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Clinical observation of meconium aspiration syndrome and effect of suctioning through endotracheal intubation on prognosis of meconium aspiration syndrome (태변 흡인 증후군의 임상적 고찰과 기관 내 삽관 후 조기 태변 흡인이 예후에 미치는 영향)

  • Yoon, Yong Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.959-964
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    • 2007
  • Purpose : The purpose was to investigate the clinical considerations of patients affected by meconium aspiration syndrome (MAS) and the effect of suctioning through endotracheal intubation immediately after delivery on the prognosis of MAS. Methods : A total of 44 inpatients diagnosed as MAS in the Neonatal Intensive Care Unit (NICU) at Cheil Hospital were selected from January 2004 to June 2006. They were divided into two groups. In the early aspiration group (12 patients), suctioning through endotracheal intubation was performed according to the neonatal resuscitation program of the American Academy of Pediatrics and the American Heart Association because infants born through meconium-stained amniotic fluid (MSAF) were not vigorous after birth. In the early non-aspiration group (32 patients), endotracheal intubation was not performed because the infants born through MSAF were vigorous after birth. These two groups were analyzed retrospectively by medical records in the fields of clinical features, obstetric risk factors, complications, treatment, and duration of hospitalization. Results : There was no significant difference in mean gestational age, mean birth weight, sex, and delivery mode between the early aspiration group and the early non-aspiration group. Mean Apgar score of the early aspiration group both in 1 and 5 minute score was significantly lower than in the early non-aspiration group. Lengths of hospitalization and duration of mechanical ventilator care were longer in the early non-aspiration group, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group than in the early aspiration group. Conclusion : In this study, the early non-aspiration group used surfactant more and had a longer duration of mechanical ventilator and hospitalization, but there was no significant difference. Total duration of oxygen therapy was significantly longer in the early non-aspiration group. Therefore, more detailed guidelines for vigorous infants born through MSAF are needed and we should study and follow up the long term prognosis of neurological complications of MAS.

Chronic Renal Failure in Children: A Nationwide Survey in Korea (소아 만성 신부전증의 전국적인 조사연구)

  • Kim, KyoSun;Jeon, Jeong-Sik;Lee, Ik-Jun;Go, Dae-Gyun;Lee, Gyeong-Il;Yun, Hui-Sang;Gu, Ja-Hun;Go, Cheol-U;Jo, Byeong-Su;Kim, Jun-Sik;Son, Chang-Seong;Yu, Gi-Hwan;An, Yeong-Ho
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.92-101
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    • 2000
  • Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

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A comparative study of three therapeutic modalities in loculated tuberculous pleural effusions (소방이 형성된 결핵성 흉막 질환에서 배액 방법에 따른 치료효과)

  • Lee, Sang Hwa;Lee, So Ra;Lee, Sang Youb;Park, Sang Muyn;Suh, Jung Kyung;Cho, Jae Youn;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.683-692
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    • 1996
  • Background: Although most of the patients with tuberculous pleural effusions completely reabsorbed their effusions and became asymptomatic within 2 to 4 months, later surgical procedures such as decortication is needed in some patients because of dyspnea caused by pleural loculations and thickening despite anti-tuberculous chemotherapy. It is obligatory to secure adequate drainage to prevent the development of complications. But, the best methods for treating loculated tuberculous pleural effusions remain debatable. Recent several reports revealed that intrapleural instillation of fibrinolytic agents is an effective adjunct in the management of complicated empyema and may reduce the need of surgery. Purpose : The effects of catheterization with intrapleural urokinase instillation were prospectively evaluated in the patients with septated tuberculous pleural effusion, and compared with other therapeutic effects of different modalities of therapy such as repeated thoracentesis and small-bored catheterization. Methods : Forty-eight patients diagnosed with tuberculous pleurisy were randomly separated into three groups; control group(n=13), catheter group(n=12), urokinase group(n=22). In urokinase group, dose of 100.000U urokinase was instilled into the pleural cavity via a percutaneous drainage catheter for complete drainage or total dose of 700,000U of urokinase. After two hours clamping, the catheter was opened and intermittently irrigated. The early and late effectiveness of therapies was assessed by radiographically and by measuring the volume of fluid drained from the catheter. Results : There was statistically significantly better result in the urokinase group in respect of frequency of catheterization, frequency of catheter obstruction and the duration of catheterization in early effectiveness(p < 0.05). There were no difference in radiologic improvement of follow-up in later phase chest X-ray between urokinase group and catheter group in later phase(p > 0.05). But there were more failure rates in control group especially honeycomb septa in pleural effusion sonographically than former two groups. And there were no complications of urokinase such as fever or hemorrhage. Conclusion : In the treatment of septated tuberculous pleurisy, there were better results in urokinase than those of catheterization alone in early effectiveness. And there was no difference in radiographic improvement between urokinase group and catheter group. Intrapleural instillation of urokinase is an effective and safe mode of treatment for septated tuberculous pleural effusions and alleviates the need for thoracotomy.

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An Legal-doctrine Investigation into the Application of ADR to Administrative Cases (행정사건에 대한 ADR의 적용에 관한 법이론적 고찰)

  • 이용우
    • Journal of Arbitration Studies
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    • v.13 no.2
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    • pp.459-488
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    • 2004
  • General interest in the out-of-court dispute resolution system are mounting in Korea, and the spread of ADR(alternative dispute resolution) is the worldwide trend. In addition, it was confirmed that the resolution of disputes by ADR such as the decision based on arbitration made by the Prime Ministerial Administrative Decision Committee is no longer in exclusive possession of the civil case. The activation of ADR could lead to the smooth agreement between parties by getting away from the once-for-all mode of decision such as the dismissal of the application or the cancellation of disposal and the like in relation to administrative cases for the years. In consequence, it is anticipated that the administrative litigation that applicants have filed by not responding to the administrative decision would greatly reduce in the future. But, it would be urgent to provide for the legal ground of the ADR system through the revision of related laws to take root in our society because ADR has no legal binding power relating to the administrative case due to the absence of its legal grounds. The fundamental reason for having hesitated to introduce ADR in relation to the administrative case for the years is the protective interest of the third party as well as the public interest that would follow in case the agreement on the dispute resolution between parties brings the dispute to a termination in the domain of the public law. The disputes related to the contract based on the public law and the like that take on a judicial character as the administrative act have been settled within the province of ADR by applying the current laws such as the Civil Arbitration Law, Mediation Law, but their application to the administrative act of the administrative agency that takes on a character of the public law has been hesitated. But as discussed earlier, there are laws and regulations that has the obscure distinction between public and private laws. But there is no significant advantage in relation to the distinction between public and private laws. To supplement and cure these defects it is necessary to include the institutional arrangement for protection of the rights and benefits of the third party, for example the provision of the imposition of the binding power on the result of ADR between parties, in enacting its related law. It can be said that the right reorganization of the out-of-court dispute resolution system in relation to the administrative case corresponds with the ideology of public administration for cooperaton in the Administrative Law. It is high time to discuss within what realm the out-of-court dispute resolution system, alternative dispute resolution system, can be accepted and what binding power is imposed on its result, not whether it is entirely introduced into the administrative case. It is thought that the current Civil Mediation Law or Arbitration Law provides the possibility of applying arbitration or mediation only to the civil case, thereby opening the possibility of arbitration in the field of the intellectual property right law. For instance, the act of the state is not required in establishing the rights related to the secret of business or copyrights. Nevertheless, the disputes arising from or in connection with the intellectual property rights law is seen as the administrative case, and they are excluded from the object of arbitration or mediation, which is thought to be improper. This is not an argument for unconditionally importing ADR into the resolution of administrative cases. Most of the Korean people are aware that the administrative litigation system is of paramount importance as the legal relief for administrative cases. Seeing that there is an independent administrative decision system based on the Administrative Decision Law other than administrative litigation in relation to administrative cases, the first and foremost task is the necessity for the shift in thinking of people, followed by consideration of the plan for relief of the rights through the improvement of the administrative decision system. Then, it is necessary to formulate the plan for the formal introduction and activation of ADR. In this process, energetic efforts should be devoted to introducing diverse forms of ADR procedures such as settlement conference, case evaluation, mini-trial, summary jury trial, early neutral evaluation adopted in the US as the method of dispute resolution other than compromise, conciliation, arbitration and mediation

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A Study on the Transmission of 'Soeburi-Song' in Ulsan (울산쇠부리소리의 전승 양상)

  • Yang, Young-Jin
    • (The) Research of the performance art and culture
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    • no.37
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    • pp.157-186
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    • 2018
  • Ulsan Soeburi song was reenacted in the 1980s based on the testimony and songs of late Choi Jae man (1987 death), the last blacksmith of the iron production plant at Dalcheon dong, Ulsan in August 1981. The purpose of this study is to analyze Soeburi song from the musical perspective based on 13 kinds of data including video in 1981, and confirm the changing patterns in the tradition process. The derived results are summarized as follows. In the results of examining Soeburi Song data in 2017, the percussion instruments consist of kkwaenggwari 2 (leading small gong 1, follow small gong 1), jing 2 (large gong 2), buk 4 (drum 4), janggu 4 (double headed drum 4), taepyongso 1 (Korean shawm 1), and Jangdan (rhythm) consists of five such as Jilgut, Jajinmori, Dadeuraegi, Deotbaegi, Jajin Deotbaegi. The vocal songs are sung accompanied by the Deotbaegi Jajin Deotbaegi (beat) of quarter small triplet time, or without accompaniment. The scale is mostly Mi La do's third note or Mi La do re's fourth note, and the range does not exceed one octave. All the cadence tones are the same as La. From the results of observing Soeburi song performance until today after the excavation in 1981, it is found that there are four major changes. First, the composition of the music is differentiated into 'long Jajin (slow fast)', and , , and are added. Second, the singing method is based on 'single cantor + multi post singers' since 1980's reenactment, and a single post singer was also specified from time to time. In addition, , which was performed in 2013, became the foundation of . Third, a melodic change of was observed. All beat structures are quarter small triplet time, but the speed gets slow, Mi La do's three notes are skeletonized to be corrected with high re and low sol, and then the characteristics of Menari tori (the mode appeared in the eastern province of the Korean peninsula) are to be clear. Lastly, the four percussion instruments such as kkwaenggwari, jing, janggu, and buk are frequently used, and depending on the performance, sogo (hand drum), taepyongso, yoryeong (bell) are also added. Jangdan played Jajinmori, Dadeuraegi, Deotbaegi and Jajin Deotbaegi from the beginning, and thereafter, the Jilgut Jangdan was added. Through these results as above, it is confirmed that at the time of the first excavation, a simple form of such as has been changed into a male labor song, the purpose of which has changed, and that the playability has become stronger and changed into a performing arts.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Hwaunsi(和韻詩) on the Poems of Tu Fu(杜甫) and Su Shi(蘇軾) Written by Simjae(深齋) Cho Geung-seop(曺兢燮) in the Turning Point of Modern Era (근대 전환기 심재 조긍섭의 두(杜)·소시(蘇詩) 화운시)

  • Kim, Bo-kyeong
    • (The)Study of the Eastern Classic
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    • no.56
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    • pp.35-73
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    • 2014
  • This paper examined the poem world of Simjae(深齋) Cho Geung-seop(曺兢燮: 1873-1933) in the turning point of the modern era, focused on his Hwaunsi (和韻詩: Poems written by using the rhymes of other poets' poems). In his poems, there are lots of Hwaunsi on the poems of Tu Fu(杜甫) and Su Shi(蘇軾), especially. This makes him regarded as a medieval poet, engaged in Chinese poem creation in the most traditional method in the turbulent period. Looking at the Hawunsi(和韻詩) alone, Simjae's creative life became the starting point of turnaround at around 40 years old. Before the age of 40, the poets in the Tang Dynasty and Song Dynasty and Ming Dynasty and Qing Dynasty and Korean figures like Lee Hwang(李滉), as well as Tu Fu and Su Shi were the subjects of his Hwanunsi. After the age of 40, some examples of writing poems using the rhymes of other poets' poems, especially Korean figures related to regions, are often found, reducing Hwaunsi on Tu Fu and Su Shi. Simjae called Tu Fu the integration of poets, talking about the integrity of poetic talent and his being highly proficient in mood and view. As reflecting such an awareness, the themes and moods and views are demonstrated diversely in Simjae's Hwaunsi. Although, he did not reveal his thinking about the poems of Su Shi, he seemed to love Su Shi's poems to some degree. The closeness to the original poems, the poems of Tu Fu are relatively higher than those of Su Shi. Roughly speaking, Simjae tried to find his own individuality, intending to follow Tu Fu, but, he seemed to attempt to reveal his intention using Su Shi's poems, rather than trying to imitate. To carefully examine, Simjae wrote Hwaunsi, but he did not just imitate, but revealed the aesthetics of comparison and difference. In many cases, he made new meanings by implanting his intentions in the poems, while sharing the opportunity of creation, rather than bringing the theme and mood and view as they are. The Hwaunsi on Su Shi's poems reveal the closeness to the original poems relatively less. This can be the trace of an effort to make his own theme and individuality, not being dominated by the Hwaun(和韻: using the rhymes of other poets' poems) entirely, as he used the creative method having many restrictions. However, it is noted that the Hwaunsi on Tu Fu's poems was not written much, after the age of 40. Is this the reason why he realized literary reality that he could not cope with anymore with only his effort within the Hwaunsi? For example, he wrote four poems by borrowing Su Shi's Okjungsi(獄中詩: poem written in jail) rhymes and also wrote Gujung Japje(拘中雜題), in 1919, while he was detained. In these poems, his complex contemplation and emotion, not restricted by any poet's rhymes, are revealed diversely. Simjae's Hwaunsi testifies the reality, in which Chinese poetry's habitus existed and the impressive existence mode at the turning point of the modern era. Although, the creation of Hwaunsi reflects his disposition of liking the old things, it is judged that his psychology, resisting modern characters' change, affected to some degree in the hidden side. In this regard, Simaje's Hwaunsi encounters limitation on its own, however, it has significance in that some hidden facts were revealed in the modern Chinese poetry history, which was captured with attention under the name of novelty, eccentricity and modernity.

Assessment of Bone Metastasis using Nuclear Medicine Imaging in Breast Cancer : Comparison between PET/CT and Bone Scan (유방암 환자에서 골전이에 대한 핵의학적 평가)

  • Cho, Dae-Hyoun;Ahn, Byeong-Cheol;Kang, Sung-Min;Seo, Ji-Hyoung;Bae, Jin-Ho;Lee, Sang-Woo;Jeong, Jin-Hyang;Yoo, Jeong-Soo;Park, Ho-Young;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.30-41
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    • 2007
  • Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.