One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.
Yoon, Seok-Nam;Pai, Moon-Sun;Park, Chan-H.;Yoo Myung-Ho;Choi, Byung-Il William
The Korean Journal of Nuclear Medicine
/
v.32
no.4
/
pp.325-331
/
1998
Purpose: We evaluated the importance of redistribution and 24 hour reinjection images in T1-201 SPECT assessment of myocardial viability after acute myocardial infarction (AMI). Materials and Methods: We performed dipyridamole stress-4 hour redistribution-24 hour reinjection T1-201 SPECT in 43 patients with recent AMI (4-16 days). The myocardium was divided into 16 segments and perfusion grade was measured visually with 4 point score from 0 to 3 (absent uptake to normal uptake). A perfusion defect with stress score 2 was considered moderate. A defect was considered severe if the stress score was 0 or 1 (absent uptake or severe perfusion decrease). Moderate defect on stress image were considered viable and segments with severe defect were considered viable if they showed improvement of 1 score or more on redistribution or reinjection images. We compared the results of viability assessment in stress-redistribution and stress-reinjection images. Results: On visual analysis, 344 of 688 segments (50%) had abnormal perfusion. Fifty two (15%) had moderate perfusion defects and 292 (85%) had severe perfusion defects on stress image. Of 292 severe stress defects, 53 were irreversible on redistribution and reversible on reinjection images, and 15 were reversible on redistribution and irreversible on reinjection images. Two hundred twenty four of 292 segments (76.7%) showed concordant results on stress-redistribution and stress-reinjection images. Therefore 24 hour reinjection image changed viability status from necrotic to viable in 53 segments of 292 severe stress defect (18%). However, myocardial viability was underestimated in only 5% (15/292) of severe defects by 24 hour reinjection. Conclusion: The 24 hour reinjection imaging is useful in the assessment of myocardial viability. It is more sensitive than 4 hour redistribution imaging. However, both redistribution and reinjection images are needed since they complement each other.
We evaluated diagnostic accuracy of diuretic renal scan with standardization in 45 childrens(107 hydronephrotic kidneys) with 91 diuretic assessments. Sensitivity was 100%, specificity was 78%, and accuracy was 84% in 49 hydronephrotic kidneys with standardization. Diuretic renal scan without standardization, sensitivity was 100%, specificity was 38%, and accuracy was 57 % in 58 hydronephrotic kidneys. The false-positive results were observed in 25 cases without standardization, and in 8 cases with standardization. In diuretic renal scans without standardization, the causes of false-positive results were 10 early injection of lasix before mixing of radioactivity in pelvocalyceal system, 4 full bladder, 2 markedly dilated pelvocalyceal systems postpyeloplsty, 6 extrarenal pelvis, and 3 immature kidneys of neonates. In diuretic renal scans with standardization the causes of false-positive results were 2 markedly dilated systems postpyeloplsty, 2 extrarenal pelvis, 1 immature kidney of neonate, and 2 severe venal dysfunction, 1 vesicoureteral reflux. In diuretic renal scan without standardization the false-positive results by inadequate study were common, but false-positive results by inadequate study were not found after standardization. The false-positive results by dilated pelvocalyceal systems postpyeloplsty, extrarenal pelvis, and immature kidneys of neonates were not dissolved after standardization. In conclusion, diagnostic accuracy of diuretic renal scan with standardization was useful in children with renal outflow tract obstruction by improving specificity significantly.
Chung, Wou Young;Byun, Min Kwang;Park, Moo Suk;Hahn, Chang Hoon;Kang, Shin Myung;Lee, Do Yon;Kim, Young Sam;Kim, Se Kyu;Kim, Sung Kyu;Chang, Joon
Tuberculosis and Respiratory Diseases
/
v.60
no.1
/
pp.65-71
/
2006
Background : Hemoptysis, when massive and untreated, has a mortality rate of over 50 percents, is considered as one of most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) has become an established procedure in the management of massive and recurrent hemoptysis, and its efficacy is widely documented thereafter by number of articles. However, the long-term success rate of BAE is known to be unfavorable. Risk factors influencing that control failure are inevitably needed. Materials and methods : Seventy-five patients underwent bronchial artery embolization due to massive hemoptysis in Severance Hospital from Jan. 2000 to Jan. 2005. Nine patients' data were not available and could not be contacted with. Finally 66 patients' (48 males, 18 females) medical records were analyzed retrospectively during a mean follow up period of 20.4 months (ranging from 1 month to 54 months). Results : Among 66 patients whose data were available, 23(34.9%) patients had recurrent major hemoptysis. Patients' age, sex, underlying disease, previous intervention history, and number of feeding vessels had no statistical validity as risk factors of recurred major hemoptysis. But bilaterality of lesion, amount of hemoptysis, and pleural thickening were revealed as meaningful factors for predicting relapse (p = 0.008, 0.018, and 0.001, respectively). Conclusion : According to our series, patients presenting with larger amount of hemoptysis, pleural thickening of chest radiography and bilateral lesion are associated with increased risk of major hemoptysis in patients treated with BAE.
Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
Tuberculosis and Respiratory Diseases
/
v.54
no.1
/
pp.45-56
/
2003
Background : Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus. Materials and Methods : Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively. Results : The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%). Conclusions : M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.
Koo, Kyo Soung;Park, Hye Rin;Choi, Jae Hyeok;Sung, Ha Cheol
Korean Journal of Environment and Ecology
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v.34
no.2
/
pp.106-114
/
2020
The development of transportation and the expansion of the pet market has become the main causes of the increase in the cross-border migration of non-native species. Moreover, recent sales over the Internet were a factor that has promoted pet trades. While the import of non-native species has been steadily increasing in the Republic of Korea, it is not clear how these imported species are traded and how large the trade is. Considering that most of the non-native species found in the wild are the results of release by humans understanding the present situation of pet trades can identify potential non-native species that can enter the wild. This study surveyed the number of species, frequency, and prices of non-native amphibians and reptiles sold in 25 online pet shops from January 22 to February 10, 2019. The results of the survey showed that a total of 677 species of non-native amphibians and reptiles were sold, and the Squamata group accounted for the largest part of them at 65.4% (443 species). The number of non-native amphibians and reptiles sold in online pet shops in 2019 was 2.1 times larger than the 325 species officially imported in 2015. The non-native amphibians and reptiles sold in most pet shops were Litoria caerulea (21 shops) and Correlophus ciliatus (24 shops). The lowest price for non-native amphibians and reptiles was 3,000 won, and the highest price was 100 million won for Rhacodactylus leachianus of Squamata. Among the non-native amphibians and reptiles sold in online pet shops, 11 species were found in the wild and were sold at relatively low prices. We confirmed that Mauremys reevesii, an endangered species class II and natural monument no. 453, and American bullfrogs (albino), an ecosystem disturbing species, were being sold in online pet shops. Moreover, 21.6% of the 677 non-native amphibians and reptiles sold in online pet shops were species designated as CITES. The results of this study can be the important reference data for understanding the status of non-native amphibians and reptiles that are imported and sold in Korea and evaluating and predicting the potential for them to enter the wild.
In orther to find the characteristics of each constitution, the examinee of Kyung Hee medical center was diagnosed constitution, and resulted body measures and diagnosis. That was considered and the results are as follows 1. The Diagnosis result of Sa-sang Constitutional Medicine is that there are 110 persons of Taeum-In(56. 1%), 58 persons of Soum-In(29.6%), 28 persons of Soyang-In(14. 3%). 2. The distribution of occupation, there are many of Taeum-In who are engaged in business, administeration, and management and many of Soeum-In who are engaged in reserch. 3. QSCC(I) has a tendency that other constitutions diagnose to Taeyang-In, the quastionare 1 has the accuracy of 76. 4% to diagnose Soeum-In. 4. Taeum-In sweats easily but Soeum-In doesn't sweat easily, Taeum-In has a good appetite and likes cold food and digests well, but Soeum-In has a poor appetite and like hot food and digest poorly. 5. The degree of obesity is the highest in Taeum-In. 6. The systoric blood pressure and diastolic blood pressure is high in Taeum-In and the high blood pressure are frequent in Taeum-In. 7. Triglyceride is the highest in Taeum-In and the Hyperlipidemia is the most frequent in Taeum-In, but Total cholesterol has no difference among constitutions. 8. GPT GGT is higher in Taeum-In than Soyang-In, but GOT has no difference among constitutions. 9. The frequency of fatty liver is the highest in Taeum-In.
Journal of the Institute of Convergence Signal Processing
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v.9
no.1
/
pp.31-38
/
2008
Ad-Hoc network is a network architecture which has no backbone network and is deployed temporarily and rapidly in emergency or war without fixed mobile infrastructures. All communications between network entities are carried in ad-hoc networks over the wireless medium. Due to the radio communications being extremely vulnerable to propagation impairments, connectivity between network nodes is not guaranteed. Therefore, many new algorithms have been studied recently. This study proposes the secondary header approach to the cluster based routing protocol (CBRP). The primary header becomes abnormal status so that the primary header can not participate in the communications between network entities, the secondary header immediately replaces the primary header without selecting process of the new primary header. This improves the routing interruption problem that occurs when a header is moving out from a cluster or in the abnormal status. The performances of proposed algorithm ACBRP(Advanced Cluster Based Routing Protocol) are compared with CBRP. The cost of the primary header reelection of ACBRP is simulated. And results are presented in order to show the effectiveness of the algorithm.
Proceedings of The Korean Society of Health Promotion Conference
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2004.10a
/
pp.111-129
/
2004
This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community. The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.
Kim, Ki-Up;Gil, Hyo-Wook;Lee, Suk-Ho;Kim, Do-Jin;Na, Moon-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
Tuberculosis and Respiratory Diseases
/
v.52
no.1
/
pp.46-53
/
2002
Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.
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