• Journal of Chest Surgery
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• v.31 no.10
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• pp.988-994
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• 1998

Background: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. Materials and methods: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. Results: Among a total of 68 patients 33(48.5%) were males and 35(51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients(17.6%) were from the 6th decade, and 10 patients(14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases(32.1%) were in the 4th decade and among the malignant tumors, 6 cases(40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases(26.4%). Osteochondroma and lipoma each had 8 cases(15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications(and their postoperative courses were uneventful). Conclusions: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

• Journal of Nutrition and Health
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• v.9 no.4
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• pp.4-8
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• 1976

영양지도원(營養指導員)은 자신(自身)이 알고 있는 기술(技術)을 다른 사람에게 전달(傳達)하여 그 사람으로 하여금 지도원(指導員)이 원하는 방향(方向)으로 행동(行動)을 하도록 해야 한다. 따라서 다른 사람을 지도(指導)하려면은 우선 지도원 자신(指導員自身)의 우수한 자질(資質)"이 필요(必要) 하며 이를 위(爲)하여 기술자(技術者)로서의 연마(硏磨)와 겸(兼)하여 인간(人間)의 지도자(指導者)로서의 수양(修養)을 쌓아야 한다. 그리하여 영양개선(營養改善) 의 선도적(先導的) 점화자(點火者)로 "뒤에서 계속 미는" 지원자(支援者)로서의 역할(役割)을 수행(遂行)하여야 한다. (1) 현직능별(現職能別) 영양지도원(營養指導員)의 범위(範圍)를 보건소(保健所)의 보건지도원(保健指導員), 농촌지도소(農村指導所)의 생활지도요원(生活指導要員), 군면(郡面)의 행정지도요원(行政指導要員), 농협(農協)의 부여지도요원(婦女指導要員), 의료계(醫療界)의 의사(醫師), 간호원(看護員), 조산원(助産員), 학교(學校) 교육기관(敎育機關)의 교사(敎師), 영양사(營養士), 영리회사(營利會社)의 사원(社員) 등을 들 수 있다. (2) 지도대상(指導對象)과 그 장소(場所)는 공장(工場), 학교(學校), 훈련장(訓練場), 병원(病院), 복지시설(福祉施設)과 공동취사(共同炊事) 재해시등(災害時等)의 집단급식장(集團給食場)과 이를 이용(利用)하는 對象者(대상자) 도시(都市) 농촌(農村)의 일반가정(一般家庭)의 주민(住民), 그리고 교실(敎室)에서 학교교과목(學校敎科目)을 통(通)한 학생(學生)의 학습(學習) 새마을운동(運動) 공보시설(公報施設)을 통(通)하여 대중(大衆)에게 "지도(指導)를 지도원(指導員)이" 전개(展開)할 수 있다. (3) 지도방법(指導方法)은 일반적(一般的) 학교교육과정(學校敎育過程)의 교육방법(敎育方法)을 적용(適用)하되 교외교육(校外敎育)이라는 점(點)을 잊어서는 안된다. 현실적(現實的)으로 이론(理論)과 경험(經驗)을 병행활용(倂行活用)하며 영양학(營養學)의 연구결과(硏究結果)가 반드시 또 는 곧 가정생활(家庭生活) 개인생활(個人生活)에 적응(適應)되는 것이 아니며, 행동화(行動化)되지 않는 지식(知識)과 기술(技術)은 무용(無用)하게 되므로 "다고 말 할 수 있다. 따라서 영양개선(營養改善)을 지도(指導)하는 지도원(指導員)은 받아들이는 가정(家庭)이나 개인(個人)의 입장(立場)에서 여러 가지 여건을 파악 최대공약수(最大公約數)의 가능치(可能値)를 알아내서 지도(指導)해야 된다. (4) 영양지도(營養指導)는 기술(技術)이 ,포함(包含)되어 있기 때문에 기술(技術)의 전달과정(傳達過程)을 분석(分析)해야 되고 (5) 지도원(指導員) 자신의 무장(武裝)을 위(爲)하여 자신(自身)의 기술지도(技術指導) 방법(方法), 인간지도자(人間指導者)로서의 능력향상(能力向上)을 독서(讀書), 교육(敎育), 훈련(訓練) 을 통(通)하여 배워 기술자(技術者)로서 인간지도자(人間指導者)로서 전달자(傳達者)로 서의 교양(敎養)을 가져야 한다. (6) 지도원(指導員)의 활동성과(活動成果)는 지도원(指導員) 자신의 열의(熱意)와 받아들이는 사람의 열의(熱意)에 의(依)하여 좌우(左右)된다. 즉(卽) 지도원(指導員)의 열의(熱意)${\times}$피지도자(被指導者)의 열의(熱意)=지도성과(指導成果) $[L{\times}P=f(L{\cdot}P)]$로 나타난다. 결론적(結論的)으로 지도원(指導員)은 영양개선(營養改善)의 전문적(專門的) 각 요소(各要素)를 깊이 알고 이것을 다시 종합(綜合)하고 체계화(體系化)할 줄 알며 직능별(職能別) 각 지도원(各指導員)과의 상호(相互) 협조(協助)로 서로 보완(補完)하고 새마을 운동(運動)과 그 직장(職場) 또는 환경(環境)여건에 결부(結付)되고 현실적(現實的)으로 행동화(行動化)할 수 있는 단계적(的) 장단기계획(長短期計劃)과 평가방법(評價方法)을 숙지(熟知)하여 또 지도방법(指導方法)에 필요(必要)한 교재(敎材)를 충실(充實)히 준비하여 자신(自身)의 실력(實力)을 충분(充分)히 발휘할 수 있도록 하여 자기 열의(熱意)를 다하고" 영양개선(營養改善)의 선도적(先導的) 점화자(點火者)로서 "계속 뒤에서 미는" 지원자(支援者)로서 사명(使命)을 다할 때 그 역할(役割)을 다하는 것이다.

• 대한공업교육학회지
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• v.38 no.1
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• pp.125-143
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• 2013

The purpose of this study was to investigate the current Status and practical use of technology laboratory at the junior high school in Chungbuk Province in order to give some suggestions on hands-on activities for technology education. First, concerning present actual conditions of technology laboratory, There was a large disparity between the urban and rural schools in the possession of a technology laboratory, as the rate of the schools equipped with the rooms respectively stood at 69.84 percent and 33.38 percent in the urban and rural regions. By the type of foundation, every national school, 86.24 percent of the public schools and 37.50 percent of the private schools were equipped with the technology laboratory. By school size, 35.59 of the schools with fewer than 10 classes, 62.11 percent of the schools with 10 to fewer than 30 classes and 85.71 percent of the schools with 31 classes or more were in possession of the laboratory. Thus, the type of foundation and school size made differences to that. As a result of asking the schools without the laboratory about the reason, as many as 88.52 percent had been equipped with the laboratory in the past but converted them into spaces for another purpose. When the schools that had no such laboratory were asked a question whether they had any plans to install a technology laboratory, just five schools(8.19%) had that plan. Second, as for the practical use of the technology laboratory, for what the rooms were actually used was asked, and most of the schools made use of them as Comprehensive General laboratory. As to the size of the rooms, each of the rooms was as large as a classroom($66m^2$) in 62.12 percent of the schools, and their region, type of foundation and student gender made little significant differences to that. Regarding the time for utilizing the laboratory, the majority of the schools used the laboratory approximately once or twice a year, and their region, type of foundation, student gender and school size made few distinctive differences to that. In terms of budget for practice in the rooms, the largest number of the schools that accounted for 36.36 percent earmarked three thousand won to less than five thousand won per student.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.59-62
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• 1996

Chemical pleurodesis with doxycycline has been used during video-assisted thoracoscopic surgery (VATS) as an auxiliary method to enhance therapeutic goal in patients with pneumothorax. However, the therapeutic effect of doxycycline pleurodesis (DP) has not been clearly defined yet. To evaluate the effect of DP, we compared two groups of patients who were given VATS bullectomy from October 1993 to June 1995. Group I composed of 21 patients who received DP and group II composed of 20 patients who did not received DP Doxycycline 500mg with saline 200ml were instilled into the pleural cavity upon a completion of bullec omy, and retained there for 0.5-1 hour and then drained out. The age of group I was 30.9 $\pm$ 20.0 and that of group II was 24.3 $\pm$ 9.49 years. Male to female ratio was 20: I in group I and 20 : 0 in group II. The postoperative indwelling time of chest tube was 5.86 $\pm$ 4.69 days in group I and 3.80 $\pm$ 2.28 days in group II. Seven patients had more than 100m1/day of chest tube drainage on the postoperative third day in group I compared to one patient in group II. Five patients had postoperative indwelling time of chest tube greater than 7 days in group I compared to two in group II. The number of patients who had postoperative fever were 3 in both group, analgesic requirements were 2.19 $\pm$ 2.77 amples in group I and 2.30 $\pm$ 1.95 ambles in group II. Follow-up was done from 2 months to 16 months after surgery. During the follow up periods, four patients had recurrence 2 (9.5%) in group I and 2 (10%) in group II. We conclude that concomitant doxycycline pleurodesis with video-assisted thor coscopic bullectomy In patients with pneumothorax is not necessary.

• The Korean Nurse
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• v.34 no.3
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• pp.85-98
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• 1995

The purpose of this study is to provide basic data regarding effective learning opportunities in childbirth education classes. Also analysis of the data indicates the optimum conditions for the welfare and improvements in the promotion of health in childbearing mothers. The results of this study are as follows; 1) The average age of the subjects in this study was 30.6 years and the total number of subjects was 58 pregnant women. The average number of children was one and 84.5% of the subjects were unemployed even though 63.8% of them held over bachelor's degrees. It was found that 22.4% of the subjects were living in an extended family. Also 61.5% of them were living with parents-in-law. The number of pregnancies were calssified as one, two, or three to nine times with the percentages of 58.7%, 22.4% and 18.9%, respectively. Further, 72.4% of the subjects had no abortion experience and 15.5% had one aborion experience. While 89.7% of the subjects planned to feed their babies with breastmilk, mixed feeding were used by only 22.4% of the sample. These data were collected at about 6 months after delivery. Thus one can see that a low rate of breastfeeding was common. 2) The length of one period of childbirth education is four weeks. It was found that 36.2% of the subjects participated in childbirth education only once, where as 13.8% participated four times and 19% of the subjects participated in this class more than four times. pregnant at least once. Further, 75.9% of the participants were participated in this education through their own will. Their motivation for participation developed through information, advertisement and posters which contained information on childbirth education. Those with unplanned pregnancies 92.9% participated after a suggestion by the nurses. The number of participants in terms of percentage according to the childbirth education contents can be classified as following. The most active participation was shown in preparation of delivery(77.6%), postpartrm management(56.9%) fetal development(37.6%) and physiology of pregnancy(17.2%). It was found that 75.9% of the subjects were willing to participate again if they were given a chance. The reason can be summarized as following: The content of the education is very helpful(47.7%). Scientific knowledge can be obtained through this program(20.5%). Participation helps in achieving psychological stability(9.1%). Participation enables one to establish a friendly relationship with other participants(6.8%) of the sample. 24.1% of the participants did not want to participate again. The reasons can be as following: They do not want another baby(42.9%). The first paricipation in childbirth education gave enough knowledge about childbirth(21.4%). Another reason for not want to participate again was because they had a cesarean birth(14.3%). Only 7.1% of them responded with a negative view. A response that they do not need childbirth education after their operation can be traced back to the general belief that childbirth education is the place where one prepares for natural birth through the Lamaze breathing technique. Of the subjects, 91.4% suggested that this program could be recommended to other childbearing mothers, because this program gave educational content along with psychological stability for childbearing women. Of the subjects 41.4% did not see any efforts towards the welfare of the baby, where as 88.2% did. Among the subjects 58.6% made some effort to eliminate the discomfort of labor by breathing and imagination and breathing and walking. Further 41.7% of the 24 subjects did not do anything toward the welfare of the baby, because they did have a cesarean section so that they didn't have a chance even though they had been educated about childbirth. Also 33.3% of the subjects did not do anything toward the welfare of the baby, because they lacked a willingness. After leaving the hospital, only 75.9% of the subjects did some exercises. The subjects who tried participate this program with their husband accounted for 20.7% of the sample. Interviewing with the subjects solved some of the uneasiness and. fear of delivery, increased self-confidence in parenting and active coping in the delivery process.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.130-137
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• 1999

Background: In cardiac surgery, hypothermia is associated with a number of major disadvantage, including its detrimental effects on enzymatic function, energy generation and cellular integrity. Warm cardioplegia with normothermic cardiopulmonary bypass cause three times more incidence of permanent neurologic deficits than the cold crystalloid cardioplegia with hypothermic cardiopulmonary bypass. Interruptions or inadequate distribution of warm cardioplegia may induce anaerobic metabolism and warm ischemic injury. To avoid these problems, tepid blood cardioplegia was recently introduced. Material and Method: To evaluate whether continuous tepid blood cardioplegia is beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Warm group(37$^{\circ}C$) consisted of 18 patients who underwent valvular surgery with continuous warm blood cardioplegia. Tepid group(32$^{\circ}C$) consisted of 17 patients who underwent valvular surgery with continuous tepid blood cardioplegia. Result: Heartbeat in 100% of the patients receiving continuous warm blood cardioplegia and 88.2% of the patients receiving continuous tepid blood cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic cross clamp. There were no differences between these two groups in CPB time, ACC time, the amount of crystalloid cardioplegia used and peak level of potassium. During the operation, the total amount of urine output was more in the warm group than the tepid group(2372${\pm}$243 ml versus 1535${\pm}$130 ml, p<0.01). There were no differences between the two groups in troponin T level measured 1hr and 12hrs after the operation. Conclusion: Continuous tepid blood cardioplegia is as safe and effective as continuous warm blood cardioplegia undergoing cardiac valve surgery in myocardial protection.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.510-517
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• 1999

Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1095-1101
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• 1996

From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.272-276
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• 2004

Purpose: The incidence of nodal metastases is as low as 2 to $20\%$ in early gastric cancer, so there is a trend to lessen the extent of surgery. In addition, the adequate range for a lymphadenectomy is controversial, especially in early gastric cancer. In this study, we tried to find the minimal range for a lymphadenectomy by analyzing sentinel-node and solitary lymph-node metastases in gastric cancer. Materials and Methods: The total of 78 patients who underwent a curative gastrectomy with a D2 lymphadenectomy for early gastric cancer between 2000 and 2002 in the Department of Surgery, Yonsei University, Seoul, Korea, were included for the evaluation of sentinel-node metastases.. After a laparotomy, 25 mg of indocyanine green was mixed in 5 ml of normal saline, and all the dye was injected into the subserosal layer around the primary tumor. All nodes stained within 5 minutes were marked. In addition, a total of 141 patients, who underwent a curative gastrectomy between 1997 and 2001 at the Department of Surgery, Yonsei University, Seoul, Korea, were analyzed for solitary lymph- node metastases. Results: Among the 78 patients, sentinel nodes were detected in 69 patients ($88.5\%$). The sentinel nodes in 60 cases ($87.0\%$) were located in the perigastric area. However, 9 cases ($13.0\%$) had sentinel nodes in the N2 group. In the 141 cases that had a solitary metastatic node, 125 cases ($88.6\%$) demonstrated the metastatic lymph node in the perigastric area, and 16 cases ($11.4\%$) showed that the metastatic node in the N2 group. Conclusion: Taken together, removal of a perigastric lymph node could miss early metastases in gastric cancer, so a D1 lymphadenectomy should not be the minimal range of dissection if a lymphadenectomy is necessary. (J Korean Gastric Cancer Assoc 2004;4:272-276)

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.292-296
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• 2007

Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter ($Pleuracan^{(R)}$) for the initial treatment of primary spontaneous pneumothorax. Material and Method: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P ($Pleuracan^{(R)}$ group). Result: Initially, the $Pleuracan^{(R)}$ catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%) : three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time ($T:\;2.1{\pm}1.5\;days,\;P:\;2.1{\pm}1.3\;days$), hospital stay ($T:\;6.4{\pm}5.4\;days,\;P:\;5.2{\pm}2.9\;days$) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy(T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage ($T:\;0.5{\pm}0.7\;days,\;P:\;0.5{\pm}1.2\;days$) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. Conclusion: Application of the $Pleuracan^{(R)}$ catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.