Hemorrhage is an important complication after operation with cardiopulmonary bypass and sometimes necessitates a further emergency operation. Between July, 1962 and June, 1985, reoperation for hemorrhage was carried out on 81 patients [3.1%] out of a total 2634 patients who had previously undergone cardiopulmonary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Yonsei University Medical Center. There were 38 males and 43 females, with an average age of 25 years [ranging 6 months to 60 years] and an average body weight of 38 kg [ranging 5 to 77 kg].There were 43 patients of cyanotic heart disease, 32 patients of acquired valvular heart disease, 4 patients of coronary artery occlusive disease, 2 patients of ascending aorta aneurysm and annuloaortic ectasia. The average amount of blood loss in the case of cyanotic heart disease was 71.7140ml/kg, in acyanotic heart disease 45.16.3ml/kg, in acquired heart disease, 56.514.4ml/kg and in coronary artery occlusive disease, 50.618.7ml/kg during first post operative day. But there was no statistical difference [p>0.05]. The mean blood loss below 10 years old was 70.412.1 ml/kg. Those below 10 years old were believed to bleed more than any other group. But there was also no statistical difference [p>0.05]. Indications for reoperation were continued excessive blood loss [74%], cardiac tamponade or hypotension [23%] and radiological evidence of a large hematoma in the thorax and pericardium [2%]. Average bypass time was 2.10.1 hours [ranging 30 minutes to 5 hours]. The interval between operation and reoperation was as follows; less than 12 hours in 49 patients [60%], 12 to 24 hours in 20 patients [25%], 24 to 48 hours in 8 patients [10%], more than 48 hours in 4 patients [5%]. The commonest sites for bleeding were chest wall [36%], heart [34%], aorta [12%], pericardium [6%], thymus [5%] and others [6%]. But no definite source was found in ll patients [31%]. Twenty seven out of 81 patients [31%] had wound problems and 5 patients [6%] were expired. [Mean SEM]. In conclusion, in order to decrease the amount of blood loss after open heart surgery with cardiopulmonary bypass, shortening of bypass time and bleeding control at the wire suture site during chest wall closure were important. If the amount of blood loss was over 45 ml/kg or 8 m/kg/hour, reoperation should be considered as soon as possible. After operating, careful wound dressings were applied to prevent wound problems.
Kim, Jae Gon;Chon, Chul-Min;Yun, Eul-Soo;Zhang, Yong-Seon;Jung, Pil-Kyun;Jung, Yeun-Tae
Korean Journal of Soil Science and Fertilizer
/
v.33
no.5
/
pp.311-317
/
2000
Acid sulfate soil and potential acid sulfate soil material are worldwide in distribution and are problematic in agriculture and environment due to their present and potential acidity developed by the oxidation of sulfides. Most of them are sedimentary origin and a few cases are reported as volcanic or metamorphic origin. We report a potential acid sulfate soil material originated from volcanic activity during Mesozoic. A profile of Bongsan series-weathered nonpyritic andesite-hydrothermally altered pyrite rich andesite was studied with field examination, chemistry, and mineralogy. Once, the pyrite rich andesite was exposed to atmosphere by excavation and leveling works for a residential area and the lay out site had subsequent acidification problem of soil and surface water. The parent material and soil profile of Bongsan series had no signs of presence of pyrite and acid sulfate weathering such as yellow mottles. However, the hydrothermally altered andesite substrata contained significant amount of pyrite showing characteristics of hydrothermal origin such as cubic and pyritohedron morphology and occurrence along cracks.
An exceptional case of inhabitation of a Sphagnum sp. was firstly confirmed at abandoned paddy terrace (APT) wetland in Ansan. Water sampling for analyzing of physicochemical conditions including nutrients such as NP, $Ca^{2+}$ and $Mg^{2+}$ was performed and the vegetation map for distribution of Sphagnum sp., topographical map, and flora list for companion species were made at field in June 2011. From the results, the Sphagnum sp. in the study site was identified as S. palustre and it covered about 8% of the wetland cover of 3,200 $m^2$. Most distributions of S. palustre were observed at tussock structures as micro-topography by sedges and grasses within a wetland (74%) and the shaded slope area under Pinus densiflora's canopy in wetland boundary (26%). Despite that APT in Ansan is relatively lower wetland in altitude than high moors, the contents of calcium ($0.45{\pm}0.2$) and magnesium ($1.48{\pm}0.6$) ion which are critical limiting factors for Sphagnum spp. were very low levels as well as NP ($PO_4$-P, $0.02{\pm}0.0$; $NO_3$-N, $0.25{\pm}0.3$; $NH_4$-N, $0.06{\pm}0.1$) and it could enable the inhabitation of S. palustre in lower APT.
The Asiatic black bear (Ursus thibetanus) is globally protected species and involved in a species restoration program by the Korea National Park Service. However, the bears could not be released into the wild were required regulation of population due to the limited space of breeding facility, so surgical castration was performed in two males. Bears were immobilized with a combination of 2 mg/kg tiletamine-zolazepam and $40{\mu}g/kg$ medetomidine, and general anesthesia was maintained with isoflurane via endotracheal tube intubation. Orchiectomy was carried out by the closed method using the LigaSure vessel sealing device through pre-scrotal incision. Subcutaneous tissues of the incision site were sutured by continuous pattern with absorbable suture material, and the skin incision was closed with tissue glue. The bears recovered uneventfully from general anesthesia after a duration of 58 min (bear A) and 53 min (bear B). Total surgical time was 26 min (bear A) and 24 min (bear B). No postoperative swelling or complications were observed. This is the first report that describes the use of the LigaSure for orchiectomy in the Asiatic black bear.
This paper provides the current status of weed science and prospects for the development of weed science based on the research trends presented at the 7th International Weed Science Conference in 2016. Approximately 520 researchers from 59 countries, including Korea, participated in the conference and presented 625 papers in nine research areas. Major research topics were herbicide resistance, weed ecology, weed management in agricultural and non-agricultural lands, herbicide spray technology, and non-chemical weed control. Studies on herbicide resistance presented more than 30% of all papers presented. Particularly, resistance to non-selective herbicides, such as glyphosate and glufosinate-ammonium, and non-target sites of resistance mechanisms were the main subjects of the herbicide resistance research area. Moreover, the conference focused on research concerning herbicide resistant weeds of staple crops of the world (corn, wheat, and rice). Arylex was introduced as a new compound which has a mode of herbicidal action similar to synthetic auxin. Three compounds being developed as HPPD inhibitors were studied for ways to reduce their toxicity and tested as mixed with safeners. Additionally, parasitic weeds, which are not native to Korea, are an expanding research subject in the world. Although 45 years have passed since the first report of herbicide resistance in 1970, herbicide resistance remains a serious problem in most intensive cropping systems of the world and will continue to be a major area of study in the future.
Transforming growth $factor-{\beta}$ ($TGF-{\beta}$)-dependent apoptosis is important in the elimination of damaged or abnormal cells from normal tissues in vivo. Gadd45b has been known to participate in $TGF-{\beta}-induced$ apoptosis by the activation of p38 kinase. In this report, we show that Gadd45b is an immediate-early response gene for $TGF-{\beta}$ during apoptosis in EpH4 cells. To elucidate the molecular mechanism of $TGF-{\beta}-induced$ Gadd45b gene expression, we cloned the 5'-flanking region of the mouse Gadd45b gene. When transfected into EpH4 cells, this 5'-flanking region conferred promoter activity and inducibility by $TGF-{\beta}$. Deletion analyses demonstrated that the minimal promoter activity was detected in the proximal region 220 bp upstream of the transcription initiation site. We also found that the proximal Gadd45b promoter is activated by $TGF-{\beta}$ through the action of Smad2, Smad3, and Smad4. Finally, we show that the expression of Gadd45b gene by $TGF-{\beta}$ is suppressed in EpRas cells in which $TGF-{\beta}$ could not induce apoptosis, suggesting that Gadd45b may be a crucial target for $TGF-{\beta}-induced$ apoptosis in EpH4 cells.
Purpose: To report a case of a 60-year-old female with rhegmatogenous retinal detachment, presenting with suprachoroidal hemorrhage after vitrectomy. Case summary: A 60-year-old woman visited our clinic complaining of floaters, flashing, and blurred vision. Best-corrected visual acuity was 0.1 in her left eye, and fundus examination of her left eye revealed macula-involved retinal detachment with a retinal break at the superotemporal quadrant. She underwent cataract surgery, 23-gauge transconjunctival sutureless vitrectomy, and 14% C3F8 gas tamponade under general anesthesia. One hour after anesthesia recovery, she suddenly complained of severe pain in her left eye. The intraocular pressure measured after removal of the pressure patch from her left eye was as high as 58 mmHg. Her ocular pain improved spontaneously within 10 minutes, and the intraocular pressure decreased to 8 mmHg. Fundus examination of her left eye revealed a reddish-brown raised lesion, suggesting suprachoroidal hemorrhage. She was placed in a prone position with a pressure patch over her left eye. Bleeding through the sclerotomy site was observed 1 day after surgery. Subsequently, hemorrhagic choroidal detachment of her left eye continued to decrease without deterioration. Three weeks after surgery, the patient received an intravitreal injection of 100% C3F8 gas into her left eye. At 3 months after surgery, best-corrected visual acuity had improved to 0.8 in her left eye, and the retina was stable. Conclusions: Suprachoroidal hemorrhage may be suspected in a patient complaining of severe ocular pain after vitrectomy.
Kim, Jin-Chun;Kim, Seok-Hyun;Yoo, Byung-Sun;Kang, Hee-Jin
Journal of Korean Society of Disaster and Security
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v.14
no.3
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pp.51-63
/
2021
This study is for the quality improvement of water-sealing & reinforcement grouting in tunnel of the construction of the underground transportation network underneath the city. Existing tunnel grouting process did not technically utilize P~q~t charts fully. It is due to the absence of technical methods to decide how P~q~t charts change in the presence of trouble and what the change represents in grouting. There were no standards to decide which chart pattern represents which ground characteristics, how to categorize ground types, and how to take measures according to the standards. This paper studies on the grouting type, ground characteristics, ground type categorizing method, and countermeasures for both general and algorithm-processed grouting in soil and rock layer to address the aforementioned problems. Newly improved P~q~t charts from grouting in soil was categorized into six different types. Different characteristics and categorization method was developed for each type. Countermeasures for each type of grouting process were developed so that on-site application can be readily available. Improved P~q~t charts for rock layer also have six different types of grouting. Each type was given the countermeasures for rock layer grouting process for easier applications. Therefore, it is expected to be used through out the entire process of grouting from preparation to the last report of the water-sealing & reinforcement grouting in tunnel of the construction of the underground transportation network underneath the city.
Tran, Bao Ngoc N.;Chen, Austin D.;Granoff, Melisa D.;Johnson, Anna Rose;Kamali, Parisa;Singhal, Dhruv;Lee, Bernard T.;Fukudome, Eugene Y.
Archives of Plastic Surgery
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v.46
no.4
/
pp.336-343
/
2019
Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.
An offshore waste disposal facility refers to a landfill site for final landfilling of stabilized inorganic solid waste such as land and marine waste incineration materials, and the aim of such a facility is to solve the problem of insufficient waste disposal space on land and create and develop environmentally friendly marine spaces. The purpose of this study is to prepare guidelines for the construction of offshore waste disposal facilities, which reflect the need and importance of paying sufficient heed to environmental considerations from the initial stage of the project, in order to investigate, predict, and assess how such guidelines will affect the marine environment in relation to the construction of offshore waste disposal facilities, with the goal of minimizing the impact on and damage to the environment. For the purpose of this research, guidelines focusing on the construction of offshore waste disposal facilities were derived through an analysis of domestic cases and similar foreign cases and an assessment of their level of compliance with existing EIA guidelines through the operation of a discussion forum. In order to review the EIA report on similar cases in Korea, 17 EIA documents (2005~2016) for dredged soil dumping areas and ash ponds of thermal power plants were analyzed to investigate the status of marine organisms, marine physics, marine water quality, and marine sediment and to understand what types of problems can occur and what improvement measures can be taken. The purpose of these guidelines were to minimize damage to the marine environment by promoting EIA protocols in accordance with scientific and systematic procedures, to reduce the consultation period related to projects, to resolve social conflicts, and to reduce economic costs.
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