• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.28 no.1
• /
• pp.48-52
• /
• 2024

Backgrounds/Aims: Splenectomy is the most frequently performed procedure as definitive management or as part of shunt surgery or devascularization in portal hypertension. Splenectomy is technically challenging because of the frequent coexistence of multiple collateral varices, splenomegaly, poor liver function, and thrombocytopenia. Early arterial ligation and late mobilization (EALDEM) is the traditional method for splenectomy in portal hypertension. Early spleen mobilization offers good control of the hilum. We aim to compare the effect of the early mobilization and delayed arterial ligation (EMDAL) technique with that of the conventional splenectomy technique in patients with portal hypertension. Methods: During the study period from September 2011 to September 2022, 173 patients underwent surgical intervention for portal hypertension at our institution. Among these patients, 114 underwent the conventional method of splenectomy (early arterial ligation and late splenic mobilization) while 59 underwent splenectomy with the EMDAL technique. Demographics were compared between the two groups. Intraoperative and postoperative outcomes were analyzed using the Mann-Whitney test in each group. A minimum follow-up of 12 months was performed in each group. Results: Demographics and type of surgical procedure were comparable in the two surgical method groups. Median blood loss was higher in the conventional group than in the EMDAL method. The median duration of surgery was comparable in the two surgical procedures. Clavien-Dindo grade III/IV complications were reported more frequently in the conventional group. Conclusions: The splenic hilum can be controlled well and bleeding can be minimised with early mobilization and delayed arterial ligation.

• Clinical Endoscopy
• /
• v.57 no.1
• /
• pp.36-47
• /
• 2024

Background/Aims: Scissor-type endoscopic submucosal dissection (ST-ESD) knives can reduce the adverse events associated with ESDs. This study aimed to compare ST-ESD and non-scissor-type (NST)-ESD knives. Methods: We identified ten studies that compared the performance characteristics and safety profiles of ST-ESD and NST-ESD knives. Fixed- and random-effects models were used to calculate the pooled proportions. Heterogeneity was assessed using the I² test. Results: On comparing ST-ESD knives to NST-ESD knives, the weighted odds of en bloc resection was 1.61 (95% confidence interval [CI], 0.90-2.90; p=0.14), R0 resection was 1.10 (95% CI, 0.71-1.71; p=0.73), delayed bleeding was 0.40 (95% CI, 0.17-0.90; p=0.03), perforation was 0.35 (95% CI, 0.18-0.70; p<0.01) and ESD self-completion by non-experts was 1.89 (95% CI, 1.20-2.95; p<0.01). There was no heterogeneity, with an I² score of 0% (95% CI, 0%-54.40%). Conclusions: The findings of reduced odds of perforation, a trend toward reduced delayed bleeding, and an improvement in the rates of en bloc and R0 resection with ST-ESD knives compared to NST-ESD knives support the use of ST-ESD knives when non-experts perform ESDs or as an adjunct tool for challenging ESD procedures.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.12 no.6
• /
• pp.193-204
• /
• 2008

This paper describes laboratory experiments modelling multiple tunnel construction in soft ground. A series of small-scale model tests have been conducted at approximately 1/50 scale in order to investigate the behaviours of existing tunnels in response to the construction of new tunnels in close proximity. The model tunnels were constructed in a consolidated Speswhite Kaolin clay using a tunnelling device involving an auger type cutter within a shield. Strain gauges and LVDTs were used for instrumenting the existing tunnels. The findings obtained from the analyses of these tests were compared to the field measurements involving the reconstruction of the Northern Line London Underground Ltd. tunnels at Old street, United Kingdom. The results were also compared to the ground movement measurements obtained from a separate set of tests undertaken using the same apparatus and experimental procedures.

• Journal of Chest Surgery
• /
• v.57 no.5
• /
• pp.484-489
• /
• 2024

Background: Catamenial pneumothorax (CP) is a rare form of spontaneous pneumothorax that is linked to endometriosis; thus, it predominantly manifests in women of reproductive age. Considerable research has explored the potential benefits of postoperative hormone therapy following various surgical interventions. This study was performed to examine the clinical implications of postoperative hormone treatment in patients with CP. Methods: The study included patients who underwent surgical intervention for CP between November 2009 and February 2023. These procedures included wedge resection, diaphragm resection, and total pleural coverage. Recurrence-free survival was analyzed using the Kaplan-Meier log-rank test to assess the impact of hormone therapy. Additionally, Cox proportional hazards analysis was employed to identify risk factors associated with postoperative CP recurrence. Results: The study included 41 patients, with a median age of 38.4 years. Among them, 27 individuals received hormone therapy, 8 of whom experienced recurrence during a median follow-up period of 1 year. Patients who received hormone therapy exhibited a lower rate of recurrence than those who did not; however, the difference was not statistically significant, likely due to the small sample size. Side effects of hormone therapy included depression (6.8%), excessive sweating (3.4%), and headache (3.4%). In the analysis of risk factors for postoperative recurrence, diaphragm resection emerged as a protective factor (hazard ratio, 0.16; 95% confidence interval, 0.03-0.77; p=0.022). Conclusion: Hormone treatment combined with surgery did not significantly impact recurrence in patients with CP. The application of diaphragm resection was the sole factor that displayed significance in preventing CP recurrence.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.21 no.1
• /
• pp.60-64
• /
• 2017

Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.44 no.1
• /
• pp.72-81
• /
• 2017

The aim of this study was to evaluate the effectiveness of artificial saliva contamination and decontamination procedures at different stages of a bonding procedure on the microtensile bond strength (MTBS) of two one-step self-etch adhesives and a two-step total-etch adhesive to dentin of primary teeth. Forty-two extracted sound primary molars were randomly divided into three groups depending on three adhesives, Scotchbond Universal Adhesive (SBU), All-Bond Universal (ABU) and Prime & Bond NT (PNT). For each adhesive, the teeth were allocated into seven groups. Except for control group, group 1, the groups were contaminated with artificial saliva at three different stages: the groups 2 and 3 - before adhesive application; the groups 4 and 5 - before adhesive polymerization; the groups 6 and 7 - after adhesive polymerization. Decontaminating procedures were rinsing, air-drying (group 2, 4, 6) and air-drying (group 3, 5, 7). The specimens were restored with composite resin (Filtek, Z350) and microtensile bond strength was measured. The data was analyzed with one-way ANOVA and Tukey HSD test (p < 0.05). In the control group, using PNT resulted in significantly higher bond strength than when ABU and SBU were used (p < 0.001). For three adhesives, the groups 2, 4 and 6 had greater bond strength than the groups 3, 5 and 7. Also, when the artificial saliva was contaminated before adhesive polymerization (group 4, 5), it showed a significantly lower bond strength. Generally the two-step total-etch adhesive generated a higher bond strength than the one-step self-etch adhesive. Artificial saliva contamination before adhesive polymerization led to a drastic decrease in bond strength, and rinsing with water followed by air-drying could not recover the bond strength.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.20 no.3
• /
• pp.131-140
• /
• 2015

To set up unicellular cyanobacterial strains with photo-biological $H_2$ production potential, live samples were repeatedly collected from 68 stations in the coastal zone of Korea for the four years since 2005. Among 77 cyanobacterial strains established six (KNU strains, CB-MAL002, 026, 031, 054, 055 and 058) were finally chosen as the excellent strains for $H_2$ production with $H_2$ accumulation over 0.15 mL $H_2\;mL^{-1}$ under general basic $H_2$ production conditions as well as positive $H_2$ production for more than 60 hr. To explore optimum procedures for higher $H_2$ production efficiency of the six cyanobacterial strains, the inter-strain differences in the growth rate under the gradients of water temperature and salinity were investigated. The maximum daily growth rates of the six strains ranged from 1.78 to 2.08, and all of them exhibited $N_2-fixation$ ability. Based on the similarity of the 16S rRNA sequences, all the test strains were quite close to Cyanothece sp. ATCC51142 (99%). The six strains, however, were grouped into separate clades from strain ATCC51142 in the molecular phylogeny diagram. Chlorophyll- a content was 3.4~7.8% of the total dried weight, and the phycoerythrin and phycocyanin contents were half of those in the Atlantic strain, Synechococcus sp. Miami BG03511. The growth of the six strains was significantly suppressed at temperatures above the optimal range, $30{\sim}35^{\circ}C$, to be nearly stopped at $40^{\circ}C$. The growth was not inhibited by high salinities of 30 psu salinity in all the strains while strain CB055 maintained its high growth rate at low salinities down to 15 psu. The euryhaline strains like CB055 might support massive biotechnological cultivation systems using natural basal seawater in temperate latitudes. base seawater. The biological and ecophysiological characteristics of the test strains may contribute to designing the optimal procedures for photo-biological $H_2$ production by unicellular cyanobacteria.

• Journal of Chest Surgery
• /
• v.35 no.5
• /
• pp.329-335
• /
• 2002

Background: The surgical technique for biventricular assist device(BVAD) implantation has mainly consisted of cannulation procedures. A median sternotomy has been the technique of choice as it gives a surgeon an excellent exposure of the heart. However, considering that most patients require a future sternotomy or already have a previous sternotomy, sternotomy-related complication remains a major concern in BVAD implantation. Based on this consideration as well as the clinical experiences of conventional heart surgery, the authors have hypothesized that the cardiac chambers for BVAD cannulation can be approached from the right side of the heart. The purpose of this studs to develop a novel surgical technique of right thoracotomy for BVAD implantation in an animals study. Material and Method: For last two years, 16 (11 calves, 3 canines, and 2 sheep) out of 30 experimental animals with AnyHeart implantation underwent a right thoracotomy. The device was used as an implantable BVAD in 14 animals, a wearable BVAD in 1, and an implantable LVAD in 1. The chest cavity was entered through the 4th intercostal space or the 5th periosteal bed. As for the BVAD use, a right inflow cannula was inserted into the right atrial free wall and a right outflow cannula was grafted onto the main pulmonary artery. A left inflow cannula was inserted into the interatrial groove and a left outflow cannula was grafted on the innominate artery of the ascending aorta. The connecting tubes were brought out through the thoracotomy wound and connected to the pump located in the subcutaneous pocket at the right flank. Result: Except for the 5 animals for a lilting test or during the early learning curve, all recovered smoothly from the procedures. The inflow drainage allowed the pump output 6.5 L/min at the maximum with 3-3.5 L/min in an average. Of the survivors, there noted no procedure-related mortality or morbidity. Necropsy findings demonstrated the well-positioned cannula tips in the each cardiac chamber

• Journal of Chest Surgery
• /
• v.13 no.3
• /
• pp.174-185
• /
• 1980

It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

• Journal of Korean Academy of Nursing Administration
• /
• v.7 no.3
• /
• pp.455-472
• /
• 2001

The purpose of this study was to serve as a basis for mapping out successful strategies to build the professional self-image of nurses through uniform, by examining their satisfaction with uniform and professional self-image by general characteristics, and identifying the correlational relationship between the two factors. The subjects in this study were 205 nurses who served in general departments of two university hospitals in Seoul. The departments where special uniform was required, including ICU, RR, OR and CSR, were excluded. The data were collected from September 15 through 22, 2000. For measurement of uniform satisfaction level, a uniform satisfaction scale was prepared by myself, and Arthur(1990)'s PSCNI translated and modified by Song Kyong Ae and Rho Chun Hee(1996) was employed. The Cronbach a of the uniform satisfaction scale and PSCNI was 0.90 and 0.86 respectively. The collected data were analyzed by SAS, and real number, percentage, average and standard deviation were calculated. Besides, t-test, one-way ANOVA, Pearson's r procedures were utilized, and Scheffe test was conducted as a posttest. The findings of this study were as below: 1. The uniform satisfaction of the nurses investigated was scored 2.52 on the basis of 4 points, which was on the medium level. By subarea, symbolicity satisfaction was 2.48, and aesthetic satisfaction was 2.60. The functionability satisfaction was 2.44. So the esthetic satisfaction was greatest. 2. Among general characteristics of the subjects, two factors made a significant difference to their uniform satisfaction : age(F=4.05, P=.0189), and total career(F=4.25, P=.0061). 3. Their professional self-image got 2.75 on the basis of 4 points, which was on upper middle level. The subarea score was 2.79 for professional work, 2.52 for satisfaction and 2.97 for communication. The communication area was rated highest, and the satisfaction area was scored lowest. 4. Among the general characteristics of the subjects, professional self-image was different according to five factors : age(F=17.83, P=.001), marital status(T=5.18, P=.0000), educational background(F=8.72, P=.0002), position(T=-5.29, P=.0000) and total career(F=15.23, p=.0001). Better professional self-image was possessed by the older group than the younger one, by the married group than the singles, by the better-educated group than the less-educated, by the nurses in position equal to or higher than charge nurse, or by the higher-career group. 5. The correlational relationship of uniform satisfaction to professional self-image was statistically significant, yet very weak(r=.1978, p=.0045). The satisfaction area of professional self-image was correlated to every uniform satisfaction area, including symbolicity(4=.4393, p=.0001), aesthetics(r=.2471, p=.0004), functionability(r=.3094, p=.0001) and total satisfaction(r=.4050, p=.0001). Therefore, the uniform satisfaction gave an impact on the satisfaction area of professional self-image of the nurses, and there was a significant correlational relationship between uniform symbolicity area and total professional self-image(r=.2416, p=.0005).