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The Surgical Treatment of Atrial Fibrillation in Patients Undergoing Simultaneous Open Heart Surgery (심장세동의 수술요법)

  • Kim, Gi-Bong;Lee, Chang-Ha;Son, Dae-Won
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.287-292
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    • 1997
  • .Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.

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A Study on The Performance and Fuel Economy of Diesel Vehicles According to Change in Fuel Properties (연료물성에 따른 경유 차량의 성능 및 에너지소비효율 연구)

  • Noh, Kyeong-Ha;Lee, Min-Ho;Kim, Ki-Ho;Lee, Jung-Min
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.3
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    • pp.667-675
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    • 2018
  • Increasing emissions regulations and demand of high-efficiency cars that travels a lot of distance with less fuel, there is growing interest in Energy Consumption Efficiency. Korean energy consumption efficiency compute combined Fuel Economy by driven city & highway driving mode and present final Energy Consumption Efficiency as using 5-cycle correction formula. Energy consumption efficiency is computed Carbon-balance-method, when used burning fuel play a key role in vehicle performance & Energy Consumption Efficiency. In Korea, vehicle fuel is circulate by Petroleum and Petroleum Alternative Business Act, there is property difference in quality standard because petroleum sector's refine method or type of crude oil. It does not appear a big difference according to fuel, because it sets steady quality standard, it may affect the performance of automobile. Thus, in research We purchase a few diesel fuel which circulated in the market in summer season though directly-managed-gas station by petroleum sector, resolve property each of fuel, we compute Fuel Economy each of them. We analyze into change depend on applying for property as nowadays utilizing Energy Consumption Efficiency calculating formula of gasoline and diesel fuel. As result, Density each of sample fuel has a maximum difference roughly 0.9%, net heat value each of sample fuel has difference 1.6%, result of current Energy Consumption Efficiency each of sample fuel has a difference roughly 1% at city drive mode, 1.4% at highway drive mode. Result of use gasoline calculator formula shows less 6% result than nowadays utilizing Energy Consumption Efficiency calculating formula, each of sample's Energy Consumption Efficiency shows maximum roughly 1.4% result in city & highway drive mode.

AN EXPERIMENT ON THE HEARING OF RAINBOW TROUT IN THE INDOOR AQUARIUM IN BUSAN (부산지방에서 실내수조를 이용한 무지개송어의 사육실험)

  • KIM In-Bae;JO Jae Yoon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.10 no.4
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    • pp.267-273
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    • 1977
  • Rainbow trout were reared in a small indoor aquarium which was equipped with a simple recirculating biofilter combined with a small amount of inflowing water for 199 days from April 25 to November 10, 1977 in Busan where very hot summer air temperature is encountered, and results obtained were promissing as following; 1. The aquarium has dimensions of $1m\;\times\;1m\;\times\;67cm(depth)$, and a bottom center sedimentation chamber of conical type through which out-flowing water is pushing fecal matter and other detritus outward. The conical sedimentation chamber measures 20 cm depth and 20 cm diameter at its upper mouth and tapers to the bottom end which is connected to 4 cm diameter draining pipe. The draining pipe goes through under the tank and then is elevated on the side. The water depth was maintained at about 40 cm depth by adjusting the heigh of draining pipe. The filter bed contained 16 l of $3\~5\;mm$ zeolite gravels, and water circulation rate was about 1030 l/hr. 2. Continuous inflowing water resulted in a good elimination of waste materials through its outflowing water thus reducing waste loading in the filter. 3. Mean temperature of water in the rearing aquarium containing about 400 l water volume was maintained at around 20 to $22^{\circ}C$ by 0.59 l/min of the inflowing well water which usually maintained the temperature of $17^{\circ}C$ during the hot summer season from the first of July to the first of October when the 10-days-mean air temperature ranged from $20^{\circ}\;to\;27.3^{\circ}C$ $(total\;mean\;24.6^{\circ}C) $ and under this condition the fish continued normal growth. 4. The production per 1 l/min of inflowing water with this simple biofilteration reached 30 hg. 5. The total cost including all feed and power during this experimental rearing period fell well within the economic establishment and if the feed and filteration system are improved the benefit-cost ratio will be much increased.

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The Related Factors of Safety Behaviors and Accident in Elementary School Children (초등학생의 안전행동 및 사고 관련 요인)

  • Kim, Kyung-Sook;Lee, Moo-Sik;Hong, Jee-Young;Hwang, Hye-Jeong;Bae, Seok-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.288-293
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    • 2011
  • This study was conducted to investigate the elementary school students' consciousness of safety, activities to prevent their accidents and factors causing such accidents. For this aim, a research was conducted from Nov. 19 through Dec. 22, 2007 by means of questionnaires distributed to 800 students enrolled in the 5th and 6th grades of 4 elementary schools in a urban-rural combined city. Out of the questionnaires distributed, 785 were collected and put to analysis by using SPSS 13.0 program to determine t-test, ANOVA, logistic regression, etc. 1. The maximum scores of safety consciousness revealing relatively high level of safety consciousness. There was, however, statistically significant difference by grade, type of residence, school life and academic achievements. In detail, 5th graders featured higher level of safety consciousness and those who live in apartments, lead a pleasant life at school and get better academic scores tended to keep higher level of safety consciousness. 2. The subjects of the high scored of activities to prevent accidents, with a statistically significant difference by gender, grade and individual personality. Females, 5th graders and active students were found to be more conscious of preventive activities for accidents. 3. In general, 6th graders and active students turned out to have experienced more accidents. 4. The main factors exerting influence on occurrence of accidents on the part of elementary school students are known to be preventive actions and consciousness of traffic safety in the category of safety consciousness. The significant variable in preventive actions was preventive actions of traffic accidents, burns and intoxication by category of accidents, but individual personality by category of general characters. Sixth graders and male students experienced more accidents, without significantly significant difference, though. As a result, From the above findings, prevention of safety accidents is found to be very important for elementary school students. It is therefore suggested that schools as well as homes should continue to conduct practical education to prevent accidents with priority placed on familiarizing students with preventive activities in daily life in consideration of their personal characters.

The Effects of Hyperglycemia and Hyperlipidemia on Muscle Glycogen Utilization during Exercise in Rats (흰쥐에서 고혈당 및 고지질혈증이 운동 중 골격근 당원이용에 미치는 영향)

  • Ahn, Jong-Chul;Lee, Dong-Woo;Shon, Oog-Jin;Lee, Seuk-Kang
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.34-42
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    • 1999
  • The effects of hyperglycemia and hyperlipidemia on utilization of muscle glycogen during 45 minute Session of treadmill running(26 m/min, 8% grade) were evaluated using Sprague Dawley rats, and the characteristics of the 4 different type of muscles, I.e., soleus, white and red gastrocnemius, and plantaris, on glycogen utilization were simultaneously investigated. Hyperglycemia was induced by 145-165 mg/dL of oral glucose administration, and hyperlipidemia was induced by combined treatment of intraperitoneal heparine injection of 444 uEq/L and 10 % intralipose oral adminstration. During the hyperglycemic trial, the glycogen utilization of plantaris muscle was decreased by 13 % in 45 minute session of treadmill running compared to the control trial(p<0.05), and the glycogen utilization of white gastrocnemius was also decreased. The sparing tendency of glycogen was observed in soleus and red gastrocnemius by 5-13 % during 30 and 45 minute session of treadmill running in hyperglycemic trial. There was no glycogen sparing effect of hyperlipidemia in soleus, red gastrocnemius and plantaris muscle subjected in this experiment during exercise. However, only a slight sparing tendency of white gastrocnemius muscle was observed. In summary, the glycogen sparing effect of hyperglycemia during exercise was observed in plantaris and white gastrocnemius muscles in rats. However, there was no glycogen sparing effect of hyperlipidemia in the 4 hindlimb muscles. It was observed that the glycogen sparing effect of hyperglycemia is more prominent in fast glycolytic muscle fibers.

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Sleep Duration and Cancer Risk: a Systematic Review and Meta-analysis of Prospective Studies

  • Zhao, Hao;Yin, Jie-Yun;Yang, Wan-Shui;Qin, Qin;Li, Ting-Ting;Shi, Yun;Deng, Qin;Wei, Sheng;Liu, Li;Wang, Xin;Nie, Shao-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7509-7515
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    • 2013
  • To assess the risk of cancers associated with sleep duration using meta-analysis of published cohort studies, we performed a comprehensive search using PubMed, Embase and Web of Science through October 2013. We combined hazard ratios (HRs) from individual studies using meta-analysis approaches. A random effect dose-response analysis was used to evaluate the relationship between sleep duration and cancer risk. Subgroup analyses and sensitivity analyses were also performed. Publication bias was evaluated using Funnel plots and Begg's test. A total of 13 cohorts from 12 studies were included in this meta-analysis, which included 723, 337 participants with 15, 156 reported cancer outcomes during a follow-up period ranging from 7.5 to 22 years. The pooled adjusted HRs were 1.06 (95% CI: 0.92, 1.23; P for heterogeneity =0.003) for short sleep duration, 0.91 (95% CI: 0.78, 1.07; P for heterogeneity <0.0001) for long sleep duration. In subgroup analyses stratified by cancer type, long duration of sleep showed an inverse relation with hormone-related cancer (HR=0.79; 95% CI: 0.65, 0.97; P for heterogeneity =0.009) and a greater risk of colorectal cancer (HR=1.29; 95% CI: 1.09, 1.52; P for heterogeneity =0.346). Further meta-analysis on dose-response relationships showed that the relative risks of cancer were 1.00 (95% CI: 0.99, 1.01; P for linear trend=0.9151) for one hour of sleep increment per day, and 1.00 (95% CI: 0.98, 1.01; P for linear trend=0.7749) for one hour of sleep increment per night. No significant dose-response relationship between sleep duration and cancer was found on non-linearity testing (P=0.5053). Our meta-analysis suggests a positive association between long sleep duration and colorectal cancer, and an inverse association with incidence of hormone related cancers like those in the breast. Studies with larger sample size, longer follow-up times, more cancer types and detailed measure of sleep duration are warranted to confirm these results.

Change of Dose Exposure and Improvement of Image Quality by Additional Filtration in Mammography (유방촬영용장치 부가필터에 따른 선량변화 및 화질개선)

  • Cho, Woo Il;Kim, Young Kuen;Lee, Gil Dong
    • Journal of Radiation Protection and Research
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    • v.38 no.2
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    • pp.78-90
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    • 2013
  • Recently, the interest on exposure to radiation is rising. The radiation exposure of mammography is higher in absorbed dose than of X-ray, therefore unnecessary exposure needs to be reduced, and higher image quality is needed. Generally, ray quality of the radiation imaging is an important factor that determines image quality and the amount of ray exposure, and they are affected by tube voltage and added filter. The X-ray energy that is exposed from mammography device is generally a continuous spectrum, which includes low energy that has minute influence on the image quality, and high energy that hinders contrast on image. Currently, molybdenum (Mo) and rhodium (Rh) are the most used added filters for mammography device, and they are used differently according to the energy region of X-ray. This study aims to find out the degree of reduction in exposure dose according to the thickness of aluminum (Al), and to study the changes in image quality and dose when the added filter plates that are made with niobium (Nb) or zirconium (Zr) are used, other than molybdenum (Mo) and rhodium (Rh), the two most used added filters that have similar atomic number and K-absorption regions as Nb and Zr. In this study, single-added filters of molybdenum (Mo), niobium (Nb), and zirconium (Zr) are used, and in some cases, Aluminum (Al) is combined with the single filters. In this case, image quality is considered to be improved depending on the type of added filters, and by using Aluminum (Al) filter together with the others, unnecessary X-ray of low energy would be absorbed, therefore the dose is expected to decrease without any influence when the concentration level becomes identical.

Results of Treatment for Children with Primary Brain Tumors : Long-Term Follow Up Results of a Single Institute (소아 원발성 뇌종양의 치료 결과 : 단일 기관에서의 장기간 추적 관찰)

  • Choi, Sung-Yeon;Won, Sung-Chul;Lyu, Chuhl-Joo;Oh, Seung-Hwan;Yang, Chang-Hyun;Suh, Chang-Ok;Choi, Joong-Uhn;Kim, Byung-Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1016-1023
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    • 2002
  • Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.

Quantitative Comparisons in $^{18}F$-FDG PET Images: PET/MR VS PET/CT ($^{18}F$-FDG PET 영상의 정량적 비교: PET/MR VS PET/CT)

  • Lee, Moo Seok;Im, Young Hyun;Kim, Jae Hwan;Choe, Gyu O
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.68-80
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    • 2012
  • Purpose : More recently, combined PET/MR scanners have been developed in which the MR data can be used for both anatometabolic image formation and attenuation correction of the PET data. For quantitative PET information, correction of tissue photon attenuation is mandatory. The attenuation map is obtained from the CT scan in the PET/CT. In the case of PET/MR, the attenuation map can be calculated from the MR image. The purpose of this study was to assess the quantitative differences between MR-based and CT-based attenuation corrected PET images. Materials and Methods : Using the uniform cylinder phantom of distilled water which has 199.8 MBq of $^{18}F$-FDG put into the phantom, we studied the effect of MR-based and CT-based attenuation corrected PET images, of the PET-CT using time of flight (TOF) and non-TOF iterative reconstruction. The images were acquired from 60 minutes at 15-minute intervals. Region of interests were drawn over 70% from the center of the image, and the Scanners' analysis software tools calculated both maximum and mean SUV. These data were analyzed by one way-anova test and Bland-Altman analysis. MR images are segmented into three classes(not including bone), and each class is assigned to each region based on the expected average attenuation of each region. For clinical diagnostic purpose, PET/MR and PET/CT images were acquired in 23 patients (Ingenuity TF PET/MR, Gemini TF64). PET/CT scans were performed approximately 33.8 minutes after the beginnig of the PET/MR scans. Region of interests were drawn over 9 regions of interest(lung, liver, spleen, bone), and the Scanners' analysis software tools calculated both maximum and mean SUV. The SUVs from 9 regions of interest in MR-based PET images and in CT-based PET images were compared. These data were analyzed by paired t test and Bland-Altman analysis. Results : In phantom study, MR-based attenuation corrected PET images generally showed slightly lower -0.36~-0.15 SUVs than CT-based attenuation corrected PET images (p<0.05). In clinical study, MR-based attenuation corrected PET images generally showed slightly lower SUVs than CT-based attenuation corrected PET images (excepting left middle lung and transverse Lumbar) (p<0.05). And percent differences were -8.01.79% lower for the PET/MR images than for the PET/CT images. (excepting lung) Based on the Bland-Altman method, the agreement between the two methods was considered good. Conclusion : PET/MR confirms generally lower SUVs than PET/CT. But, there were no difference in the clinical interpretations made by the quantitative comparisons with both type of attenuation map.

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A Study on the Effect of Cold Application Using a Sponge Bath in Healthy Adults (냉요법 적용방법에 따른 냉요법 효과에 관한 연구-건강한 성인 여성에서 스폰지 목욕방법을 중심으로)

  • Chung, Hyun-Sook;Kang, Kyu-Sook;Hwang, Ae-Ran
    • The Korean Nurse
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    • v.28 no.3
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    • pp.68-82
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    • 1989
  • This study was a quasi-experimental research study to test the characteristics of temperature regulation according to sponge bath methods of cold application. Thirteen volunteers were selected from among nursing college students according to an established criteria using a purposive sampling technique. Four different cold application methods were used: $\circled1$ tepid water sponge bath at $28^{\circ}C$, $\circled2$ 20% alcohol sponge bath at $28^{\circ}C$, $\circled3$ 40% alcohol sponge bath at $28^{\circ}C$ and $\circled4$ tepid water sponge bath at 28$^{\circ}$C plus an ice bag to the head. Changes in rectal temperature, mean skin temperature, mean body temperature, heat content change and thermal discomfort during the cold application were measured at 5 minute intervals over a 120 minute period. The data collection period was from Dec. 20, 1988 to Feb. 3, 1989. The data were analyzed using descriptive statistics, simple regression, ANOVA, Duncan's multiple range test and Pearson correlation coefficient using the SPSS-X Program. The results of the study are summarized as follows. Five general hypothesis were tested. Hypothesis 1 that "Change in heat content will be decreased for each cold application method according to the cold application time" was rejected. (tepid water sponge bath: after 10 minutes of cold application, 20% alcohol sponge bath: after 25 minutes of cold application: 40% alcohol sponge bath: after 45 minutes of cold application, tepid water sponge bath plus an ice bag to the head: after 80 minutes of cold application) Hypothesis 2 that "Thermal discomfort will be changed for each cold application method according to the cold application time" was rejected after 5minutes of cold application. Hypothesis 3 that "Change in heat content will differ among the cold application methods" was accepted except 0~5, 0~10, 0~65, 0~105 and 0~120 minute. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 4 that "Thermal discomfort will differ among the cold application methods" was accepted at 15, 20, 35, 45, 75, 80, 90, 95, 100, 105, 110, 115 and 120 minute of cold application time. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 5 that "The higher the change in heat content, the higher the thermal discomfort during the cold application time" was accepted for between 10~60 and 75 minute of cold application. In conclusion, this study showed that in sponge bath at $28^{\circ}C$, 10~80 minute was a effective cold application time in the view of heat loss through the skin. Concerning the effects of evaporation and thermal discomfort, it was found that there was no difference with regard to the solutions; tepid water sponge bath; 20% alcohol sponge bath or 40% alcohol sponge bath at a $28^{\circ}C$ controlled solution temperature. So it was thought that the type of solution itself did not have a big influence on the heat loss through skin. The combined effect of sponge bath with an ice bag to the head showed a significant difference and also showed a slight increase in thermal discomfort. On the basis of this research it can be concluded that cold application, for example, an ice bag to the head during a tepid water sponge bath is a good method as it increase heat loss through conduction, although fit can also cause a slight increase in thermal discomfort. The correlation between changes in heat content and thermal discomfort were not high. So factors other than change in heat content are considered to have an effect on the cognition of thermal discomfort.

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