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The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis (수장부 다한증환자의 흉부 교감신경절단술후 교감신경 피부반응)

  • 김오곤;홍종면;이석재;홍장수;이광래;김상규
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.579-583
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    • 1999
  • Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

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Management Efficiency of Chestnut-Cultivating Households in Chungnam Province (충남지역 밤나무 재배 임가의 경영 효율성 분석)

  • Won, Hyun-Kyu;Jeon, Jun-Heon;Yoo, Byoung-Il;Lee, Seong-Youn;Lee, Jung-Min;Ji, Dong-Hyun
    • Journal of Korean Society of Forest Science
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    • v.102 no.3
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    • pp.390-397
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    • 2013
  • The study, utilizing a data envelopment analysis (DEA) which is one of the nonparametric estimation methods, aims to evaluate the management efficiency of chestnut tree cultivators in such provinces in Chungchungnam-do as Cheong-yang, Gong-ju, Bu-yeo and so on. The analysis data of this study is based on inputs and outputs of 20 forestry households surveyed in the 2012 survey titled 'A Study on Current Level and Condition of Chestnut Cultivation and Management', which was conducted from March 2012 to October 2012. The elements of inputs are composed of management cost, harvesting cost, material cost, non-operation expenses and cultivation area, while the element of output is a gross margin only. Then the study analyzes a technical efficiency, a puretechnical efficiency and a scale efficiency using CCR and BCC model among DEA methods. Based on that, it also provides improvement methods for forestry households that turned out to be inefficient. In order to verify the result of DEA analysis, the study additionally compares a result of this efficiency study with that of chestnuts management standard diagnostic table. According to the result, the average value of technical efficiency analyzed was 0.667, proving to be inefficient in general. Given that the average value of pure-technical efficiency was 0.944 and that of scale efficiency was 0.703, it can be inferred that inefficiency exists in the field of scale, not in the field of cultivation techniques. As for forestry households with the efficiency score of 1, it is shown that there were 6 households that recorded 1 in the technical efficiency field and 13 households that recorded 1 in the pure technical efficiency. Meanwhile, there were 6 households that recorded 1 in all of the three aspects. In the comparison with the scores from chestnuts management standard diagnostic table, there were 5 households made a high score of over 80, among which are 3 households with score 1 in the technical efficiency. Also, the results of this study and the chestnuts management standard diagnostic table are proved to have the same result, both of them showing the same households that recorded the highest score and the lowest score. This means the management efficiency evaluation using DEA can be applied to the fieldwork along with the chestnuts management standard diagnostic table.

Biochemical Composition of Rotifer, Brachionus plicatilis Enriched with Different Commercial Enrichments (영양 강화제 종류에 따른 rotifer, Brachionus plicatilis의 생화학적 조성)

  • ;Joseph A. Brown
    • Journal of Aquaculture
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    • v.17 no.3
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    • pp.187-196
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    • 2004
  • This study was carried out to investigate changes in biochemical composition of rotifer, Brachionus plicatilis, enriched with the commercial enrichments (Enhance, Advantage, Algamac-2000, DHA-Selco and Advantage + Chlorella) at various durations of enrichment (0, 6, 12 and 24 hr) to improve the growth and survival of marine fish larvae. Total lipid content of rotifers enriched with various enrichments tended to increase with an increase in durations of enrichment up to 6 hr, but after that, was not significantly affected by enrichment materials. However, total protein content of rotifers enriched groups except for Advantage+Chlorella decreased with the increase in duration of enrichment. The highest protein/lipid ratio showed 2.7 in rotifer enriched with the Advantage +Chlorella. The phospholipid/lipid ratio of rotifer enriched with the Enhance, Advantage and Advantage+Chlorella groups was significantly higher than that of enriched rotifer with the Algamac-2000 and DHA-Selco groups. The highest DHA level, 2.5%, of rotifer enriched for 24 hr was obtained in the Advantage, but was not significantly different among other groups, except for Algamac-2000. No significant difference in DHA level of rotifer enriched with the DHA-Selco, Algamac-2000 and Advantage+Chlorella groups was observed between l2h and 24hr of enrichment. The DHA/EPA ratio in the enriched rotifers varied among enrichment material groups, ranged from a high level of 11.1:1 in the Advantage+Chlorella group to a low level of 4.1:1 in DHA-Selco group. The results from this study indicate that rotifers enriched with Enhance, Advantage and Advantage+Chlorella seemed to be effective to improve nutritional value of rotifer for marine fish larvae because phospholipid, DHAJEPA and protein/lipid ratios of rotifer enriched with Enhance, Advantage+Chlorella were higher than those of rotifer enriched with either DHA-Selco or Algamac-2000. Especially, supplementation of the Chlorella to these enrichments would appear to be effective for improvement of fish larval performance because of no reduction of protein level in rotifer, which is critical for growth of fish larvae.

Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

Improvement of Green-up of Zoysiagrass and Cool-season Grass during Early Spring in Korea (한국잔디 및 한지형 잔디의 초봄 그린업 촉진)

  • Lee Jae-Pil;Kim Doo-Hwan
    • Asian Journal of Turfgrass Science
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    • v.19 no.2
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    • pp.103-113
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    • 2005
  • This study was conducted to improve the green up of zoysiagrass(2. japonica) and cool-season grass($80\%$ Kentucky bluegrass+$20\%$ Perennial ryegrass) during early spring in Korea. Treatments fur zoysiagrass were control, Polyethylene film, Black screen, Black screen+polyethylene film, Green screen+polyethylene film, Polyethylene film+Black screen, Polyethylene film+Green screen, low mowing height(1.5-2cm) and homing. For cool-season grass, non-punched Polyethylene film, punched Polyethylene film treatments were included. Application dates of covering with Polyethylene film were Feb. 22, Feb. 28, March 7, and March 14. Green up was evaluated by visual color rating. The results are as follows; 1. The best method for improving green up of zoysiagrass were Polyethylene film and optimal covering day for zoysiagrass was on Feb. 22. 2. Low mowing height(1.5-2cm) and burning of zoysiagrass showed the faster greening 1$\sim$weeks before than control. .3 Non-punched Polyethylene film covering was best to improve green up of cool-season grass. More time of covering time with cool-season grass induces rapid green up.

Pediatric Renal Transplantation in Asia (아시아 소아 신장이식 현황)

  • Kim Ji-Hong;Choi Yong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.131-141
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    • 2002
  • Purpose : Renal transplantation which allows children normal growth and development and a return to normal life. is now proven to be the best modality for children with ESRD Up to Recently, the number of renal transplantations in Asia has rapidly increased and the outcome has also improved. This investigation was planned to estimate the current status of pediatric renal transplantation in Asia and to find the keys for better improvement of outcome in pediatric renal allograft in Asian countries. Material and methods : The participating countries and institutions for this investigation were China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, Thailand, Korea, KSPN (Korean Society of Pediatric Nephrology), KONOS (Korean Network for Organ Sharing). Results : Many countries in Asia still do not have a well organized nation wide renal transplantation registration system independently in the pediatric field. So it's very difficult to evaluate the real state of pediatric transplantation among Asian countries. According to the estimation with fragmented data from each countries, in the front running countries of pediatric renal transplantation in Asia, about 40 or more transplants were performed in each country per year and the five year actuarial renal allograft survival was around 80% which is similar to that of western countries. But there were large gaps among the behind groups. Conclusion : Vigorous attempts to perform renal transplantation for children especially younger than 5 years old would be encouraged as well as organ donation from brain dead donor and non heart beating cadaveric donor also should be activated to cope effectively with the shortage of living donor supply. Large number of recent reports shows the favorable outcome of pre-emptive renal transplantation, we should make more efforts toward pre-emptive renal transplantation. First of all, in order to improve the outcome and to narrow the gap between Asian countries in pediatric renal transplantation, effective and continuous efforts to establish nationwide pediatric renal transplantation registration program as well as official, nation-to-nation data sharing program should be needed.

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Effects of light intensity and temperature on photosynthesis and respiration of Panax ginseng leaves (인삼엽(人蔘葉)의 광합성(光合成)과 호흡(呼吸)에 미치는 광도(光度) 및 온도(溫度)의 영향(影響))

  • Park, Hoon;Lee, Chong-Hwa;Bae, Hyo-Won;Hong, Young-Pyo
    • Korean Journal of Soil Science and Fertilizer
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    • v.12 no.1
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    • pp.49-53
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    • 1979
  • Effects of temperature and light intensity on photosynthesis, respiration and chlorophyll content of ginseng (Panax ginseng C. A. Meyer) were as follow. 1. Optimum light intensity for apparent photosynthesis at $25^{\circ}C$ was 25Klux($1.35mgCO_2/dm^2{\cdot}hr$) for two years old ginseng grown in pot and 30Klux($1.94mgCO_2/dm^2{\cdot}hr$) for the six years old palmate cut leaves. Optimum temperature at 25Klux was $15^{\circ}C$ ($1.40mgCO_2$) for the 2 years old and 20 to $22^{\circ}C$ ($2.03mgCO_2$) for the 6 years old. 2. Dark respiration increased almost linearly with the increase of air temperature till $25^{\circ}C$ (2.6times between $16^{\circ}C$ to $25^{\circ}C$ for the 6 years old and 1.8 times between $15^{\circ}C$ to $25^{\circ}C$ for the 2 years old). Dark respiration was 11.1 % of net photosynthesis at $16^{\circ}C$, 17.8% at $25^{\circ}C$ for the 6 years old and 40% at $15^{\circ}C$, 64.7% at $25^{\circ}C$ for 2 years old. 3. Stomata appeared only in abaxial surface (lower epidermis) and stomatal frequency was $37per\;mm^2$. 4. Above results together with other informations quoted here strongly suggest that air temperature is much better criteria than light intensity for the improvement of shading roof material and shading construction. That is to promise maximum light intensity unless air temperature is above $25^{\circ}C$.

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Role of the Inferior Thyroid Vein after Left Brachiocephalic Vein Division During Aortic Surgery

  • Park, Hyung-Ho;Kim, Bo-Young;Oh, Bong-Suk;Yang, Ki-Wan;Seo, Hong-Joo;Lim, Young-Hyuk;Kim, Jeong-Jung
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.530-534
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    • 2002
  • Background: In aortic surgery, division and ligation of the left brachiocephalic vein(LBV) may improve exposure of the aortic arch but controversy continues about the safety of this division and whether a divided vein should be reanastomosed after arch replacement was completed. The safety of LBV division and the fate of the left subclavian venous drainage after LBV division were studied. Material and Method: From November 1998 to January 2001, planned division and ligation of the LBV on the mid-line after median sternotomy was peformed in 10 patients during the aortic surgery with the consideration of local anatomy and distal aortic anastomosis. Assessment for upper extremity edema and neurologic symptoms, measurement of venous pressure in the right atrium and left internal jugular vein, and digital subtraction venography(DSV) of the left arm were made postoperatively. Result: In 10 patients there was improvement in access to the aortic arch for procedures on the ascending aorta or aortic arch. The mean age of patients was 62 years(range 24 to 70). Follow-up ranged from 3 weeks to 13 months. One patient died because of mediastinitis from methicilline-resistant staphylococcus aureus strain. All patients had edema on the left upper extremity, but resolved by the postoperative day 4. No patient had any residual edema or difficulty in using the left upper extremity during the entire follow-up period. No patient had postoperative stroke. Pressure difference between the right atrium and left internal jugular vein was peaked on the immediate postoperative period(mean peak pressure difference = 25mmHg), but gradually decreased, then plated by the postoperative day 4. In all DSV studies left subclavian vein flowed across the midline through the inferior thyroid venous plexus. Conclusion: We conclude that division of LBV is safe and reanastomosis is not necessary if inferior thyroid vein, which is developed as a main bridge connecting the left subclavian vein with right venous system, is preserved.

Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

The Clinical Outcome of Pulmonary Thromboendarterectomy for the Treatment of Chronic Pulmonary Thromboembolism (만성 폐동맥 색전증 환자에서의 폐동맥 내막절제술의 임상적 결과)

  • Bang, Jeong-Hee;Woo, Jong-Soo;Choi, Pil-Jo;Jo, Gwang-Jo;Park, Kwon-Jae;Kim, Si-Ho;Yie, Kil-Soo
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.254-259
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    • 2010
  • Background: Diagnosing chronic pulmonary embolism at an early stage is difficult because of the patient’s nonspecific symptoms. This condition is not prevalent in Korea, and in fact, there have been only a few case reports on this in the Korean medical literature. We analyzed the surgical outcome of performing pulmonary thromboendarterectomy in patients with chronic pulmonary embolism. Material and Method: The study subjects included those patients who underwent surgery for chronic pulmonary embolism from 1996 to 2008. For making the diagnosis, echocardiography, chest CT and a pulmonary perfusion scan were performed on the patients who complained of chronic dyspnea. Result: Pulmonary endarterectomy was performed as follows: by incision via a mid-sternal approach (7 patients); by incision via a left posterolateral approach (1 patient); using the deep hypothermic circulatory arrest technique (4 patients); under ventricular fibrillation (3 patients); and under cardioplegic arrest (1 patient). The postoperative systolic pulmonary artery blood pressure significantly decreased from a preoperative value of $78.9{\pm}14.5\;mmHg$ to $45.6{\pm}17.6\;mmHg$ postoperatively (p=0.000). The degree of tricuspid regurgitation was less than grade II after surgery. Two patients died early on, including one patient who had persistent pulmonary hypertension without improvement and right heart failure. Conclusion: Patients who have chronic pulmonary embolism are known to have a poor prognosis. However, we think that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient's life.