• Title/Summary/Keyword: Management methods

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Comparison of the Hydration, Gelatinization and Saccharification Properties of Processing Type Rice for Beverage Development (음료 개발을 위한 가공용 쌀의 수화, 호화 및 당화특성 비교)

  • Shin, Dong-Sun;Choi, Ye-Ji;Sim, Eun-Yeong;Oh, Sea-Kwan;Kim, Si-Ju;Lee, Seuk Ki;Woo, Koan Sik;Kim, Hyun-Joo;Park, Hye-Young
    • The Korean Journal of Food And Nutrition
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    • v.29 no.5
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    • pp.618-627
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    • 2016
  • This study evaluated the hydration, gelatinization, and saccharification properties of rice processing for beverage development. The properties of rice were studied on 10 rice cultivars (Samkwang, Ilpum, Seolgaeng, Anda, Dasan-1, Goami-4, Danmi, American rice, Chinese rice, and Thai rice) and employing four kinds of pre-treatment methods (dry grain, wet grain, dry flour, and wet flour). The results showed that moisture content of rice was between 11.88~15.26%. Increase in soaking time along with highest water absorption was noted in American rice cultivar (46.81%). The water binding capacity of Thai rice was higher when compared to that of other rice flours. In addition, solubility and swelling power of rice were 4.52~26.65% and 0.19~2.05%, respectively. The amylose content of Goami-4 was higher in rice processing. Using a rapid visco analyzer (RVA), the initial pasting temperature of Danmi cultivar was found to be the highest; the peak viscosities of Anda cultivar and Dasan-1 cultivar, and Chinese rice were higher than of those of other rice flours. After saccharification, the pH, soluble solids content, and reducing sugar content of rice processed through different pre-treatment methods were in the range of 6.22~7.08, $4.67{\sim}16.07^{\circ}Brix$, and 0.35~11.67% (w/w), respectively. In terms of color values, the L-value of dry grain, a-value of wet (grain, flour), and b-value of dry sample (grain, flour) were found to be the highest. Assessment of various factors and cultivars characteristics of the raw grains are of importance in the development of rice beverage.

The Clinical Aspects of Regional Lymphadenitis following BCG Vaccination (BCG 접종 후 국소 림프절염의 임상양상)

  • Bae, Sun Young;Park, Yang Joon;Kim, Jong-Hyun;Oh, Jin Hee;Koh, Dae Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.137-146
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    • 2006
  • Purpose : A regional lymphadenitis is the most frequent adverse reaction of BCG. In order to find out developmental factors and establish a strategy of management, we investigated the clinical courses of children with lymphadenitis following BCG on the aspect of BCG strains, suppurative rates according to the sizes of lymph node and the clinical difference with or without treatment. Methods : From January 1997 to June 2004, 52 children less than 24 month-age-old diagnosed as BCG lymphadenitis in Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea were enrolled. The type of BCG strain, place of vaccination, location and size of lymphadenitis were assessed with medical records, retrospectively. Finally, we analysed the correlations between BCG strains or the sizes of lymph node and natural remission or suppuration. Results : The first detected mean age of BCG lymphadenitis was 5.5 month-age. The larger of the measurement was at the first visiting, the younger of age that was first presented. The most frequent location was the same sided axillary region of BCG injection. Among 52 subjects, 46 cases(88.5%) were vaccinated with intradermal Pastuer strain, and only 5 cases(9.6%) were done with percutaneous multipunctured Tokyo strain. Twenty eight cases(53.8%) were regressed naturally, otherwise 24 cases(46.2%) were suppurated. The larger those were sized, the higher freqeuncies those were suppurated on, significantly. Treatment with medications could not prevent the suppuration and could not shorten the healing periods. Conclusion : We predict that there are differences between the occurrent rate of BCG lymphadenitis and BCG strains or methods. Treatment with medication is not recommended owing to its ineffectiveness. Especially, in case of non-suppurative lymphadenitis should be onlyless influence on the tuberculin skin test, cause less adverse reactions, and is inexpensive. observed without treatment, because it could be regressed naturally. An ideal BCG makes a scar, We should make an effort to choose the best BCG strain that can fulfill such requirements.

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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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The comparison of Patient Hygiene Performance(PHP) Index according to the number of Oral Health Care worker with Disabled (장애인 구강건강관리인력에 따른 구강환경관리능력 지수 비교)

  • Kim, So-Yeon;Kim, Su-ji;Kim, Yeon-seon;Kim, Ji-Hong;Kim, Hyo-Jin;Jung, Seung-min;Hong, Ji-Hee
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.116-126
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    • 2019
  • Objectives: Currently, oral health of the disabled is taken care of by the social workers, not by dental hygienists, who are the oral health professional in this area. Therefore, we aim to enhance the equity of oral health for the disabled by providing the correct oral health care method to social workers residing in the welfare facility for the disabled. Methods: Four dental hygienists and four social workers were given the class I intellectual disabilities living in 'o' welfare facilities for disabled people in Songpa-gu, Seoul from April 13, 2019 to April 20, 2019. Patient Hygiene Performance(PHP) Index were measured and compared. In advance, the social workers were taught brushing (Rolling method), and the method of brushing and measuring tools were integrated. Results: Twice a total of dental hygienists and social workers practiced toothbrushing(Rolling method) for the class I intellectual disabilities who is a person to be brushed. When comparing the Patient Hygiene Performance(PHP) Index after the second round, the result shows that both the first and second dental hygienists' Patient Hygiene Performance(PHP) Index is lower. Conclusions: Comparing oral health knowledge level and Patient Hygiene Performance(PHP) index of dental hygienist and social workers, the result shows that dental hygienist has higher oral health care ability. Therefore, the dental hygienist should be placed in welfare facility for the disabled as an expert in oral health management to create an environment in which the disabled and social workers can be trained. In addition, the curriculum of the college that nurtures the dental hygienists should have a course to understand the characteristics of the disabled person in order to enhance the professionalism of dental hygienists.

Ecological Risk Assessment of Pesticide Residues in Agricultural Lake : Risk Quotients and Probabilistic Approach (농업용수를 공급하는 호소 수역 내 잔류 농약의 생태위해성평가 : 위해지수방법과 확률론적 방법)

  • Lee, Ji-Ho;Park, Byung-Jun;Park, Sang-Won;Kim, Won-Il;Hong, Su-Myung;Im, Geon-Jae;Hong, Moo-Ki
    • Korean Journal of Environmental Agriculture
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    • v.30 no.3
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    • pp.316-322
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    • 2011
  • BACKGROUND: Pesticides concentration was monitored in 50 agricultural lakes, and ecological risk for aquatic organism was assessed using risk quotient (RQ) and probabilistic methods. METHODS AND RESULTS: Pesticides concentrations detected in 50 agricultural lakes during peak season (June and September) were in the range of $0.17{\sim}0.99{\mu}g/L$. The RQ for algae and the other species was estimated to be 0.25 and below 0.01, indicating medium risk and no risk. Oxadiazon predominantly contributed to RQ value of 99% for algae, fishes, and amphibians. In terms of hazardous concentration at 5% of species ($HC_5$), ecological risk quotients (ERQ) for oxadiazon ranged from 0.18~0.33, showing a medium risk level. Overall, the concentrations of pesticides were much lower than $HC_5$), value. Probability of combined ecological risk for pesticides ranged from 1.82% to 2.41%. CONCLUSION(s): Combined ecological risk probability did not exceed the acceptable level of 5%, indicating no ecological risk for selected aquatic species. This study suggests that regular ecological risk assessment (ERA) will be required to protect and manage an agricultural lake. Not only ERA at screening level by comparing exposure with toxic effects for aquatic species also advanced ERA technique considering species in indigenous to Korea, chronic toxicity, pulse dose, fate, and environmental factors should be required.

Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta (단순 대동맥 축착의 외과적 치료 후 중.장기 결과)

  • Lee, Seung-Cheol;Yoon, Tae-Jin;Park, Jeong-Jun;Song, Meong-Gun;Kim, Young-Hwee;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.83-89
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    • 2007
  • Background: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist. Material and Method: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods. Result: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups. Conclusion: Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.

Diagnostic Methods Used in the Bone Infections in Children (소아기 골 감염의 진단방법에 관한 조사)

  • Lee, Eun Sil;Choi, Kwang Hae
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.210-217
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    • 1997
  • Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

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An Assessment of the Utility of Respiratory Synchronized Systems in the PET/CT Examination (PET-CT 검사 시 호흡 동조 시스템들의 유용성 평가)

  • Seong, Yong-Jun;Yoon, Seok-Hwan;Hyun, Jun-Ho;Lee, Hong-jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.34-38
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    • 2017
  • Purpose During PET/CT examinations, the movements of internal organs caused by respiration are captured in images during multiple breathing cycles, resulting in the increases in tumor size and effects on SUV. Respiratory synchronized systems were used to evaluate tumor sizes and SUV changes. Materials and Methods Biograph mCT 64 was used for the equipment, and RPM and Anzai systems were used for the respiratory synchronized systems. We used point source and micro-phantom for an experimentation. We were performed on 12 patients who had solid tumors discovered at the base of the lung or at the top of the liver from August through September 2016. The PET images of the exhalation-to-breathing state and the CT images of the post-exhalation suspension state were gained to evaluate changes in radioactivity concentration (KBq/mL), SUVmax, cylinder diameter (mm), and tumor diameter (cm) under the conventional Static, RPM, and Anzai methods. Results The result of measuring the radioactivity concentration of the point source was RPM 94% and Anzai 91% against Static, respectively. In the two cylinders of different radioactivity in the micro-phantom, the SUVmax increased to RPM 61% and 78%, and Anzai 58% and 77% against Static, whereas the cylinder diameters decreased by RPM -26% and -28%, and Anzai -28% and -26%, each respectively. Among the patients, the SUVmax increased from a minimum of RPM 8.2% to a maximum of 94.4% against Static, and from a minimum of Anzai 7.6% to a maximum of 68.3%, respectively. As for the tumor diameters, a minimum of RPM -7.6% to a maximum of -28.9% were achieved, while the Anzai fell by a minimum of -9.6% to a maximum of -27.7%, respectively. There was no significant difference discovered in the phantom study between the RPM and Anzai, yet there was a meaningful difference in the patients' tumors (P<0.05). Conclusion The respiratory synchronized systems of RPM and Anzai yielded no significant difference in the phantom study in which the respiration was executed at regular intervals. However, it was discovered that the patients had a meaningful difference for the irregular respiratory cycle and inter-system differences. Still, the respiratory synchronized systems would be useful for the accurate diagnosis and SUV measurement as the tumor decreased in size against the existing Static and the SUV increased.

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Risk Ranking Analysis for the City-Gas Pipelines in the Underground Laying Facilities (지하매설물 중 도시가스 지하배관에 대한 위험성 서열화 분석)

  • Ko, Jae-Sun;Kim, Hyo
    • Fire Science and Engineering
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    • v.18 no.1
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    • pp.54-66
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    • 2004
  • In this article, we are to suggest the hazard-assessing method for the underground pipelines, and find out the pipeline-maintenance schemes of high efficiency in cost. Three kinds of methods are applied in order to refer to the approaching methods of listing the hazards for the underground pipelines: the first is RBI(Risk Based Inspection), which firstly assess the effect of the neighboring population, the dimension, thickness of pipe, and working time. It enables us to estimate quantitatively the risk exposure. The second is the scoring system which is based on the environmental factors of the buried pipelines. Last we quantify the frequency of the releases using the present THOMAS' theory. In this work, as a result of assessing the hazard of it using SPC scheme, the hazard score related to how the gas pipelines erodes indicate the numbers from 30 to 70, which means that the assessing criteria define well the relative hazards of actual pipelines. Therefore. even if one pipeline region is relatively low score, it can have the high frequency of leakage due to its longer length. The acceptable limit of the release frequency of pipeline shows 2.50E-2 to 1.00E-l/yr, from which we must take the appropriate actions to have the consequence to be less than the acceptable region. The prediction of total frequency using regression analysis shows the limit operating time of pipeline is the range of 11 to 13 years, which is well consistent with that of the actual pipeline. Concludingly, the hazard-listing scheme suggested in this research will be very effectively applied to maintaining the underground pipelines.