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A retrospective clinical study of isolated patent ductus arteriosus (동맥관 개존증의 임상적 고찰)

  • 곽영태
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.593-606
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    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

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An Analysis on the Current Farm Management Record Practices and Characteristics (농업인의 경영기록 실태 및 특성 분석)

  • Lee, Sang-Hak;Choi, Se-Hyun;Son, Chan-Soo;Ha, Hyun-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.7
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    • pp.2937-2948
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    • 2012
  • Record-keeping is one of the most fundamental practices in good farm management as it shows a systemic managerial and analytic data essential for a successful farm operation. Despite such obvious benefits in record-keeping, however, today`s farmers do not take advantage of this practice for various reasons. To make the matter worse, not much research has been done to resolve this incompatibility. Therefore, it is urgent for both the government and the farmers to come up with a better method or book of record-keeping that will show the farmers where their operation has been in the past, where it is now, and where it is heading in the future. This study will survey and analyze the current status of record-keeping practice among farmers using statistic models such as logit and ordered probit model. The results showed that the majority of the farmers lack knowledge about management record. Also, appropriate record-keeping books and related education were not available. Therefore, the government should develop and provide farmers with record-keeping books that are easy to use and at the same time giving proper education about agricultural management skills. Finally, this study suggests some improvement plans about agricultural record-keeping based on the results drawn.

Rapid Education and Training Methodology for North Korean Construction Workers through a Survey (설문조사를 통한 북한 건설노동자의 급속 양성 교육·훈련 방안)

  • Jung, In-Su;Lee, Giu;Kim, Keum-Ji;Park, Hyeong-Geun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.407-416
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    • 2020
  • North Korea's demand for infrastructure construction and maintenance is growing rapidly. On the other hand, the number of skilled workers is insufficient. Therefore, through a survey of North Korean defectors, this study analyzed the status of construction technology and the difficulties of construction workers. In addition, an attempt was made to derive an appropriate education and training program process and operation plan. As a result of the survey, the reason for the low technical level of construction workers was the lack of skills, lack of motivation to work, and the lack of training and management systems. The appropriate education and training period was 56% of the total response within one year and 36% within six months. Based on the results of this survey, the period of education and training for the rapid training of construction technical personnel in North Korea was adopted as one year. Moreover, compared to the NCS standard in South Korea, appropriate training hours were suggested, excluding training courses, such as planning and design, construction management that require specialized knowledge. Finally, the curriculum corresponding to the education and training courses and the standards for facility names and required areas for facility operation were suggested.

The Effect of Non-Invasive Sobu(H8) Point Stimulus by 'DONG CHU CHIM' on HRV (동추침(東樞鍼)에 의한 비침습적 소부혈(少府穴) 자극이 심박변이도에 미치는 영향)

  • Jung, Dae-Sun;Han, Chang-Hyun;Park, Soo-Jin;Kwon, Young-Kyu
    • Korean Journal of Oriental Medicine
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    • v.13 no.1 s.19
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    • pp.129-138
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    • 2007
  • Background : Recently a discussion about Qi including a study about the effect or the theory of acupuncture is getting prevailing in various angles. In most of studies about acupuncture stimulus, 'Filiform acupuncture'(毫鍼) is used. A study about Nine kinds of acupuncture(九鍼), except 'Filiform acupuncture'(毫鍼) has not been reported yet, and there is no study about using a special acupuncture made for controling Qi either. Objectives : 'DONG CHU CHIM' can be used for patients who are scared of a pain because it is a medical Qikong tool and non-invasive stimulus one. To assess a effect of Qikong operation using 'DONG CHU CHIM' objectively, we stimulated non-invasive to Sobu point of 30 normal adults using 'DONG CHU CHIM' and examined the result in the basis of high confirmed and repetitive HRV which is a functional assessment method of the autonomic nervous system. Method : This study has been proceeded in three periods. Total was 35min : 10min for the former and latter period of acupuncture stimulus, l5min for the acupuncture stimulus period. For each period, we measured 5min of 3 times(Stage I, II, III). Result : Comparing the changes of HRV during pre-stimulation and post-stimulation, HRT was significantly reduced, LOGTP, LOGVLF, LOGLF, LF/HF were significantly increased and SDNN, LOGHF were generally increased but did not show any significant changes. So we think that the stimulus of 'DONG CHU CHIM' affects on the sympathetic system and parasympathetic system, it activates the autonomic nervous system, and it makes the inequality of the sympathetic and parasympathetic nerve to be equal status. Conclusions : We can conclude that the non-invasive stimulus of 'DONG CHU CHIM' can affect significantly to the autonomic nervous system. So it can be used in clinic as a tool of Qikong operation, and it can be also used to weak patients or children because it doesn't give a lot of pain like 'Filiform acupuncture'(毫鍼) compared to invasive stimulus. By the basis of this study, more studies about the effect of 'DONG CHE CHIM' should be done in the future.

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Valuation of Road Guard System to Reduce Road-Kills (로드킬 저감을 위한 로드가드시스템의 가치 평가에 관한 연구)

  • Lee, Byung-Joo;Kim, Tae-Sik;Chung, Bong-Jo;NamGung, Moon
    • International Journal of Highway Engineering
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    • v.13 no.1
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    • pp.107-118
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    • 2011
  • This study carries out to evaluate the value of introducing the road guard system that merges the function of a fence that induces wild animals and a grass inhibitor to an existing guard rail that acts as road safety facilities. For this purpose, we surveyed that road user's willingness-to-pay and recognition characteristics for road safety facilities using contingent valuation Method. By establishing a willingness-to-pay assumption model, the average willingness-to-pay was 5,018 won, which was higher than the average proposed amount of 3,883 won and shows that the road guard system is an appropriate alternative facility to increase road safety and reduce road kills. Therefore, it would be prudent to review the introduction of the road guard system to newly constructed roads or current roads in operation as a way of reducing road kills. In the future, the road guard system must be tested in areas that are highly susceptible to road kills after consulting with the relevant highway managing authorities to conduct a comparison study on the before and after installation effect of the road guard system to investigate its operation and the current status of road kills to clearly identify its effectiveness.

An Analysis of Domestic Experimental Results for Soil-to-Crops Transfer Factors of Radionuclides (주요 핵종의 토양-작물체 전이 계수의 국내 실험 결과에 대한 분석)

  • Jun, In;Choi, Young-Ho;Keum, Dong-Kwon;Kang, Hee-Seok;Lee, Han-Soo;Lee, Chang-Woo
    • Journal of Radiation Protection and Research
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    • v.31 no.4
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    • pp.211-217
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    • 2006
  • For more realistic assessment of Korean food chain radiation doses due to the operation of nuclear facilities, it is required to use domestically produced data for radionuclide transfer parameters in crop plants. This paper analyzed results of last about 10 year's studies on radionuclide transfer parameters in major crop plants by the Korean Atomic Energy Research Institute, comparing with the published international data, and consequently suggested the proper parameters to use. The trends of transfer parameter shows normal distributions if we have a lot of experimental data, but some radionuclides showed enormous variations with the environment of experimental, crops and soils. These transfer factors can be used to assess realistic radiation doses or to predict the doses in crops for normal operation or accidental release. Some kinds of parameter can be produced as conservatives or fragmentary results because soil-to-plant transfer factors were measured through greenhouse experiments which sometimes showed improper field situations. But these parameters mentioned in this paper can be representative of the status of Korean food chain than that of foreign country.

PERIODONTAL RESPONSE FOLLOWING APPLICATION OF INTRUSIVE FORCES TO THE INCISORS WITH BONE LOSS AND PERIODONTAL DISEASE IN ADULT DOGS (골결손과 치주질환 유도 후 성견 절치의 실험적 함입이동시 치주조직의 반응)

  • Hwang, Hyeon-Shik;Park, Yang-Soo;Choi, Hong-Ran
    • The korean journal of orthodontics
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    • v.28 no.3 s.68
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    • pp.431-440
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    • 1998
  • While periodontal disease results in the extrusion of upper incisors with interdental spacing in adult patient, the intrusive movement should be executed for the rehabilitation in terms of esthetics and function. The present study was peformed to investigate the periodontal response following orthodontic intrusion of teeth with infrabony pocket. Bone defect and periodontal disease were produced adjacent to the both maxillary second lateral incisors in four adult dogs. Four weeks later, a flap operation was performed to eliminate inflammation and a reference notch was made on the root surface at the level of bottom of each defect. Two weeks after periodontal surgery, 4 weeks of intrusion and subsequent another 4 weeks of retention was executed on the right side of incisors while left incisors served as the control. Through the histologic analysis, following results were obtained. 1. Histologic section of control side showed the reduction of pocket depth after flap operation. However, the status of long junctional epithelium was observed while new connective tissue attachment occurred in a small area adjacent newly formed cementum 2. Epithelial attachment was less around the intruded incisor while new connective tissue attachment was much more compared to the control side. 3. Plenty of cells were observed in the connective tissue around the reference notch of the intruded incisor and the degree of the new cementum formation was higher in the intruded incisor than the control. The results of the present study suggested that an orthodontic intrusion of periodontally involved and extruded incisors could be carried out with a desirable periodontal response, provided that inflammation is under control.

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Surgical Treatment of Tracheal Restenosis following Operation for Postintubation Tracheal Stenosis - Two cases report - (기관 삽관에 의한 기관 협착의 수술 후 발생한 기관 재협착에 대한 수술적 치료-2예 보고-)

  • Kim Dae Hyun;Yi In Ho;Youn Hyo Chul;Kim Soo-Chul;Kim Bum Shik;Cho Kyu Seok;Hwang En Gu;Park Joo Chul
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.795-798
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    • 2005
  • The treatment of choice for post-intubation tracheal stenosis is partial tracheal resection and end-to-end ana-stomosis. The surgical treatment of tracheal restenosis that results from unsuccessful repair of post-intubation tracheal stenosis is not easy. Failed reoperation results in permanent tracheostomy and loss of voice. If the first operation fails, about $4\~6$ months of period for resolution of inflammatory reaction, edema, and fibrosis is needed. The exact evaluation of the patient's status is necessary and success rate of reoperation for the appropriate candidates is over $90\%$. We report the results of treatment in two cases of tracheal restenosis that resulted from unsuccessful repair of post-intubation tracheal stenosis with review of literatures.

Policy Measures for Improving Health Care Services in Rural Areas (농촌보건의료서비스 향상을 위한 제도 개선방안)

  • Moon, O.R.;Lee, L.S.;Park, J.Y.;Ko, D.H.;Lee, K.H.
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.97-119
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    • 1991
  • Korea has made a rapid economic development since the last three decades. This has helped Korea narrow the gap in health service differences in resource availability and in quality of care. However urban and rural differentials are still remarkable. This study has maintained that health status of rural residents is inferior to that of urban dwellers. Therefore, this study was carried out to develop policy measures for improving health services in rural areas. In order to achieve the objective of this study the authors collaborated closely and made field visits, interviews and conducted an extensive literature review regarding rural health services. The following policy options are recommended as a summary ; First, the quality of rural health personnel is a single most important factor influencing the level of rural health services. An innovative program for public health doctors to the internship and/or residency training program such as specialty board program of family medicine. Second, dissatisfaction regarding employment of public health doctors is problematic. More rational employment and deployment programs are needed to meet their personal desire. One way to do this is to make it wide open and competitive. Third this study shows how to increase physician productivity in the rural public health sector. Incentive system needs to be elaborated for the career development of rural health workers. University linked job opportunity as clinical professor is an example. Fourth, without straightening the function of health centers and subcenters, the future of rural health services is doomed to failure. Straightening primary health care is one way to enrich the program of public health facilities and reactivating the operation of health center/hospital is another. A close linkage of public facilities with private hospitals is a minimum requirement for the operation of health delivery system within a health district. Fifth, some measures are urgently required to enhance hospital services in medically underserved areas. Financial subsidy, tax exemption, long-term public loans and higher priority of health manpower deployment are some of them. Sixth, new health programs should be in tiated to meet changing needs of peoples in rural areas. Home health care program, hospice program, nursing home, residential program for the elderly are recommended.

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A Study on Activation device of 119 Emergency Care (119구급대의 활성화 방안에 관한 연구)

  • Koh, Jae-Moon;Kim, Gyoung-Wan;Chung, Yong-Tai
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.27-40
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    • 2007
  • Even now, 119 rescue services have dissatisfactory aspects in operation, system and equipments as discussed above, It is the most urgent subject to systemize rescue services so that they can be suitable for our status, for we will make 21C welfare state come true before long. So, this author suggest that the followings have to be raised to activate 119 rescue service. 1) Bring up experts and offer high-quality rescue service 2) Prepare more up-to-date equipments 3) Operate transfer joint organizations 4) Promote the ability to meet with a press at the time of rescue service activities 5) Adjust regulations related to rescue services 6) Make up for a countermeasure to traffic accidents of ambulances 7) Adjust regulations making it mandatory to establish heliport at the target on hospitals more than a defined scale 8) Install more rescue service teams 9) Educate and train officials belonging to briefing rooms, where the officials with long experiences are arranged 10) Minimize the time for rescue team to reach fields 11) Establish legal protection system for rescue the team Nowadays, our country operates the department of fire fighting and rescue services without great difficulty, even though the circumstances are bad - insufficient members and the inferior circumstances. All of the fire fighting officials are given heavy duties in bad circumstances, and so are the team of rescue service. The rescue service team, taking charge of some emergency medical system, do a fire fighting inspection as a non-duty service, though they are scanty of sleep due to prevention and protection services of the fire fighting service team. But, they can not engage in rescue services completely and have to deal with miscellaneous duties. So they can not offer professional emergency medical services. But now, almost every fire fighting organization, belonging to National Emergency Management Agency, are separating rescue services, which shows a lot of good results. People recognize rescue services to get better and better gradually and the demands for this rescue services increase. So, this is the best time when rescue service teams should offer qualitative services rather than quantitative services. The people will recognize this rescue service team to be an organization sacrificing and serving for them. However well institutes and operation systems should be established, the rescue service team can not come true their aim without strong wills that they will serve and sacrifice themselves for people from their hearts. In addition, it is essential for the officials in charge of policies about emergency medical services to have a concernment on and practice the policy without failure.

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