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Three Cases of Obesity-Hypoventilation Syndrome (Pickwickian Syndrome) (비만성 저환기 증후군 (Pickwickian 증후군) 3예)

  • Jung, Ji-Hyun;Lee, Sang-Haak;Choi, Young-Mee;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.561-568
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    • 2002
  • Severe obesity can produce a marked impairment of respiratory function. The obesity hypoventilation or Pickwickian syndrome comprises of extreme obesity, alveolar hypoventilation, somnolence, plethora, pulmonary hypertension and right heart failure. It is sometimes associated with obstructive sleep apnea but can be distinguished from obstructive sleep apnea by the presence of awake $CO_2$ retention. Alt hough uncommon, it is important to recognize this syndrome because due to its potential life threatening nature and because can be reversed by appropriate treatment. Here, we report 3 cases of obesity hypoventilation syndrome.

A stuffy on the environmental Impact Assessment of golf course development - A comparative cross - cultural analysis between Korea and Japan (골프장 개발에 따른 환경영향평가에 관한 연구 -한국과 일본의 문화적 비교 분석-)

  • ;Tsunekawa Atsushi,;Hayashi kuniyoshi
    • Journal of the Korean Institute of Landscape Architecture
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    • v.18 no.2
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    • pp.1-13
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    • 1990
  • In recent years, the construction of golf course has been increasing very rapidIy and serious concern is paid to its environmental consequences both in Korea and in Japan. EIA systems as a major requirements for golf course developments emerged to reduce the adverse impact of their developments in Korea as well as in Japan. This study aims to compare EIA systems, procedures and methodologies employed between Korea and Japan in order to demonstrate the success and failure of EIAs in each country. The results of this study can be summarized as follows : 1) EIAs are systematically undertaken based upon law in Korea but on regulation in Japan. 2) Public participation Isn't encouraged in the Korean EIA procedure while the Japan EIA system involves public participation. 3) Korean EISs shall be prepared after the proposed projects are approved according to the related laws and be followed by the necessary procedures, but in the carte of Japan, EISs be prepared prior to their approval . 4) ELSs shall be prepared by agencies with special expertise with respect to 7he environmental impacts (appointed by government) or the sponsoring agencies themselves in Korea whereas they be prepared by agencies proposing the projects in japan. 5) EISs both in Korea and in Japan are characterized by cliches which may be unfamiliar to reviews and the public. 6) EIAs describe the existing presence and predict and evaluate that a development work influences the present conditions. Here Japan EIA treats mainly natural - and life environment, whereas Korean EIA dose social - and economic environment. And hence in the case of Japan is undertaken more quantitative and scientific analysis, whereas in the case of Korea is less. It is suggested that the key point to impact analysis is to use the correct concepts, fomulate the comparative studies of methodologies and find the methods that suit the decision as well as which country's own circumstances.

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The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children

  • Lee, Eun;Lee, So-Yeon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.63 no.7
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    • pp.251-258
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    • 2020
  • Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%-58.0%. Although 18.1%-31.1% of the general population used HDs, only a small proportion of HD users were diagnosed with HD-ILDs. This finding suggests that investigation of the pathophysiologies underlying HD-ILDs is needed in addition to the identification of susceptibility to HD-ILDs. Further, there have been several concerns regarding the diverse health effects of exposure to toxic chemicals in HDs, including those that have not been identified, and long-term prognoses in terms of pulmonary function and residual pulmonary lesions observed on follow-up chest images. In this review, we summarize the clinical features, pathologic findings, and changes in radiologic findings over time in patients with HD-ILDs and the results of previous experimental research on the mechanisms underlying the effects of toxic chemicals in HDs. Studies are currently underway to identify the pathophysiologies of HD-ILDs and possible health effects of exposure to HDs along with the development of targeted therapeutic strategies. The experience of identification of HD-ILDs has encouraged stricter control of safe chemicals in everyday life.

Finite Element Analysis on the Sealing Behavior and Endurance Safety of O-rings with a V-groove (V홈을 갖는 오링의 밀봉거동과 내구 안전성에 관한 유한요소해석)

  • Kim, Chung Kyun
    • Journal of the Korean Institute of Gas
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    • v.17 no.1
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    • pp.73-80
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    • 2013
  • This study presents sealing behavior and endurance safety of V-grooved o-rings as functions of a strain, compression stress, and contact normal stress using a FEM technique. The FEM results on the sealing behavior and endurance safety show that the maximum strain, maximum compression stress, and maximum contact normal stress of V-grooved o-rings are approximately 1.2 times higher than those of conventional solid o-rings. This is why that an o-ring has a V-groove in the center between two overlapped circles, which is very effective in sealing for ball valves, pressure vessels, and gas equipment. And the extrusion failure in V-grooved o-rings does not take place under an increased gas pressure due to a V-groove. This may extend sealing life compared with that of a conventional solid o-ring.

Fault Detection of Rolling Element Bearing for Low Speed Machine Using Wiener Filter and Shock Pulse Counting (위너 필터와 충격 펄스 카운팅을 이용한 저속 기계용 구름 베어링의 결함 검출)

  • Park, Sung-Taek;Weon, Jong-Il;Park, Sung Bum;Woo, Heung-Sik
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.22 no.12
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    • pp.1227-1236
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    • 2012
  • The low speed machinery faults are usually caused by the bearing failure of the rolling elements. As the life time of the bearing is limited, the condition monitoring of bearing is very important to maintain the continuous operation without failures. A few monitoring techniques using time domain, frequency domain and fuzzy neural network vibration analysis are introduced to detect and diagnose the faults of the low speed machinery. This paper presents a method of fault detection for the rolling element bearing in the low speed machinery using the Wiener filtering and shock pulse counting techniques. Wiener filter is used for noise cancellation and it clearly makes the shock pulse emerge from the time signal with the high level of noise. The shock pulse counting is used to determine the various faults obviously from the shock signal with transient pulses not related with the bearing fault. Machine fault simulator is used for the experimental measurement in order to verify this technique is the powerful tool for the low speed machine compared with the frequency analysis. The test results show that the method proposed is very effective parameter even for the signal with high contaminated noise, speed variation and very low energy. The presented method shows the optimal tool for the condition monitoring purpose to detect the various bearing fault with high accuracy.

Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy (외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례)

  • Kim, Ji-Hoon T.;Han, Myung-Sik;Choi, Gun-Moo;Jang, Hyuck-Jae;Kwak, Jin-Ho;Kim, Ji-Hoon S.
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.56-59
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    • 2011
  • Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

Chest Injuries due to Blunt Chest Trauma (둔좌상에 의한 흉부손상의 임상적 관찰)

  • Jin, Jae-Kwon;Park, Choo-Chul;Yoo, Seh-Young
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.418-423
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    • 1979
  • Chest injuries due to blunt trauma often result in severe derangements that lead to death. And we have to diagnose and treat the patients who have blunt chest trauma immediately and appropriately. A clinical analysis was made on 324 cases of chest injury due to blunt trauma experienced at department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyung Hee University during 8-year period from 1972 to 1979. Of 324 patients of blunt chest injuries, there were 189 cases of rib fracture, 121 of hemothorax or/and pneumothorax, 108 of soft tissue injury of the chest wall only, 41 of lung contusion, 24 of flail chest, 13 of scapular fracture, 7 of diaphragmatic rupture and others. The majority of blunt chest injury patients were traffic accident victims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 3rd decade and 4th decade [60%] and 238 patients were male comparing to 86 of female [Male: Female = 3:1 ]. In the patients who have the more number of fractured ribs, the more incidence of intrathoracic injury and intraabdominal organ damage were found. The principal associated injuries were head injury on 58 cases, long bone fractures on 37, skull fractures on 12, pelvic fractures on 10, renal injuries on 6 and intraabdominal organ injuries on 5 patients. The principle of early treatment of chest injury due to blunt trauma were rapid reexpansion of the lung by closed thoracotomy which was indicated on 96 cases, but open thoractomy was necessary on 14 cases because massive bleeding, intrapleural hematoma and/or fibrothorax, or diaphragmatic laceration-On 15 cases who were young and have multiple rib fracture with severe dislocation delayed elective open reduction of the fractured ribs with wire was done on the purpose of preserving normal active life. The over all mortality was 2.8% [9 of 324 cases] due to head injury on 3 cases, massive bleeding on 2,wet lung syndrome, acute renal failure on 1 and septicemia on 1 patient.

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Heart Transplantation in the Elderly Patients: Midterm Results

  • Yeom, Sang Yoon;Hwang, Ho Young;Oh, Se-Jin;Cho, Hyun-Jai;Lee, Hae-Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.111-116
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    • 2013
  • Background: Heart transplantation in elderly patients has raised concerns because of co-morbidities and limited life expectancy in the era of donor shortage. We examined the outcomes after heart transplantation in elderly patients. Materials and Methods: From March 1994 to December 2011, 81 patients (male:female=64:17, $49.1{\pm}14.0$ years) underwent heart transplantation. The outcomes after heart transplantation in the younger patients (<60 years; group Y, n=60) were compared with those in the elderly patients (${\geq}60$ years; group O, n=21). The follow-up duration was $51.8{\pm}62.7$ months. Results: Early mortality (${\leq}30$ days) occurred in 5.0% (3/60) and 4.8% (1/21) of groups Y and O, respectively (p>0.999). There were no differences in overall survival between the two groups (p=0.201). Freedom from rejection was higher in group O than in group Y (p=0.026). Multivariable analysis revealed that age ${\geq}60$ years was not a significant risk factor for long-term survival; postoperative renal failure was the only significant risk factor for long-term survival (p=0.011). Conclusion: Early and mid-term results of heart transplantation in elderly patients were similar to those in younger patients.

A Case of Congenital Laryngeal Atresia with Single Umbilical Artery Who Required a Tracheotomy (기관절개술을 받았던 단일 제대동맥이 동반된 선천성 후두폐쇄증 1례)

  • Wi, Ho Sung;Baek, Hey Sung;Oh, Jae Won;Yum, Myung-Kul;Kim, Yong Joo;Moon, Soo Jee;Tae, Kyung;Kim, Chang-Ryul
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.557-560
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    • 2005
  • Congenital laryngeal atresia is a rare cause of airway obstruction that is almost always lethal within a few minutes after birth. Therefore congenital laryngeal atresia should be diagnosed in the prenatal period. If not, it should be considered in newborn infant with life-threatening symptoms at birth such as cyanosis and dyspnea that need emergent procedures like a tracheotomy. We report a case of congenital laryngeal atresia with single umbilical artery diagnosed in a one-day-old neonate who required a tracheotomy and ventilator care after intubation failure.

A Life-Threatening Case of Tubular Esophageal Duplication Complicated with Aneurysm of the Aorta (대동맥류를 초래한 식도 중복 1례)

  • Jung, Yeon Kyung;Lee, Gyeong Hoon;Chung, Hai Lee;Park, Ki Sung;Jung, Kyung-Jae;Cho, Chang Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.655-659
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    • 2005
  • Esophageal duplication cysts are rare congenital lesions that occur as a result of a failure in the tubulation of the esophagus. They are most frequently single, tubular, or cystic. They may cause compressive symptoms or may be discovered incidentally on chest radiographs. They become symptomatic when complications develop. Symptoms often are related to the location of the duplication; esophageal lesions can create respiratory difficulties. The definitive diagnosis of esophageal duplication cysts requires the pathological evaluation of the cyst after surgical removal. We experienced a rare tubular esophageal duplication, in a 2-month old girl who presented with fever and grunting. This is the first reported case in which the sequence of events of ruptured tubular esophageal duplication with empyema, mediastinitis and aneurysm occured.