• 제목/요약/키워드: mortality improvement

검색결과 337건 처리시간 0.026초

농흉의 임상적 연구 (Clinical study of empyema thoracis)

  • 남구현
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.171-175
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    • 1983
  • The authors made a clinical study of 107 cases of empyema who were treated at Department of Thoracic Surgery of Chungnam National University Hospital during the period of Jan. 1976 through Aug. 1982 and compared the empyema of infant and children with that of adults. Following was the remits: 1. Male was predominant to female with the ratio of 2.5 to 1 and adult to infant was 2.6 to 1. 2. The cardinal symptoms were dyspnea, coughing, chest pain and fever. 3. Positive remit of bacteriological culture study was reported in 57% and the most common causative organism was staphylococcus in infant and childhood, E. coil in adult. 4. Most frequent predisposing factors of thoracic empyema in infant and childhood was pneumonia [53%], and in adult was pulmonary tuberculosis [40%]. 5. Treatment were combined with antibiotics therapy and several surgical procedures for empyema. 24 cases [22.4%] required open thoracotomy. 6. The mortality rate was 7.4% [8/107]. 86 cases [80.4%] were discharged with recovery and improvement.

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선천성 대동맥협착증 수술치험 14례 보 (Surgical correction of congenital aortic stenosis - Report of 14 cases -)

  • 조범구
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.710-714
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    • 1987
  • Over the past 6 years, from July, 1981. through June, 1987., 14 consecutive patient with congenital aortic stenosis underwent corrective surgery in our department of Thoracic and Cardiovascular Surgery. The patient ranged in age from 1 to 20 years. There were 8 male and 6 female patients. According to the operative findings, stenotic site was valvular stenosis [5 cases], subvalvular stenosis [5 cases], supravalvular stenosis [2 cases], valvular and supra valvular stenosis [1 case]. We have performed valvotomy and commissurotomy [5 cases]. Resection of subvalvular membrane [3 cases], patch enlargement of Ascending aorta [2 cases], LV myotomy [2 cases], valvotomy and excision of membrane [1 case], patch enlargement of ascending aorta and valve ring [1 case]. There was one hospital mortality [7.1%]. He died of C-I bleeding and sepsis on the 25th postoperative day. All survivors showed improvement in NYHA functional class in the 160 patient/month follow up period.

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어독성 시험에 의한 그라우팅재의 수질오염 평가 (The Evaluation of Toxic Effect of Grouting Materials by Fish Poison Test)

  • 천병석;김진춘;이영근
    • 한국지하수토양환경학회:학술대회논문집
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    • 한국지하수토양환경학회 1998년도 공동 심포지엄 및 추계학술발표회
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    • pp.156-161
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    • 1998
  • As grouting materials for ground improvement, silicate materials such as water glass, silica-sol and so forth are used worldwide. However, they may pollute underground water. In this study, fish poison test(Korean standard industrial code KS M 0111) which estimates toxicity for fish is applied to evaluate the toxic effect by grouting materials. From the test result of the sample made of LW, LC50(Median Lethal Concentration) reaches within 24 hours. In case of the silica-sol, it does not even in 96 hours. Therefore, we can conclude that the sililca-sol grouting method is more free from the danger of underground water pollution. From the result that the mortality of fish under the condition of pH 8.6 is 0% within 96 hours, the groundwater can be saved by controlling pH below 8.6 for the grouting in the field.

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바이러스성 새우질병 방제법의 개발 (Develoment of the Control System against Shrimp Viral Disease)

  • 허문수;손홍주
    • 생명과학회지
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    • 제8권5호
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    • pp.550-556
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    • 1998
  • 염소, 요오드, 담수처리에 의한 바이러스 병원성 약화 시험결과, 염소 5 ppm이상에서, 담수 50% 이상에서 살균효과를 나타내었으나 요오드는 효과가 없었다. Peptidoglycan, schzophyllan의 면역증강 효과를 시험한 결과, 각각 7일간 격 투여구와 2일간격 투여구에서 생존율이 대조군에 비해 높게 나타났다. 화학적, 효소적, 생물활균제를 투여하여 수질 및 저질 개선시험결과 화학적 개선제, Mg(OH)$_2$의 효과가 수질, pH, 강열감량 부분에서 효과가 가장 컸으며, 특이하게 효소적 개선제는 총 황화물의 농도를 약간 높이는 것으로 나타났다.

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고식적 단락술후 활로 4 징증의 완전교정수술 (Results of Two-stage Surgical Treatment of Tetralogy of Fallot)

  • 이재동;한승세;김규태
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.101-108
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    • 1988
  • Between July, 19S4. and July, 1987, 9 two-stage repair of symptomatic tetralogy of Fallot were carried out at the department of thoracic and cardiovascular surgery, Kyungpook national university hospital. Their age ranged from 5 years to 18 years [mean age 9.4 years] at the time of total correction, and there were improvement of systemic oxygen saturation values by 10% and decrease of hemoglobin by 1.6gm/dl after shunt procedures. The interval between the initial shunting procedure and total correction ranged for 7 to 101 months with a mean of 32.7 months. Four of these patients required patching of the infundibulum alone, three required patching of the right ventricular outflow tract across the pulmonary annulus, and valved conduit was used in one due to coronary artery anomaly. Aortic cross clamping time averaged 122.2minutes [range from 60minutes to 150minutes], and cardiopulmonary bypass time averaged 174.4 minutes [range from 80minutes to 300minutes]. The operative mortality rate was 22% [2/9].

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복잡심기형의 외과적 치료 (Surgical treatement of complex cardiac malformations)

  • 조형곤
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.122-133
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    • 1986
  • Thirteen patients with cyanotic cardiac malformations having more complex intracardiac defects, hemodynamics and operative procedures than ones in Tetralogy of Fallot undertaken total surgical corrections from July 1981 to August 1985. The cases of corrective surgery for complex cardiac malformations were 3.9% of all congenital cardiac malformations and 12.6% of cyanotic cardiac malformations. Six patients died within 30 days after surgery. So operative mortality was 46%; Transposition of the great arteries, two of 4 patients, due to low cardiac output syndrome and tracheal bleeding ; Univentricular heart, one of 3 patients, due to bleeding; Corrected transposition of the great arteries, one of 2 patients, due to acute heart failure; Tricuspid atresia, one of 2 patients, due to low cardiac output syndrome; Double outlet right ventricle, one of single patient, due to respiratory failure. The cases of surgical correction for complex cardiac malformations are progressively increasing in numbers. The more accurate evaluation of anatomical condition and hemodynamics in preoperative diagnosis, studies on applicable surgical procedure and perioperative care of patients are necessary in the improvement of clinical and surgical results.

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원발성 종격동 종양 및 낭종의 임상적 고찰 (Clinical Review of Primary Tumors and Cysts of the Mediastinum)

  • 장기경
    • Journal of Chest Surgery
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    • 제27권8호
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    • pp.689-694
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    • 1994
  • A retrospective analysis was performed on 36 patients with primary cysts and tumors of the mediastinum seen at the Department of Thoracic and Cardiovascular Surgery of Maryknoll Hospital from January 1983 to December 1993. There were 21 female and 15 male patients in the study. Ages ranges from 2 years to 72 years, with a mean of 34.7. There were 9 malignant tumors and 27 benign tumors.Thymic neoplasms were the most common. For the whole series, 29 of the patients had tumors in the anterior mediastinum. There appears to be an in6rease in tumors in the anterior compartment. There were 30 symptomatic patients in our series. Of the patients with malignant disease, 89 % were symptomatic. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation. There were 9[27.3 %] postoperative complications. There was no postoperative mortality. Follow-up was available on 27 patients. There was no recurrence, malignant degeneration, or growth of any tumor. It is hoped that careful evaluation and aggressive treatment of mediastinal tumors will continue to provide improvement in the prognosis for these patients.

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초저열량 식이와 한방비만치료를 통한 당뇨 개선 1례 보고 (Improvement of Type II Diabetes by Very-low-calorie Diet - A Case Report)

  • 김길수;김호준
    • 한방비만학회지
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    • 제2권1호
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    • pp.83-87
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    • 2002
  • Increasing body weight is closely associated with increasing risk for glucose intolerance and type II diabetes. Especially, abdominal distribution of weight and visceral obesity also seriously increase the morbidity and mortality. Dietary program including very-low-calorie diet(VLCD) is regarded as most effective in the control of obesity and diabetes, which mainly due to calorie restriction rather than weight loss itself. We are reporting a case of diabetes with obesity whose fast glucose was over 220 mg/dl and BMI was $25.1kg/m^2$(fat rate 32.8%, WHR 0.9). She was prescribed VLCD and oriental medical diet program. After 10 days of hospitalization, her glucose level dropped dramatically with 3kg loss of body weight She has further lost her weight until about 53kg, but the glucose level ceased to go down probably due to loosened calorie restriction.

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Various injury patterns due to combustion (typical but unfamiliar to physicians and easy to miss) in Korea: a case report

  • Hyung Il Kim
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.393-398
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    • 2023
  • Patients transported from fire sites may exhibit various injury patterns. Major trauma, skin burn, inhalation burn, and carbon monoxide poisoning are typical injuries. However, most physicians may be unfamiliar that cyanide poisoning can frequently occur due to combustion. Cyanide poisoning is highly significant owing to high mortality and the existence of antidotes. I present a 35-year-old man who was transported from a burning building and suffered severe metabolic acidosis despite no major bleeding as well as mild carbon monoxide poisoning. I suspected cyanide poisoning and administered the antidote; subsequently, the patient showed improvement. The next day, sudden airway obstruction developed, and emergency endotracheal intubation was performed. The inhalation damage was detected only in the lower airway tract and not in the upper airway. Physicians should be aware of cyanide poisoning and inhalation burn to avoid missing treatment opportunities.

관동맥우회술의 위험인자 분석 (Analysis of Risk Factors in Coronary Artery Bypass Surgery)

  • 정태은;한승세
    • Journal of Chest Surgery
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    • 제31권11호
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    • pp.1049-1055
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    • 1998
  • 연구배경 : 관동맥우회술은 허혈성 심질환의 중요한 치료법의 하나이다. 수술로 인한 합병증과 수술사망률은 최근 현저히 감소하고 있는 추세이나 아직도 개선이 필요하다 재료 및 방법 : 이 연구에서는 술전 및 수술 변수들을 위험인자로 설정하고 이들의 영향을 후향적으로 분석하였다. 1992년부터 1997년 까지 허혈성 심질환 환자에서 관동맥우회술을 시행한 86명을 대상으로 하였다. 대상환자들의 임상적 특징을 살펴보면 평균 나이는 58.6±8.4(36~74)세 였고 남자가 61명 여자가 25명 이었다. 수술 전 관동맥 풍선확장술 혹은 stent 삽입술을 시행한 환자는 14명이 있었다. 불안전성 협심증이 41례로 48%를 차지하였고 삼중혈관 질환이 45례로 52%를 차지하였다. 좌심실 조영술상 구축률이 저하된 경우(<35%)가 7례 있었다. 응급수술은 10례에서 시행되었다. 동반수술로 승모판막 치환술이 2례, 대동맥판막 치환술이 2례, 심방중격결손 봉합이 1례 그리고 심실중격결손 봉합 1례를 시행하였다. 관동맥우회술의 평균 원위부 문합수는 환자당 3.5개 였으며 대동맥 차단시간은 평균 115분이었다. 이 연구에서 분석지표로 사용된 변수들은 고령 (70세 이상), 여성, 저체표면적(1.5M2이하), 술전 관동맥풍선확장술 혹은 stent 삽입력, 고지혈증, 흡연력, 고혈압, 당뇨, 만성 폐쇄성폐질환, 긴급 혹은 응급수술, 좌주관동맥질환, 좌심실구축률의 저하(35%이하), 동반수술 등이었다. 결과 : 수술 사망은 총 7례 였으며 그 원인으로는 저심박출증이 5례, 내과적 치료에 반응하지 않는 심실성 빈맥이 1례 그리고 심장압전증이 1례 있었다. 수술 합병증으로 술후 심근경색과 뇌졸증이 각각 6례로 가장 많았으며 출혈로 인한 재수술이 5례, 급성 신부전증이 4례 그리고 위장관 합병증과 종격동염이 각각 3례 였다. 합병증 발생의 위험인자로서는 저체표면적, 당뇨병력 그리고 좌심실구축률의 저하가 통계적으로 유의하였으며(p<0.05) 사망률의 위험인자로는 좌심실구축률의 저하가 의미있게 분석되었다(p<0.05). 결론 : 관동맥우회술과 관련된 수술합병증의 위험인자는 저체표면적, 당뇨병력 그리고 좌심실구축률의 저하 등이 있었고 사망률의 위험인자는 좌심실구축률의 저하로 나타난 것으로 보아서 좌심실기능장애가 심하지 않은 상태에서의 수술이 필요하다고 생각된다.

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