Video-assisted thoracic sympathicotomy is a safe and effective therapy for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathicotomy at various levels and the extent of block, we are to determine the optimal level of sympathicotomy and which method will result in minimal side effects and maximal benefits. Material and Method: From January 1998 to June 2001, the thoracoscopic sympathicotomy was performed in 150 patients suffering from essential hyperhidrosis in the Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into three groups. GroupI(n=50): patients having undergone 72,3,4 sympathicotomy, GroupII (n=50): patients having undergone 72 sympathicotomy which consist of blocking the interganglionic neural fiber on the second rib, and group 111(n=50): patients having undergone 73 sympathicotomy which consist of blocking the interganglionic neural fiber on the third rib. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory sweating, postoperative complications, and changes of plantar sweating. Results: There was no difference in age and sex among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However the rate of long-term satisfaction were 80%, 92%, and 96% in groupsI,II, and III respectively(p<0.05). More than embarrassing compensatory hyperhidrosis was present in 50%, 28%, and 18% in groups I,II ,and III respectively(p<0.05). Slight but comfortable amounts of palmar humidness was expressed in decreasing order, group III(34%), groupII(6%), and group I(4%) respectively(p<0.05). In regard to plantar sweating, decrease in sweating was expressed in each of the three groups, but was not significant between the groups.
Between April 1981 and June 1996, 65 patients had aortic root replacement at our institution. Disease entities were pure aortic annuloectasia in 31 patients(47.7%), Stanford type A aortic dissection with annuloectasia in 8(43.1%), atherosclerotic aneurysm with aortic regurgitation in 4(6.2%), and paravalvular leakage after aortic valve replacement in 2(3.1 %). 34 patients(52.3%) had the clinical stigmata of the Marfan syndrome. The operative procedures were Bentall operation in 61 patients(93.8%); 3 of conventional procedure and 58 of Cabrol's modification, aortic valve-sparing operation in 2(3.1 %), and root replacement with homograft in 2(3.1%). Hospital deaths occurred in 3 patients(4.8%) because of uncontrolled bleeding(1) and bypass weaning failure due to low cardiac output(2), and all had emergency operation with Cabrol's procedure. Postoperative complications developed in 19(29.2%) patients and most of them were transient. Surviving 62 patients have been followed up to cumulative total 315.0 patient-years(mean 60.2 $\pm$42.4 months). Late deaths occurred in 7 patients(11.3%), aneurysmal changes of remaining aorta were detected in 12 patients(19.4%). Actuarial survival rate at 10 years was 72.0 $\pm$ 9.7%, and the subsequent aortic operation-free rate at 10 years was 68.0$\pm$ 8.9% In a multivariate analysis, Marfan syndrome, emergency operation, preoperative dissection, combined arch replacement, and total circulatory arrest emerged as significant risk factors for hospital death or subsequent aortic operation. Over 60 years of age was the only risk factor for late death. Our 16 years'cummulative experience shows that aortic root replacement, mainly by means of Cabrol's procedure, can be applied successfully to variety of aortic root disease. However, long-term follow up will be needed to determine the late result of aortic valve-saving operation and root replacement with homograft. When dissection is present or the distal native aorta is diseased in'Marfan patients, close follow-up is necessary because of the subsequent aneurysmal change of remaining aorta.
This paper describes a simple method that uses differences among Carlson's (1977) trophic state index (TSI) values based on total phosphorus (TP), chlorophyll a (CHL) and Secchi depth (SD) to draw inferences regarding the factors that are limiting to phytoplankton growth and the composition of lake seston. Examples are provided regarding seasonal and spatial patterns in a large subtropical lake (Lake Okeechobee, Florida, USA) and inter- and intra-lake variations from a multilake data set developed from published studies. Once an investigator has collected routine water quality data and established TSI values based on TP, CHL, and SD, a number of inferences can be made. Additional information can be provided where it also is possible to calculate a TSI based on total nitrogen (TN). Where TSI (CHL)<>TSI (SD), light attenuating particles are large (large filaments or colonies of algae), and the phytoplankton may be limited by zooplankton grazing. Other limiting conditions are inferred by different relationships between the TSI values. Results of this study indicate that the analysis is quite robust, and that it generally gives good agreement with conclusions based on more direct methods (e.g., nutrientaddition bioassays, zooplankton size data, zooplankton removal experiments). The TSI approach, when validated periodically with these more costly and time-intensive methods, provides an effective, low cost method for tracking long-term changes in pelagic structure and function with potential value in monitoring lake ecology and responses to management.
This study was designed to examine the effectiveness of an unused tunnel as a rice storage place. The physicochemical changes of rice grains were investigated during 8-months of storage in the tunnel located at Kyungnam province, Korea. Two kinds of tunnel stored rices, NP(rice grown with no pesticides) and LP(rice grown with less pesticides) were compared with $5^{\circ}C$ stored rice as a control. The peroxidase activities, as an index of freshness of rice grains, gradually decreased and NP appeared to be fresher than LP. Whiteness, grain wholeness, and chalkyness were less desirable for the tunnel stored rice than the control, with no significant difference of physicochemical properties, including the broken, damaged, colored rice, and contents of moisture, protein, and amylose. Palatability dropped below 70 in all three groups at later phase. The sensory evaluation showed that overall preference was slightly higher for the control but not significantly different from the other two groups. From all the evidences shown, unused tunnels may be an effective place for a long-term rice storage, since the average temperature inside the tunnel was maintained very constantly around $14.3^{\circ}C$ and relative humidity was optimal for rice storage, especially during spring and summer seasons.
[ $\underline{Purpose}$ ]: We performed this prospective randomized study to evaluate the efficacy and the complications of radiotherapy for Subfoveal CNV in ARMD and to compare the treatment results at two dosages (14.4 Gy and 19.8 Gy). $\underline{Materials\;and\;Methods}$: 60 eyes of 55 patients were enrolled, and randomized into 14.4 Gy (31 eyes) or 19.8 Gy (29 eyes) groups. CT was used to plan the radiotherapy. All patients received radiotherapy with a 1.8 Gy daily dose using 4 MV photon. We categorized treatment results as improved, stable, or deteriorated based on visual acuity changes of more than 2 lines on the ETDRS chart. $\underline{Results}$: Median follow-up period was 33.5 months. At 12 months, visual acuity improved in 9 (16.7%), stable in 41 (75.9%), and aggravated in 4 (7.4%) of 54 evaluated eyes. At 24 months, 49 eyes (81.7%) were evaluated. Visual acuity improved in 6 (12.2%), was stable in 33 (67.4%), and deteriorated in 10 (20.4%). At 36 months, 37 eyes were evaluated. Six (16.2%) eyes were improved, 21 (56.8%) stable, and 10 (27.0%) deteriorated. No significant difference in response was observed between the 14.4 Gy and 19.8 Gy groups (Mantel-Haenszel $x^2=0.4756$). The proportion of eyes with a vision of $20/100{\leq}increased$ from 28.3% initially to 32.7% after 24 months of radiotherapy. There were no severe acute or chronic complications. $\underline{Conclusion}$: External beam radiotherapy with doses of 14.4 or 19.8 Gy may be an effective treatment for subfoveal CNV in ARMD. No dose-response relationships with respect to treatment response or toxicity were observed between the 14.4 Gy and 19.8 Gy groups.
Park, Chan-Beom;Kwon, Jong-Bum;Park, Kuhn;Won, Yong-Soon
Journal of Chest Surgery
/
v.34
no.8
/
pp.591-596
/
2001
Coronary artery bypass graft with cardiopulmonary bypass is a conventional method of operative revascularization of coronary artery disease. Because of many troubles of cardiopulmonary bypass such as systemic inflammatory reaction, mechanical trauma of blood components and coagulopathy, coronary artery bypass graft without cardiopulmonary bypass has been popularized. Material and Method: From March 1999 to September 2000, 35 patients under went CABG at our institution. Among them, 14 patients received CABG without the use of CPB and 21 patients under went CABG with the use of CPB. Mean operative time, mean postoperative tracheal intubation time, mean ICU stay, mean hospital stay, the amount of transfusion, postoperative use of inotropic agents, and postoperative changes of cardiac enzymes were compared in both groups. Result: There were differences between the CABG without CPB group and CABG with CPB group with regard to mean tracheal intubation time, the amount of transfusion and the elevation of postoperative cardiac enzymes(p<0.05). Conclusion: While CABG without CPB provided satisfactory results, more long term follow-up is required.
Journal of the korean academy of Pediatric Dentistry
/
v.29
no.2
/
pp.243-254
/
2002
For the purpose of evaluating the biocompatability of 3 kinds of metallic materials frequently used in pediatric dentistry (stainless steel crown, orthodontic band, orthodontic wire), cellular and molecular studies, including cell growth and proliferation, screening of cell death with determination of types whether necrosis or apoptosis and changes in expressions of related signaling molecules were examined, using cultured human gingival fibroblasts (HGF-1), HGF-1 was cultured in Dulbecco's modified Eagle's medium. among which the 3rd to 6th generations of HGF-1 were used. The specimen were divided into stainless steel crown (R), band (B) and wire (W). The immunocytochemical study was done for the detection of anti-PCNA (proliferating cell nuclear antigen) labeling. With extracted protein, western blot was done for the detection of ERK1/2, JNK, and p38, using individual antibodies. Cultured cells proliferated, remarkably till 7 day and slightly at 11 day. There was no statistical significance in the counts of proliferating HGF-1 between control and experimental groups (p>0.05). Relative growth rates were no statistically significant difference between control and experimental groups (p>0.05). PCNA labeling indexes showing similar patterns in control and experimental groups. The expressions of ERK1 and ERK2, p38 were similar in control and experimental groups. The expression of JNK increased at 1st day, slightly decreased at 4th day and markedly increased at 7th and 11 day. Although the patterns of control and experimental groups were similar, the increased expressions of JNK at late period suggest a possible stress due to inhibited cell growth and proliferation, and worse culture condition. Conclusively, the 3 kinds of metal specimens used in this study did not induce cellular and molecular hazards during short term culture of HGF-1. But, for the better clinical stability, the establishment of long period culture and animal experiment was thought necessary.
The introduction of cash payments for care is a distinct trend that characterizes changes in care policies since the 1990s. Recently, many developed countries have newly introduced or extended cash payments for care that allow care users to be able to plan themselves for their cares instead of receiving direct care services from the state. Cash payments for care can be said to be one of the alternative policies by which user choices are extended, and it becomes possible to establish demand-cantered care delivery systems more economically and effectively, hence addressing the issue of the financial limitations and rigid systems that are common in modern welfare states, which make it difficult to response to various needs. However, the design and administration of cash for care vary across different countries. Such variations of cash for care policies influence on the combination of consumerism (based on liberal market values intrinsic in the care market) and citizenship based on social solidarity. Those variations eventually produce impacts on the balance of responsibilities and the roles of families, the state and market regarding care in other words, balancing of welfare pluralism. This paper has attempted to find general meanings and particularity of cash for care polices in modem welfare states by means of looking at the characteristics of cash for care policies of four different countries (Netherlands, France, Germany and Italy) and their impacts on their care market. If the four countries are ranked by the degree that they emphasize citizenship in light with social rights, the Netherlands, France, Germany and Italy could be placed in due order. From an economic point of view and in terms of cost containment, those countries will be placed in an inverse order, It is apparent that in the course of planting cash for care policies in the existing social systems involving different socio-cultural conditions and labour markets, sometimes more emphasis is placed on the citizenship of care users, family carers and care providers than on cost containment issue, and sometimes vice versa. Behind this lies the process of different social valuation on what care is about; who can better deliver care; who should be responsible for care; how responsibilities should be shared and so on.
This study is aimed at investigating the compensatory education which was already implemented or is being implemented in the U.S.A. and Japan; and at studying the types of programs and their characteristics; and at sounding out the possibilities of the application of such programs in family and social conditions is Korea. In order to achieve the above mentioned objectives, the established items for the study are as follows: (1) Various types of early children's education (2) Programs of compensatory education for the disadvantaged Children (3) Head Start Program, Early Training Project and Montessori School (4) Integrated Preschool Programs (5) Day-Care Center for employed mothers We investigated the various compensatory education programs for the preschool children who are in economically, socially, culturally disadvantaged conditions. Head Start Programs were federally supported programs for preschool children and opened as summer programs in 1965 for the first time. The purpose of Head Start has been to give preschool children the kinds of experiences they need in preparation for school. The Head Start children were found to be significantly better prepared for school than the normal children. However, after six to eight months, their initial advantages had virtually. disappeared and then the simple problem with Head Start and other such programs was that little long-term good could be evidenced unless the high quality educational environment was maintained. Therefore, to solve this problem, three other programs were funded as part of the overall Head Start. These three programs are the Parent-Child Center, Home Start, and the Child and Family Resources Program. The Early Training Project for disadvantaged children was implemented by Klaus and Gray of Peabody College in 1962. The program was a field research study concerned with the development and testing over time of procedures for improving the educability of young children from low income homes. Its major concern was to study whether it was possible to offset the progressive retardation observed in the public schooling careers of children, living in deprived circumstances. Children, who were trained through the Early Training Project were superior to control groups in the test of IQ and vocabulary as well as linguistic abilities, and preparation for reading. This project showed the possibilities which could prevent preschool children from being disadvantaged socially, culturally and mentally. In 1907, Montessori School was established by Maria Montessori in Italy and her school program has been introduced at present to several countries in the world as one compensatory educations. She first began her experimental methods with retarded children, followed by disadvantaged children from the tenements of Rome. The Montessori approach futures a prepared environment and carefully designed, self-correcting materials. The Montessori curriculum presents tastes that feature sequence, order, and regularity, in addition to those that develop motor and sensory skills. She was interested in children's intellectual development and in developing good work habits. One of the latest developed programs for disadvantaged children is "Integrated Preschool Program" which has successfully integrated handicapped and nonhandicapped children. Several studies have showed that handicapped children in integrated school environments are accepted by and interact with their nonhandicapped peers. In fact, this program provides a number of potential, and perhaps opportunities for nonhandicapped children to serve as valuable resources in fostering the development of their handicapped peers. Next we turn to Japanese programs which are divided into two different types. One is Day-Care Center which was established by Child Welfare Law and the other is kindergarten organized by School Education Law. The kindergarten opened in 1876 and it has been part of school systems since 1947 by the implementation of education law, and the Day-Care Center which started in 1890 for the employed mothers. was changed into Day-Nursery by the enactment of child welfare law in 1947. The laws and operational regulations for the Day-Nursery were set up and were put in effect by the establishment standard acts of children welfare facilities, and the Day-Nursery has been operated in various types by the increasing demand, chiefly because of the socio-economical changes of family structures in both urban and suburban areas. Nursery education for physically and mentally disadvantaged children is for those who are blind, deaf and dumb, mentally retarded; physically disadvantaged by accidents or diseases. Montessori education in Japan was started in 1968 and many research groups for studying Montessori were organized. In 1977, Montessori remedial education society was also organized in which they started a number of studies; a study for developing materials; in-service training for the remedial education; and seminars and lectures, etc It is strongly suggested that we study the early educations that are being implemented in Japan and a variety of compensatory educations that were already implemented in the U.S.A. and modify them for the organization of our own model and properly accommodate them to our social needs.
This study was carried out to investigate the ecological succession sere and conservative value, and to provide the basic data for the planning of the Provincial Park Management in Seonamsagol(Valley), Jogyesan(Mt.) Provincial Park(altitude 884m), Suncheon City, Korea by analysing the structure of the plant community. Twenty plots(size is $20m{\times}20m$) were set up at an altitude of range from 315m to 480m. As a result of analysis of TWINSPAN which is one of the ordination technique, the plant communities were divided into four groups which are community I(Quercus variabilis community), community II(Q. serrata community), community III(Decideous broad-leaved plant community), and community IV(Carpinus tschonoskii community). The warmth index is $104^{\circ}C{\cdot}month$ based on the data of monthly mean temperature during the past thirty years(1981~2010), so we found out that the vegetation of the study site located in the South Temperate Climate Zone. We supposed that the ecological succession sere of the study site is in the early stage of developing from Q. serrata community to Carpinus tshonoskii community, however we should do a long-term monitoring to investigate the changes of the ecological succession each plant community, meanwhile Sasa borealis was dominant species in the shrub layer. The diameter at breast height of specimen tree is range from 20 to 55cm(average 36cm) and the height of that is range from 14 to 35m(average 23cm). The age of community I was 64 years old, that of community II was from 59 to 64 years old, that of community III was from 51 to 62 years old, and that of community IV was from 41 to 68 years old, thus the age of the study site is about from 38 to 72 years old. According to the index of Shnnon's diversity(unit: $400m^2$), community IV was ranged from 0.8452 to 1.2312, community III was ranged from 0.8044 to 1.1404, community II was ranged from 0.8221 to 0.9971, and community I was 0.8324.
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