• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.3
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• pp.153-159
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• 2017

Purpose: Acid neutralization during chemical clearance is significantly prolonged in children with cystic fibrosis, compared to symptomatic children without cystic fibrosis. The absence of available reference values impeded identification of abnormal findings within individual patients with and without cystic fibrosis. The present study aimed to test the hypothesis that significantly more children with cystic fibrosis have acid neutralization durations during chemical clearance that fall outside the physiological range. Methods: Published reference value for acid neutralization duration during chemical clearance (determined using combined impedance/pH monitoring) was used to assess esophageal acid neutralization efficiency during chemical clearance in 16 children with cystic fibrosis (3 to < 18 years) and 16 age-matched children without cystic fibrosis. Results: Duration of acid neutralization during chemical clearance exceeded the upper end of the physiological range in 9 of 16 (56.3%) children with and in 3 of 16 (18.8%) children without cystic fibrosis (p=0.0412). The likelihood ratio for duration indicated that children with cystic fibrosis are 2.1-times more likely to have abnormal acid neutralization during chemical clearance, and children with abnormal acid neutralization during chemical clearance are 1.5-times more likely to have cystic fibrosis. Conclusion: Significantly more (but not all) children with cystic fibrosis have abnormally prolonged esophageal clearance of acid. Children with cystic fibrosis are more likely to have abnormal acid neutralization during chemical clearance. Additional studies involving larger sample sizes are needed to address the importance of genotype, esophageal motility, composition and volume of saliva, and gastric acidity on acid neutralization efficiency in cystic fibrosis children.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.164-170
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• 1999

Background: The diffuse infiltrative lung disease often requires biopsy for its final diagnosis. Unlike the limited exposure that can be achieved through small thoracotomy incisions in open lung biopsy technique, the thoracoscopic approach allows visualization and biopsy of nearly entire surface of the lung without morbidity of large standard thoracotomy. The purpose of this study was to compare the diagnostic efficacy and operative safety of thoracoscopic lung biopsy(TLB) with open lung biopsy(OLB) in the diagnosis of diffuse infiltrative lung disease. Material and Method: From March 1993 to August 1997, 81 patients were referred for diagnostic lung biopsy. 51 of them underwent standard open lung biopsy and the remaining 30 patients underwent thoracoscopic lung biopsy. Result: Mean operative time was 63 minutes for TLB and 79 minutes for OLB (p=0.04). The volume of biopsy specimen was not different between two groups(TLB 7.8 cm3, OLB 6.9 cm3 : p=0.72) and the diagnostic accuracy of each methods was comparable (TLB 100%, OLB 96%). The duration of hospital stay was significantly less in TLB (TLB 13days, OLB 22days : p=0.01). The duration of parenteral narcotics administration was also less for TLB(TLB 2.5days, OLB 5.2days, p=0.05). Meanwhile, the duration of chest tube drainage, the frequency of parenteral narcotic injection were not significantly different between two groups. Complications occurred in 2 among the TLB patients (6.67%) and 4 among the OLB patients (7.84%). There was no operative mortality in both groups. Conclusion: We concluded that TLB is a good alternative procedure to OLB in the diagnosis of diffuse infiltrative lung disease with lower morbidity and comparable diagnostic accuracy.

• Journal of Gastric Cancer
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• v.18 no.1
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• pp.90-98
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• 2018

Purpose: We evaluated the learning curve and short-term surgical outcomes of robot-assisted distal gastrectomy (RADG) performed by a single surgeon experienced in open, but not laparoscopic, gastrectomy. We aimed to verify the feasibility of performing RADG without extensive laparoscopic experience. Materials and Methods: Between July 2012 and December 2016, 60 RADG procedures were performed by a single surgeon using the da $Vinci^{(R)}$ Surgical System (Intuitive Surgical). Patient characteristics, the length of the learning curve, surgical parameters, and short-term postoperative outcomes were analyzed and compared before and after the learning curve had been overcome. Results: The duration of surgery rapidly decreased from the first to the fourth case; after 25 procedures, the duration of surgery was stabilized, suggesting that the learning curve had been overcome. Cases were divided into 2 groups: 25 cases before the learning curve had been overcome (early cases) and 35 later cases. The mean duration of surgery was 420.8 minutes for the initial cases and 281.7 minutes for the later cases (P<0.001). The console time was significantly shorter during the later cases (168.6 minutes) than during the early cases (247.1 minutes) (P<0.001). Although the volume of blood loss during surgery declined over time, there was no significant difference between the early and later cases. No other postoperative outcomes differed between the 2 groups. Pathology reports revealed the presence of mucosal invasion in 58 patients and submucosal invasion in 2 patients. Conclusions: RADG can be performed safely with acceptable surgical outcomes by experts in open gastrectomy.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.20-27
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• 1988

Continuous cervical epidural anesthesia with two different concentrations of bupivacaine had been performed in 43 cases for surgery of upper extremity and cervical spine. After the initial dose of 0.33% bupivacaine 15ml to Group I(n=22) and 0.5% bupivacaine 15ml to Group II(n=21) was injected respectively, we observed the circulatory and pulmonary functions to be changed, and evaluated the duration of those analgesic action. The number of spinal segment to be affected and the complications were checked. Statistical significance of changes after the initial dose in both groups was determined by student's t-test. All values are impresed as mean$\pm$1S.D.. The results were as follows: 1) Circulatory functions; Systolic B.P. and Pulse rate were decreased by 10~15torr and 5~6 beats per minute respectively between 10~30 minutes following the initial dose, which were statistically significant in both groups. 2) Pulmonary functions; The diminution of minute volume showed to 20% and a rise of $PaCO_2$ level to 5~6 torr respectively between 30~60 minutes following the initial dose, which were statistically significant in both groups. There were no significant changes in self respiration and respiratory rate in both groups. 3) The duration of analgesic action was $72.3{\pm}25.7$(min) in Group I and $83.5{\pm}28.5$(min) in Group II which was not statistically significant between two groups, and the number of affected spinal segment at ore hour following the Anesthusia was $8.7{\pm}2.0$ in Group I and $10.5{\pm}2.4$ in Group II which was statistically significant between two groups. 4) Complications; a. Hypotension(below 80torr in systolic pressure) was appeared in 5% of all patients. b. Bradycardia(below 60 beats per minutes) was appeared in 25% of all patients. c. Inadvertent dural puncture was developed in only one patient, In conclusion, the 0.33% bupivacaine as well as 0.5% bupivacaine were enough for those analgesic effect in the above mentioned surgery even though the duration of analgesic action was about 10 minutes shorter in Group I than that of Group II. The cardiopulmonary function was clinically rather stable in Group I than that of Group II. Therefore we thought 0.33% bupivacaine was satisfactory for the clinical practicality in the cervical epidural anesthesia.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.143-147
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• 2004

Background : It is important to predict the exercise capacity and dyspnea, as measurements of lung volume, in patients with COPD. However, lung volume changes in response to an improvement in airflow limitation have not been explored in detail. In the present study, it is hypothesized that lung volume responses might not be accurately predicted by flow responses in patients with moderate to severe airflow limitations. Methods : To evaluate lung volume responses, baseline and follow up, flow and lung volumes were measured in moderate to severe COPD patients. The flow response was defined by an improvement in the $FEV_1$ of more than 12.3%; lung volume changes were analyzed in 17 patients for the flow response. Results : The mean age of the subjects was 66 years; 76% were men. The mean baseline $FEV_1$, $FEV_1$/FVC and RV were 0.98L (44.2% predicted), 47.5% and 4.65 L (241.5%), respectively. The mean follow up duration was 80 days. The mean differences in the $FEV_1$, FVC, TLC and RV were 0.27 L, 0.39 L, -0.69 L and -1.04 L, respectively, during the follow up periods. There was no correlation between the delta $FEV_1$ and delta RV values(r=0.072, p=0.738). Conclusion : To appropriately evaluate the lung function in patients with moderate to severe airflow limitations; serial lung volume measurements would be helpful.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.540-547
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• 1993

Backgrounds: The measurement of volume of isoflow has been considered as a sensitive test for detecting small airway diseases showing normal pulmonary function in a routine pulmonary function test. To evaluate the functions of small airway among dust exposed workers, the changes of volume of isoflow were measured and its applicability of managing early stage pneumoconiosis patients was studied. Method: The subjects were 67 male, pneumoconiosis with small opacity and FEV1>80%, FEV1/FVC>75% in spirometry and the controls were 20 male, no dust-exposed office workers. The maximal epiratory volume curves after inhalation of indoor air and $He-O_2$ gas mixtures were measured and ${\Delta}V_{max50},\;{\Delta}V_{max75},\;V_{iso}V/VC$ between the dust exposed and control workers were compaired. Results: 1) There were no significant differences between two group in ${\Delta}V_{max50}$ and ${\Delta}V_{max75}$. But the ratio of $V_{iso}V/VC$ of the subjects was siginificantly higher than that of the control (p<0.01). This study confirms that $V_{iso}V/VC$ is a very useful index in early detection of small airway dysfunction. 2) The ratio of $V_{iso}V/VC$ of the subjects was signigicantly different between only smoker group and mixed group(smoker and nonsmoker). It suggestes that smoking is an important cousative factor of small airway dysfunction. 3) As the profusion of the chest X-ray increased, the rartio of $V_{iso}V/VC$ increased, but no significant difference of $V_{iso}V/VC$ was found between categories of pneumoconiosis. The categories of pneumoconiosis and small airway dysfunction may not be related. 4) No significant relationship was established between the duration of work and the ratio of $V_{iso}V/VC$. Conclusions : It is concluded that the measurement of $V_{iso}V/VC$ is useful to detect small airway dysfuction of early stage pnuemoconiosis patents with small opacities but showing normal pulmonary function in a routine pulmonary function test.

• Water Engineering Research
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• v.2 no.4
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• pp.243-259
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• 2001

Local phenomena around bridge piers and abutments are generally considered to be similar, nevertheless the presence of the incoming boundary layer on the side wall in the abutment case generates extra pressure gradients and consequently a more complex vortex pattern. In the literature, experimental data for bridge abutments are relatively scarce; in particular almost no data are available for the time evolution of the scour. In this work we present the results of several long duration (3 days longrightarrow5weeks) clear water scour laboratory tests around bridge abutments; the time evolution of the erosion process is analysed with respect to local and global characteristic values (maxima, volume, hole shape). In particular we analyse the effect of the constriction ratio b/B between the transversal obstacle dimension and the flume width: in many practical situations abutments (or piers) obstruct a significant portion of the channel, so that the average acceleration due to constriction is expected to increase the scour effects of the local acceleration around the obstacle. Measured values for maximum scour are poorly predicted by literature formulas. Scour depths are positively correlated with the constriction ratio, but increases are smaller than expected from literature indications. Experimental results show that models for bridge piers cannot be directly applied to abutments; in particular, time scales for the latter are significantly larger than for piers.

• Journal of Aquaculture
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• v.6 no.1
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• pp.55-62
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• 1993

A tetraploid cyprinid loach, Misgurnus anguillicaudatus was induced by applying heat shock. The efficiency of inductions changed with the time of initiation of treatment and the duration of treatment. The highest incidence of tetraploid was obtained at the treatment of $41^{\circ}C$ for 3 min, 28 min after fertilization. Ploidy level was estimated by kariological examination and flow cytometric analysis. The tetraploid cyprinid loach had 4n = 100 chromosomes, while the diploid had 2n = 50. The erythrocytic volume of the tetraploid was 1.65 times larger than that of the diploid. The DNA content of the tetraploid and diploid showed 6.547 pg/cell and 3.067 pg/cell, respectively.

• Journal of Environmental Health Sciences
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• v.44 no.2
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• pp.107-114
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• 2018

Objectives: The objectives of this study are to describe strategy for exposure assessment of humidifier disinfectant (HD) used in the national program to associate the use of HD with lung injury. Methods: Strategy and method employed to evaluate HD use characteristics were developed to associate health effects including HD associated with lung injury (HDLI). We developed HD-specific questionnaire to assess potential HD exposure, which was consistently used in the national program. Trained environmental health scientists visited the residences of registered subjects and investigated HD use characteristics. Results: Major HD exposure related variables were type of HD brand/s used; HD volume added to the humidifier, frequency of HD addition, and time spent in room/s with the humidifier; duration of HD use in the household in average months/year, weeks/month, and days/week; average sleeping hours in a room with an operating humidifier containing a disinfectant; number of HD brands used and type of HD; average distance of the bed from the humidifier in meters. Conclusions: We concluded that estimated airborne HD concentration was significantly associated with the risk of HDLI.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.149-155
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• 1996

Doctors who treat pregnant women ore usually cautious in writing their prescription for the drugs. The problem of which psychotropic medications ore sale during pregnancy seems to remain unsolved for many years. Although the rate of absorption is reduced due to a reduced rate of gastric emptying, the extent of absorption of drug is generally unchanged during pregnancy. Plasma volume and total body water increase during pregnancy. There is suggestion that drug metabolizing activity may be increased in pregnancy. Since the pregnancy increase the glomerular filtration rate significantly, drugs mainly eliminated by renal excretion will be cleared more quickly. Factors contributing to the potential teratogenecity of a drug include the type of compound, dose and duration of use, developmental stage of fetus at the time of exposure, and the effect of the drug on fetal pharmacokinetics. All major classes of psychotropic agents should be assumed to diffuse readily across the placenta to the fetus and to be present in some quantity in the breast milk. To decide when and how to start the drug treatment depends on an assessment of the risks related both with and without drug treatment of psychiatric disorders.