• Title/Summary/Keyword: 2차공기

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Clinical Results Following T3, 4 vs T3 Thoracoscopic Sympathicotomy in 30 Axillary Hyperhidrosis Patients (겨드랑이 다한증 환자에서 흉부교감신경의 차단부위(T3-4와 T4)에 따른 임상결과)

  • Choi, Soon-Ho;Lee, Sam-Youn;Lee, Mi-Kyung;Cha, Byoung-Ki
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.469-475
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    • 2008
  • Background: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. Material and Method: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. Result: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was $38.7{\pm}2.3$ months, and the mean follow-up for the T4 group was $18.7{\pm}3.6$ months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. Conclusion: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.

The Influence of Office Indoor Air Qualitys on the Dry Eye Symptom of Contact Lens Wearers (사무실 실내공기질과 콘택트렌즈 착용여부가 안구 건조증에 미치는 영향)

  • Kim, Dea Jong;Park, Moon Chan;Lee, Se Hoon;Kim, Hyun Uk;Lee, Wha Ja;Cha, Jung Won
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.2
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    • pp.215-222
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    • 2012
  • Purpose: This study was performed to investigate the influence of indoor air qualities of an office environment on dry eye syndrome for wearing contact lens and non-wearing contact lens. Methods: To study the effects of indoor air qualities on dry eye syndrome for seventy-one subjects, $CO_2$, temperature, humidity, TSP, PM10, HCHO were measured. Each subject was tested by a McMonnie's dry eye syndrome questionnaire, a Schirmer Tear Test-I (S.T.T-I), a Schirmer Tear Test-II with anesthetics (S.T.T-II), and Tear film break-up time (T.B.U.T) in the their offices. Results: There was significant relation between the indoor air quality and dry eye syndrome for wearing contact lens and non-wearing when TSP was over $200{\mu}g/m^3$, PM10 was higher than $86.7{\mu}g/m^3$ and Formaldehyde was over $0.4{\sim}1.0{\mu}g/m^3$. However, there was no significant effect on dry eye syndrome with $CO_2$ (p=.0146), temperature (p=0.074) and humidity (p=0.053). Conclusions: It was indicated that $CO_2$, temperature and humidity were no effect on dry eye syndrome in the office environment. However TSP, PM10, formaldehyde, and wearing contact lens were effect on dry eye syndrome. Therefore, the entire management of wearing contact lens and the individual evaluation of the indoor air quality are required.

Report on the External Audits Conducted by Korean Society of Medical Physics (한국의학물리학회 선형가속기 외부 품질관리 실시 현황보고)

  • Huh, Hyun Do;Cho, Kwang Hwan;Cho, Sam Ju;Choi, Sang Hyoun;Kim, Dong Wook;Hwang, Ui-Jung;Kim, Ki Hwan;Min, Chul Kee;Choi, Tae Jin;Oh, Young Kee;Lee, Seoung Jun;Park, Dahl;Park, Sung-Kwang;Ji, Young Hoon
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.315-322
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    • 2013
  • The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

The Safety and Usefulness of Combined Video-Assisted Mediastinoscopic Lymph Adenectomy and Video-Assisted Thoracic Surgery Lobectomy for Left-sided Lung Cancer (좌측 폐암 환자에서 동반 시행한 비디오 종격동경 림프절 절제술과 흉강경 폐엽 절제술의 안정성과 유용성)

  • Jung, Hee Suk;Kim, Yong Hee;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.33-38
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    • 2010
  • Background: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. Material and Method: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. Result: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (${\geq}$10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. Conclusion: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.

A Study on the Heavy Metals Concentrations in the Air of the Dental Laboratories, in the Blood and Urine of Dental Laboratory Technicians (치과기공실 공기중 및 치과기공사의 혈액, 요중 중금속 함량에 관한 연구)

  • Cha, Sung-Soo
    • Journal of Technologic Dentistry
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    • v.10 no.1
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    • pp.11-24
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    • 1988
  • The purpose of this study was to determine the concentration of cadmium, nickel and chromium in the air of the work-place, blood of and urine of workers and compare the level of those heavy metals by the duration of work, work-place, process of work, smoking and other factors. In this study, 48 male dental laboratory technicans and 72 office workers as the control group were subjected. The concentration of cadmium, nickel and chromium in their blood sand urine, and that of heavy metals in the air of their work-rooms were examined and analyzed from June I 1987 to September 30, 1987. The results were as follows : 1. The concentration of cadmium in the air was the highest in the porcelain part, $0.0087{\pm}0.0016mg/m^3$, that of nickel was the highest in the crown bridge part, $0.4253{\pm}0.0052mg/m^3$, and that of chrnmium was highest in the partial denture part, $0.1063{\pm}0.0024mg/m^3$. 2. cadmium, nickel and chromium concentrations in the blood and urine of dental laboratory techincians were higher that in the office workers'. Especially the concentration of cadmium in the blood($1.92{\pm}1.23{\mu}g$/100ml) of th dental laboratory techician was about two times as high as that in the office workers'($0.90{\pm}0.73{\mu}g$/100ml), and the concentration of nickel in the urine($48.53{\pm}38.83{\mu}g$/e) of the dental laboratory thchnician was about two times as high as that in the office worker's($20.24{\pm}15.35{\mu}g$/e). 3. there was no difference in the concentration of cadmium, nickel and chromium in the blood and urine with a longer duration of work. 4. The concentration of cadmium and chromium in the blood and urine differed significantly depending upon the place of work. The concentration of cadmium was the highest in the blood of dental laboratory technicians working kin the poreclain part marking at $2.53{\pm}1.08{\mu}g$/100ml. The chromium level was the heighest in the blood of partial denture park workers with a concentration of $3.60{\pm}1.02{\mu}g$/100ml. Concerning the level of cadmium in urine, it was the highest in the porcelain part workers with a concentration of $3.41{\pm}3.15{\mu}g$/e. 5. The concentration of cadmium in the urine of metal trimming and polishing group($2.64{\pm}2.41{\mu}g$/e) was higher than that of non-metal trimming and polishing group($1.39{\pm}1.18{\mu}g$/e). 6. The concentration of chromium in the blood of smoking group($2.46{\pm}1.54{\mu}g$/100ml)was higher than that lf non-smoking group($1.54{\pm}1.25{\mu}g$/100ml). 7. The height positive correlation coefficient was shown between the concentration of nickel and chromium in the blood among the all correlations between 3metals(Cd, Ni, Cr) in the blood and those in urine. The correlation coefficient was relatively high(r=0.605,,p<0.01). In general, the higher the concentration of heavy metals in the air of work places the higher the concention lf them in the blood and urine of workers, mere attention should be paid to the working environment of dental laboratory workers, Furthermore, continuous biological monitoring and further research are required for an efficient health management for dental laboratory workers.

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Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.497-503
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    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

The Effects of Additional Tetracycline Pleurodesis during Thoracoscopic Procedures for Treating Primary Spontaneous Pneumothorax (일차성 자연 기흉의 흉강경 수술 시 추가로 시행한 Textracycline 흉막 유착술의 효용)

  • Lee, Hyeon-Woong;Lee, Jae-Ik;Kim, Keun-Woo;Park, Kook-Yang;Park, Chul-Hyun;Hyun, Sung-Youl;Jeon, Yang-Bin;Choi, Chang-Hyu
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.729-735
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    • 2008
  • Background: This study was performed to evaluate the safety and efficacy of performing additional tetracycline pleurodesis during the thoracoscopic treatment of primary spontaneous pneumothorax. Material and Method: Between March 2004 and December 2007, 91 cases of primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The thoracoscopic procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. For 27 cases (Tetracycline group, group I), 20 mg/kg tetracycline was instilled into the pleural space through a trocar before closing the chest. The control group (group II) consisted of 64 cases of primary spontaneous pneumothorax for which the same thoracoscopic procedures alone were performed during the same study period. Result: There was no significant difference between the two groups in terms of the demographic data, the operative findings and the operation time. The percentage of cases that needed intravenous analgesics and the duration of intravenous analgesics were comparable in both groups. There was no significant difference in the duration of air leaks and complications between the two groups. The patients treated with tetracycline pleurodesis had a longer period of postoperative chest drainage (4.2 days vs 3.5 days, respectively, p=0.03) and hospitalization (5.0 days vs 4.0 days, respectively, p=0.006). During the follow up period, the ipsilateral recurrence rate was much lower for the patients who were treated with tetracycline pleurodesis (0% vs 10.9%, respectively, p=0.099), and freedom from recurrence tended to be more favorable for group I (p=0.077), although this was not statistically significant. Conclusion: Additional tetracycline pleurodesis during thoracoscopic treatment for primary spontaneous pneumothorax caused prolongation of chest drainage and a prolonged hospital stay. However, further investigations are needed because tetracycline pleurodesis can be performed safely without serious complications and it showed a distinct tendency to reduce the rate of recurrence.

Measurement of the Mucosal Surface Distance in the Early Gastric Cancer Using CT Gastrography (조기 위암에서 CT Gastrography를 이용한 위점막 표면 거리 측정)

  • Choi, Hyang-Hee;Yu, Wan-Sik;Ryeom, Hun-Kyu;Lee, Jae-Hyuk;Choi, Jae-Jeong;Kim, Hee-Su;Cleary, Kevin;Mun, Seong-Ki;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.161-166
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    • 2006
  • Purpose: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. Materials and Methods: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. Results: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was $5.3{\pm}2.9\;mm(range,\;0{\sim}23\;mm)$. The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001). Conclusion: These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.

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A Study on the Variation of Transmission Factors, Output Factors and Percent Depth Doses by Wedge Filters for 4~10 MV X-Ray Beams (4~10 MV X-선의 쐐기 (wedge) 필터의 투과율과 출력계수, 선축상 선량분포의 변화에 관한 연구)

  • 강위생
    • Progress in Medical Physics
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    • v.8 no.2
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    • pp.3-17
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    • 1997
  • Because a wedged beam consists of attenuated primary photons and scattered radiations from wedge, the spectrum of the wedged beam does not coincide with that of an open beam with same geometry. The aims of current report are to get exact information about whether effects of 15-60$^{\circ}$ wedge for 4 -10 MV photon beams should be considered for dose calculation or not, and to suggest a reference condition for measurement of wedge transmission factor. Percent depth dose of both open and wedged fields with angles of 15, 30, 45, 60$^{\circ}$ for beams of 4 MV(Clinac 4/100, Varian), two 6 MV(Clinac 6/100 and Clinac 2100C, Varian), 10 MV(Clinac 2100C, Varian) X-rays were measured to 30cm deep in water using ionization chambers. Hardening factors of photon beams were calculated with measured PDDs. Both field size factors and transmission factors of wedge filters were measured at d$_{max}$ in water. Beam hardening factors of wedged fields of 4 and 6 MV X-ray were larger than 1 for all wedge angles, field sizes and depths deeper than d$_{max}$ Beam hardening factors for wedge angles 15, 30, 45, 60$^{\circ}$ for 10$\times$10cm were respectively 1.010, 1.014, 1.023 and 1.034 for 4MV X-ray, 1.005, 1.008, 1.019, and 1.024 for 6MV X-ray of Clinac 6/100, 1.011, 1.021, 1.032, 1.036 for 6MV X-ray of Clinac 2100C, and 1.008, 1.012, 1.012 and 1.012 for 10MV X-ray. Beam hardening factors of 10MV X-ray were 1 within 1.2% difference for all wedge angles, depths and field sizes. It was made clear that for 6MV X-rays, the beam hardening factor depends on treatment machine. The relationship of the factor and depth was linear. Field size factor at d$_{max}$ was independent of wedge angle except for the field of 15$\times$15cm. and maximum difference of the field size factors for the field size was 1.4% for 4MV X-ray. When the wedge factor is determined, dependence of the factor on field size is negligible at d$_{max}$ but should be considered at deeper depth. Calculating dose distribution or MU, the beam hardening factor should be applied for 4~6MV X-ray beams, but might not be considered for 10MV beam. When wedge transmission factor was determined at d$_{max}$ or in air, field size factors for open field are also applicable to wedged fields, but otherwise, field size factor for each wedge or wedge factor depending on field size should be applied.

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Changes in Quality of Hanwoo Bottom Round under Different Freezing and Thawing Conditions (한우육의 냉동 및 해동 조건에 따른 품질 변화)

  • Chun, Ho Hyun;Choi, Eun Ji;Han, Ae Ri;Chung, Young Bae;Kim, Jin Se;Park, Suk Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.2
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    • pp.230-238
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    • 2016
  • This study examined the effects of freezing and thawing conditions on quality of Hanwoo bottom round. The beef samples were frozen by air blast freezing at $-20^{\circ}C$ or ethanol immersion freezing at $-70^{\circ}C$ and then stored at $-20^{\circ}C$ for 10 days. After 10 days of storage, the frozen samples were thawed with air blast thawing at $4^{\circ}C$ or water immersion thawing at $4^{\circ}C$ and subjected to subsequent analyses of drip loss, water holding capacity, thiobarbituric acid reactive substance (TBARS), volatile basic nitrogen (VBN), total aerobic bacteria, and microstructure. Drip loss significantly increased in samples treated with air blast freezing compared to ethanol immersion freezing, whereas freezing and thawing processes had no significant impact on water holding capacity of the samples. Thawing conditions had a much stronger influence on the TBARS and VBN of the samples than freezing conditions. There was no significant difference in the population of total aerobic bacteria among the four samples subjected to one freeze-thaw cycle. In addition, to analyze the effects of freeze-thaw cycle on the quality of beef, three freeze-thaw cycles were performed during storage. Multiple freeze-thaw cycles increased drip loss, TBARS, and VBN and decreased water holding capacity, accelerating microstructural damage. These data indicate that Hanwoo bottom round can be rapidly frozen and thawed by using ethanol immersion freezing and water immersion thawing methods with minimal impact on meat quality.