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Clinical Study of the Patients, in Whom Pulmonary Embolism was Suspected by Lung Perfusion Scan (폐 관류주사검사상 폐동맥 색전증 소견을 보인 환자의 임상적 고찰)

  • Lee, Gwi-Lae;Kim, Jae-Yeol;Park, Jae-Suk;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.889-898
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    • 1997
  • Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

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Temporary Use of External Fixators for Soft Tissue Lengthening in the Treatment of Complications after Limb Salvage Surgery (사지 구제술 합병증 치료에서 연부조직 연장을 위한 한시적 외고정 기기의 유용성)

  • Yoon, Pil-Whan;Kang, Hyun-Guy;Kim, Kap-Jung;Oh, Joo-Han;Lee, Sang-Hoon;Lee, Sang-Ki;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.134-140
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    • 2005
  • Purpose: We evaluated the effectiveness of temporary using the extendible external fixator (EF) for lengthening of soft tissue that contracture caused by tumor prosthesis removal in the treatment of complications after limb salvage surgery like deep infection and loosening. Materials and Methods: Five patients six cases were included who underwent extendible EF (Dyna-extor(r)). EF was applied after insertion of half pin to the proximal and distal bone of defect area. EF lengthening started at third day of post-operation, above 2-3 mm per day in the range of no neurological sign. Results: The treatment area was three in femur and two in tibia. Mean age when the time of EF apply was 22.2 years old (range 15-29), but its primary limb salvage operation had done in 13.4 years old (range 9-19), therefore mean times of interval between initial tumor prosthesis reconstruction and temporary EF apply was 8.8 years (range 3-14). One patient had EF for 150 days with 7.2 cm lengthening. Others 5 cases of 4 patients had EF for mean 37 days (range 25-50) and mean soft tissue lengthening was 5.8 cm. Three patients underwent re-insertion of tumor prosthesis and two patients underwent knee fusion as final operation and showed no evidence of infection through mean 22 months follow up period. Conclusion: Temporary using of extendible EF is an effective method for correction of leg shortening which occurred by soft tissue contracture in the complications of limb salvage operation or their treatment process, and it could be provide easily application of tumor prosthesis and knee fusion as final operation.

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Initial changes of dental plaque, gingivitis and decalcification in Korean orthodontic patients with fixed appliance (한국인 고정식 교정 환자의 치태, 치은염 및 탈회의 초기 변화에 관한 연구)

  • Kang, Kook-Jin;Shon, Byung-Hwa
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.361-374
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    • 1999
  • Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

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Prevalence of Hypertension and Related Risk Factors of the Older Residents in Andong Rural Area (안동 농촌지역 중년 및 노인 주민의 고혈압 유병율과 위험요인 분석)

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.7
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    • pp.852-861
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    • 2009
  • This study was performed to assess the risk factors associated with hypertension from Jan/2003 to Feb/2003. The subjects were 1,296 people (496 males, 800 females) aged 40 years and over living in Andong rural area. The hypertensive group was composed of 602 people (272 males, 330 females), who were diagnosed as hypertension ($SBP{\geq}140\;mmHg$ or $DBP{\geq}90\;mmHg$) for the first time at this health examination. The mean anthropometric values of body weight, body fat (%), body mass index (BMI) and waist circumference were significantly higher in hypertensive group than those in normal group. However, the biochemical measurements such as total-cholesterol (TC), triglyceride (TG), HDL-C, LDL-C and fasting blood glucose (FBG) levels did not show any difference between two groups except TG in female. The risk factors of interest in the development of hypertension were analyzed using the multiple logistic regression and expressed as odds ratio (OR) and 95% confidential interval (CI). The results showed that age, sex, obesity, waist circumference, alcohol drinking and meat intakes were risk factors for hypertension. In contrast, cigarette smoking, exercise and the increased fish, fruit and vegetable (except Kimchi) consumption, blood lipid levels and FBG were not linked with the development of hypertension. Nutrient intakes were not associated with hypertension, either. In conclusion, we cannot assert that this study established the existence of the cause-and-effect relationship between nutrient intakes and risk of hypertension in the subjects, but it does suggest that this is a question worth investigating further using a larger scale of case-control study to determine how the past exposure to some nutrient or dietary component relates to the development of the disease.

Effective Ways of Performing Surveillance Surface Cultures in Extremely Low Birth Weight Infants

  • Lee, Ju-Young;Kim, Ee-Kyung;Lee, Jin-A;Choi, Chang-Won;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.240-247
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    • 2011
  • Purpose: The rationale for skin surface cultures is that bacterial colonization precedes infection and, as a result, that identification of a potential pathogen is predictive of later systemic infection in preterm infants. We aimed to analyze results of surveillance surface cultures in extremely low birth weight (ELBW) infants and seek for effective ways of performing surveillance surface cultures. Methods: We analyzed the surveillance surface cultures of 113 ELBW infants over a 4-year period. Surveillance cultures were obtained routinely from five sites: axilla, external ear canal, nasopharynx, throat (or tracheal aspirate if intubated) and anus. Each surface culture obtained during the 13 days, prior to the date of the blood culture, was compared with the blood culture obtained when sepsis was suspected. The sensitivity, specificity and positive predictive value (PPV) of the surveillance cultures were calculated among 1894 blood-surface culture pairs by surface sites, recovered organisms and interval between surveillance samples and blood cultures. Results: The overall sensitivity, specificity and PPV of surface cultures were 45.9, 22.4 and 6.8%, respectively. The PPV was highest for the throat/tracheal cultures (11.0%) and lowest for the anal cultures (2.3%). As the time of culturing progressed toward the day of blood culturing, the sensitivity and specificity of the surface cultures significantly increased. Only axillary and throat/tracheal cultures were useful in predicting the microorganisms causing sepsis. Conclusion: Surface cultures could help to predict sepsis pathogens and infection surveillance in preterm infants could be continued with a reduced number of cultured sites focusing on the axilla and throat/trachea.

Analysis of Rainfall Infiltration Velocity for Unsaturated Soils by an Unsaturated Soil Column Test : Comparison of Weathered Gneiss Soil and Weathered Granite Soil (불포화토 칼럼시험을 통한 불포화토 내 강우침투속도 분석: 편마암 풍화토와 화강암 풍화토의 비교)

  • Park, Kyu-Bo;Chae, Byung-Gon;Kim, Kyeong-Su;Park, Hyuek-Jin
    • Economic and Environmental Geology
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    • v.44 no.1
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    • pp.71-82
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    • 2011
  • The unsaturated soil column tests were carried out for weathered gneiss soil and weathered granite soil in order to obtain the relationship between rainfall intensity and infiltration velocity of rainfall on the basis of different unit weight conditions of soil. In this study, volumetric water content and pore water pressure were measured using TDR sensors and tensiometers at constant time interval. For the column test, three different unit weights were used as in-situ condition, loose condition and dense condition, and rainfall intensities were selected as 20 mm/h and 50 mm/h. In 20 mm/h rainfall intensity condition, average rainfall infiltration velocities for both gneiss and weathered granite soils were obtained as $2.854{\times}10^{-3}$ cm/s ~ $1.297{\times}10^{-3}$ cm/s for different unit weight values and $2.734{\times}10^{-3}$ cm/s ~ $1.707{\times}10^{-3}$ cm/s, respectively. In 50 mm/h rainfall intensity condition, rainfall infiltration velocities were obtained as $4.509{\times}10^{-3}$ cm/s ~ $2.016{\times}10^{-3}$ cm/s and $4.265{\times}10^{-3}$ cm/s ~ $3.764{\times}10^{-3}$ cm/s respectively. The test results showed that the higher rainfall intensity and the lower unit weight of soil, the faster average infiltration velocity. In addition, the weathered granite soils had faster rainfall infiltration velocities than those of the weathered gneiss soils except for the looser unit weight conditions. This is due to the fact that the weathered granite soil had more homogeneous particle size, smaller unit weight condition and larger porosity.

Effect of Soil Water Potential on Pysico-Chemical Properties of Soil and Cucumber(Cucumis sativus L.) Growth (토양(土壤) 수분(水分)포텐셜이 오이(Cucumis sativus L.)생육(生育)과 토양(土壤) 이화학적(理化學的 ) 특성(特性)에 미치는 영향(影響))

  • Bum, In-Sook;Kim, Yong-Woong;Kim, Kwang-Sik;Kim, Kil-Yong;Sohn, Bo-Kyoon;Kim, Hyun-Woo
    • Korean Journal of Soil Science and Fertilizer
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    • v.32 no.2
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    • pp.171-181
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    • 1999
  • A field experiments was carried out to investigate the physicochemical properties of soil and cucumber growth in vinyl house when irrigation point was made at 0.2, 1/3, 0.5 and 1.0 bar. The obtained results was summarized as follow: The taxonomic class of the soil used was loam and each content of the required water was 4.4, 7.3, 9.6 and 13.4 mm per each irrigation time at 0.2, 1/3, 0.5 and 1.0 bar treatments in spring culture, respectively. At 0.2 bar and 1.0 bar treatments, interval of irrigation was 2.3 and 14.8 day, the times of irrigation was 37 and 6, and total irrigation volume was 163.5 and 80.3 mm, respectively. After cucumber culture, pH, EC concentration and exchangeable K content of soil at 0.2 bar treatment was distributed near to the level of improvement target while EC, available $P_2O_5$ and exchangeable base content in other treatments were higher compared to improvement target. At 1.0 bar treatment, ratios of the solid and liquid phase were 44.9 and 27.1%, respectively, and bulk density was $1.26g\;cm^{-3}$ which was the highest among the treatments. At 0.2 bar treatment, the ratio of the solid and liquid phase was 41.7 and 22.8%, respectively, and bulk density was $1.09g\;cm^{-3}$ which was the lowest. The root length and radius at 0.2 bar treatment were best, while those at 1/3 bar were worst. At 0.2 bar treatment, the total yield was 7,269 kg and the weight of good products was 5,677 kg which was the highest among treatments. At 0.33 bar treatment, the yield was the lowest with the high ratio of deformity.

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Experimental Pathogenesis of Pullorum Disease with the Local Isolate of Salmonella enterica serovar. enterica subspecies Pullorum in Pullets in Bangladesh

  • Haider, M.G.;Chowdhury, E.H.;Khan, M.A.H.N.A.;Hossain, M.T.;Rahman, M.S.;Song, H.J.;Hossain, M.M.
    • Korean Journal of Poultry Science
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    • v.35 no.4
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    • pp.341-350
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    • 2009
  • The research work was carried out to study the pathogenesis covering the clinical signs, gross and histopathological lesions in different organs, and reisolation and identification of the organisms after experimental infection with the local isolate of Salmonella enterica serovar. enterica subspecies (S.) Pullorum at different time interval of the experiment during the period February 2006 to December 2006. One hundred pullets (seronegative to S. Pullorum of 12 weeks age were purchased and divided into 5 (A, B, C, D and E) groups and each group consisted of 20 birds. Four groups (A, B, C and D) were infected orally with a dose of $10^6\;CFU$, $10^7\;CFU$, $2{\times}10^7\;CFU$, $10^8\;CFU$ of S. Pullorum, respectively, and one group (E) was treated as uninfected control. The used methods were necropsy and histopathology, culture of bacteria, staining and biochemical test of Salmonella. Five birds from each group were randomly selected and sacrificed $1^{st}$ week, $2^{nd}$, $3^{rd}$ and $4^{th}$ weeks of post infection (PI). From all the groups, the bacteriological samples (crop, liver, lung, heart, spleen, bile duodenum, ceca and blood) were collected with pre enriched in buffered peptone water in sterile poly bags. Liver, lungs, heart, spleen, intestine, etc. were collected in 10% buffered-formalin for histopathological examination. No clinical signs, gross and histopathological lesions were found in control group and no S. Pullorum was reisolated. Clinical sign of experimentally infected with S. Pullorum in pullets were loss of appetite (100%), slight depression (75%), ruffled feathers (85%), diarrhea (60%) and loss of weight (100%) in chickens. The feed intake and body weight at different weeks after PI differed significantly (p<0.01) among the groups. Grossly, the highest recorded lesion was button-like ulcer in the ceca (80%) and the lowest was white nodules in lungs (1.25%). S. Pullorum were reisolated from crop (91.25%), liver (91.25%), lung (83.75%), heart (71.25%), spleen (87.75%), bile (33.25%), duodenum (92.50%), ceca (97.50%) and from different group of infection (61.25%). The highest microscopic findings were intestinal and cecal mucosa and submucosa exhibited infiltration of mononuclear cells and congestion (96.25%), and the lowest finding was nodule formation in the lungs (3.75%). The pattern of the disease production by local isolate of S. Pullorum in Bangladesh is almost similar with other isolates in different countries.

Clinical Spectra of Auto-amputated Polyps: Comparison of Juvenile Polyps and Meckel's Diverticula (자동절제 대장 용종의 임상 양상: 연소성 용종 및 멕켈 게실과의 비교)

  • Kim, Jae-Young;Park, Jae-Hong;Choi, Gwang-Hae;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.10-15
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    • 2009
  • Purpose: The manner of rectal bleeding of auto-amputated polyps (AP) is similar to juvenile polyps (JP) or Meckel's diverticula (MD). We conducted this study to characterize the clinical spectrum of AP. Methods: Fourteen patients were enrolled this study who were diagnosed AP due to painless rectal bleeding. The clinical data of AP was assessed and then compared with the clinical data of JP and MD retrospectively. Results: The prevalence of AP was 10.4% (14/135) and high in younger patients compared with that of JP (p=0.042 below 2 years). Whereas JP was more common in patients aged 2 to 5 years (p=0.005). Male was predominant in AP (p=0.008 AP vs JP). The manner of rectal bleeding in AP group was sudden and transient. There was no significant difference in time interval between onset of rectal bleeding and diagnosis between the 3 groups. However AP was diagnosed in 9 patients (64.3%) within 7 days after onset of rectal bleeding, but JP was diagnosed in 5 patients (4.1%) in the same period (p<0.001). All of AP were located in the rectum and the sigmoid colon. The mean hemoglobin was 11.3${\pm}$1.5 g/dL in AP, 11.8${\pm}$1.3 g/dL in JP, and 8.4${\pm}$1.2 g/dL in MD (p<0.001, only significant in MD). Conclusion: AP may be considered in male older than 1 year with transient and sudden onset or increase of painless rectal bleeding without drop of hemoglobin level.

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A Follow-up Study of Fertility and Pregnancy Wastage of Women in Rural Area (추적조사에 의한 농촌 여성의 출산력과 임신소모율)

  • Park, Jung-Han;Kim, Sin-Hyang;Chun, Byung-Yeol;Kim, Gui-Yeon;Yeh, Min-Hae;Cho, Seong-Eok;Cho, Jae-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.21-30
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    • 1988
  • To measure the fertility rate and pregnancy wastage of women in rural area, 3,780 married women under 50 years old who were not sterilized either woman or husband in Gunwee county were followed up for 2 years. Seventeen Myun health workers visited these women periodically to check the status of their family planning practice and menstruation. Pregnant women were interviwed for their past obstetric history and followed up to the time of delivery. Family planning was practiced in 51.6% of the 6,826 women-years observed during the period from April 1, 1985 to March 31, 1987. Pregnancy, abortion and delivery covered 7.6% of the observed women-years and family planning was not practiced in 36.5% of the women-years. When sterilized women at the beginning of the study were included, the family planning practice rate was 72.1% which was slightly higher than the national family planning practice rate. However, 28% of the women of 30-39 years old had not practiced family planning although they had 2-3 children and they used more such less effective methods as safe-period method and condom than the women of 20-29 years old. Overall pregnancy rate was 14.3 per 100 woman-years. Women of 25-29 years old had the highest pregnancy rate of 27.4 per ,100 woman-years. Pregnancy wastage including spontaneous and induced abortions and still births was 22.0% of all pregnancies and it increased with the age of women; 15.8% in women less than 30 years old and 43.7% in women of 30 years and over. Women who terminated the pregnancy with induced abortion had more pregnancies, more previous induced and spontaneous abortions and shorter pregnancy interval than those women who terminated with live birth. Pregnant women terminated with a live birth had received 4.2 prenatal cares on the average. Eighty-five percent of deliveries occurred at a medical facility and 15% at home which was substantially lower home delivery rate than the other rural area of Korea. This may be due to the effects of the demonstration project for the primary health care in 1970s in Gunwee county. These findings suggest that family planning service in rural area should be strengthened by promoting the use of more effective contraceptive method among women over 30 years of age.

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