• Title/Summary/Keyword: post-operation

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흉총창에 의한 심방파열 치험 2례

  • Lee, Doo-Yun;Kwack, Sang-Ryong
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.60-65
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    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

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Effect of low-dose Aprotinin on Postoperative Bleeding and Renal Function after Cardiopulmonary Bypass (체외순환후 출혈감소와 신기능에 미치는 저용량 aprotinin효과)

  • 박철현;현성열;이현재;박국양;김주이;임창영
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.32-39
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    • 1998
  • High-dose aprotinin(Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243$\pm$ 123 ml versus 406$\pm$303 ml(P=0.037) during 6 hours immediate-postoperatively, 494$\pm$358 ml versus 869$\pm$570 ml(P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference(55$\pm$23 versus 24$\pm$10 in the alpha-1-microglobulin/creatinine, 56$\pm$19 versus 38$\pm$25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.

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Serial $^{99m}Tc$-HMPAO Brain SPECT for Assessing Perfusion Improvement after EDAS in Moyamoya Patients (모야모야병에서 EDAS 수술효과의 평가를 위한 수술전후 $^{99m}Tc$-HMPAO SPECT의 유용성)

  • Lee, Kyung-Han;Lee, Sang-Hyung;Yeo, Jeong-Seok;Kwark, Chul-Eun;Chung, June-Key;Lee, Myoung-Chul;Cho, Byoung-Kyu;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.22-30
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    • 1994
  • Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with $^{99m}Tc$-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade I to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal lobes being the most frequently involved site. $4{\times}4$ pixel sized ROIs were applied on the frontotemporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as: PI (%)=average F-T activity/average cerebellar activity${\times}100$ Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean: $74.3{\pm}17%$) and increased significantly after operation ($81.4{\pm}17%$, p<0.001). Individual post-EDAS PI improved in 15/21 cases, showed no significant change in 5 and was slightly aggravated in 1. The amount of clinical improvement (${\Delta}CI$) was graded with a scale of 0 to 4 based on frequency and severity of TIA attacks. When patients were grouped according to pre-EDAS PI, group II (PI 70-89) showed a significantly higher ${\Delta}CI$ (3.3) compared to group I (PI< 70, 1.57) or group III (PI >90, 0.5) (P< 0.001). The amount of perfusion improvement (${\Delta}PI$) showed significant correlation with ${\Delta}CI$ (r=0.42, p=0.04). ${\Delta}PI$ did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

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A Study on the Application and Development of the Strategic Environmental Assessment(SEA) Model with Reference to Urban Comprehensive Plan (전략환경평가 모형의 개발과 적용에 관한 연구(I): 도시기본계획 평가를 중심으로)

  • Sung, Hyun-Chan;Kim, Kwi-Gon
    • Journal of Environmental Impact Assessment
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    • v.6 no.1
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    • pp.5-31
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    • 1997
  • Strategic Environmental Assessment (SEA) is an assessment process integrated with policy and planning processes considering environmental impacts, not at the level of individual project, but at higher level of policy and plan. Presently, two systems for the SEA are being implemented in Korea. One is "the consultation of environmental investigation into a change in national land utilization", which is to be pre-discussed with the head of the related central administrative organizations, based on the respective individual code. The other is "the consultation of environmental investigation into an administrative plan and project", which is to be pre-discussed with the minister of the environments for the administrative plan. However, these two systems are not integrated procedures with the planning process. In other words, there is a separate post-environmental assessment after planning. Also concrete proposal is not yet prepared for the method and procedure of environmental investigation about details of the planning. Therefore, they do not playa role in taking precautions for environmentally sustainable development. In this study, for the effective environmental investigation at the level of planning, environmental assessment model to be integrated with urban comprehensive plans was developed. The results of this study can be summarized as follows: First, based on the analysis of systematic problems in environmental investigation of this country, the study compared and analysed the SEA method of foreign countries. derived the potential limitations in its applications to this country. Also, the new method in this study, is integrated into planning process by improving the limitations. Thus, we developed the SEA model for this country, which consists of seven steps ; Phase 1; establishing a work program, Phase 2; defining the scop. of the SEA, Phase 3; analyzing an existing environmental situation, Phase 4; examining the consistency with environmental policy, Phase 5; appraising and synthesizing the plan content, Phase 6; proposing recommendations, Phase 7; monitoring and feedback. Second, the two types of application program of the developed assessment model were proposed. One is to integrate this model into planning process, and the other is for the institute and ministry of environments to implement SEA after planning. An aim of this study was developing an environmental assessment model at the planning level which was not yet established in this country and was to apply the model to urban comprehensive plan for inspection. This research will make the effective operation of environmental investigation system possible at the planning level in this country and contribute to the environmental protection at the global level.

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Effect of Type I Collagen on Hydroxyapatite and Tricalcium Phosphate Mixtures in Rat Calvarial Bony Defects

  • Kim, Jung-Hwan;Kim, Soung-Min;Kim, Ji-Hyuck;Kwon, Kwang-Jun;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.1
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    • pp.36-48
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    • 2008
  • To repair bone defects in the oral and maxillofacial field, bone grafts including autografts, allografts, and artificial bone are used in clinical dentistry despite several disadvantages. The purpose of this study was to evaluate new bone formation and healing in rat calvarial bone defects using hydroxyapatite (HA, $Ca_{10}[PO_4]_6[OH]_2,\;Bongros^{(R)}$, Bio@ Co., KOREA) and tricalcium phosphate (${\beta}-TCP,\;Ca_3[PO_4]_2$, Sigma-Aldrich Co., USA) mixed at various ratios. Additionally, this study evaluated the effects of type I collagen (Rat tail, BD Biosciences Co., Sweden) as a basement membrane organic matrix. A total of twenty, 8-week-old, male Sprague-Dawley rats, weighing 250-300g, were divided equally into a control group (n=2) and nine experimental groups (n=2, each). Bilateral, standardized transosseous circular calvarial defects, 5.0 mm in diameter, were created. In each experimental group, the defect was filled with HA and TCP at a ratio of 100:0, 80:20, 70:30, 60:40, 50:50, 40:60, 30:70, 20:80, and 0:100 with or without type I collagen. Rats were sacrificed 4 and 8 weeks post-operation for radiographic (standardized plain film, Kodak Co., USA), histomorphologic (H&E [Hematoxylin and Eosin], MT [Masson Trichrome]), immunohistochemical staining (for BMP-2, -4, VEGF, and vWF), and elementary analysis (Atomic absorption spectrophotometer, Perkin Elmer AAnalyst $100^{(R)}$). As the HA proportion increased, denser radiopacity was seen in most groups at 4 and 8 weeks. In general radiopacity in type I collagen groups was greater than the non-collagen groups, especially in the 100% HA group at 8 weeks. No new bone formation was seen in calvarial defects in any group at 4 weeks. Bridging bone formation from the defect margin was marked at 8 weeks in most type I collagen groups. Although immunohistochemical findings with BMP-2, -4, and VEGF were not significantly different, marked vWF immunoreactivity was present. vWF staining was especially strong in endothelial cells in newly formed bone margins in the 100:0, 80:20, and 70:30 ratio type I collagen groups at 8 weeks. The calcium compositions from the elementary analysis were not statistically significant. Many types of artificial bone have been used as bone graft materials, but most of them can only be applied as an inorganic material. This study confirmed improved bony regeneration by adding organic type I collagen to inorganic HA and TCP mixtures. Therefore, these new artificial bone graft materials, which are under strict storage and distribution systems, will be suggested to be available to clinical dentistry demands.

Rapid Detection of Enterotoxigenic Staphylococcus aureus by Polymerase Chain Reaction (중합효소 연쇄반응에 의한 식중독성 황색포도상구균의 신속한 검출)

  • Kim, Eun-Seon;Jhon, Deok-Young
    • Korean Journal of Food Science and Technology
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    • v.28 no.6
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    • pp.1001-1008
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    • 1996
  • Staphylococcal food poisoning is the major cause of bacterial food poisoning occurring in this country. Therefore government regulates commercial foods through Official Dictionary of Food that there should be free of enterotoxigenic Staphylococcus aureus in Korean rice cakes, bread, and a box lunch. Since at least 5 days are required to identify the S. aureus by the official method in the Dictionary it is difficult to prevent the food poisoning and the investigation of the outbreaks. In this report an improved determination method of the S. aureus has been developed using polymerase chain reaction (PCR) technique. Sense and antisense primers for specific amplification of genes encoding staphylococcal enterotoxins were designed and synthesized for the PCR. Rapid chromosomal DNA isolation method was also developed from S. aureus using lysostaphin. The PCR condition was developed as follows. Reaction solution $(50\;{\mu}l)$ consisted of target DNA $2\;{\mu}l$ (about 20ng), 10X buffer $5\;{\mu}l$, primer 100pmole, dNTP (10 mM) $4\;{\mu}l$ and Taq DNA polymerase 2.5 unit in a thin-wall tube. Operation condition of the PCR was 5 min pre-denaturation at $94^{\circ}C$, 15 sec denaturation at $94^{\circ}C$, 15 sec annealing at $50^{\circ}C$, 20 sec extension at $72^{\circ}C$, and 5 min post-extension at $72^{\circ}C$, and 30 cycles of denaturation-annealing- extension. Using the PCR with Perkin Elmer GeneAmp PCR system 2400, types of enterotoxigenic S. aureus could be identified from Ddok or bread in a day.

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Effects of CELL curriculum participation on college students' learning flow, learning motivation, academic self-efficacy, and self-directed learning ability (CELL교육과정 참여가 대학생의 학습몰입, 학습동기, 학업적자기효능감, 자기주도학습능력에 미치는 효과)

  • Yang, Jae-Hoon;Cho, Bo-Ram;Hwang, In-Seob
    • Journal of Digital Convergence
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    • v.18 no.8
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    • pp.55-67
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    • 2020
  • The purpose of this study was to investigate the effects of CELL curriculum participation on learning flow, learning motivation, academic self-efficacy, and self-directed learning ability. To this end, in the first semester of 2020, 386 students from K University conducted a pre-post survey and analyzed using SPSS. The main research results are as follows. First, participation in the CELL curriculum showed statistically significant improvement in the student's learning flow, learning motivation, academic self-efficacy, and self-directed learning ability. Second, the analysis by gender showed significant improvement in learning flow, academic self-efficacy, and self-directed learning ability only for female students. Third, in the analysis by grade level, the sophomore showed significant improvement in learning flow and self-directed learning ability, the junior in all variables, and the senior in academic self-efficacy and self-directed learning ability. Fourth, participation impressions and improvements were summarized through interviews of participating students. This study is significant in that it examines the effectiveness of the CELL curriculum and suggests practical measures for systematic operation and support.

A Study on the education status in department of Dental Technology (Focusing on the Dental Laboratory practice education) (임상 실습을 중심으로한 치기공(학)과 교육 실태조사)

  • Park, Jong-Hee
    • Journal of Technologic Dentistry
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    • v.37 no.3
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    • pp.131-144
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    • 2015
  • Purpose: This study set out to propose plans for more efficient and effective clinical practice by investigating the current state of clinical practice in the field of dental technology and thus provide basic data to develop pre- and post-education programs for clinical practice. Methods: The subjects include dental technicians at dental technical laboratories that were appointed as the place of clinical practice by the Department of Dental Technology of G University. The survey period spanned from December 22, 2014 to January 20, 2015. Total 250 questionnaires were distributed to them, and 190(76.0%) were returned. After excluding 23 whose answers were uncertain or seemed to lack reliability, total 167(66.8%) were used in final analysis. Results: 1. The most frequent practice the student did during clinical practice was articulator attachment, which was followed by pin operation or model making, one's own task and practice, sand and crow sculpturing, burying, casting, and grinding. 2. In case of going through the entire process, porcelain had the most students at 39(23.4%), being followed by crown & bridge at 28(16.8%), clinical model at 23(13.8%), full denture at 17(10.2%), and partial denture at 17(10.2%) in the order. 3. Of the students, 59.8%(30.5% for reinforced basic practice; 29.3% for intensive practice education) said that intensive practice education should be reinforced in school; and 22.3% said that intensive theory and practice education was needed, which indicates that 82.6% voiced their opinion of reinforcing education around practice. 4. The students felt that they lacked diligence, passion, and theoretical knowledge somewhat and were relatively good at clinical adaptation and operational skills. Conclusion: The findings show that the students felt an absolute lack of practice education as the school education was focused on theory and national exams in the field of dental technology, thus raising a need to reinforce practice education. Of all the respondents, 62.9% said there was a need to improve the current education with a focus on jobs. In future, education of dental technology should work to bring up able dental technicians that can perform in clinical dental technology right after graduation by reinforcing job-based practice education.

A Case of Giant Gastric Schwannoma Accompanied with Bleeding (출혈을 동반한 거대 위 신경초종 1예)

  • Kim, Je-Yeon;An, Ji-Yeong;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.47-51
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    • 2006
  • The origin of a submucosal tumor is difficult to determine by endoscopic biopsy. One type of submucosal tumor, which originates in Schwann cell, a schwannoma represents 0.2% of all gastric tumors. We experienced the case of a 57-year-old female patient with a gastric schwannoma presenting with melena and anemia. Computed tomography and upper gastrointestinal endoscopy showed a protruded huge mass from 3 cm below the cardia to angle. Seven endoscopic biopsies indicated only necrotic debri and granulation tissue, chronic gastritis. Because we suspected an advanced gastric cancer, or lymphoma with bleeding, It was performed an operation for an exact diagnosis and a treatment for bleeding. A-post-operative histopathological, immunohistochemical examination led to the final diagnosis of a gastric schwannoma.

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A Study on the Architecture Modeling of Information System using Simulation (시뮬레이션을 이용한 정보시스템 아키텍쳐 모델링에 관한 연구)

  • Park, Sang-Kook;Kim, Jong-Bae
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2013.10a
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    • pp.455-458
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    • 2013
  • The conventional design of the information system architecture based on the personal experience of information systems has been acted as a limit in progress utilizing appropriate resource allocation and performance improvements. Architecture design depending on personal experience makes differences in variance of a designer's experience, intellectual level in related tasks and surroundings, and architecture quality according to individual's propensity. After all these problems cause a waste of expensive hardware resources. At working place, post-monitoring tools are diversely developed and are running to find the bottleneck and the process problems in the information operation. However, there are no simulation tools or models that are used for expecting and counteracting the problems at early period of designing architecture. To solve these problems we will first develop a simulation model for designing information system architecture in a pilot form, and will verify validity. If an error rate is found in the permissible range, then it can be said that the simulation reflects the characteristic of information system architecture. After the model is developed in a level that can be used in various ways, more accurate performance computation will be able to do, getting out of the old way relying on calculations, and prevent the existence of idle resources and expense waste that comes from the wrong design of architecture.

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