• Title/Summary/Keyword: recovery period

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Changes of Ventricular Function and Mitral Regurgitation after Repair of Anomalous Origin of Coronary Artery from the Pulmonary Artery (관상동맥 폐동맥 이상 기시증의 외과적 치료 후 좌심실 및 승모판 기능의 변화)

  • Lee Jeong Ryul;Oh Sea Jin;Kim Woong Han;Kim Yong Jin;Rho Joon Ryang;Bae Eun Jung;Noh Chung II;Yun Yong Soo
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.523-528
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    • 2005
  • Background: Investigation of the change of ventricular function and mitral regurgitation after surgical repair of patient with anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) is key issue for the better surgical outcome. Material and Method: From April 1986 to July 2002, 12 patients presented with ALCAPA. The median age at repair was 4 months. Surgical methods included left coronary artery transfer to the aorta (10), Takeuchi procedure (1), saphenous vein free graft bypass (1). Mitral valve was repaired in 1. Result: There were 2 hospital death $(16.7\%)$. The mean follow-up period was $7.1\pm4.1$ years (range, 7 months to 13 years). Four patients required postoperative circulatory assist for $2.2\pm1.1$ days and one needed left ventricular assist device (LVAD) for 1day. Postoperative echocardiography demonstrated significant improvements in mean fractional shortening $(33.4\pm9.1\%\;vs\;17.7\pm9.6\%,\;n=10,\;p<0.05);$ left ventricular end diastolic dimension $(33.4\pm7.3\;mm\;vs\;44.8\pm7.0\;mm,\;n=10,\;p<0.05)$ and systolic dimension $(22.2\pm7.5\;mm\;vs\;33.4\pm7.9\;mm,\;n=10,\;p<0.05)$. Severities of mitral regurgitation decreased in all survivors at 1st and 4th year follow-up echocardiography. There were 2 reoperation due to residual MR and right ventricular outflow obstruction (Takeuchi case). Conclusion: Anatomic repair of anomalous left coronary artery from the pulmonary artery offered an excellent surgical results, especially in terms of the recovery of left ventricle function and mitral regurgitation. However, preoperative indications for mitral procedure is to be evaluated.

Effects of the Massage Therapy on Weight, Stress Hormone and Mother - Infant Interaction (마사지요법이 저체중아의 성장, 생리적 변화 및 모.영아 상호작용에 미치는 효과)

  • Kim, Mi-Ye;Kim, Sun-Hee
    • Korean Parent-Child Health Journal
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    • v.3 no.1
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    • pp.1-14
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    • 2000
  • The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

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Alterations in Thyroid Hormone Levels After Open Heart Surgery (개심술 후 갑상선 호르몬치 변화에 대한 연구)

  • 김광휴;조삼현
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.131-136
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    • 1997
  • The hemodynamic effects of thyroid hormones which is well established, affect myocardial contractility, heart rate, and myocardial oxygen consumption. The alterations in thyroid function test are frequently seen in patients with nonthyroidal illness and often correlate with the severity of the illness and the prosnosis. In this study, thyroid hormone changes were investigated in 20 patients who received cardiopulmonary bypass(CPB). All patients showed a state of biochemical euthyroidism preoperatively: The results were as follows : 1. Serum triiodothyronine(73) reached to its nadir(30.05 $\pm$ 17.5ng/dl, p(0.001) at 10 minutes after the start of CPB and remained low(p(0.05) throughout the study period. 2. Serum thyroxine(74) concentr tion slightly decreased after CPB, but maintained within normal range. 3. Serum free thyroxine(W4) concentration slightly increased after CPB, but maintained within normal range. 4. Serum thyroid stimulating hormone(TSH) concentration increased 10 minute after CPB, reached to its nadir(3.37 $\pm$ 0.81u1U/m1, p(0.001) at 2 hours after CPB. After then, serum TSH concentration decreased and reached its normal levels at 24 hours after CPB. 5. The patients whose postoperative recovery was uneventful(Group 1) had higher serum 73 levels than those who had postoperative complications(Group 2)(p<0.05). Group 1 showed elevating patterns of serum 73 in the fourth day after operation, whereas group 2 did not show such an elevating pattern. These findings are similar to the euthyroid sick syndrome seen in severely ill patients and indicate that patients undergoing open heart surgery have suppression of the pituitary-thyroid axis.

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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The Variations of Stratospheric Ozone over the Korean Peninsula 1985~2009 (한반도 상공의 오존층 변화 1985~2009)

  • Park, Sang Seo;Kim, Jhoon;Cho, Nayeong;Lee, Yun Gon;Cho, Hi Ku
    • Atmosphere
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    • v.21 no.4
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    • pp.349-359
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    • 2011
  • The climatology in stratospheric ozone over the Korean Peninsula, presented in previous studies (e.g., Cho et al., 2003; Kim et al., 2005), is updated by using daily and monthly data from satellite and ground-based data through December 2009. In addition, long-term satellite data [Total Ozone Mapping Spectrometer (TOMS), Ozone Monitoring Instrument (OMI), 1979~2009] have been also analyzed in order to deduce the spatial distributions and temporal variations of the global total ozone. The global average of total ozone (1979~2009) is 298 DU which shows a minimum of about 244 DU in equatorial latitudes and increases poleward in both hemispheres to a maximum of about 391 DU in Okhotsk region. The recent period, from 2006 to 2009, shows reduction in total ozone by 6% relative to the values for the pre-1980s (1979~1982). The long-term trends were estimated by using a multiple linear regression model (e.g., WMO, 1999; Cho et al., 2003) including explanatory variables for the seasonal variation, Quasi-Biennial Oscillation (QBO) and solar cycle over three different time intervals: a whole interval from 1979 to 2009, the former interval from 1979 to 1992, and the later interval from 1993 to 2009 with a turnaround point of deep minimum in 1993 is related to the effect of Mt. Pinatubo eruption. The global trend shows -0.93% $decade^{-1}$ for the whole interval, whereas the former and the later interval trends amount to -2.59% $decade^{-1}$ and +0.95% $decade^{-1}$, respectively. Therefore, the long-term total ozone variations indicate that there are positive trends showing a recovery sign of the ozone layer in both North/South hemispheres since around 1993. Annual mean total ozone (1985~2009) is distributed from 298 DU for Jeju ($33.52^{\circ}N$) to 352 DU for Unggi ($42.32^{\circ}N$) in almost zonally symmetric pattern over the Korean Peninsula, with the latitudinal gradient of 6 DU $degree^{-1}$. It is apparent that seasonal variability of total ozone increases from Jeju toward Unggi. The annual mean total ozone for Seoul shows 323 DU, with the maximum of 359 DU in March and the minimum of 291 DU in October. It is found that the day to day variability in total ozone exhibits annual mean of 5.7% in increase and -5.2% in decrease. The variability as large as 38.4% in increase and 30.3% in decrease has been observed, respectively. The long-term trend analysis (e.g., WMO, 1999) of monthly total ozone data (1985~2009) merged by satellite and ground-based measurements over the Korean Peninsula shows increase of 1.27% $decade^{-1}$ to 0.80% $decade^{-1}$ from Jeju to Unggi, respectively, showing systematic decrease of the trend magnitude with latitude. This study also presents a new analysis of ozone density and trends in the vertical distribution of ozone for Seoul with data up to the end of 2009. The mean vertical distributions of ozone show that the maximum value of the ozone density is 16.5 DU $km^{-1}$ in the middle stratospheric layer between 24 km and 28 km. About 90.0% and 71.5% of total ozone are found in the troposphere and in the stratosphere between 15 and 33 km, respectively. The trend analysis reconfirms the previous results of significant positive ozone trend, of up to 5% $decade^{-1}$, in the troposphere and the lower stratosphere (0~24 km), with negative trend, of up to -5% $decade^{-1}$, in the stratosphere (24~38 km). In addition, the Umkehr data show a positive trend of about 3% $decade^{-1}$ in the upper stratosphere (38~48 km).

Alteration of Growth Factor Expression after Acute Ischemic Renal Injury (급성 허혈성 신손상 후 여러 성장인자 발현의 변화)

  • Koe, Yang Sim;Lee, Soo Yeon;Kim, Won;Cho, Soo Chul;Hwang, Pyoung Han;Kim, Jung Soo;Lee, Dae-Yeol
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.687-694
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    • 2003
  • Purpose : Regeneration and repair after ischemic renal injury appears to be modulated by circulating or locally produced growth factors. This study examined the changes of serum insulin like growth factor(IGF-I) and renal expression of IGF-I and II, vascular endothelial growth factor(VEGF), transforming growth $factor-{\beta}$($TGF-{\beta}$), and connective tissue growth factor(CTGF) during the active regeneration period after acute ischemic injury. Methods : Sera and kidney tissue samples(whole kidney, cortex, outer medullae and inner medullae) were obtained before and after one, three, five and seven days of 40 minutes bilateral renal pedicle clamping. Acute renal failure was assessed by measuring the concentration of serum creatinine. Serum IGF-I level was measured by radioimmunoassay. The mRNA expression in kidney was measured by RT-PCR. The distribution of IGF-I and CTGF was detected by immunohistochemistry. Resuts : Serum IGF-I concentration after one day following acute ischemic renal injury was significantly decreased compared to preischemic value. The mRNA levels of IGF-I, IGF-II, $TGF-{\beta}1$ and VEGF in whole kidney were temporally decreased on day one of ischemic injury. IGF-I and IGF-II expressions in outer medullae were significantly decreased on day one after ischemic injury. $TGF-{\beta}1$, CTGF and VEGF expressions were markedly decreased in medullae after one day of ischemic injury compared to other kidney sections. IGF-I was markedly decreased in cortical tubules on day one of uremic rat. CTGF was markedly increased on tubule within three days of ischemic injury. Conclusion : These findings suggest that IGFs, $TGF-{\beta}1$ and CTGF may involve in the pathogenesis or the recovery from acute ischemic renal injury.

Epidemiology and Clinical Characteristics of Clostridium difficile-associated Disease in Children: Comparison between Community- and Hospital-acquired Infections (소아에서 발생한 Clostridium difficile 관련 질환의 역학과 임상양상: 지역사회감염과 원내감염의 비교)

  • Cho, Hye-Jung;Ryoo, Eell;Sun, Yong-Han;Cho, Kang-Ho;Son, Dong-Woo;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.2
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    • pp.146-153
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    • 2010
  • Purpose: Recent studies have reported an increase in the incidence of community-acquired Clostridium difficile-associated disease (CA-CDAD) among children. There is an overall lack of information on CA-CDAD in the pediatric population. The aim of our study was to compare the epidemiologic and clinical features between CA-CDAD and hospital-acquired C. difficile-associated disease (HA-CDAD) in children. Methods: We retrospectively reviewed the medical records of all patients who were diagnosed with C. difficile-associated disease (CDAD) at Gil Hospital between April 2008 and March 2009. The diagnosis of CDAD was made when patients with gastrointestinal symptoms had positive results for C. difficile toxins A and B assay or stool culture. Results: Sixty-one (male, 32 and female, 29) patients were included. The mean age was 3.79${\pm}$4.54 years. Of the 61 patients, 22 (36.1%) were <1 year of age. Twenty-three patients (37.7%) had a history of antibiotic exposure in the previous 3 months. Forty-one patients (67.2%) were diagnosed with CA-CDAD. There were no significant differences in age, gender, symptoms, laboratory findings, recovery period, complications, and recurrence between the CA-CDAD and HA-CDAD groups. On the other hand, exposure to antibiotics was significantly more frequent among patients in the HA-CDAD group (p=0.005). Conclusion: This study suggests that the occurrence of CA-CDAD is increasing in the pediatric population, especially in younger children with no history of exposure to antibiotics and in outpatients. Awareness of the increasing incidence of CA-CDAD and prompt investigation of C. difficile in susceptible patients is needed to avoid misdiagnosis and for appropriate therapy.

Studies on Silk Textile Wash and Wear Finishing (絹織物 Wash and Wear 加工硏究)

  • Choe, Byong-Hee;Lee, Yang-Hoo
    • Journal of Sericultural and Entomological Science
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    • v.23 no.1
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    • pp.47-55
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    • 1981
  • Silk textile finishing has been studied for many years by many workers in order to meet more utilities for various endusers. Such studies, however, could not be successful because any natural fibers are hardly change their natures by artificial treating methods. Textile finishing is of course to improve the mechandise qualities and the poor natures of silk so that it may be available as the best textile fiber in the world. Sometimes, famous trade marked textile plays more power than its quality in the silk market, nevertheless, this should be over line of research activities. Meantime, the silk demand has been also transferred from ladies stocking to other clothes since nylon or other synthetic fibers were developed. That is why, the extension of silk demand should be developed by various research works. Specially, silk is known as difficult textile to handle it during washing or ironing process which happened to depress down the silk usage for house wives. In order to solve such problems, the reporter has been worked for many years and now, he believes that he has developed a proper finishing method to coversuch problems. The developed finishing method may be said to eligible with economical aspect and shorten the dry duration after water washing in half against normal silk textile without harming the specific silk nature. As all of us know, silk fiber starts to denature since it was spinned by silkworm and the fiber is formed as overlapped "S" type curves during its concooning process. After it is made as raw silk or sericin silk, it shows as straight line form, but it changes in to waved form in case refining or degumming process in order return to its original spinned form. Such nature is continued during its textile form and ends with hard ironing nature than other textile fibers. Mean while, the silk fiber keeps to continue its denaturing and this is iniciated by repeat of washing and drying which takes many years to reach its final stage, The reporter has found the iniciating denature of silk by his finishing process, with out heat, decreasing the swollen nature which ended with shortening the drying duration after wash. Each washing was carried out by soaking the previously weighed sample in cold water for one hour, then pressed the sample for ten minutes to eliminate its free water component before weighing with same condition. According to this, the treated silk showed much denaturing after the finishing, but the standard silk progressed the denaturing by and by with the repeat of washing and drying, finally reached the same swollen degree of treated silk, Such treating result explains that the treated silk happened to be stebilized nature by the treating immediately. On the other that the treated silk happened to be stebilized nature by the treating immediately. On the other hand, standard silk may reach to such condition by the time of worn out clothes after repeat of washing and drying for many years while the clothes will be no more useful. The decreased swelling nature has brought about the drying period in half against standard silk after all. Not only the tests of tenacity and elongation but also crease resistance recovery, stiffness and shrinkage tests were carried out after each washing and drying which he has found better result on the treated silk textile against the standard silk. The most important thing was to keep the textile feeling of silk by such finishing work before improve any poor nature of silk. The general silk has a nature to absorb smoke or dirt from its surrounding air and reaches to dirty color shade upon such exposure, but the treated one has improved such nature because of its artificial denaturing, another word, it keeps clean longer than the normal silk. Many previous finishing works could improve some specific nature of silk, but it happened to deprave other important natures. The reporters work is, however, specialized to improve the silk to be useful as Wash and Wear Silk without harming its standard natures. So far, this work happened to be a overall innovative finishing method of silk textile.

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Effect of Recovery of Pulmonarv Function in Hypothermic Lung Preservation (폐의 저량보존법이 폐기능 회복에 미치는 영향)

  • Lee, Man-Bok;Kim, U-Jong;Gang, Chang-Hui;Lee, Gil-No
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.253.1-262
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    • 1997
  • Hypothermia during lung preservation decreases metabolic processes. After the rabbit lung was flushed with modified Euro-Collins solution, heart-lung block was harvested and the left lung was assessed after ligation of the right pulmonary artery and right main-stem bronchus. Heart-lung block was immersed in the same solution for 6 hours. The modified Euro-Collins solution and storage temperature of group 1(10 cases) was 4t, roup 2(10 cases) was l$0^{\circ}C$. On completion of the storage period, the left lung was ventilated and reperfused with blood u:high used a cross-circulating paracorporeal rabbit as a "biologic deoxygenator" for 60 minutes. Pulmonary artery pressure, airway pressure, difference in oxygen tension between mow and outflow perfusate and degree of pulmonary edema were assessed at 10-minute intervals while the left lung was ventilated at 0.8 of the inspired oxygen fraction. The mean pulmonary venous oxygen tensions at 10 and 60 minutes after reperfusion were 209.52$\pm$42.46 and 103.48$\pm$ 15.96 mmHg in group I versus 247.78$\pm$36.19 and 147.91 $\pm$ 11.07 mmHg in group II(p=0.049, (0.0001). The mean alveolar-arterial oxygen differences at 20 and 60 minutes after reperfusion were 357. 95$\pm$ 12.84 and 437.31 14.26 mmHg in group I versus 310.88$\pm$3).47 and )90.93$\pm$ 15.86 mmHg in group II (p=0.0092, (0.0001). The mean pulmonary arterial pressures at 10 and 60 minutes after reperfusion were 40.56$\pm$ 18.66 and 87. 2$\pm$ 17.22 mmHg in group I versus 31.22$\pm$6.84 and 65.78$\pm$ 11.02 mmHg in group rl (p : 0.048, 0.0062). The mean pulmonary vascular resistances at 10 and 60 minutes after reperfusion were 2.69$\pm$0.85 and 4.36$\pm$0.86 mmHg/ml/min in group I versus 1.99$\pm$0.39 and 3.29$\pm$0.55 mmHg/ml/min in group II(p : 0.0323, 0.0062). There were no difference between groups in peak airway pressure, lung compliance and degree of pulmonary edema. In conclusion that preservation of lung at l$0^{\circ}C$ was superior to preservation at 4$^{\circ}C$.}C$.

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Effect of Ethane 1,2-Dimethane Sulfonate (EDS) on the Accessory Sex Organs in Adult Rats : A Histological Study (Ethane 1,2-Dimethane Sulfonate(EDS)가 성체 흰쥐의 부속 생식기관에 미치는 효과 : 조직학적 연구)

  • Lee, Won-Yong;Lee, Sung-Ho
    • Development and Reproduction
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    • v.13 no.2
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    • pp.105-114
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    • 2009
  • Ethane 1,2-dimethane sulfonate (EDS) is a well-known alkylating agent used as selective Leydig cell (LC) toxicant to create a testicular dysfunction model. Previous studies including our own clearly demonstrated the dramatic weight loss of the androgen dependent accessory sex organs such as epididymis, seminal vesicle and prostate gland in this 'LC knock-out' rats. The present study was performed to evaluate the effect of EDS administration on histological changes of the epididymis, seminal vesicle and prostate in adult rats. Adult male Sprague-Dawley rats (350$\sim$400 g B.W.) were injected with a single dose of EDS (75 mg/kg, i.p.) and sacrificed on weeks 0, 1, 2, 3, 4, 5, 6 and 7. Tissue weights (testis, epididymis, seminal vesicle and prostate gland) were measured. The histological changes of tissue were observed by a light microscopy using hematoxylin & eosin staining. Weights of the reproductive and accessory organs progressively declined after the EDS treatments (weeks 1, 2 and 3). After this, the decrease was stopped, then gradually returned to the normal levels. There was a partial (about 60%) recovery of the epididymis weight during weeks $6{\sim}7$. The cross section of epididymis revealed an increase in thickness of the epithelium during weeks $1{\sim}3$. In contrast, considerable reduction of epithelial thickness in seminal vesicle was observed during same period. Similarly, a reduction in thickness of prostate epithelial layer was found during weeks $1{\sim}3$, then it was back to normal thickness after week 4. Taken together, the present study demonstrated that the temporally induced androgen-deficiency by EDS treatment could result the prominent alterations in histology of the accessory sex organs. Further studies on the physiological and molecular regulation of these androgen-sensitive organs using EDS model will be helpful to understand the normal and pathological development and differentiation mechanism of these organs.

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