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The Clinical Study for Empyema: 176 Cases (농흉의 임상적 고찰[176예])

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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Promotion of Agricultural Technology Innovations for the Poor Smallholders in Marginal Rural Areas of Bangladesh: An Innovative Business Model Approach

  • Mohammad, Ikhtiar;Malek, Mohammad Abdul
    • Asian Journal of Innovation and Policy
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    • v.6 no.1
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    • pp.58-84
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    • 2017
  • This article aims at demonstrating location specific approach for agricultural technology promotion and adoption in improving the livelihood of the small farmers in the haor basin and coastal belt of Bangladesh. Innovative technologies that have potentials are initially screened by ex-ante investigation and instrumented by the business model canvas, which is used as a bottom-up approach for sustainability of the adoption of proposed technology innovations. Village-level extension farmers, sub-district extension officers and farmers' cooperative are the unique and central features to the business models and forward linkages. Extension service, power tiller, low-lift pump, sunflower, shallow tube well, quality seed, forward linkage for farmed duck eggs, live ducks and open catch fish etc. are the suggested potential technology innovations for the small farmers. The technology adoption business model can be reinvented for different locations within or beyond the country considering the local agricultural problems and prospects for greater sustainability.

A Study of Etiology and Treatment of Spontaneous Pneumothorax (자연기흉의 원인 및 치료에 관한 연구)

  • 김종원;김진식
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.125-134
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    • 1975
  • The record of 137 patients with spontaneous pneumothorax seen at Busan National University Hospital during past 3years were reviewed to study the possible pathogenesis and its effective management. and the results obtained as follows; 1] The incidence of the "spontaneous" pneumothorax which developed without underlying pathology was 13-1%. The majority of those cases was considered as the result of rupture of subpleural blebs. 2] The incidence of secondary pneumothorax which developed with underlying pathology was 50.0%, in which 42.3% was combined with pulmonary tuberculosis and 8, 0% was combined with pulmonary infection. The traumatic pneumothorax was developed in 36-5% of total series. 3] In age distribution, there was pronounced difference between spontaneous and secondary pneumothorax. The majority of spontaneous pneumothorax cases was 20-30 decade and tall and tall and thin in body structure. In secondary pneumothorax, however, the incidence was relatively high in age group more than 50 years old. 4] The incidence of pneumothorax combined with pulmonary tuberculosis was particularly high in our country, and the cause of pneumothorax was seemed due to the rupture of subpleural caseous foci in some cases, but the majority was seen due to the rupture of emphysematous blebs which were formed with a pathological process of chronic tuberculosis. 5]Closed [tube] thoracotomy was the main therapeutic approach of choice in the great majority ,of pneumothorax in our series with the relapse rate of 19.6%. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage over 7 days and recurrent attack of pneumothorax.

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Analysis of Postpneumonectomy Complications (전폐절제술후 발생한 합병증에 대한 분석)

  • 허강배
    • Journal of Chest Surgery
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    • v.26 no.8
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    • pp.613-619
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    • 1993
  • As developing surgical techniques and postoperative cares, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other type of pulmonary resection, but a postpneumonectomy complication is a life-threatening serious problem if it occurred. We performed one hundred twenty-five cases of pneumonectomy for treatment of various causes of pulmonary diseases in Kosin Medical College during about ten years, and we experienced 41 cases of postoperative complications in 29 patients, so we analyzed them. The most common complication is an empyema thoracis in 13 cases[10.4%], of which one case combined with bronchopleural fistula died on early postoperative day. Of them except one case, the early postoperative empyema thoracis[within 30 days] were 6 cases, and the late postoperative empyema thoracis[above 30 days] were 6 cases. The main etiologic pathogens were a staphylococcus in early postoperative empyema and a streptococcus in late postoperative empyema, but the most cases were mixed infections with pseudomonas, klebsiella, acinectobacter, and candida. The treatment of postoperative empyema thoracis were that 4 cases were treated with open drainage using chest tube, 7 cases with Clagett`s operation, and 1 case with thoracoplasty. The next common complication was a postoperative serious respiratory insufficiency in 7 cases. And the other complications were massive postoperative bleeding in 5 cases, of which 2 cases advanced to occurrence of postoperative empyema thoracis, and wound disruption in 4 cases, cardiac arrhythmia in 3 cases, contralateral pneumothorax and pneumonia in each of 2 cases, esophagopleural fistula in 1 case. The postoperative deaths were 9 cases[7.2%] of 125 cases, the causes of death were respiratory insufficiency in 6 cases, sepsis in 2 cases, and cardiac arrhythmia in 1 case.

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Clinical Study of Empyema Thoracis: a review of 64 cases (농흉의 임상적 고찰64례 보고)

  • Chang, Jung-Su;Lee, Chong-Kook
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.403-410
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    • 1979
  • A Clinical analysis of 64 patients of thoracic empyema was done who received surgical intervention at Dept. of Thoracic Surgery of the Chosun University Hospital in the period of 3 years from September 1976 to October 1979. Following was the results: 1. Seven cases [10.9%] were under the age of 15 years, 16 cases [25%] was between 15-30 years and 41 cases [64.1%] was above the age of 30 years. A proportion of children and adult was 1:8. 2. Male and female ratio was 3:1. Right and left side pleural cavity ratio was 2.4:1. 3. Predisposing factors were pneumonia [35.9%] and pulmonary tuberculosis [28.1%]. 4. Most frequently encountered symptoms were dyspnea, cough, chest pain and fever in order. 5. Etiologic organisms were confirmed in 39 cases [86.7%] which requested in 45 cases. Staphylococcal infections were 11 cases and streptococcal, pneumococcal pseudomonas infection was infected in order. 6. Pneumothorax was associated with empyema on 21 cases [32.8%]; among those 13 cases [61.9%] were tuberculous in nature. 7. Sensitivity test was revealed that Minocin was most very sensitive drug, and next Erythromycin, Gentamycin and Penbrex in order. But most resistant drugs were Penicillin, Kanamycin, Streptomycin and Tetracycline in order. 8. Treatments were combined with antibiotics therapy and several surgical procedures for empyema. 26 cases [40.6%] were treated with closed thoracotomy drainage, 17 cases [26.6%] with open thoracotomy tube drainage and 9 cases decortication and 9 cases thoracoplasty. 9. 2 death cases occurred in 64 cases of thoracic empyema, and 79.7% cases were discharged with recovery and improvement.

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Clinical analysis of the chest trauma - 823 cases - (흉부손상의 임상적 고찰)

  • 노태훈
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.715-722
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    • 1987
  • A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

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TREATMENT OF FOODWASTE AND POSPHORUS REMOVAL USING STRUVITE CRYSTALLIZATION IN HYBRID ANAEROBIC REACTOR WITH SAC MEDIA

  • Park, In-Chul;Kim, Dong-Su;Kim, Sung-Man;Lee, Jung-Jun
    • Proceedings of the Korean Institute of Resources Recycling Conference
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    • 2001.05b
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    • pp.129-132
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    • 2001
  • The purpose of this research was to understand possibility of foodwaste treatment by hybrid anaerobic reactor(HAR). The Possibility of methane utility and applicability of hybrid reactor system using foodwaste as substrate was investigated. The maximum loading rate and optimized operational conditions were determined. Hybrid anaerobic reactor was filled with packing material 50% of its total volume between the tube and the outer surface. The packing material used was randomly packed open-pore synthesis activated ceramic(SAC) media as support media for microbial attachment, growth, and chemical stability protected bacteria from effect of organic acid accumulation. In this research, although foodwaste has high concentrations C $l^{[-10]}$ and S $O_{4}$$^{2-}$ concentration the possibility of foodwaste anaerobic treatment was when foodwaste is treated by anaerobic digestion, this study focused on the possibility using C $H_4$ gas made under the anaerobic treatment as an alternative energy source. Other objective of this research is to study struvite formation and crystal forms in anaerobic digester. HAR is used to investigate phosphate crystallization without the addition of chemicals.

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Hyperbilirubinemia after Open Heart Surgery (체외순환후의 고빌리루빈증의 검토)

  • 박종호
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.170-179
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    • 1993
  • Three hundred consecutive adult patients having cardioaortic surgery under the cardiopulmonary bypass for a variety of cardioaortic lesions were evaluated retrospectively for postoperative hyperbilirubinemia[above 5mg/100ml].We found twenty eight patients with postoperative hyperbilirubinemia and divided them into two groups according to the postoperative day of peak s-bilirubin .Group A was the patients with a peak s-bilirubin level within three days ,and group B above three days postoperatively.Group B was divided into group S[survive] and group D[death] . We had compaired the survival & death group and observed the correlation between the decreasing tendency of postoperative s-bilirubin & the nutrition per os in group B. The incidence of postoperative hyperbilirubinemia,as defined by a s-bilirubin concentration of 5.0mg/100ml or greater,was 9.3%.The mortality rates of group A & B were 0.0% and 35.7% respectively.Important contributing factors between group A & B were the age,duration of ICU,Max.DOAB[maximum dose of catecholamine used],amount of blood transfused during or shortly after surgery and preoperative pulmonary hypertension[main pulmonary artery pressure > 30mmHg] and backward heart failure. The risking factors of group D compared to group S were as follows the age,preoperative & postoperative SGOT[serum glutamic-oxaloacetic trasaminase],postoperative total & indirect bilirubin,cardiopulmonary bypass time,duration of ICU & mechanical ventilation ,Max.DOAB,preoperative pulmonary hypertension and backward heart failure.The six patients in group B showed good correlation between the decreasing point of s-bilirubin and the starting day of oral or tube feeding.

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Spontaneous Pneumothorax: Clinical Investigation of 142 Cases (자연기흉에 대한 임상적 고찰)

  • 정상조
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.887-893
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    • 1990
  • We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.

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Plasma Enhanced Thermal Nitridation of $SiO_2$ for VLSI (VLSI를 위한 플라즈마 열적 질산화막의 형성)

  • 이재성;이용현;최시영;이덕동
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.26 no.11
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    • pp.1699-1705
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    • 1989
  • Nitridation of about 300\ulcornerSiO2 filmss thermally grown on Si was performed in NH3 plasm ambient (0.2-2 torr) at 900\ulcornerC-1100\ulcorner for 15-20 minutes. The peoperties of those films have been investigated by analyzing the AES and the SIMS data, and the results of the I-V and the C-V measurements. At the plasma ambient of less than 1.5 torr pressure, etching of the films have been shown. Above the 1.5 torr pressure, however, SiO2 films were nitrided as SiIxNy. Plasma thermal nitridation of SiO2 by addition of small amount (6%) of CF4 to the NH3 showed higher pile-up N concentration in the surface region of SiOxNy film. The higher the nitridation temperature is and the longer the nitridation time is the larger the dielectric constant is. The plasma thermal nitridation of silicon dioxide on silicon causes the flat-band voltage shift based on the formation of the positive charge. The conduction mechanism for SiOxNy films could be elucidated by Fowler-Nordheim tnneling model. By SIMS analysis, surface of the film nitrided in plasma process has less contamination than that of the film nitrided in open-tube process.

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