• Tuberculosis and Respiratory Diseases
• /
• 제72권1호
• /
• pp.37-43
• /
• 2012

Background: A lung bulla may rarely shrink as a result of an inflammation within the bulla or a closing of a bronchus involved in the inflammation process, which is termed 'autobullectomy'. The purpose of this study was to describe clinical features of patients with regressions of bullae during follow-up. Methods: We retrospectively reviewed the cases and individuals who showed unequivocal evidence of interval regressions in a pre-existing bulla. A total of 477 cases with a bulla >5 cm in diameter were screened manually. Thirty cases with bullae that showed regression during follow-up were selected. Results: Regressions of large bullae occurred in 30 of 477 cases (6.3%). The median age of those patients was 61 (range, 53~66) years and 87% of those patients were men. The main cause of a bulla was emphysema (80%). Among 30 cases, 16 cases had pneumonia in the lung parenchyma of the peribullous area. Another 7 cases had a regressed bulla accompanied by an air-fluid level within the bulla. The remaining 7 cases showed a spontaneous regression of the bulla without such events. Complete regression of a bulla occurred in 25 cases. A follow-up chest-X ray showed that in all cases except one, the bulla remained in a collapsed state after 24 months. Forced expiratory volume in one second ($FEV_1$) improved in 3 cases and the other 2 cases had increased forced vital capacity (FVC). In addition, total lung capacity (TLC) and residual volume (RV) decreased in another 2 cases. Conclusion: Regression of a lung bulla occurred not only after pneumonia or the presence of air-fluid level within the bulla, but also without such episodes. The clinical course of regression of a lung bulla varied. After regression of a bulla, lung function could be improved in some cases.

• Membrane and Water Treatment
• /
• 제6권3호
• /
• pp.237-249
• /
• 2015

In this study we investigate a laboratory scale vacuum membrane distillation system to produce pure water from model oil in water emulsion. Experimental determination of liquid entry pressure (LEP) of a commercial Durapore$^{TM}$ GVPH flat sheet membrane using model emulsions in various oil concentrations has been carried out. Two different methods of liquid entry pressure determination - a frequently used, so-called static and a novel dynamic method - have been investigated. In case of static method, LEP value was found to be 2.3 bar. No significant effect of oil content on LEP was detected up to 3200 ppm. In contrast, LEP values determined with dynamic method showed strong dependence on the oil concentration of the feed and decreased from 2.0 bar to a spontaneous wetting at 0.2 bar in the range 0-250 ppm, respectively. Vacuum membrane distillation tests were also performed. The separation performance is evaluated in terms of flux behavior, total organic carbon removal and droplet size distribution of the feed and final retentate. No significant effect of oil content on the flux was found ($5.05{\pm}0.31kgm^{-2}h^{-1}$) up to 250 ppm, where a spontaneous wetting occurred. High separation performance was achieved along with the increasing oil concentration between 93.4-97.0%.

• Journal of Ginseng Research
• /
• 제42권3호
• /
• pp.298-303
• /
• 2018

Background: Panax ginseng is one of the most commonly used medicinal herbs worldwide for a variety of therapeutic properties including neurocognitive effects. Ginsenoside Rg1 is one of the most abundant active chemical constituents of this herb with known neuroprotective, anxiolytic, and cognition improving effects. Methods: We investigated the effects of Rg1 on the medial prefrontal cortex (mPFC), a key brain region involved in cognition, information processing, working memory, and decision making. In this study, the effects of systemic administration of Rg1 (1 mg/kg, 3 mg/kg, or 10 mg/kg) on (1) spontaneous firing of the medial prefrontal cortical neurons and (2) long-term potentiation (LTP) in the hippocampal-medial prefrontal cortical (HP-mPFC) pathway were investigated in male Sprague-Dawley rats. Results: The spontaneous neuronal activity of approximately 50% the recorded pyramidal cells in the mPFC was suppressed by Rg1. In addition, Rg1 attenuated LTP in the HP-mPFC pathway. These effects were not dose-dependent. Conclusion: This report suggests that acute treatment of Rg1 impairs LTP in the HP-mPFC pathway, perhaps by suppressing the firing of a subset of mPFC neurons that may contribute to the neurocognitive effects of Rg1.

• 대한소아치과학회지
• /
• 제28권4호
• /
• pp.575-582
• /
• 2001

영구 전치부에 발생한 외상성 치은연하 파절과 자연 맹출을 기대하기 어려운 함입탈구가 발생한 경우에 여러 가지 치료방법이 알려져 있으나, 교정적 치아 정출술이 골수술을 동반한 치관길이 연장술이나 의도적 재식술에 비해 양호한 치료 성과를 나타내는 것으로 보고되고 있다. 본 증례는 외상으로 인해 치은연하로 치관파절을 보이는 환아들에서 근관치료와 함께 고정성 장치를 이용하여 치주수술을 동반한 교정적 치아 정출술을 시행한 후 복합레진 수복술로 치료하였다. 또한 치아함입이 있는 환아에서는 6개월 동안 자연 맹출을 기다린 후 맹출되지 않아 가철성 장치를 이용한 치아 정출술을 시행하여 치아를 원래의 위치로 회복시킬 수 있었는데, 이 환아의 경우 치료도중 실활의 증상을 보여 근첨성형술을 시행하였고 근첨이 형성된 후에는 근관충전을 통하여 비교적 양호한 임상적 결과를 얻을 수 있었다.

• Restorative Dentistry and Endodontics
• /
• 제40권2호
• /
• pp.155-160
• /
• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Journal of Korean Neurosurgical Society
• /
• 제30권sup2호
• /
• pp.259-265
• /
• 2001

Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.

• Journal of Korean Neurosurgical Society
• /
• 제37권5호
• /
• pp.364-369
• /
• 2005

Objective: Spinal instrumentation without fusion often fails due to biological failure of intervertebral joints (spontaneous fusion, degeneration, etc). The purpose of this study is to investigate the influence of fixation rigidity on viability of intervertebral joints. Methods: Twenty pigs in growing period were subjected to posterior segmental fixation. Twelve were fixed with a rigid fixation system(RF) while eight were fixed with a flexible unconstrained implant(FF). At the time of the surgery, a scoliosis was created to monitor fixation adequacy. The pigs were subjected to periodic radiological examinations and 12pigs (six in RF, six in FF) were euthanized at 12-18months postoperatively for analysis. Results: The initial scoliotic curve was reduced from $31{\pm}5^{\circ}$ to $27{\pm}8^{\circ}$ in RF group (p=0.37) and from $19{\pm}4^{\circ}$ to $17{\pm}5^{\circ}$ in FF group (p=0.21). Although severe disc degeneration and spontaneous fusion of facet joints were observed in RF group, disc heights of FF group were well maintained without major signs of degeneration. Conclusion: The viability of the intervertebral joints depends on motion spinal fixation. Systems allowing intervertebral micromotion may preserve the viability of intervertebral discs and the facet joint articular cartilages while maintaining a reasonably stable fixation.

• Journal of Korean Medical Science
• /
• 제33권52호
• /
• pp.335.1-335.17
• /
• 2018

Background: Spontaneous bacterial peritonitis (SBP) is a serious infectious complication in patients with liver cirrhosis. However, information about prognosis of SBP in hepatocellular carcinoma (HCC) patients is limited. We investigated the clinical course of SBP in HCC patients. Methods: This study enrolled patients diagnosed with SBP between 2005 and 2017. Medical records of patients were reviewed and clinical course was compared between the non-HCC and HCC groups. Results: In total, 123 SBP cases including 49 HCC cases were enrolled. Men were predominant (48/74, 64.9% vs. 34/49, 69.4%; P = 0.697); median age was 58 years in both non-HCC and HCC groups (P = 0.887). The most common etiology was alcohol (32/74, 43.2%) in non-HCC group and hepatitis B (30/49, 61.2%) in HCC group (P = 0.009). Antibiotic resistance rate was higher in non-HCC than in HCC group (29.7% vs. 12.2%; P = 0.028); in-hospital mortality did not differ between the groups (25/74, 33.8% vs. 13/49, 26.5%; P = 0.431). Development rate of hepatorenal syndrome did not differ between non-HCC and HCC group (14/74, 18.9% vs. 10/49, 20.4%; P = 1.000), but hepatic encephalopathy was less common in HCC group (26/74, 35.2% vs. 9/49, 18.3%; P = 0.008). The most important predictor of in-hospital mortality in patients with HCC was white blood cell count above $11,570cells/mm^3$ (odds ratio, 6.629; 95% confidence interval, 1.652-26.590; P = 0.008). Conclusion: Prognosis of SBP in HCC patients is relatively less severe. This result may be related with reduced antibiotics resistance and lower development rates of other complications, such as hepatic encephalopathy. Degree of systemic inflammation may be the most important factor for in-hospital mortality.

• Acute and Critical Care
• /
• 제33권4호
• /
• pp.260-268
• /
• 2018

Background: The purpose of this study was to evaluate the clinical application of modified Burns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT) as a predictor of successful liberation from mechanical ventilation (MV) in patients with endotracheal intubation. Methods: Patients requiring MV for more than 72 hours and undergoing more than one SBT in a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. The m-BWAP score at first SBT was obtained by a critical care nursing practitioner. Results: A total of 103 subjects were included in this study. Their median age was 69 years (range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admission to first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation from MV was 84.5% (n=87). In the total group of patients, the successful liberation from MV group at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessful group (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the area under the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidence interval, 0.650 to 0.847), while the cutoff value based on Youden's index was 53 (sensitivity, 76%; specificity, 64%). Conclusions: The present data show that the m-BWAP score represents a good predictor of weaning success in patients with an endotracheal tube in place at first SBT.

• Journal of Chest Surgery
• /
• 제52권2호
• /
• pp.91-99
• /
• 2019

Background: The relationship between the size of bullae and pneumothorax recurrence is controversial. The aim of this study was to retrospectively evaluate the role of blebs or bullae in predicting ipsilateral recurrence in young patients experiencing their first episode of primary spontaneous pneumothorax (PSP) who underwent conservative treatment. Methods: A total of 299 cases of first-episode PSP were analyzed. The status of blebs or bullae was reviewed on high-resolution computed tomography (HRCT). The dystrophic severity score (DSS; range, 0 to 6 points) was calculated based on HRCT. Results: The 5-year recurrence rate was 38.2%. In univariate analysis, age (<20 years), body mass index (<$20kg/m^2$), a unilateral lesion, and intermediate risk (DSS 4 and 5) were associated with recurrence. Sex; smoking history; and the presence, number, and maximal size of blebs or bullae were not related to recurrence. In Cox regression, age and intermediate risk were independent risk factors for recurrence. High risk (DDS 6) was not an independent risk factor. Conclusion: The presence, number, and size of blebs or bullae did not affect ipsilateral recurrence. DSS failed to show a positive correlation between severity and recurrence. The decision to perform surgery in patients experiencing their first episode of PSP should not be determined by the severity of blebs and bullae.