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Analysis of Complications Associated with the Nuss Procedure: Risk Factors and Preventive Measures (너스수술의 합병증에 대한 고찰: 위험인자 분석과 예방책의 제시)

  • Park, Hyung-Joo;Chang, Won-Ho;Jeon, Cheol-Woo;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.524-529
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    • 2004
  • Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

Effect of a Combined Treatment with Uniconazole, Silver Thiosulfate on Reduction of Ozone Injury in Tomato Plant (Uniconazole 과 Silver Thiosulfate 의 복합처리가 토마토의 오존피해경감에 미치는 효과)

  • Ku, Ja-Hyeong;Won, Dong-Chan;Kim, Tae-Il;Krizek, Donld T.;Mirecki, Roman M.
    • Korean Journal of Environmental Agriculture
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    • v.11 no.1
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    • pp.50-58
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    • 1992
  • Studies were conducted to determine the combined effect of uniconazole [(E) -1-(4-chlorophenyl)-4, 4-demethyl 2-(1,2,4 triazol-1-yl)-1-penten-3-ol] and silver thiosulfate $[Ag {(S_2O_3)}^3\;_2-]$ (STS) on reduction of ozone injury in tomato plants(Lycopersicon esculentum Mill. 'Pink Glory'). Plants were given a 50ml soil drench of uniconazole at concentrations of 0, 0.001, 0.01 and 0.1 mg/pot at the stage of emerging 4th leaf. Two days prior to ozone fumigation, STS solution contained 0.05% Tween-20 was also sprayed at concentrations of 0, 0.3 and 0.6 mM. Uniconazole at 0.01 mg/pot and STS at 0.6 mM were effective in providing protection against ozone exposure(20h at 0.2ppm) without severe retardation of plant height and chemical phytotoxicity, respectively. Combined treatment with uniconazole, STS significantly reduced ozone injury at the lower concentration than a single treatment with uniconazole or STS. Uniconazole treatment reduced plant height, stem elongation and transpiration rate on a whole plant level and increased chlorophyll concentration. STS did not give any effect on plant growth and chlorophyll content but increased transpiration rate in non-ozone-fumigated plants. Ethylene production in the leaves of ozone-fumigated plants was decreased by uniconazole and STS pretreatment, but there was no protective effect on epinasty of leaves in uniconazole-treated plants. STS increased ethylene production in non-ozone-fumigated plants, but it significantly reduced the degree of epinasty and defoliation of cotyledons when plants were exposed to ozone. Uniconazole slightly increased superoxide dismutase and peroxidase activities. But STS showed little or no effects on such free radical scavengers. Day of flowering after seeding was shortened and percentages of fruit set were increased by uniconazole treatment. STS was highly effective on protecting reduction of fruit set resulting from ozone fumigation. These results suggest that combined use of uniconazole and STS should provide miximum protection against ozone injury without growth retardation resulting in yield loss.

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Clinical Features of Benign Infantile Convulsions with Gastroenteritis (위장관염과 동반된 양성 영아 경련의 임상적 고찰)

  • Lee, Jung Sun;Kwon, Hae Oak;Jee, Young Mee;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.753-759
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    • 2005
  • Purpose : This study was performed to characterize clinical features of benign convulsions with gastroenteritis(CwG) in infants. Methods : We reviewed clinical features of 67 episodes in 64 patients with afebrile seizure accompanied gastroenteritis admitted to Dept. of Pediatrics Bundang CHA hospital from January 2001 to June 2004. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded. Results : There were 32 boys and 35 girls. The age of onset ranged from 1 to 42 months($18.5{\pm}6.1$ months). The number of children admitted to the hospital with acute gastroenteritis was 2,887 in the same period. The percentage of patients with CwG was 2.3. Seizure type was exclusively generalized tonic or tonic-clonic seizure. The average number of seizures during a single episode was 3.1 (range, 1-13). Two or more seizures occurred in 53(79.1%) of the 67 episodes. Antiepileptic drugs were administered for 42 episodes. Seizure did not cease after the administration of one kind of antiepileptic drug in 23 episodes(54.7%). The seizures were rather refractory to initial antiepileptic treatment. There were no abnormalities in serum biochemistry test including glucose and electrolytes. Cerebrospinal fluid was normal in all 54 episodes. Stool cultures were negative in 49 episodes. Rotavirus was positive in stools in 51(82.3%) of 62 episodes. Norovirus was positive in stools in 2 episodes and astrovirus in 1 of 18 episodes. CT and/or MRI were performed in 15 cases and demonstrated no neuroradiologic abnormalities. Of 73 Interictal EEG, initial 24 cases showed occasional spike or sharp wave discharges from the mid-line area during stage I-II sleep, which were apparently differentiated from vertex sharp transient or K-complexes. The mean follow-up period was 5.7 months(1-36 months). Three patients experienced a recurrence of CwG, but all patients exhibited normal psychomotor development at the last follow-up. Conclusion : Afebrile infantile convulsions with gastroenteritis are brief generalized seizure in cluster with normal laboratory findings and good prognosis. Therefore CwG is likely to be categorized as situation-related seizure of special syndrome. Recognition of this entity should lead to assurance of the parents and long-term anticonvulsant therapy is not usually warranted.

A Microcomputer-Based Data Acquisition System (Microcomputer를 이용(利用)한 Data Acquisition System에 관(關)한 연구(硏究))

  • Kim, Ki Dae;Kim, Soung Rai
    • Journal of Biosystems Engineering
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    • v.7 no.2
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    • pp.18-29
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    • 1983
  • A low cost and versatile data acquisition system for the field and laboratory use was developed by using a single board microcomputer. Data acquisition system based on a Z80 microprocessor was built, tested and modified to obtain the present functional system. The microcomputer developed consists of 6 kB ROM, 5 kB RAM, 6-seven segment LED display, 16-Hex. key and 8 command key board. And it interfaces with an 8 channel, 12 bits A/D converter, a microprinter, EPROM programmer for 2716, and RS232C interface to transfer data between the system and HP3000 mini-computer manufactured by Hewlett Packard Co., A software package was also developed, tested, and modified for the system. This package included drivers for the AID converter, LED display, key board, microprinter, EPROM programmer, and RS232c interface. All of these programs were written in 280 assembler language and converted to machine codes using a cross assembler by HP3000 computer to the system during modifying stage by data transferring unit of this system, then the machine language wrote to the EPROM by this EPROM programmer. The results are summarized as follows: 1. Measuring program developed was able to control the measuring intervals, No. of channels used, and No. of data, where the maximum measuring speed was 58.8 microsec. 2. Calibration of the system was performed with triangle wave generated by a function generator. The results of calibration agreed well to the test results. 3. The measured data was able to be written into EPROM, then the EPROM data was compared with original data. It took only 75 sec. for the developed program to write the data of 2 kB the EPROM. 4. For the slow speed measurements, microprinter instead of EPROM programmer proved to be useful. It took about 15 min. for microprinter to write the data of 2 kB. 5. Modified data transferring unit was very effective in communicating between the system and HP3000 computer. The required time for data transferring was only 1~2 min. 6. By using DC/DC converting devices such as 78-series, 79-series. and TL497 IC, this system was modified to convert the only one input power sources to the various powers. The available power sources of the system was DC 7~25 V and 1.8 A.

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The Optimal Time for Embryo Transfer in Fresh IVF: Comparison between Day 3 and Day 5 on Pregnancy Outcomes (체외수정술 후 난할단계 배아와 포배기단계 배아를 이식했을 때의 임신예후의 비교)

  • Lyu, Sang-Woo;Kim, A-Ri;Seok, Hyun-Ha;Kim, You-Shin;Lee, Woo-Sik;Yoon, Tae-Ki;Won, Hyung-Jae
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.143-151
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    • 2010
  • Objective: The aim of this study was to compare day 3 embryo transfer (D3ET) with day 5 ET (D5ET) in fresh in vitro fertilization (IVF) cycle on pregnancy outcomes. Methods: We conducted a retrospective matched case control study that included 90 women with D3ET and 90 women with D5ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and IVF cycle characteristics. Two good quality embryos were transferred in both groups. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with D3ET and D5ET groups were not statistically different: implantation rate (39.4% vs. 32.8%), positive PR (57.8% vs. 46.7%), clinical PR (53.3% vs. 45.6%), ongoing PR (50.0% vs. 42.2%), respectively. Both groups showed high multiple PR (37.5% vs. 34.1). Conclusion: D5ET may not be beneficial and necessary in comparison with D3ET on pregnancy outcomes, and elective single ET should be considered to decrease multiple pregnancies in women with favorable conditions and good quality embryos undergoing IVF.

Effects and Improvement of Carbon Reduction by Greenspace Establishment in Riparian Zones (수변구역 조성녹지의 탄소저감 효과 및 증진방안)

  • Jo, Hyun-Kil;Park, Hye-Mi
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.6
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    • pp.16-24
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    • 2015
  • This study quantified storage and annual uptake of carbon for riparian greenspaces established in watersheds of four major rivers in South Korea and explored desirable strategies to improve carbon reduction effects of riparian greenspaces. Greenspace structure and planting technique in the 40 study sites sampled were represented by single-layered planting of small trees in low density, with stem diameter at breast height of $6.9{\pm}0.2cm$ and planting density of $10.4{\pm}0.8trees/100m^2$ on average. Storage and annual uptake of carbon per unit area by planted trees averaged $8.2{\pm}0.5t/ha$ and $1.7{\pm}0.1t/ha/yr$, respectively, increasing as planting density got higher. Mean organic matter and carbon storage in soils were $1.4{\pm}0.1%$ and $26.4{\pm}1.5t/ha$, respectively. Planted trees and soils per ha stored the amount of carbon emitted from gasoline consumption of about 61 kL, and the trees per ha annually offset carbon emissions from gasoline use of about 3 kL. These carbon reduction effects are associated with tree growth over five years to fewer than 10 years after planting, and predicted to become much greater as the planted trees grow. This study simulated changes in annual carbon uptake by tree growth over future 30 years for typical planting models selected as different from the planting technique in the study sites. The simulation revealed that cumulative annual carbon uptake for a multilayered and grouped ecological planting model with both larger tree size and higher planting density was approximately 1.9 times greater 10 years after planting and 1.5 times greater 30 years after than that in the study sites. Strategies to improve carbon reduction effects of riparian greenspaces suggest multilayered and grouped planting mixed with relatively large trees, middle/high density planting of native species mixed with fast-growing trees, and securing the soil environment favorable for normal growth of planting tree species. The research findings are expected to be useful as practical guidelines to improve the role of a carbon uptake source, in addition to water quality conservation and wildlife inhabitation, in implementing riparian greenspace projects under the beginning stage.

Current status, mechanism and control of herbicide resistant weeds in rice fields of Korea (한국 논에서 제초제 저항성잡초의 발생 현황, 메카니즘 및 방제)

  • Park, Tae Seon;Seong, Ki Yeong;Cho, Hyun Suk;Seo, Myung Chul;Kang, Hang Won;Park, Kee Woong
    • Korean Journal of Agricultural Science
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    • v.41 no.2
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    • pp.85-99
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    • 2014
  • Sulfonylurea (SU)-resistant weeds of eight annual weeds, Monochoria vaginalis, Scirpus juncoides and Cyperus difformis, etc., and four perennial weeds, Scirpus planiculmis, Sagittaria pigmaea, Eleocharis acicularis and Sagittaria trifolia as of 2013 since identification Monochoria korsakowii in the reclaimed rice field in 1998. And the resistant Echinochloa oryzoides to ACCase and ALS inhibitors has been confirmed in rice fields of the southern province, Korea in 2009. In the beginning, the M. vaginalis, S. juncoides and C. difformis of these SU-resistant weeds were rapidly and individually spreaded in different fields, however, these resistant weeds have been occurring simultaneously in the same filed recently. The resistant biotype by weed species demonstrated about 10-to 1,000-fold resistance, based on $GR_{50}$ values of the SU herbicides tested. And the resistant biotype of E. oryzoides to cyhalofop-butyl, pyriminobac-methyl, and penoxsulam was about 14, 8, and 11 times more resistant than the susceptible biotype base on $GR_{50}$ values. The products and applied area of SU-included herbicides have been increased rapidly, and have accounted for about 69% and 96% in Korea, respectively. In Korea, the main cause of SU-resistant weed is extensive use of these herbicides. The top ten herbicides by applied area were composed of all SU-included herbicides by 2003. The concentrated and successive treatment of ACCase and ALS inhibitors for control of barnyardgrass in rice led up to the resistance of E. oryzoides. Also, SU-herbicides like pyrazosulfuron-ethyl and imazosulfuron which effective to barnyardgrass can be bound up with the resistance of E. oryzoides. The ALS activity isolated from the resistant biotype of M. korsakowii to SU-herbicides tested was less sensitive than that of susceptible biotype. The concentration of herbicide required for 50% inhibition of ALS activity ($I_{50}$) of the SU-resistant M. korsakowii was 14-to 76-fold higher as compared to the susceptible biotype. No differences were observed in the rates of [$^{14}C$]bensulfuron uptake and translocation. Acetolactate synthase (ALS) genes from M. vaginalis resistant and susceptible biotypes against SU-herbicides revealed a single amino acid substitution of proline (CCT), at 197th position based on the M. korsakowii ALS sequence numbering, to serin (TCT) in conserved domain A of the gene. Carfentrazone-ethyl and pyrazolate were used mainly to control SU-resistant M. vaginalis by 2006 in Korea. However, the alternative herbicides such as benzobicyclone, to be possible to control simultaneously the several resistant weeds, have been developing and using broadly, because the several resistant weeds have been occurring simultaneously in the same fieled. The top ten herbicides by applied area in Korea have been occupied by products of 3-way mixture type including herbicides with alternative mode of action for the herbicide resistant weeds. Mefenacet, fentrazamide and cafenstrole had excellent controlling effects on the ACCase and ALS inhibitors resistant when they were applied within 2nd leaf stage.

Shallow subsurface structure of the Vulcano-Lipari volcanic complex, Italy, constrained by helicopter-borne aeromagnetic surveys (고해상도 항공자력탐사를 이용한 Italia Vulcano-Lipari 화산 복합체의 천부 지하 구조)

  • Okuma, Shigeo;Nakatsuka, Tadashi;Komazawa, Masao;Sugihara, Mitsuhiko;Nakano, Shun;Furukawa, Ryuta;Supper, Robert
    • Geophysics and Geophysical Exploration
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    • v.9 no.1
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    • pp.129-138
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    • 2006
  • Helicopter-borne aeromagnetic surveys at two different times separated by three years were conducted to better understand the shallow subsurface structure of the Vulcano and Lipari volcanic complex, Aeolian Islands, southern Italy, and also to monitor the volcanic activity of the area. As there was no meaningful difference between the two magnetic datasets to imply an apparent change of the volcanic activity, the datasets were merged to produce an aeromagnetic map with wider coverage than was given by a single dataset. Apparent magnetisation intensity mapping was applied to terrain-corrected magnetic anomalies, and showed local magnetisation highs in and around Fossa Cone, suggesting heterogeneity of the cone. Magnetic modelling was conducted for three of those magnetisation highs. Each model implied the presence of concealed volcanic products overlain by pyroclastic rocks from the Fossa crater. The model for the Fossa crater area suggests a buried trachytic lava flow on the southern edge of the present crater. The magnetic model at Forgia Vecchia suggests that phreatic cones can be interpreted as resulting from a concealed eruptive centre, with thick latitic lavas that fill up Fossa Caldera. However, the distribution of lavas seems to be limited to a smaller area than was expected from drilling results. This can be explained partly by alteration of the lavas by intense hydrothermal activity, as seen at geothermal areas close to Porto Levante. The magnetic model at the north-eastern Fossa Cone implies that thick lavas accumulated as another eruption centre in the early stage of the activity of Fossa. Recent geoelectric surveys showed high-resistivity zones in the areas of the last two magnetic models.

The moment generated by the torque of the orthodontic rectangular wire : Three-dimensional finite element analysis (교정용 각형선재에 부여된 torque가 브라켓에 발생시키는 모멘트에 관한 유한요소법적 분석)

  • Ha, Do-Won;Kim, Young-Suk;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.31 no.3 s.86
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    • pp.335-346
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    • 2001
  • The purpose of this study was to investigate the ideal clinical torque(In the SWA rectangular wire, the torque by the angle between the plane part and twisted part to move the tooth) of the orthodontic rectangular wire which produce the proper labiolingual movement of the single tooth during finishing stage of the orthodontic treatment. The clinical torque is the sum of the play and the active torque which generates the moment at the bracket. The play is calculated by the formula and the active torque is calculated by the computer aided three-dimensional finite element method. The finite element model was consist of the three brackets which formed a row and 3 kinds of orthodontic rectangular wire(stainless steel, TMA, NiTi) which inserted in brackets. Both sides of the model were twisted and the moment generated in the center bracket was calculated. The sizes of seven wires which were used commonly were .016'X.022', .017'X.022', .017'X.025', .018'X.025', .019'X.025', .020'X.025', .021'X.025'. In 018' bracket, 016'X.022', .017'X.022', .017'X.025' wires were inserted and in 022' bracket, all the sizes of wires except .016'X.022' were inserted and tested. The following conclusions could be drawn from this study. 1. The moments generated on the same size of the wires by the same active torque were equal regardless of the bracket slot size. 2. The moments were increased with the size of the wires. The moment generated on the .021'X.025' wire was about 1.75 times as large as that on the .016'X.022' wire regardless of the material. 3. The moments were increased in the order of the NiTi, TMA stainless steel. The moment of the TMA wire was 0.35 times as small as that of the stainless steel wire and the moment of the NiTi was0.16 times as small as that of the stainless steel wire. 4. The moment was decreased as the interbracket distance was increased. 5. To get a desired moment with the specific size and material of the wire on the specific bracket slot, the formula and the results were displayed.

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Studies on the Epidemiological Change of Clonorchiasis After Mass Chemotherapy in Highly endemic Areas (집단치료사업에 따른 간흡충증의 역학적 변동에 관한 조사)

  • Joo, Kyoung-Hwan;Chu, Paul B.;Rim, Han-Jong;Lee, Joon-Sang
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.80-93
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    • 1987
  • Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

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