• Journal of Chest Surgery
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• 제25권7호
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• pp.685-692
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• 1992

In spite of multiple technical advances, large amount of homologous blood transfusions usually required for open heart surgery. Because the complications associated with transfusion are increased as the number of homologous transfusion increase, especially as transfusion related acquired immunodeficiency syndrome has appeared in recent years, such risks have stimulated recent interest in the use of autologous blood. This is a report concerning 23 consecutive adult autologous donors[autologous group] who had elective cardiac surgery at the Yonsei Cardiovascular Center, Yonsei University College of Medicine, from march, 1990 to august, 1991. A similar group of 23 patients operated during the same periods without autologous blood donation was used for comparison [control group] to investigate the effect of predonated autologous blood in decreasing the need of homologous transfusion and to investigate predonation related adverse effect. Autologous group consisted of 15 men and 8 women. Control group consisted of 7 men and 16 women. There were no significant differences in mean age, hemoglobin, hematocrit, RBC count, platelet count and prothrombin time on admission between the two groups. The mean autologous blood donation in autologous group was 2.2 units. In 10[43.5%] of the 23 atuologous group patients, no homologous RBC products transfusion was required. However, all patients required homologous transfusion in control group. In autologous group, patients required less homologous RBC products than control patients[2.1 units versus 5.3 units; p<0.001]. There were no significant differences in hemoglobin, hematocrit, RBC count and platelet count between the two groups before discharge. There were no serious complications related to preoperative blood donation, although 3 patients complained of mild dizziness during donation We conclude that preoperative autologous predonation of blood is a safe and effective method for reducing homologous transfusion and is recomended in all patients undergoing elective cardiac surgery except limited contraindications such as severe aortic valve stenosis or unstable angina pectoris.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.395-407
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• 2022

Purpose: This study aimed to investigate the relationship between clinical and laboratory parameters and complication status to predict which patients can be safely discharged from the hospital on the third postoperative day (POD). Materials and Methods: Data from a prospectively maintained database of 2,110 consecutive patients with gastric adenocarcinoma who underwent curative surgery were reviewed. The third POD vital signs, laboratory data, and details of the course after surgery were collected. Patients with grade II or higher complications after the third POD were considered unsuitable for early discharge. The performance metrics were calculated for all algorithm parameters. The proposed algorithm was tested using a validation dataset of consecutive patients from the same center. Results: Of 1,438 patients in the study cohort, 142 (9.9%) were considered unsuitable for early discharge. C-reactive protein level, body temperature, pulse rate, and neutrophil count had good performance metrics and were determined to be independent prognostic factors. An algorithm consisting of these 4 parameters had a negative predictive value (NPV) of 95.9% (95% confidence interval [CI], 94.2-97.3), sensitivity of 80.3% (95% CI, 72.8-86.5), and specificity of 51.1% (95% CI, 48.3-53.8). Only 28 (1.9%) patients in the study cohort were classified as false negatives. In the validation dataset, the NPV was 93.7%, sensitivity was 66%, and 3.3% (17/512) of patients were classified as false negatives. Conclusions: Simple clinical and laboratory parameters obtained on the third POD can be used when making decisions regarding the safe early discharge of patients who underwent gastrectomy.

• 한국안전학회지
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• 제19권4호
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• pp.141-149
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• 2004

가솔린 엔진을 장착한 자동차는 고전압발생장치인 점화코일을 이용하여 고전압을 발생 연소실 내의 혼합기를 점화 및 연소시킴으로써 동력을 얻고 엔진을 구동하게 된다. 점화코일은 1차측 낮은 전압을 스위칭 작용으로 2차측 높은 전압을 발생시키고, 이를 전극으로 보내는데, 점화코일에 작은 결함이 발생하게 되면 제 성능을 발휘하지 못한다. 본 연구에서는 현재 사용하고 있는 에폭시 성형 점화코일과 절연재료인 에폭시수지를 시료로 선택하여 시료에 전압이 인가될 때 발생하는 부분방전 특성을 측정하여 전압변화에 따른 위상각, 방전전하량 및 발생빈도 수 등의 분포를 연구하고 검토한 결과를 실제 자동차점화장치에 접목시켜 점화코일의 성능향상과 전기장치의 신뢰성 확보에 기여하고자 한다.

• 한국전기전자재료학회논문지
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• 제28권12호
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• pp.831-836
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• 2015

This paper dealt with the PD (partial discharge) characteristics produced by metallic particles presented in a gas insulated switchgear. Four types of metallic particles such as a ball, a trapezoid, a rectangle, and a twist were fabricated and placed in a PD cell filled with $SF_6$ gas. PD pulses were detected through a $50{\Omega}$ non-inductive resistor. Calibration was carried out according to IEC 60270 and the sensitivity was calculated as 4 mV/pC. Apparent charge, pulse count, DIV (discharge inception voltage), DEV (discharge extinction voltage), and TRPD (time resolved partial discharge) were analyzed. Among the metallic particle types, the twist frequently occurred PD pulse at the lowest DIV, while the rectangle showed the highest. DEV of the twist was about 2 times lower than that for the rectangle. Kurtosis of ball clustered at high value, and skewness of other three metallic particles distributed at low value. TRPD showed different distribution by metallic particle types.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.670-673
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• 2009

Purpose: Epidural abscesses and subdural empyemas after craniotomy are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage and dural reconstruction in these patients are challenging. Methods: A 28 - year - old female patient showed recurrent intracranial infection after craniotomy for evacuation of a arachnoid cyst and subdural hematoma. Despite prolonged systemic antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated WBC count, CSF leakage, low CSF glucose level, and purulent wound discharge. The authors removed the previously applied lyophilized dura and transferred free omental flap to reconstruct the dura, obliterate the cyst and cover the cerebral hemisphere in the craniotomy defect. Microvascular anastomosis was between gastroepiploic and superficial temporal vessels. Results: The postoperative course was uneventful and flap survival was excellent. The infection - resistant omental tissue allowed sufficient blood circulation and dead space control. The patient was discharged 1 month after surgery and wound discharge or recurrence was absent during 13 months of follow up periods. Conclusion: The use of vascularized free omentum proved useful in cases of intractable cranial wound infection and cerebrospinal fluid leakages.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.75-83
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• 2018

목적: 호스피스 완화의료에서 환자의 기대 여명 예측뿐 아니라 퇴원형태를 예측하여 적절한 치료를 제공할 필요가 있다. 이번 연구에서는 입원 초기 환자의 퇴원 형태 예측에 유의한 요소들을 알아보고 효율적인 완화의료의 방향에 대해 제시하고자 한다. 방법: 2016년 4월 1일부터 2017년 12월 31일까지 P병원 호스피스 병동에 입원한 말기암환자 568명 중 377명을 대상으로 하였으며 입원 시 사정한 환자의 수행 지수, 증상 및 징후, 사회 경제적 상태와 혈액검사 자료를 바탕으로 연구를 진행하였다. 결과: 입원 당시 높은 수행지수, 양호한 증상 및 징후, 정상에 가까운 혈액검사 수치를 보일 때 생존 퇴원할 가능성이 높았다. 결론: 환자의 퇴원형태 예측에 ECOG, KPS, Global health, Mental status와 같은 수행지수, dyspnea, anorexia, dysphagia, fatigue와 같은 증상 및 징후, CBC, LFT, BUN, CRP 혈액검사 수치가 유의한 지표임을 확인하였다.

• 한국산학기술학회논문지
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• 제20권11호
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• pp.121-129
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• 2019

본 연구의 목적은 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자에게 계획된 퇴원 간호 중재 지침을 개발하여 적용한 후 약물복용 이행도, 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과를 확인하기 위한 것이다. 서울 소재 K 종합병원에서 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자를 대상으로 자료수집 기간은 2010년 3월 16일부터 12월 31일까지이며, 실험군 29명, 대조군 30명이 연구 대상자로 참여하였다. 계획된 퇴원 간호 중재 지침은 포괄적인 문헌 고찰과 임상 경험을 바탕으로 개발되었다. 계획된 퇴원 간호 중재는 흉부외과 간호사가 3회 실시하였으며 1회 교육시간은 약 30~40분 정도가 소요되었다. 연구결과 계획된 퇴원 간호 중재 제공 후 치료 지시 이행도는 유의한 차이가 없었다. 그러나 복약순응도(t=-2.05, p=.044), 약알 세기 약물 이행도(t=-2.61, p=.011), 질병에 대한 지식(t=-4.39, p=.001), 간호 만족도(t=-4.13, p=.001)는 유의한 차이가 있었다. 본 연구에서 계획된 퇴원 간호 중재의 제공은 기흉 진단으로 수술을 시행 받은 환자를 위한 임상에서 적용 가능한 효과적인 간호 중재임을 확인하였다. 합병증이나 재발과 같은 장기적 영향을 평가하기 위한 종단적 연구가 필요하다.

• Journal of Nutrition and Health
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• 제27권8호
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• pp.844-855
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• 1994

The purpose of this study is to investigate the nutritional status and dietary intake of gastrectomized cancer patients. For this study, from 1993. 1 to 1993. 8, 50 postoperative gastric cancer patients were selected to examine anthropometric and laboratory data(Body Weight, Body Fat, serum Albumin, Total Lympocyte count), and dietary intake related symptoms. The results were 1) All anthropometric and laboratory data were significantly deteriorated by gastrectomy(s-Albumin, TLC. Body Fat : p<0.001). Weight loss of gastrectomized patients was 8.23$\pm$3.72% from admission to discharge. 2) In many gastrectomized cancer patients, preoperative dietary intake was decreased by abdominal discomfort, indigestion, early satiety, and anorexia. 3) Postoperative energy intake was 602$\pm$158㎉, and it is correspond to 31.18$\pm$.90% of daily energy requirement(1918$\pm$236㎉). The cause of poor oral intake is mostly fear, abdominal distension and fullness, and early satiety. In consideration of the fact that an inadequate energy intake was the main cause of the decreasing nutritional status, a careful nutritional care and dietary education is necessry after gastrectomy.

• 한국전기전자재료학회:학술대회논문집
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• 한국전기전자재료학회 1998년도 춘계학술대회 논문집
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• pp.285-288
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• 1998

Ultrasonic signal characteristics related with the growth of electrical trees in epoxy resin are examined under 67[Hz] ac voltage application along with a CCD camera and PD current method. The ultrasonic sensor with a resonant frequency of 200[Hz] supported by a mechanical spring is attached directly to the lower-side of plane electrode. The magnitude of Partial discharge and count rate of ultrasonic signals have been measured according to the tree growth from a needle tip in an epoxy sample.

• 한국전기전자재료학회:학술대회논문집
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• 한국전기전자재료학회 1997년도 추계학술대회 논문집
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• pp.381-384
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• 1997

This paper describes the method of diagnosing the degradation by void defects of insulator inside in operation. Needle-shape void specimens, made from LDPE, were used to generate an electrical tree under ac voltage. The method uses a neural network system with input signal of AE patterns. AE pattern consists of the pulse count and average amplitude according to the phase angle. After the learning process was over, unknown emission patterns were put into the network. It was shown that the network discriminates the void deflects well. The effectiveness of the neural network system for partial discharge recognition was shown.