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Clinical Analysis Of Ventricular Septal Defect (심실중격결손증의 외과적 고찰)

  • Seong, Suk-Hwan;Suh, Kyung-Pill
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.90-97
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    • 1982
  • Two hundred one patients of ventricular septal defect, which were operated at Seoul National University Hospital, were analysed on clinical background during the period from January, 1975 to December, 1980. The results were as follows: 1. Of the 201 patients, 118 patients were male [58.7%] and 83 patients were female [41.3%]. Their age ranged from 15 months to 40 years, and the mean age was 8.7 years. 40% of the patients were between 4 and 8 years. 2. The most common symptoms showed frequent U RI and exertional dyspnea. 3. On Kirklin`s anatomical classification, type I constituted 26.9%, type II 58.2%, type III 12.4%, and type IV 1.0%. We showed marked increased incidence of type I VSD as compared to Caucasians* 4. 46 cases were associated with other congenital cardiac diseases. They were PDA [13 cases], AI[11 ], ASD[6], PS[10], MI[4], and Double aortic arch [1]. 5. In 128 patients, who had complete hemodynamic data and were not associated with other congenital cardiac diseases, an attempt was made to correlate the EKG findings with the hemodynamic data, and defect size with the hemodynamic data. The children had variable distribution of PA syst. pr. and Rp/Rs. But most of adults had $R_P$/$R_S$of 0.15 or less. As $P_P$/$P_S$increased, the rate of operative complication increased also. 6. When a normal EKG pattern was present, $Q_P$/$Q_S$and $R_P$/$R_S$and $P_P$/$P_S$were relatively low. When EKG findings were LVH pattern, there was diastolic volume overload to left ventricle. As RVH, there was systolic pressure overload to right ventricle. And as BVH, there was mixed pattern of diastolic volume overload to left ventricle and systolic pressure overload to right ventricle. 7. Among patients in defect was less than 1 $cm^2$ per $M^2$ of BSA, $Q_P$/$Q_S$was less than 2:1, and $R_P$/$R_S$less than 0.25, and PAsyst. pr. less than 50 mmHg, and $P_P$/$P_S$was less than 0.5. But patients with the defect greater than 1 $cm^2$ per $M^2$ of BSA had no correlationship between $Q_P$/$Q_S$, $R_P$/$R_S$, PAsyst. pr. and defect size in each other. Most of patients with the defect greater than 2 $cm^2$/$M^2$ BSA, $R_P$/$R_S$was greater than 0.5. 8. Operative mortality rate was 9.5% [19 cases] among 201 patients. And complication rate including mortality rate was 22.9% [46 cases].

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Influence of coarse particles on the physical properties and quick undrained shear strength of fine-grained soils

  • Park, Tae-Woong;Kim, Hyeong-Joo;Tanvir, Mohammad Taimur;Lee, Jang-Baek;Moon, Sung-Gil
    • Geomechanics and Engineering
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    • v.14 no.1
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    • pp.99-105
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    • 2018
  • Soils are generally classified as fine-grained or coarse-grained depending on the percentage content of the primary constituents. In reality, soils are actually made up of mixed and composite constituents. Soils primarily classified as fine-grained, still consists of a range of coarse particles as secondary constituents in between 0% to 50%. A laboratory scale model test was conducted to investigate the influence of coarse particles on the physical (e.g., density, water content, and void ratio) and mechanical (e.g., quick undrained shear strength) properties of primarily classified fine-grained cohesive soils. Pure kaolinite clay and sand-mixed kaolinite soil (e.g., sand content: 10%, 20%, and 30%) having various water contents (60%, 65%, and 70%) were preconsolidated at different stress levels (0, 13, 17.5, 22 kPa). The quick undrained shear strength properties were determined using the conventional Static Cone Penetration Test (SCPT) method and the new Fall Cone Test (FCT) method. The corresponding void ratios and densities with respect to the quick undrained shear strength were also observed. Correlations of the physical properties and quick undrained shear strengths derived from the SCPT and FCT were also established. Comparison of results showed a significant relationship between the two methods. From the results of FCT and SCPT, there is a decreasing trend of quick undrained shear strength, strength increase ratio ($S_u/P_o$), and void ratio (e) as the sand content is increased. The quick undrained shear strength generally decreases with increased water content. For the same water content, increasing the sand content resulted to a decrease in quick undrained shear strength due to reduced adhesion, and also, resulted to an increase in density. Similarly, it is observed that the change in density is distinctively noticeable at sand content greater than 20%. However, for sand content lower than 10%, there is minimal change in density with respect to water content. In general, the results showed a decrease in quick undrained shear strength for soils with higher amounts of sand content. Therefore, as the soil adhesion is reduced, the cone penetration resistances of the FCT and SCPT reflects internal friction and density of sand in the total shear strength.

Nephropathy in Chronic Lead Poisoning (만성 연중독자에서 발생한 신장해)

  • Kim, Byoung-Gwon;Kim, Sung-Ryul;Hong, Young-Seoub;Rha, Seo-Hee;Kim, Jung-Man;Jung, Kap-Yull;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.43-50
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    • 1996
  • We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.

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An Inquiry on the effect of the formation Jhāpeti-Rites 『Seongmunsanguicho (釋門喪儀抄)』 in 『Osamnanyasinhakbiyoung(五杉練若新學備用)』 (『오삼연약신학비용(五杉練若新學備用)』이 다비법 『석문상의초(釋門喪儀抄)』 성립에 미친 영향)

  • Lee, Sun-Yi
    • (The)Study of the Eastern Classic
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    • no.59
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    • pp.359-386
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    • 2015
  • To date, the study of the $jh{\bar{a}}peti$ is small. "Osamnanyasinhakbiyoung" was found in the Gumamodo University in 2006, research has gained a new opportunity. The '연약(練若)' of "Osamyunyaksinhakbiyoung(오삼연약신학비용)" is an abbreviation of ara?ya should be unified in "Osamnanyasinhakbiyoung(五衫練若新學備用)". The second volume contains the following information. Since the Buddhist ritual of ordinary people, this made according to fit the rules in accordance with the environment(隨方毗尼). Obok(五服) is called according to the meaning Osam(五衫) of dressed standard. Gamguhyodangdo is to install one incense and one lanterns to illuminate their own buddha, is where enshrines the relics(śarīra). Back to the article, which should show the face bitter and sad hearts. Over white paper it should represent an article. Posts containing the meaning of the sacrifice must necessarily meant to inform heaven as articles for the dead. Such "Osamnanyasinhakbiyoung" of structure and contents of the second volume was reflected in "Sungmoonsanguicho(釋門喪儀抄)". "Osamnanyasinhakbiyoung" written intent is reflected in the prolegomena of the "Sungmoonsanguicho" it influenced $Jh{\bar{a}}peti$-Rites during the Joseon Dynasty. "Osamnanyasinhakbiyoung" of prepare after death and "Sunksiyoram(釋氏要覽)" of funeral was incorporated as "Sungmoonsanguicho". It built the $st{\bar{u}}pa$ is a symbol of tranquility achieved a kind of enlightenment. Human life ends with death, and it completed the $Jh{\bar{a}}peti$-Rites in "Sungmoonsanguicho". The significance here is in. Tying the funeral and burial in one enshrine the relics will be shown on the top by the completion of life. In particular, Kankyungdogam(刊經都監) published in the $Jh{\bar{a}}peti$-Rites "Osamnanyasinhakbiyoung" were engraved production and dissemination. That it will have another significance.

Effects Unripe and Ripe Rubus coreanus Miquel on Peritoneal Macrophage Gene Expression Using cDNA Microarray Analysis (미숙과와 성숙과 복분자의 섭취가 복강 Macrophages의 유전자 발현에 미치는 영향)

  • Lee, Jung Eun;Cho, Soo-Muk;Kim, Jin;Kim, Jung-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.10
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    • pp.1552-1559
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    • 2013
  • Rubus coreanus Miquel (RCM) has been used as one of the Korean traditional medicines for prostate health. In addition, recent studies have reported that RCM reduced chronic inflammatory diseases such as cancer, and rheumatoid arthritis. Therefore, in this study, we investigated the effects of unripe and ripe RCM on inflammationrelated gene expressions in LPS-stimulated mouse peritoneal macrophages. Mice were fed with 2% unripe RCM (U2), 10% unripe RCM (U10), 2% ripe RCM (R2), and 10% ripe RCM (R10) for 8 weeks. Peritoneal macrophages were isolated and stimulated with LPS then proinflammatory mediators (TNF-${\alpha}$, IL-$1{\beta}$, and IL-6), and prostaglandin E2 ($PGE_2$) productions were assessed. Moreover, gene expression profiles were analyzed by cDNA microarray method. Unripe and ripe RCM significantly reduced TNF-${\alpha}$ production but only unripe RCM decreased IL-$1{\beta}$ and IL-6 production. RCM intake significantly reduced inflammatory-related gene expressions such as arachidonate 5-lipoxygenase, interleukin 11, and nitric oxide synthase 2. Furthermore, unripe and ripe RCM significantly decreased ceruloplasmin, tissue plasminogen activator, thrombospondin 1, and vascular endothelial growth factor A expression which modulates symptoms of chronic inflammatory diseases. RCM intake also significantly increased hypoxia inducible factor 3, alpha which is the negative regulators of hypoxia-inducible gene expression. Furthermore, only unripe RCM reduced chemokine (C-C motif) ligand 8, chemokine (C-X-C motif) ligand 14, and phospholipase A2 expression. In this study, we showed that RCM had anti-inflammatory effects by suppression of pro-inflammatory mediator expressions and may reduce chronic inflammatory disease progress through regulation of gene expressions. These findings suggest that RCM might be used as a potential functional material to reduce chronic inflammatory responses.

A Comparative Study on Closed vs. Open Endotracheal Suctioning on the Newborn Infants Treated with Ventilator (인공호흡기 사용 신생아의 폐쇄형과 개방형 기관흡인에 관한 연구)

  • Park, Jeong-Won;Park, Yeong-Ae
    • 아동간호학회:학술대회논문집
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    • 1997.11a
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    • pp.61-74
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    • 1997
  • Endotracheal suctioning is a routine procedure used for clearing secretions from the airway of the intubated infant. This procedure is not without complications. Endotracheal suctioning has been associated with decreases in $PaO_2$, decreases in systemic venous oxygenation, alterations in mean arterial Pressure, disturbances in cardiac rhythm and development of nosocomial pneumonia. So several endotracheal suctioning techniques have been developed to prevent these blown complications. Another method of Endotracheal suctioning eliminates the risk associated with disconnecting the infant from the ventilatior to perform the suctioning procedure. Studies examining closed endotracheal suctioning methods reported that the closed method results in less arterial oxygen saturation, and less systemic venous oxygen desaturation. However those studies have focused on adult patients, and there have been no published studies for newborn infants. The specific purpose of this study is to investigate the two methods and to make a comparison in terms of (1)variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning; (2)difference in occurrence of nosocomial infection; (3)difference in recovery time to arrive at pre-suction baseline after suctioning and in nursing time taken for the suctioning. The present study is based on the data obtained from two groups of newborn infants : one group comprises 8 infants with closed suctioning (a total of 304 suctions) among 17 infants treated with ventilator and the other group 9 infants with open method (a total of 629 suctions). The data were analyzed using the SPSS statistical program package. As the distribution test on dependent variables with the Skewnesser Shapiro Wilk test showed an asymmetric distribution, the Wilcoxon Matched-pairs Singled- Ranks test was used for the test of variations in $SaO_2$, heart rate, and respiration rate appeared before and after the endotracheal suctioning. The difference in $SaO_2$ recovery time and nursing time was analyzed with the Mann-Whitney U-Test. The difference in physiologic consequences and occurrence of nosocomial infection between the two groups was analyzed with the Fisher's Exact Test. The results of the study are summarized as follows. For the hypothesis 1 (There would be a difference in $SaO_2$, heart rate, and respiration rate before and after suctioning between the two suctioning methods), the difference in $SaO_2$ turns out to be statistically significant (P=0.015), but heart rate and respiration rate do not procedure a notable difference (P=0.630). The hypothesis 2 (There would be a difference in rates at which a complication arises after suctioning between the two groups) does not prove to be statistically valid (P=0.246). For the hypothesis 3(There would be a difference in $SaO_2$ recovery time and nursing time between the two groups), the average $SaO_2$ recovery time after suctioning turned out to have somewhat significant difference (P=0.064), however the difference in nursing time taken for the suctioning was not statistically significant (P=0.610). The analyses indicate that the closed endotracheal suctioning is more efficient as compared with the open method, in maintaining pre-suction baseline $SaO_2$ and a rapid recovery of newborn infants. Based on these results we suggust to apply the closed method to newborn infants in the ventilation treatment. We also suggest to extend the investigation to include the comparison of suction cost taking into account the case in which a complication arises after endotracheal suctioning between the two groups.

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Clinical Characteristics of Mycoplasma pneumoniae Pneumonia in Children during Recent 10 Years (최근 10년간 Mycoplasma pneumoniae 폐염의 임상양상에 대한 고찰)

  • Lee, Gang Woo;Ryu, Ho Jun;Kim, Il Kyung;Seong, Ho;Choi, Chang Hee
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.86-92
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    • 1999
  • Purpose : The purpose of this study is to know the epidemiology and clinical characteristics in patients with M. pneumoniae pneumonia during study period retrospectively. Methods : We had reviewed 500 patients with Mycoplasma pneumoniae pneumonia who were hospitalized at the pediatric ward of Seoul Adventist Hospital from July 1986 through June 1996. we had analysed clinical and laboratory problems of pulmonary and extrapulmonary manifestations including demographics and epidemiological characteristics. Results : Peak occurrence of the disease was 3 years interval and seasonal occurrence of the disease had no difference. 43.4% of patients was below 4 years old and male to female ratio was nearly 1:1. The most common site of infiltration on chest PA was right lower lobe and the most common type of pneumonia was interstitial pneumonia(43%). Pulmonary complications were atelectasis(11cases), emphysema(5cases), pleural effusion(27cases) and sinusitis(13cases) and extrapulmonary manifestations were hepatitis(109cases), skin rash(29cases), proteinuria(20cases) and hematuria(16cases). cold agglutinin test was carried out in 500cases and mycoplasma antibody test was carried out in 448cases. sensitivity of mycoplasma antibody test was 53.3%. Conclusion : Mycoplasma pneumoniae pneumonia showed epidemics at intervals of 3 year in its major occurrence. it exhibits a tendency that occurs at younger age group not in school age group. diagnosis of the disease need more accurate method due to low sensitivity of mycoplasma antibody test. also we need to carried out other laboratory test(for example, LFT, U/A).

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The Effect of Temporary Cement Cleaning Methods on the Retentive Strength of Cementation Type Implant Prostheses (임시 시멘트 제거방법이 시멘트 유지형 임플란트 보철물의 유지력에 미치는 영향)

  • Shin, Hwang-Kyu;Song, Young-Gyun;Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.125-140
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    • 2011
  • The remnant of temporary cement on the intaglio surface of cast restoration may have a negative effect on the retentive strength of permanent cement. This study was to evaluate the effect of temporary cement cleaning methods on the retentive strength of cementation type implant prostheses. Prefabricated implant abutments - height 5.5mm, diameter 4.5mm, 6 degree axial wall taper with chamfer margins were used. Forty copings-abutment specimens were divided into four groups(each n=10) according to the cleaning methods for temporary cement(Temp-$Bond^{(R)}$) as follows : no temporary cementation(the control group), orange solvent, ultrasonic cleaning, air borne-particle abrasion. After the application of temporary cement and the separation, the cleaning procedure was performed according to the protocol of each group. The specimens were cemented with $Premier^{(R)}$ Implant $Cement^{TM}$. After the permanent cementation, the specimens were subjected to thermocycling and pulled out from the specimens with a universal testing machine at a cross-head speed of 0.5mm/min. After the retentive strength test, all the specimens were cleaned using ultrasonic cleaning, abraded with air borne-particles, and steam-cleaned. Likewise, the specimens were temporarily cemented(Temp-$Bond^{(R)}$ NE), cleaned according to the protocol of each group, cemented with $Premier^{(R)}$ Implant $Cement^{TM}$ and subjected to thermocycling and measurement of their retentive strength. The mean of group with orange solvent were significantly lower than those of other groups(p<0.05). There was no significance between group with ultrasonic cleaning and group with air borne-particle abrasion. Group with ultrasonic cleaning and group with air-particle abrasion were no significance at control group. There was no significance between group cemented with Temp-$Bond^{(R)}$ and group cemented with Temp-$Bond^{(R)}$ NE. Within the limitation of this study, it can be concluded that the temporary cement cleaning method with only orange solvent may have a negative effect on the retentive strength of permanent cement. Ultrasonic cleaning and air borne-particle abrasion methods are recommended for the temporary cement cleaning method on cementation type implant prostheses.

An Analysis on Changing Pattern of Economic Active Population by Working Life Table for Korean Men (우리나라 노동생명표에 의한 노동력추이 분석)

  • 조진만
    • Korea journal of population studies
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    • v.13 no.2
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    • pp.1-18
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    • 1990
  • This is a study which attempt to analyze changing patierns of economic active popu-lation, t o estimato- future patterns, and exa- mine vartons problems arises by changing c ire u mst ances of t he labor force market in- clunging soici al, economic ic, heathl th and demoi-graph ic aspects. We have constructed series of wotking life table which are useful in syt uiolyioig the lirocess of growth and structural change of labor force. Work i ng life tables represent ihie life eyele of econrmic' activity in hi ypothetical cohorts, that is. gen-erat i on of men Sn bject at eat' b period ot f their lives th given ra to's o mor tali it y and of par-- tici pation in economic activities. The tabloes prot' ide measorues of the alvet'age he ng t able of economically aeti \- e life. and agespecific rates of en trannee' into and retirement from the hahn' force. In const routing working life tables, age-specific activity rates and life tabole popula- titoto which represents contemporary condi-tions of moortality in Korea au'e the basic' maltoerials. We have derived the age-specific rates foorm economically active population survey, whoich were conducted by the Bureau of Statistics, Economic Planning Borard of the Korean government. Working life tables are constructed for men wtable these materi- als in the year of 1970, 1980 and 1988 by a modified Wolfbein-Wool's method. Some of the findings may be summerized as follow : 1) A central part of constructing working life table is calculation of stationary' economic active population, which represents the number of men in the stationtary population extoected to be in the labor force at each age group in the life span. The stationary economic active population by age have generally a universal pattern, where they rise sharply in the early twenties, approach its' peak in the thirties decline thereafter. at first graolually and then more rapidly at an advanced age. Korean men show the same general pa ttern of age distribution of stationary eco-- nomic active population with sharp increase hegining from the age interval of 20 to 24, reaching to maximum level at older age. The population. however, presumably, increased substantially due to increaseing school atte endance rates. Another difference exiSts in the youngest age groups, that is the activity rate in the year of 1988 is lower than that of Japan. The table shows an analysis of changes in the age distrihution of labor force between 1970, 1980 and 1988. 2) It was shown an analysis of changes in the age distribution and cause of separation from labor force. The entrance rate to labor force has increased from 18~\5 persons to 299 persons per 1000 head of stationary population between that of 1980 than that of 1988 for Korean men in 20~24 age group. The entrace rate to labor force shows a rapid entrance appearance concentrated on the 15~24 age group. The separation rate from labor force by retirment in Korea in the year of 1988 shows a great difference of the about four times as much as that of Japan. 3) The functions of table illustrate the patterns of working life of males in Korea in 1970, 1980 and 1988. The average remaining number of economically active years, e at age 15 in 1988 is 46.39 which is 2.12 years of increase compared with that of at age 15 in 1970,1980 and 1988 are 43.90,44.27 and 46.39 respectively, showing steadily increase dur- ing the past double decade the increase in the length of economically active life various age may be considered to have come both from extention of general life expectancy and from increasing entrance rate to economic activity in high age that of working is far greater in 1988 than that of 1980. The gaps between expectation of life and average remaining years of economically active widened due to rapid improvement of mortality level in Ko- rea. This observation together with the population pressure by the appearance of a group of younger population implies that constant increase of economically inactive population among older age group.

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