce high-quality wave data but have disadvantages of the high risk of damage and loss of the instrument, and high maintenance cost in the offshore area. On the other hand, remote observation method such as radar is easy to maintain by installing the equipment on the land, but the accuracy is somewhat lower than the direct observation method. This study investigates the data quality of MIROS Wave and Current Radar (MWR) installed at Dokdo and improve the data quality of remote wave observation data using the wave buoy (CWB) observation data operated by the Korea Meteorological Administration. We applied and developed the three types of wave data quality control; 1) the combined use (Optimal Filter) of the filter designed by MIROS (Reduce Noise Frequency, Phillips Check, Energy Level Check), 2) Spike Test Algorithm (Spike Test) developed by OOI (Ocean Observatories Initiative) and 3) a new filter (H-Ts QC) using the significant wave height-period relationship. As a result, the wave observation data of MWR using three quality control have some reliability about the significant wave height. On the other hand, there are still some errors in the significant wave period, so improvements are required. Also, since the wave observation data of MWR is different somewhat from the CWB data in high waves of over 3 m, further research such as collection and analysis of long-term remote wave observation data and filter development is necessary.

The Effect of Aging Treatment on the High Temperature Fatigue Fracture Behavior of Friction Welded Domestic Heat Resisting Steels (SUH3-SUS 303) (마찰용접된 국산내열 강 (SUH3-SUS303 )의 시효열처리가 고온피로강도 및 파괴거동에 미치는 영향에 관한 연구)

  • Lee, Kyu-Yong;Oh, Sae-Kyoo
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.17 no.2
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    • pp.93-103
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    • 1981
  • It is well-known that nowadays heat resisting and anti-corrosive materials have been widely used as the components materials of gas turbines, nuclear power plants and engines etc. In the fields of machine production industry. And materials for engine components, like as the exhaust valve of internal combustion engine, have been required to operate under the high temperature range of $700^{\circ}C$-$800^{\circ}C$ and high pressured gas with repeated mechanical load for the high performance of engines. For these components, friction welding for bonding of dissimilar steels can be applied for in order to obtain process shortening, production cost reduction and excellent bonding quality. And age hardening recently has been noticed to the heat resisting materials for further strengthening of high temperature strength, especially high temperature fatigue strength. However, it is difficult to find out any report concerning the effects of age hardening for strengthening high temperature fatigue strength to the Friction welded heat resisting and anti-corrosive materials. In this study the experiment was carried out as the high temperature rotary bending fatigue testing under the condition of $700^{\circ}C$ high temperature to the friction welded domestic heat resisting steels, SUH3-SUS303, which were 10hr., 100hr. aging heat treated at $700^{\circ}C$ after solution treatment 1hr. at $1, 060^{\circ}C$ for the purpose of observing the effects of the high temperature fatigue strength and fatigue fracture behaviors as well as with various mechanical properties of welded joints. The results obtained are summarized as follows: 1) Through mechanical tests and micro-structural examinations, the determined optimum welding conditions, rotating speed 2420 rpm, heating pressure 8kg/mm super(2), upsetting pressure 22kg/mm super(2), the amount of total upset 7mm (heating time 3 sec and upsetting time 2 sec) were satisfied. 2) The solution treated material SUH 3, SUS 303, have the highest inclination gradient on S-N curve due to the high temperature fatigue testing for long time at $700^{\circ}C$. 3) The optimum aging time of friction welded SUH3-SUS 303, has been recognized near the 10hr. at $700^{\circ}C$ after the solution treatment of 1hr. at $1, 060^{\circ}C$. 4) The high temperature fatigue limits of aging treated materials were compared with those of raw material according to the extender of aging time, on 10hr. aging, fatigue limits were increased by SUH 3 75.4%, SUS 303 28.5%, friction welded joints SUH 3-SUS 303 44.2% and 100hr. aging the rates were 64.9%, 30.4% and 36.6% respectively. 5) The fatigue fractures occurred at the side of the base matal SUS303 of the friction welded joints SUH 3-SUS 303 and it is difficult to find out fractures at the friction welding interfaces. 6) The cracking mode of SUS 303, SUH 3-303 is intergranular in any case, but SUH 3 is fractured by transgranular cracking.

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Relationships of Obesity, Total-Cholesterol, Hypertension and Hyperglycemia in Health Examinees with Disabilities (장애인 건강검진 수검자들의 비만, 콜레스테롤, 고혈압, 고혈당의 관련성)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.10
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    • pp.591-599
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    • 2016
  • Among the employer-supported subscribers to the National Health Insurance Service, 6,797 people with mild disabilities with western ages of 20 and up and who received health checkups were investigated. Of these 6,797 people, 3,186 and 3,611 received health checkups in 2009 and 2013, respectively. Those people who were diagnosed with physical handicaps, brain lesions, visual impairment, hearing impairment, intellectual disabilities, mental disorders, kidney disorders or other disorders according to the classification standard for people with disabilities were classified into disability groups of the 3rd through 6th degrees. The purpose of this study was to examine the dangerous influence of obesity of people with mild disabilities on their hyperglycemia, hypertension and high cholesterol. The items measured in this study were abdominal obesity, body mass index, fasting glucose, total cholesterol, systolic blood pressure and diastolic blood pressure. To look for connections between the obesity level and at-risk groups for each disease, cross tabulation and multinomial logistic regression analyses were utilized. Higher levels of abdominal obesity and BMI were found among those who were male, were younger and had higher incomes. The risks of abdominal obesity and BMI were higher in the abnormal groups for each disease. In 2009, the obesity group whose BMI was higher had a 1.51-fold higher risk of hypertension than the normal group. The abdominal obesity group had a 1.59-fold higher risk of high cholesterol, a 1.26-fold higher risk of hypertension and a 1.54-fold higher risk of hyperglycemia than the normal group. In 2013, the obesity group whose BMI was higher had a 1.72-fold higher risk of high cholesterol and a 1.43-fold higher risk of hypertension than the normal group. Those with abdominal obesity had a 1.59-fold higher risk of hyperglycemia than the normal subjects. As the risk of obesity was higher in those with disabilities than in those without disabilities, the former should be encouraged to undergo health checkups on a regular basis, and the coverage of the health checkups should be extended to keep track of their illness. In addition, appropriate education and concern are both required to prevent obesity.

Association of total dietary antioxidant capacity with oxidative stress and metabolic markers among patients with metabolic syndrome (대사증후군 환자 및 위험군의 식사 내 총 항산화능과 산화스트레스 및 대사 지표의 연관성)

  • Ham, Dongwoo;Jun, Shinyoung;Kang, Minji;Shin, Sangah;Wie, Gyung-Ah;Baik, Hyun Wook;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.50 no.3
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    • pp.246-256
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    • 2017
  • Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual's TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of ${\gamma}$-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of ${\alpha}$-tocopherol (p < 0.05) and ${\gamma}$-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.