• Title/Summary/Keyword: 등급 분류

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Is Premedication Necessary for Outpatient Fiberoptic Bronchoscopy (외래환자의 기관지내시경검사시 전처치의 필요성)

  • Won, Jun-Hee;Park, Jae-Yong;Cha, Seung-Ick;Kang, Tae-Kyong;Park, Ki-Su;Kim, Yeon-Jee;Kim, Chang-Ho;Jung, Tee-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.251-259
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    • 1999
  • Background: Even though the necessity for premedication has been questioned, some combinations of antisialogogues, sedatives and analgesics are usually employed by most bronchoscopists. The goal of this study was to determine whether fiberoptic bronchoscopy(FOB) could be performed safely and effectively without premedication while using a standardized topical anesthetic. Method: Eighty outpatients were randomized in a double-blind manner into group I(n=20) with 1 ml normal saline, group II(n=20) with 0.5mg of atropine, group III(n=20) with 0.5mg of atropine plus 5mg of midazolam, and group IV(n=20) with 0.5mg of atropine plus 50mg of meperidine, given intramuscularly 30 minutes before FOB as premedication Topical anesthetics administered were same in each group. Each patient was given 5ml(200mg) of 4% nebulized lidocaine and additional intratracheobronchial 2% lidocaine. Oxygen saturation, pulse rate and electrocardiogram were monitored and recorded before, during, just after and 2 minutes after FOB. Immediately after FOB, the bronchoscopists answered four questions such as ease of procedure, extent of coughing, extent of secretion, and overall impression. Before leaving bronchoscopy suite, patients completed similar questions on discomfort during procedure, and willingness to return for a repeat procedure. Results: Age, gender, baseline pulmonary function, dose of 2% lidocaine used for topical anesthesia, and duration of FOB were not significantly different. There was no statistical difference among group I to IV with regard to extent of coughing answered by bronchoscopist. But extent of secretion was significantly different between group I without atropine and group II-IV with atropine. And there was also significant difference in ease of procedure and overall impression among groups. There was no statistical difference in patient's willingness and level of discomfort among the groups. Thirteen patients(16%) showed hypoxemia(arterial oxygen saturation: <90%), and 3 patients(4%) showed significant tachyarrhythmia(heart rate: > l60/min), but the rate of complication was not statistically different among the groups. Conclusion: These results suggest that the value of premedication is questionable for outpatient FOB, although it may be necessary in excessively anxious patient.

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Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction (급성 심근경색 환자의 Tc-99m Tetrofosmin 심근 관류 지연영상에서 관찰되는 역재분포 현상의 임상적 의의)

  • Park, Soon-Ah;Kim, Dae-Weung;Kim, Chang-Guhn;Jeong, Jin-Won;Kim, Nam-Ho;Yun, Kyeong-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.112-119
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    • 2009
  • Purpose: This study was performed to investigate the clinical significance of reverse redistribution(RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography(SPEG) in patients with acute myocardial infarction after revascularization. Materials and Methods: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography(CAG) were performed 9 months later. Results: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments(31%) and in 43 patients(64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR(p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR(p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. Conclusions: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.

A Study on the Reduction of Kidney Uptake of 18F-FDG due to the Water Intake at the Time of Additional Examination in the PET/CT scan (PET/CT 검사에서 추가 검사 시 수분섭취에 따른 18F-FDG의 신장 섭취 감소에 대한 고찰)

  • Lee, Yi Lang;Kim, Sang Gyu;Ham, Jun Chul;Nam-Koong, Hyuk;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.47-51
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    • 2016
  • Purpose By ingestion of 18F-FDG of kidney of PET/CT during the inspection, if additional examination is required, depending on whether you want to water intake, we want to confirm a change in the rate of decrease of F-18 FDG of the kidney. Materials and Methods The 80 patients without kidney disease were performed PET/CT examination. Device was analyzed after setting the kidney to a three-dimensional region of interest. In patients require additional examination, and inspection after 30 minutes, a PET/CT torso examination after the water of the 500 cc ingested at a time. After the addition of both water intake group and no hydration group of kidney of SUV, it was compared with PET/CT torso scan. Results High and low of the kidney SUV did not show a significant difference in the rate of decrease. Reduction rates of background (BKG) of additional examination was 2.8% and reduction rates of SUV was 49.7% (Hydration) : -6.8% (No hydration), so did show a significant difference. In the image blind test, the average point score of hydration and no hydration was 34.25 : 17.25. Conclusion An undercurrent of 18F-FDG in the kidney at the time of torso examination, it was confirmed that the reduction rate after the addition of water intake is high. It is considered that can be expected to improve the quality of an image due to a decrease in elongation through the kidneys examination with additional fluid intake as needed intake.

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Phylogentic Position, Pigment Content and Optimal Growth Condition of the Unicellular Hydrogen-Producing Cyanobacterial Strains from Korean Coasts (한국 연안산 단세포성 수소생산 남세균 종주들의 분류계통, 색소함량 및 최적성장 환경)

  • PARK, JONG-WOO;KIM, JU HEE;CHO, AE-RA;JUNG, YUN-DUK;KIM, PYOUNG JOONG;KIM, HYUNG-SEOP;YIH, WONHO
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.20 no.3
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    • pp.131-140
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    • 2015
  • To set up unicellular cyanobacterial strains with photo-biological $H_2$ production potential, live samples were repeatedly collected from 68 stations in the coastal zone of Korea for the four years since 2005. Among 77 cyanobacterial strains established six (KNU strains, CB-MAL002, 026, 031, 054, 055 and 058) were finally chosen as the excellent strains for $H_2$ production with $H_2$ accumulation over 0.15 mL $H_2\;mL^{-1}$ under general basic $H_2$ production conditions as well as positive $H_2$ production for more than 60 hr. To explore optimum procedures for higher $H_2$ production efficiency of the six cyanobacterial strains, the inter-strain differences in the growth rate under the gradients of water temperature and salinity were investigated. The maximum daily growth rates of the six strains ranged from 1.78 to 2.08, and all of them exhibited $N_2-fixation$ ability. Based on the similarity of the 16S rRNA sequences, all the test strains were quite close to Cyanothece sp. ATCC51142 (99%). The six strains, however, were grouped into separate clades from strain ATCC51142 in the molecular phylogeny diagram. Chlorophyll- a content was 3.4~7.8% of the total dried weight, and the phycoerythrin and phycocyanin contents were half of those in the Atlantic strain, Synechococcus sp. Miami BG03511. The growth of the six strains was significantly suppressed at temperatures above the optimal range, $30{\sim}35^{\circ}C$, to be nearly stopped at $40^{\circ}C$. The growth was not inhibited by high salinities of 30 psu salinity in all the strains while strain CB055 maintained its high growth rate at low salinities down to 15 psu. The euryhaline strains like CB055 might support massive biotechnological cultivation systems using natural basal seawater in temperate latitudes. base seawater. The biological and ecophysiological characteristics of the test strains may contribute to designing the optimal procedures for photo-biological $H_2$ production by unicellular cyanobacteria.

Pulmonary Valve Replacement with Tissue Valves After Pulmonary Outflow Tract Repair in Children (소아에서 폐동맥유출로 재건 후 시행한 조직판막을 이용한 폐동맥판 대치술)

  • Lee, Jeong-Ryul;Hwang, Ho-Young;Chang, Ji-Min;Lee, Cheul;Choi, Jae-Sung;Kim, Yong-Jin;Rho, Joon-Ryang;Bae, Eun-Jung
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.350-355
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    • 2002
  • Background: Most of pulmonary regurgitation with or without stenosis appears to be well tolerated early after the repair of pulmonary outflow tract. However, it may result in symptomatic right ventricular dilatation, dysfunction and arrhythmias over a long period of time. We studied the early outcome of pulmonary valve replacement with tissue valves for patients with the above clinical features. Material and Method: Sixteen consecutive patients who underwent pulmonary valve replacement from September 1999 to February 2002 were reviewed(9 males and 7 females). The initial diagnoses included tetralogy of Fallot(n=11), and other congenital heart anomalies with pulmonary outflow obstruction(n=5). Carpentier-Edwards PERIMOUNT Pericardial Bioprostheses and Hancock porcine valves were used. The posterior two thirds of the bioprosthetic rim was placed on the native pulmonary valve annulus and the anterior one third was covered with a bovine pericardial patch. Preoperative pulmonary regurgitation was greater than moderate degree in 13 patients. Three patients had severe pulmonary stenosis. Tricuspid regurgitation was present in 12 patients. Result: Follow-up was complete with a mean duration of 15.8 $\pm$ 8.5months. There was no operative mortality. Cardiothoracic ratio was decreased from 66.0 $\pm$ 6.5% to 57.6 $\pm$ 4.5%(n=16, p=0.001). All patients remained in NYHA class I at the most recent follow-up (n=16, p=0.016). Pulmonary regurgitation was mild or absent in all patients. Tricuspid regurgitation was less than trivial in all patients. Conclusion: In this study we demonstrated that early pulmonary valve replacement for the residual pulmonary regurgitation with or without right ventricular dysfunction was a reasonal option. This technique led to reduce the heart size, decrease pulmonary regurgitation and tricuspid regurgitation as well as to improve the patients'functional status. However, a long term outcome should be cautiously investigated.

Pond Vegetation Assessment of Golf Courses in the Capital Region of Korea (수도권 지역 골프장의 연못식생 평가)

  • Kim Chang-Hwan;Ahn Deug-Soo
    • Journal of Environmental Science International
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    • v.14 no.3
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    • pp.279-288
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    • 2005
  • The vascular plant at Korea CC was researched in 95 taxa and Korea CC had the highest number of vascular plants among the ponds of 9 golf courses in the capital region. The number of vascular plants at Eunhwasam CC was 21 taxa which followed as the second most. Most of the vascular plants surveyed consist of a mon-ocotyledon with 1-2 years of life and a dicotyledon as perennial. The ratio between an introduced species of pond vegetation and planting species from Jisan CC is $52.3\%$, which is the highest. The lowest ratio of those is $21.1\%$, which is from Pine Creek Cc. Pine Creek CC has 25 plant communities in total, with 16 semi-natural and natural communities and 9 planting or introduced communities. Pine Creek CC has the most varied plant communities among 9 golf clubs. There are plant communities of semi-natural and natural vegetation from all ponds, and there are 12 aquatic plant communities at disturbance or planting vegetation. We found out that Pine creek CC has more natural communities than disturbance or planting communities compared to other golf clubs, and there is not any natural vegetation at Pristine Valley CC. According to value grade from assessment indicator, the natural aspect of Seseoul CC and Eunhwasam CC are the lowest among 9 golf clubs. Taeyoung CC, Eunhwasam CC, Jisan CC, Seseoul CC are superior in made vegetation among the group in terms of euclidean similarity coefficient on natural aspect and are classified as one group. Korea CC and Pristine Valley CC have distinguished semi-natural vegetation and Midas Valley CC and Pine Creek CC, which have a relatively high natural aspect, are classified as one group. Blue Heron CC is separated from other groups into its own group because it has a high value of scenery in particular. In conclusion, there is a correlation between the natural aspect of a pond and size of vegetation.

Clinical Aspects of Pulmonary Radioactivity Observed in Radiocolloid Liver Scintigraphy (간 스캔에서 관찰되는 폐 방사능에 관한 임상적 고찰)

  • So, Young;Lee, Kang-Wook;Lee, Heon-Young;Lee, Won-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.185-194
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    • 2002
  • Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia (전신마취동안에 복와위시 자유로운 복근 움직임이 심혈관계에 미치는 영향)

  • Kim, Ji-Yoon;Lee, Dong-Won;Seo, Il-Sook;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.206-215
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    • 2007
  • Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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A Study on the Potential Vegetation Recovery according to the Environment and Type of Tunnel Entrance and Exit (고속도로 터널 입·출구부 유형과 주변 환경에 따른 식생복구 잠재성에 관한 연구)

  • Lee, Sang-Cheol;Choi, Song-Hyun;Kim, Dong-Pil;Song, Jae-Tak;Oh, Hyun-Kyung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.6
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    • pp.161-172
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    • 2012
  • The purpose of this study is to classify, evaluate and grade the existing highway tunnels to increase landscape and natural statistics keeping the structural safety about tunnel gates area and induce the ones that will be constructed in the future by drawing the improvements and restoring the techniques as an environment-friendly. To examine the types of tunnel gate area, total 54 tunnels were investigated by selecting Gyeongbu Expressway, Yeongdong Expressway, and Jungang Expressway. Tunnel entrances and exit ports were classified as a Wall-closed type and Protruding type, which is based on tunnel gate type. Vegetation Landscape types were classified as Multilayer-Same as the surrounding landscape_(MS), Multilayer-Difference of surrounding landscape_(MD), Single layer-Same as the surrounding landscape_(SS), Single layer-Difference of surrounding landscape_(SD), and a Desolate type which based on vegetation layers and environment-friendly. Potential vegetation recovery was identified based on the structural stability and revegetation potential of the tunnel. The factors include the structural stability of the slope height and slope gradient were selected. Revegetation potential was identified as a growth potential. This factor was used in the step to classify vegetation recovery potential of a tunnel. The result, which investigated the types of tunnel entrances and exit parts has found that the most typical in 33 places was a Wall closed type with 61.1% of the total ones. The case of vegetation landscape types was created but different from the ones surrounding it with 85.2% of the total ones. It is judged that the currently constructed vegetation of tunnel entrance and exit parts had put convenience on the safety and management before landscape consideration. In addition, tunnel entrance and exit parts with excellent potential for vegetation recovery were all Protruding type. In addition, it is judged that slope stability can easily obtain growth. Therefore, entrance and exist of the highway tunnels, which will be constructed in the future, should reflect location and the result of the natural and ecological survey in design by performing it in advance and their types, which minimize the damage area range, should be applied to the local characteristics suitably. In addition, the ecologically healthy tunnel construction should be done by introducing active vegetation recovery techniques based on its safety.

Changes of Benthic Macroinvertebrate Communities after a Small Dam Removal from the Gyeongan Stream in Gyeonggi-do, Korea (경기도 경안천에서 소형 보(洑)의 철거 이후에 변화된 저서성 대형무척추동물 군집)

  • Kil, Hye-Kyung;Kim, Dong-Gun;Jung, Sang-Woo;Shin, Il-Kwon;Cho, Kang-Hyun;Woo, Hyo-Seop;Bae, Yeon-Jae
    • Korean Journal of Environmental Biology
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    • v.25 no.4
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    • pp.385-393
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    • 2007
  • Benthic macroinvertebrate communities were studied after a small dam removal from the mid-section of the Gyeongan stream in Gyeonggi-do, Korea. Quantitative sampling was conducted at immediately upstream (upper) and downstream (lower) sites from the dam as well as at the site where the dam was located (dam site: middle) using a Surber sampler (50$\times$50 cm, mesh 0.25 mm), four times (November 2004, May 2005, January 2006, and May 2006) after the dam removal. As a result, 46 species of benthic macroinvertebtates, belonged in 35 genera, 27 families, 11 orders, 5 classes, and 4 phyla, were sampled from the stream sites, but the number of species that occurred at each sampling trial was different (ranged 3$\sim$17 spp.) according to the seasons and sites. Approximately one year after the dam removal, the species number has in-creased and taxa composition has changed as the microhabitat became more heterogeneously due to a riffle formation in the upstream site. Chironomid larvae and tubificid worms, which are common in Korean urban streams, were the dominant species, while Hydropsyche kozhantschikovi was the 2nd dominant species at some sampling trials. In general, McNaughton's dominance indices decreased and Shannon species diversity indices increased approximately one year after the dam removal. Compositions of collector-filterers, clingers, and swimmers increased as hydropsychid caddisflies, heptageniid mayflies, and baetid mayflies increased, respectively, in the upstream site. The group pollution index and the ecological score using benthic macroinvertebrates both indicated that water environment has been improved in the upstream site after the dam removal.