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Clinical Study of the Patients, in Whom Pulmonary Embolism was Suspected by Lung Perfusion Scan (폐 관류주사검사상 폐동맥 색전증 소견을 보인 환자의 임상적 고찰)

  • Lee, Gwi-Lae;Kim, Jae-Yeol;Park, Jae-Suk;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.889-898
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    • 1997
  • Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

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A Study on a Method for Fire Suppression in a Central Area inside the Roof of a Wooden Cultural Property using a Gas Extinguishing Apparatus (가스소화설비를 이용한 목조 문화재 적심부 화재진압 방법에 관한 연구)

  • Kim, Hyunsung;Kim, Byung Sean;Cho, Woncheol;Lim, Yun Mook
    • Journal of Korean Society of societal Security
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    • v.3 no.2
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    • pp.65-71
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    • 2010
  • This study was conducted to provide a method for fire suppression in a central area inside the roof of a wooden cultural property using a gas extinguishing apparatus, which is used as one of fire suppression methods with view to preventing valuable wooden properties inherited from ancestors from being destructed by fire. For a wooden property, it is very difficult to suppress fire when combustion spreads to a central area inside its roof, so it is impossible to put out a fire without destructing it. Such a fire fighting apparatus as a sprinkler, etc., installed in modern structures, is very effective, but the possibility of damaging a cultural property is highly probable after installment and operation, which leads to its low adaptability to a wooden property. Thus, the necessity of developing a fire suppress ion apparatus was raised to minimize the said problem and to obtain the desired results, and the need of making a plan on the installment was also raised based on the results of a test whose validity was proven. The central area inside a roof is a traditional - architectural style which is found in Korean wooden structures only, so it is impossible to discover similar cases in foreign countries. For this reason, this study was conducted to verify the effectiveness by developing a fixed fire suppression apparatus designed considering the speed and effectiveness in fire suppression. This study was sequentially carried out in the following steps. First, a frame for this study was made and the specific plan on a fire suppression method was established. Then, a fire suppression apparatus was installed. In the first step, the effectiveness for fire suppression was tested by installing valve open - punched - main water pores, and in the second step, the same effectiveness was tested by valve opened - punched - injection ports. For a wooden property similar to "Sungnyemun"(Gate of Exalted Ceremonies), its central area of the roof decides whether the fire suppression is successful or not, so the opinions on how to put out a fire were presented in this study, and thus the objective data to establish a method on fire suppression in a wooden structure(cultural property) was secured. Lastly, a scientific verification in the effectiveness for fire suppression measures was presented by installing a gas - fixed fire suppression apparatus.

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A Study on the Utilization of Information and Communication Assistive Devices for Bridging the Digital Divide of the Disabled (장애인 정보격차 해소를 위한 정보통신 보조기기 활용방안 연구)

  • Kim, Jung-Ho;Suh, Jun-Kyo Francis;Koo, Jun
    • Science of Emotion and Sensibility
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    • v.13 no.3
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    • pp.581-596
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    • 2010
  • The purposes of this study are to investigate and analyze the level of information and the state of digital divide of the disabled by surveying the demand for information and communication assistive devices, and to provide basic data for plans on the development and utilization of information and communication assistive devices. In order to understand the actual condition and the state of digital divide of persons with disabilities, the differences of possession and accessibility of information technology devices, usage ability, and utilization were analyzed according to the disability profile by using the T-test. The results show that there are significant differences (T=-2.510*) of possession and accessibility of information technology devices with respect to the disability profile, and that the disabled have lower possession and accessibility of devices than the non-disabled. Result of this study's demand forecast shows that about 28% of total respondents are currently using information and communication assistive devices, and a majority (67%) of them answered that the use of assistive devices lend great help to their lives. The proportion of those who have been supported by the government or related organizations with information and communication assistive devices were 36% of the total respondents, and those satisfied with the performance of the devices were 46% of the total responses. Meanwhile, only 36% of total users answered that the operation and use of functions of the devices was easy and convenient, responding that the difficulty of operating assistive devices was the greatest inconvenience. Moreover, the general requests of respondents in regards to the devices were stabilization of device performance, miniaturization of size, simplification of buttons, and reduction of weight.

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Comparison of X-ray VCUG with RI VCUG for Diagnosing VUR in Children (소아의 방광 요관 역류 진단시 X-ray 배뇨성 방광 요도 조영술(X-ray VCUG)과 방사성 동위원소 배뇨성 방광 요도 조영술(RI VCUG)의 비교)

  • Hong Hyun-Soook;Choi Deuk-Lin;Kim Eun-Mi;Kim Sung-Jun
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.187-195
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    • 1999
  • Purpose : VUR is state where urine regurge from bladder to ureter and kidney. It is shown in about 1/3 of urinary tract infection patients and it is classified as grade I to V. We compared results from RI VCUG(Radiisotope voiding cystourethrography) and X-ray VCUG which used in diagnosing VUR in children, to evaluate which is better in diagnosing VUR in children. Methods : 41 Patients(19 males, 21 females), who visited Pediatric department, Soonchunhyang university Hospital from peroid of 1991. January to 1998. July for recurrent urinary tract infection or abnormalities in ultrasonogams, were enrolled in the study. The age ranged from 9 months to 17 years and mean age was 5 1/2 years. Both RI VCUG and X-ray VCUG were done and follow-up test of urine culture, renal ultrasonogram and RI VCUG were done every month, every 3 month and every 6 month, respectively to observe the disappearance of VUR and evaluated the prognosis. Results : 24 patients had taken RI VCUG and 17(70.1%) patients showed positive result. 22 patients had taken X-ray VCUG and 9(40.1%) patients showed findings of VUR. 17 patients had taken both tests and 14 patients showed positive result in RI VCUG and 6 of these patients also showed reflux in X-ray VCUG. 3 patients who showed negative in RI VCUG, showed negative also in X-ray VCUG. For prognosis, resolution and scar formation was shown in 8 patients each. Persistent VUR was shown in 6 patients and 2 of these patients VUR was corrected by operation, 1 patient showed decreased renal function, and 1 patient was not follwed up. 8 of 9 patients who showed findings of VUR on DMSA scan formed a scar and 8 patients who showed no findings of VUR didn't form a scar. Urine culture was positive in 17 of 19 patients with VUR. Positive rate in urine culture was higher than that of patients with no VUR who showed positivity in 15 of 21 patients for urine culture. E. coli was most common organism and the period free of UTI was 14 months in VUR patients and it was shorter compared to patients without VUR which was 26 months. Conclusion : In diagnosing VUR in children, the positive rate was higher in RI VCUG than X-ray VCUG. Therefore, in early diagnosis when VUR is suspicious but not shown in X-ray VCUG, RI VCUG should be done and it will help to make accurate diagnosis.

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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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PERIPHERAL NERVE REGENERATION USING POLYGLYCOLIC ACID CONDUIT AND BRAIN-DERIVED NEUROTROPHIC FACTOR GENE TRANSFECTED SCHWANN CELLS IN RAT SCIATIC NERVE (BDNF 유전자 이입 슈반세포와 PGA 도관을 이용한 백서 좌골신경 재생에 관한 연구)

  • Choi, Won-Jae;Ahn, Kang-Min;Gao, En-Feng;Shin, Young-Min;Kim, Yoon-Tae;Hwang, Soon-Jeong;Kim, Nam-Yeol;Kim, Myung-Jin;Jo, Seung-Woo;Kim, Byung-Soo;Kim, Yun-Hee;Kim, Soung-Min;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.465-473
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    • 2004
  • Purpose : The essential triad for nerve regeneration is nerve conduit, supporting cell and neurotrophic factor. In order to improve the peripheral nerve regeneration, we used polyglycolic acid(PGA) tube and brain-derived neurotrophic factor(BDNF) gene transfected Schwann cells in sciatic nerve defects of SD rat. Materials and methods : Nerve conduits were made with PGA sheet and outer surface was coated with poly(lactic-co-glycolic acid) for mechanical strength and control the resorption rate. The diameter of conduit was 1.8mm and the length was 17mm Schwann cells were harvested from dorsal root ganglion(DRG) of SD rat aged 1 day. Schwann cells were cultured on the PGA sheet to test the biocompatibility adhesion of Schwann cell. Human BDNF gene was obtained from cDNA library and amplified using PCR. BDNF gene was inserted into E1 deleted region of adenovirus shuttle vector, pAACCMVpARS. BDNF-adenovirus was multiplied in 293 cells and purified. The BDNF-Adenovirus was then infected to the cultured Schwann cells. Left sciatic nerve of SD rat (250g weighing) was exposed and 14mm defects were made. After bridging the defect with PGA conduit, culture medium(MEM), Schwann cells or BDNF-Adenovirus infected Schwann cells were injected into the lumen of conduit, respectively. 12 weeks after operation, gait analysis for sciatic function index, electrophysiology and histomorphometry was performed. Results : Cultured Schwann cells were well adhered to PGA sheet. Sciatic index of BDNF transfected group was $-53.66{\pm}13.43$ which was the best among three groups. The threshold of compound action potential was between 800 to $1000{\mu}A$ in experimental groups which is about 10 times higher than normal sciatic nerve. Conduction velocity and peak voltage of action potential of BDNF group was the highest among experimental groups. The myelin thickness and axonal density of BDNF group was significantly greater than the other groups. Conclusion : BDNF gene transfected Schwann cells could regenerate the sciatic nerve gap(14mm) of rat successfully.

Empirical Analysis of Consumer Behavior on the Internet Shopping Mall Choice from the Schema Perspective: Comparison Between Bricks & Clicks and Pure-Player Shopping Mall (스키마 관점에서 살펴본 인터넷 쇼핑몰 선택에 대한 소비자행동의 이해: Bricks & Clicks와 Pure-Player 인터넷 쇼핑몰 비교를 중심으로)

  • Chung, Nam-Ho;Lee, Kun-Chang
    • Asia pacific journal of information systems
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    • v.17 no.4
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    • pp.165-186
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    • 2007
  • With the advent of a wide variety of Internet shopping malls, consumers can choose a best appealing shopping mall from among the Bricks-and-Clicks and Pure-Player malls. Pure-Players launched their operation grandiosely with the early stage of Internet use in 1995. However, after the burst of Dot-com company bubbles in 1997, Pure-Players introduce various types of business models to meet potential needs of consumers. While Pure-Players suffer skeptical views from market analysts as well as consumers, traditional offline companies learned important lessons from Dot-com companies collapse phenomena, and expanded their business channels into online in the name of Bricks-and-Clicks. Nowadays, Bricks-and-Clicks successfully establish in the market as one of reliable business partners among consumers. Therefore, it is no surprise that recent competitions between Bricks-and Clicks and Pure-Players become fiercer than ever to attract potential customers to their websites. In this situation, consumers can choose a shopping mall to their best satisfaction. Consumers can enjoy both offline and online options for shopping because Bricks-and Clicks provide both offline and online channels to consumers, which is compared with Pure-Players offering only online channel. Offline channel is unique in providing consumers with chances to touch and feel target products and services. Meanwhile, online channel is considered very viable and convenient shopping options for consumers. In this respect, it is easily assumed that consumers will show different online shopping behavior when they have to choose either Bricks-and-Clicks mall or Pure-Player mall for the sake of shopping. Remaining research issue in this case is how much consumers' schema would influence online shopping behavior between Bricks-and-Clicks and Pure-Players. Basically, schema is a framework for synthetic information recognition that individual consumers have and is very characteristic in that it focuses not on fragmentary facts but on the combination of various causes affecting results. Consumers' schema is closely represented by trust, structural assurance, and perceived relative advantage towards a specific type of shopping mall. In literature, there exist a lot of studies comparing Bricks-and-Clicks and Pure-Players. However, there is no study to pursue the analysis of consumer behaviors comparing Bricks-and Clicks and Pure-Players from the schema perspective. Therefore, this study aims to investigate this research gap. Empirical analysis is adopted by garnering valid questionnaires from 514 Internet shopping mall users. 237 were mainly using Bricks-and-Clicks for shopping, while 277 were found to visit Pure-Players for shopping. PLS was applied to analyze the survey data to verify the proposed research hypotheses. Findings from the empirical test results are as follows. First, consumers perceive more trust and relative advantage in Pure-Players, comparing with Bricks-and-Clicks. This result is against widely-accepted perception that Bricks-and-Clicks would be perceived by consumers as more trustworthy and relatively advantageous because they have offline reputation and stores. Therefore, it becomes more obvious that Internet is becoming daily necessaries, and consumers increasingly feel very comfortable in using the Internet for their own personal purposes. Second, consumers have firm faith in transaction safety, regardless Bricks-and-Clicks and Pure-Players. This seems due to the fact that most of shopping malls showing dubious transaction safety have no place in the market. In a nutshell, empirical results tell us that Pure-Players will grow very much in the future, to the extent that consumers perceive no difference in comparison with Bricks-and-Clicks. Besides, consumers' schema accumulated through trust and perceived relative advantage plays crucial role in determining consumer behavior.

Preservation of Pulmonary Function after Sleeve Lobectomy in Patients with Lung Cancer (Sleeve 폐엽절제술 후 폐기능 보존에 대한 연구)

  • Koh, Young-Min;Park, Sang-Joon;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Kim, Kwhan-Mien;Kim, Jhin-Gook;Shim, Young-Mog
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.35-41
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    • 1999
  • Background: Sleeve lobectomy of the main bronchus has been proposed to spare lung tissue in patients who cannot tolerate pneumonectomy because of impaired lung function. The purpose of this study was to evaluate whether sleeve lobectomy can preserve lung function as expected from preoperative evaluation of lung function in patients with non-small cell lung cancer. Method: Between January 1995 and March 1998, 15 patients with non-small cell lung cancer who underwent sleeve resection were evaluated. Preoperative evaluations included spirometry and quantitative lung perfusion scan, from which predicted postoperative $FEV_1$ was calculated. At least 3 months after operation follow up spirometry and bronchoscopy were performed. Predicted FEVj was compared with measured postoperative $FEV_1$. Result: Fourteen men and one woman, with median age of 58 years, were reviewed. The diagnosis was squamous cell carcinoma in 13 patients and adenocarcinoma of lung in 2 patients. Our results showed a excellent preservation of pulmonary function after sleeve lobectomy. Correlation between the predicted (mean, $2180{\pm}570mL$) and measured $FEV_1$ (mean, $2293{\pm}499mL$) was good(r=0.67, P<0.05). Furthermore, patient with low $FEV_1$ (<2L) showed improved lung function after sleeve lobectomy. Conclusion: These findings indicated a complete recovery of the reimplanted lung lobes after sleeve lobectomy. Therefore, this technique could be safely used in lung cancer patients with impaired lung function.

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A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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Consideration of Shoulder Joint's Image with the Changed Tube Angle of the Shoulder Oblique Projection in Supine Position (Supine 자세에서 Shoulder oblique촬영시 Tube angle 변화에 따른 Shoulder joint에 대한 고찰)

  • Seo, Jae-Hyun;Choi, Nam-Gil
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.109-114
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    • 2008
  • There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

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