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Radiotherapy Results for Recurrent Uterine Cervical Cancer after Surgery (수술 후 국소재발한 자궁경부암에서의 방사선치료 성적)

  • Ryu Mi Ryeong;Kay Chul Seung;Kang Ki Moon;Kim Yeon Shil;Chung Su Mi;Namkoong Sung Eun;Yoon Sei Chul
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.217-222
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    • 1999
  • Purpose : To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. Materials and Methods : Between October 1983 and July 1990, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five ($84.9\%$) patients had squamous cell carcinoma, seven ($13.2\%$) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients ($77.4\%$) and pelvic side wall in 12 patients ($22.6\%$). Recurrent tumor size was devided into two groups : less than 3 cm in 43 patients ($81.1\%$) and more than 3 cm in 10 patients ($18.9\%$). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients ($34\%$) or intracavitary irradiation in 24 patients ($45.3\%$). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. Results : Overall response rate was $66\%$ (35/53). Among them, six patients ($17.1\%$) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months), Therefore overall recurrence rate was $45.3\%$. Overall five-year actuarial survival rate was $78.9\%$ and distant failure rate was $10\%$ (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 ($20/%$) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. Conclustion : Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer.

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Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients (승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰)

  • Sim, Hyung-Tae;Yun, Tae-Jin;Park, Jeong-Jun;Jung, Sung-Ho;Uhm, Ju-Yeon;Jhang, Won-Kyoung;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.536-545
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    • 2007
  • Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

Mineralogy and Biogeochemistry of Intertidal Flat Sediment, Muan, Chonnam, Korea (전남 무안 갯벌 퇴적물에 관한 광물학적 및 생지화학적 연구)

  • Park, Byung-No;Lee, Je-Hyun;Oh, Jong-Min;Lee, Seuug-Hee;Han, Ji-Hee;Kim, Yu-Mi;Seo, Hyun-Hee;Roh, Yul
    • Journal of the Mineralogical Society of Korea
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    • v.20 no.1 s.51
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    • pp.47-60
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    • 2007
  • While sedimentological researches on Western coastal tidal flats of Korea have been much pelformed previously, mineralogical and biogeochemical studies are beginning to be studied. The objectives of this study were to investigate mineralogical characteritics of the inter-tidal flat sediments and to explore phase transformation of iron(oxyhydr)oxides and biomineralization by metal-reducing bacteria enriched from the inter-tidal flat sediments from Muan, Jeollanam-do, Korea. Inter-tidal flat sediment samples were collected in Chungkye-myun and Haeje-myun, Muan-gun, Jeollanam-do. Particle size analyses were performed using the pipette method and sedimentation method. The separates including sand, silt and clay fractions were examined by scanning electron microscopy (SEM) with energy dispersive X-ray (EDX) analysis, transmission electron microscopy (TEM), and X-ray diffiaction (XRD). After enriching the metal-.educing bacteria from the into,-tidal flat sediments, the bacteria were used to study phase transformation of the synthesized iron (oxyhydr)oxides and iron biomineralization using lactate or glucose as the electron donors and Fe(III)-containing iron oxides as the electron accepters. Mineralogical studies showed that the sediments of tidal flats in Chung]rye-myun and Haeje-myun consist of quartz, plagioclase, microcline, biotite, kaolinite and illite. Biogeochemical researches showed that the metal-reducing bacteria enriched from the inter-tidal flat sediments reduced reddish brown akaganeite and mineralized nanometer-sized black magnetite. The bacteria also reduced the reddish brown ferrihydrite into black amorphous phases and reduced the yellowish goethite into greenish with formation of nm-sized phases. These results indicate that microbial Fe(III) reduction may play one of important roles in iron and carbon biogeochemistry as well as iron biomineralization in subsurface environments.

Evaluation of External Quality of Brand Soybeans (콩 시판 브랜드 제품의 외관 품질 평가)

  • Jong, Seung-Keun;Woo, Shun-Hee;Kim, Hong-Sig
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.3
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    • pp.239-248
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    • 2007
  • Although high nutritional values and continuous identification of important functional substances of soybean [Glycine max (L.) Merrill.] promote consumption of soybean products worldwide, informations on quality of brand soybean is not enough for consumers. Total of 100 brand soybeans [32 for soypaste and source, 45 black testa (lage), and 17 black testa (small) or medicinal soybean and beansprout soybean] were collected at supermarkets and several external quality factors were analyzed. Brand soybeans were marked with the environmental friendly and intimating words along with soybean (white or yellow), black soybean (black-, frost-, late frost-, green or inner-green-), medicinal soybean and beansprout soybean. Among 100 brand soybeans 30% was 1 kg package and 59% was 500 g package, difference between printed and actual weights of 70% brand soybeans was ${\pm}1%$ and weights of 2/3 of brand soybeans were higher than printed weight. Range of 100 seed weights of soypaste and source, black testa (large) and black testa (small) and beansprout soybeans were $23.7{\sim}47.8g$, $21.9{\sim}44.5g$ and $9.5{\sim}15.0g$, respectively. Although ranges of 100 seed weights of soypaste and source and black testa (large) soybeans were similar, 63% of soypaste and source were less than 29 g, while 78% of black testa (large) soybeans were higher than 30 g. Although average and highest percentages of seeds separated with 6.7 mm sieve were similar with 87.4% and 99.9% for soypaste and source soybean and 86.5% and 99.5% for black testa (large) soybean, respectively, the lowest percentages were 70.7% for soypaste and source soybean and 14.4% for black testa (large) soybean. When 100 seed weight was greater than 35 g, 90% of seeds were remained on 6.7 mm sieve. On the other hand 100 g weight and percentage of seeds remained on 6.7 mm sieve showed significantly positive correlations [r=0.7488** for soypaste and source soybean and r=0.7874** for black testa (large) soybean when 100 seed weight was $20{\sim}30g$. Based on hilum color and/or appearance, 76% of brand soybeans collected (more than 90% in yellow testa soybeans) were found to be mixed more than 10% with other cultivars or landraces. Foreign materials such as sand, piece of clothe, wood piece, dead insects, other soybeans were found in 20% of brand soybeans. Average test weight of brand soybeans was 762g $L^{-1}$ with a range of $645{\sim}820g\;L^{-1}$. Soybeans from local markets were as good as brand soybeans in 100 seed weight, uniformity of seeds, weight of foreign materials and test weight.

Mesothermal Gold Mineralization in the Boseong-Jangheung area, Chollanamdo-province (전라남도 보성-장흥지역의 중열수 금광화작용)

  • 허철호;윤성택;소칠섭
    • Economic and Environmental Geology
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    • v.35 no.5
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    • pp.379-393
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    • 2002
  • Within the Boseong-Jangheung area of Korea, five hydrothermal gold (-silver) quartz vein deposits occur. They have the characteristic features as follows: the relatively gold-rich nature of e1ectrurns; the absence of Ag-Sb( -As) sulfosalt mineral; the massive and simple mineralogy of veins. They suggest that gold mineralization in this area is correlated with late Jurassic to Early Cretaceous, mesothermal-type gold deposits in Korea. Fluid inclusion data show that fluid inclusions in stage I quartz of the mine area homogenize over a wide temperature range of 200$^{\circ}$ to 460$^{\circ}$C with salinities of 0.0 to 13.8 equiv. wt. % NaCI. The homogenization temperature of fluid inclusions in stage II calcite of the mine area ranges from 150$^{\circ}$ to 254$^{\circ}$C with salinities of 1.2 to 7.9 equiv. wt. % NaCI. This indicates a cooling of the hydrothermal fluid with time towards the waning of hydrothermal activity. Evidence of fluid boiling including CO2 effervescence indicates that pressures during entrapment of auriferous fluids in this area range up to 770 bars. Calculated sulfur isotope composition of auriferous fluids in this mine area (${\delta}^34S$_{{\Sigma}S}$$\textperthousand$) indicates an igneous source of sulfur in auriferous hydrothermal fluids. Within the Sobaegsan Massif, two representative mesothermal-type gold mine areas (Youngdong and Boseong-Jangheung areas) occur. The ${\delta}^34S values of sulfide minerals from Youngdong area range from -6.6 to 2.3$\textperthousand$ (average=-1.4$\textperthousand$, N=66), and those from BoseongJangheung area range from -0.7 to 3.6$\textperthousand$ (average=1.6$\textperthousand$, N=39). These i)34S values of both areas are comparatively lower than those of most Korean metallic ore deposits (3 to 7TEX>$\textperthousand$). And, within the Sobaegsan Massif, the ${\delta}^34S values of Youngdong area are lower than those of Boseong-Jangheung area. It is inferred that the difference of ${\delta}^34S values within the Sobaegsan Massif can be caused by either of the following mechanisms: (1) the presence of at least two distinct reservoirs (both igneous, with ${\delta}^34S values of < -6 $\textperthousand$ and 2$\pm$2 %0) for Jurassic mesothermal-type gold deposits in both areas; (2) different degrees of the mixing (assimilation) of 32S-enriched sulfur (possibly sulfur in Precambrian pelitic basement rocks) during the generation and/or subsequent ascent of magma; and/or (3) different degrees of the oxidation of an H2S-rich, magmatically derived sulfur source ${\delta}^34S = 2$\pm$2$\textperthousand$) during the ascent to mineralization sites. According to the observed differences in ore mineralogy (especially, iron-bearing ore minerals) and fluid inclusions of quartz from the mesothermal-type deposits in both areas, we conclude that pyrrhotite-rich, mesothermal-type deposits in the Youngdong area formed from higher temperatures and more reducing fluids than did pyrite(-arsenopyrite)-rich mesothermal-type deposits in the Boseong-Jangheung area. Therefore, we prefer the third mechanism than others because the ${\delta}^34S values of the Precambrian gneisses and Paleozoic sedimentary rocks occurring in both areas were not known to the present. In future, in order to elucidate the provenance of ore sulfur more systematically, we need to determine ${\delta}^34S values of the Precambrian metamorphic rocks and Paleozoic sedimentary rocks consisting the basement of the Korean Peninsula including the Sobaegsan Massif.

Geological Structure of the Moisan Epithermal Au-Ag Mineralized Zone, Haenam and its Tectonic Environment at the Time of the Mineralization (해남 모이산 천열수 금-은 광호대의 지질구조와 광화작용 당시의 지구조환경)

  • Kang, Ji-Hoon;Lee, Deok-Seon;Ryoo, Chung-Ryul;Koh, Sang-Mo;Chi, Se-Jung
    • Economic and Environmental Geology
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    • v.44 no.5
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    • pp.413-431
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    • 2011
  • An Epithemal Au-Ag mineralized zone is developed in the Moisan area of Hwangsan-myeon, Haenam-gun, Jeol-lanam-do, Korea, which is located in the southwestern part of the Ogcheon metamorphic zone. It is hosted in the Hwangsan volcaniclastics of the Haenam Formation of the Late Cretaceous Yucheon Group. This research investigated the characteristics of bedding arrangement, fold, fault, fracture system, quartz vein and the time-relationship of the fracture system to understand the geological structure related to the formation of the mineralized zone. On the basis of this result, the tectonic environment at the time of the mineralization was considered. Beds mainly trend east-northeast and gently dip into north-northwest or south-southeast. Their poles have been rearranged by subhorizontal-upright open fold of (east)-northeast trend as well as dip-slip fault. Fracture system was formed through at least 6~7 different deformation events. D1 event; formation phase of the main fracture set of EW (D1-1) and NS (D1-2) trends with a good extensity, D2 event; that of the extension fracture of NW trend, and conjugate shear fracturing of the EW (dextral) and NS (sinistral) trends, D3 event; that of the extension fracture of NE trend, and conjugate shear refracturing of the EW (sinistral) and NS (dextral) trends, D4 event; that of the extension fracture of NS trend showing a poor extensity, D5 event; that of the extension fracture of NW trend, and conjugate shear refracturing of the EW (dextral) and NS (sinistral) trends, D6 event; that of the extension fracture of EW trend showing a poor extensity. Frequency distribution of fracture sets of each deformation event is D1-1 (19.73 %)> D1-2 (16.44 %)> D3=D5 (14.79 %)> D2 (13.70 %)> D4 (12.33 %)> D6 (8.22 %) in descending order. The average number of fracture sets within 1 meter at each deformation event is D6 (5.00)> D5 = D4 (4.67)> D2 (4.60)> D3 (4.13)> D1-1 (3.33)> D1-2 (2.83) in descending order. The average density of all fractures shows 4.20 fractures/1 m, that is, the average spacing of all fractures is more than 23.8 cm. The frequency distribution of quartz veins at each orientation is as follows: EW (52 %)> NW (28 %)> NS (12 %)> NE (8 %) trends in descending order. The average density of all quartz veins shows 4.14 veins/1 m, that is, the average spacing of all quartz veins is more than 24.2 cm. Microstructural data on the quartz veins indicate that the epithermal Au-Ag mineralization (ca. 77.9~73.1 Ma) in the Moisan area seems to occur mainly along the existing D1 fracture sets of EW and NS trends with a good extensity not under tectonic stress but non-deformational environment directly after epithermal rupture fracturing. The D1 fracturing is considered to occur under the unstable tectonic environment which alternates compression and tension of NS trend due to the oblique northward subduction of the Izanagi plate resulting in the igneous activity and deformation of the Yucheon Group and the Bulguksa igneous rocks during Late Cretaceous time.

The Eating Behaviors, Nutrient Intakes and Hematological Status of Primary School Children in Gwangju (광주지역 일부 초등학교 아동의 식습관과 영양소 섭취량 및 혈액성상에 관한 연구)

  • 황금희;정난희;지혜련
    • The Korean Journal of Food And Nutrition
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    • v.14 no.1
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    • pp.1-9
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    • 2001
  • The purpose of this study was to examine height, weight, chest circumference, sitting height, hemato logical status, eating behaviors and nutrient intakes for primary school children in Gwangju. The subjects consisted of 101 boys and 109 girls aged $10{\sim}12$ years old. There were significant differences in the height, weight, chest circumference, sitting height between the boys and girls. Hct, WBC, RBC, Hb, serum GOT, GPT and cholesterol were measured. With regard to meal regularity, 47.4% of the subjects has been 'regular'. With regard to meal volume, 15.8% of the subjects has been 'heavy'. With regard to meal balance, 44.7% of the subjects has been 'no'. The study also found that 63.4% of the subjects skipped breakfast, liked western food. Their dietary intakes were assesed for 1 day by means of 24 hours dietary recall method. The mean energy intakes of the subjects were 1,663kcal for boys and 1,427kcal for girls. The subjects for boys(girls) consumed 58(52)g protein, 43(60)g lipid, 4.8(6.5)g fiber, 470(514)mg calcium, 896(824)mg phosphorous, 9.6(16.4)mg iron, 3,301(3,468)mg sodium, 2,169(2,192)mg potassium, 388(466)RE retinol, 1.1(0.9)mg thiamin, 1.1(2.2)mg riboflavin, 12.2(26.3)NE niacin, 146(99)mg ascorbic acid and 251(159)mg cholesterol respectively. Energy, protein, calcium, iron and retinol intakes were lower than the Korean RDA. The intakes of fat, fiber, calcium, iron, sodium, retinol, riboflavin and niacin of the boys were significantly lower than those of the girls. There were positive correlations between meal time and protein intake or fat intake of fiber intake or iron intake or retinol intake : negative correlations between meal time and sodium intake : negative correlations between saltiness and cholesterol intake : positive correlations between use of perilla seeds and riboflavin intake or niacin intake : negative correlations between energy intake or carbohydrate intake or phosphorous intake : negative correlations between frequency of eating-out and protein intake or fat intake or fiber intake or iron intake or retinol intake or thiamin intake or riboflavin intake or niacin intake.

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Seasonal Variation in Lipids and Fatty Acid Composition of Neutral and Phospholipids of Hibernant Fishes(I) - Variation of Muscle Lipid Compositions of Loach (Misgurnus mizolepis) - (동면 어류의 지방질과 중성 및 인지질 조성의 시기적 변화(I) - 미꾸라지 근육 지질 조성의 변화-)

  • 홍재식;최선남;박일웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.14-24
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    • 1997
  • The seasonal variation in lipids, and fatty acid composition of neutral lipid(NL) and phospholipid(PL) contained in the muscles of hibernant fish(loach) were investigated. In the investigation, four groups of wild loaches ere used, those caught May, 1993(before spawning period), August, 1993(after spawning period), November, 1993(just before hibernation) and March, 1994(just after hibernation). The NL was the most abundant in muscle lipid, followed by PL and glycolipid(GL), and also the composition and variation patterns were almost similar between female and male throughout all the periods. NL content began to increase gradually after March and came to the maximum in August(under 90%) ; hereafter got to decrease gradually again and came to the minimum in March of the next year(under 60%). While the variation-pattern of GL and PL was in inverse proportion with that of NL and their content came to the maximum in March of the next year. The NL and PL fractions were mainly consisted of triglyceride and phosphatidyl choline respectively, and both of the contents showed the highest value in August, the lowest in March of the next year. The major fatty acids in NL fraction were 16:0, 16:1, 18:1, 18:2 and 18:3($\omega$3). In particular, the ratio of 16:1 was much higher than that in PL, while those of highly unsaturated fatty acids(HUFAs) such as 20:4($\omega$6), 20:5($\omega$3) and 22:6($\omega$3) were much lower. The ratio of 16:0 in NL was almost constant through the year, however those of 16:1, 18:1, 18:2 and 18:3($\omega$3) showed a tendency to increase after March and were about 2~4% higher in May, compared with that in March, while those of HUFAs were about 2~4% lower. In particular, the ratio of 16:1 in NL continuously decreased after May and markedly decreased in March of the next year, but those of 18:1, 18:2 were almost constant until November. In August, saturates and monoenes were higher levels due to the slight increase of 18:0, 14:1 and 17:1 than in the other periods, while those of HUFAs decreased and the unsaturation(TUFA/TSFA) of NL showed the lowest value in August. On the contrary, saturates and monoenes gradually decreased after November and the most of them including 18:0, 16:1, 18:1 and 18:2 rapidly decreased in March of the next year, while 20:1, 20:4(~6), and 20:5(~3), and 22:6(~3) were in inverse proportion. PL consisted mainly of 16:0, 16:1, 18:1, 18:2, 20:4(~6), and 20:5(~3). Saturates and monoenes-composition showed almost no difference in March and May, while polyene acids ratio showed similar changes with that of NL. In August, the ratio of saturates(16:0, 18:0) were high but that of HUFAs were low, and after November 16:0, 18:0, 18:1, 18:2 and 18:3($\omega$3) began to decrease, while most of HUFAs increased in their composition-ratio until the marking increase of their unsaturation and the big changes of 18:2, 18:3($\omega$3), 20:4($\omega$6), 22:6($\omega$3) in March of the next year.

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Retrospect and prospect of political geography and general-synoptic part of human geography in Korea (한국 정치지리학과 인문지리학 일반 50년의 회고)

  • ;Im, Duck-Soon
    • Journal of the Korean Geographical Society
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    • v.31 no.2
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    • pp.295-308
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    • 1996
  • 1. Retrospect of Political Geographic Studies since Liberation, 1945 : 1) Period from 1945 to mid 1960s : There was not political geography as a science in Korea at the time of liberation from Japan 1945. At that time were not pure political geographers in Korea. In 1947, Moon-Hwa Pyo, economics professor, published a book titled Outline of Korean Geopolitics. This book was a first one in the field of political geography and available at that time in the logical descriptions. Bok-Hyon Choi was a first political geographer who in 1959 wrote a book titled Political geography for the collegians of Seoul National University. Professor Choi introduced American-style political geography through the book above mentioned. In 1963, Kie-Joo Hyong published an article titled "Korean Unification: Possibility from the Geopolitical Viewpoint" which was a first article published by Korean young scholar who studied geography in this country. 2) Period from late 1960s to late 1980s : Both Yoon Cha and Duck-Soon Im published frequently several articles of political geography or geopolitics respectively in 1968-1969. And they issued geopolitical disputes on Korean geopolitical structure and an application of rimland theory to Korean peninsula in 1969 through a magazine named Joung-Kyong Younku (the political and economic researches). The disputes played an important role of showing political geography (or geopolitics) to political sciences especially international political Science. Active researches still continued in 1970s. In that atmosphere the first Korean book of political geography written by a post-liberation scholar (Duck-Soon Im) titled Principles of Political Geography was published in 1973. This book was influenced much by American political geography after Second World War. In 1980s, the researches continued more actively. Especially administrative districts, capital cities, and sub-capital cities were frequently studied during this period. 3) Period from late 1980s to Present: Recent Studies : 1985 was a year of much production of articles of political geography. The first Ph.D thesis of political geography published in the same year in our country. And since 1985 produced many M.A. articles. Several categories of esearches of political geography was made in the period from late 1980s to present. Capital cities, Korean unification, administrative districts, urban politics, elections, sub-capital cities, and defense walls were important research categories. Reviewing the researches from 1945 to present. I found eight categories of political geography in Korea: capital cities, administrative districts, geopolitical structure of Korean peninsula, division and unification of Korea, sub-capital cities, defense walls, elections, and urban politics. Each category includes several scholars respectiveiy. 2. Study Tasks and Prospects in Korean Political Geography: In relation to Korean circumstances there are three study-tasks. The first task of Korean people is unification of two Koreas. Political geographers of Korea must al survey titled Survey Methods of Human Geography for collegians. This book was first one on survey part in Korea. The book however, is insufficient in comprehensiveness in aspects too. I think that the important tasks of general-synoptic human geography in Korea are \circled1 publication of comprehensive books of human geography in the aspects and methodologies for collegians and \circled2 acceptance of academic world of human geography in Korea of variety in methodologies of human geography for future progress. progress.

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Difference in Patient's Work of Breathing Between Pressure-Controlled Ventilation with Decelerating Flow and Volume-Controlled Ventilation with Constant Flow during Assisted Ventilation (보조환기양식으로서 감속형유량의 압력-조절환기와 일정형유량의 용적-조절환기에서 환자의 호흡일의 차이)

  • Kim, Ho-Cheol;Park, Sang-Jun;Park, Jung-Woong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.803-810
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    • 1999
  • Background : The patient's work of breathing(WOBp) during assisted ventilation may vary according to many factors including ventilatory demand of the patients and applied ventilatory setting by the physician. Pressure-controlled ventilation(PCV) which delivers gas with decelerating flow may better meet patients' demand to improve patient-ventilator synchrony compared with volume-controlled ventilation(VCV) with constant flow. This study was conducted to compare the difference in WOBp in two assisted modes of ventilation, PCV and VCV with constant flow. Methods : Ten patients with respiratory failure were included in this study. Initially, the patients were placed on VCV with constant flow at low tidal volume($V_{T,\;LOW}$)(6-8 ml/kg) or high tidal volume($V_{T,\;HIGH}$)(10-12 ml/kg). After a 15 minute stabilization period, VCV with constant flow was switched to PCV and pressure was adjusted to maintain the same tidal volume($V_T$) received on VCV. Other ventilator settings were kept constant. Before changing the ventilatory mode, WOBp, $V_T$, minute ventilation($V_E$), respiratory rate(RR), peak airway pressure (Ppeak), peak inspiratory flow rate(PIFR) and pressure-time product(PTP) were measured. Results : The mean $V_E$ and RR were not different between PCV and VCV during the study period. The Ppeak was significantly lower in PCV than in VCV during $V_{T,\;HIGH}$. HIGH ventilation(p<0.05). PIFR was significantly higher in PCV than in VCV at both $V_T$ (p<0.05). During $V_{T,\;LOW}$ ventilation, WOBp and PTP in PCV($0.80{\pm}0.37\;J/min$, $164.5{\pm}74.4\;cmH_2O.S$) were significantly lower than in VCV($1.06{\pm}0.39J/mm$, $256.4{\pm}107.5\;cmH_2O.S$)(p<0.05). During $V_{T,\;HIGH}$ ventilation, WOBp and PTP in PCV($0.33{\pm}0.14\;J/min$, $65.7{\pm}26.3\;cmH_2O.S$) were also significantly lower than in VCV($0.40{\pm}0.14\;J/min$, $83.4{\pm}35.1\;cmH_2O.S$)(p<0.05). Conclusion : During assisted ventilation, PCV with decelerating flow was more effective in reducing WOBp than VCV with constant flow. But since individual variability was shown, further studies are needed to confirm these results.

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