• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.81-85
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• 2019

Background: Bronchoscopy is a useful diagnostic and therapeutic tool. However, the clinical use of high-flow nasal cannula (HFNC) in adults with acute respiratory failure for diagnostic and invasive procedures has not been well evaluated. We present our experiences of well-tolerated diagnostic bronchoscopy as well as cases of improved saturation in hypoxaemic patients after a therapeutic bronchoscopic procedure. Methods: We retrospectively reviewed data of hypoxaemic patients who had undergone bronchoscopy for diagnostic or therapeutic purposes from October 2015 to February 2017. Results: Ten patients (44-75 years of age) were enrolled. The clinical purposes of bronchoscopy were for diagnosis in seven patients and for intervention in three patients. For the diagnoses, we performed bronchoalveolar lavage in six patients. One patient underwent endobronchial ultrasonography with transbronchial needle aspiration of a lymph node to investigate tumour involvement. Patients who underwent bronchoscopy for therapeutic interventions had endobronchial mass or blood clot removal with cryotherapy for bleeding control. The mean saturation ($SpO_2$) of pre-bronchoscopy in room air was 84.1%. The lowest and highest mean saturation with HFNC during the procedure was 95% and 99.4, respectively. The mean saturation in room air post-bronchoscopy was 87.4%, which was 3.3% higher than the mean room air $SpO_2$ pre-bronchoscopy. Seven patients with diagnostic bronchoscopy had no hypoxic event. Three patients with interventional bronchoscopy showed improvement in saturation after the procedure. Bronchoscopy was well tolerated in all 10 cases. Conclusion: This study suggests that the use of HFNC in hypoxaemic patients during diagnostic and therapeutic bronchoscopy procedures has clinical effectiveness.

• Journal of Chest Surgery
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• 제44권6호
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• pp.418-422
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• 2011

Background: It has recently become most general to use the small bore catheter to perform closed thoracostomy in treating iatrogenic pneumothorax. This study was performed for analysis of the efficacy of treatment methods by using small bore catheter such as 7 F (French) central venous catheter, 10 F trocar catheter, 12 F pigtail catheter and for analysis of the appropriateness of each procedure. Materials and Methods: From March 2007 to February 2010, Retrospective review of 105 patients with iatrogenic pneumothorax, who underwent closed thoracostomy by using small bore catheter, was performed. We analyzed the total success rate for all procedures as well as the individual success rate for each procedure, and analyzed the cause of failure, additional treatment method for failure, influential factors of treatment outcome, and complications. Results: The most common causes of iatrogenic pneumothorax were presented as percutaneous needle aspiration(PCNA) in 48 cases (45.7%), and central venous catheterization in 26 cases (24.8%). The mean interval to thoracostomy after the procedure was measured as 5.2 hours (1~34 hours). Total success rate of thoracostomy was 78.1%. The success rate was not significantly difference by tube type, with 7 F central venous catheter as 80%, 10 F trocar catheter as 81.6%, and 12 F pigtail catheter as 71%. Twenty one out of 23 patients that had failed with small bore catheter treatment added large bore conventional thoracostomy, and another 2 patients received surgery. The causes for treatment failure were presented as continuous air leakage in 12 cases (52.2%) and tube malfunction in 7 cases (30%). The causes for failure did not present significant differences by tube type. Statistically significant factors affecting treatment performance were not discovered. Conclusion: Closed thoracostomy with small bore catheter proved to be effective for iatrogenic pneumothorax. The success rate was not difference for each type. However, it is important to select the appropriate catheter by considering the patient status, pneumothorax aspect, and medical personnel in the cardiothoracic surgery department of the relevant hospital.

• 한국수정란이식학회지
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• 제15권3호
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• pp.271-277
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• 2000

This study was conducted to establish the optimal culture conditions for in vitro production of bovine embryos derived from slaughter house ovaries. Cumulus-oocyte- complexes (COCs) collected by aspiration from follicles of 2~7 mm in diameter were matured in Ham's F-10 medium supplemented with 0.01 $\mu\textrm{g}$/m1 epidermal growth factor (EGF) at 39$^{\circ}C$ in a humidified atmosphere of 5% $CO_2$in air. After 24 hrs of culture, the oocytes were co-cultured with epididymal sperm selected off by Percoll-density gradient in TALP medium for 24 hrs. The presumptive zygotes were cultured in HECM-6 medium for 3 d post-insemination, and followed by cultured in TCM199 medium until 7 to 10d post-insemination. The cultures were compared of their cleavage and development into later stage in culture medium by additions of different protein sources (PVA, BSA and BCS) and by different embryo density. The rates of cleavage and development rates into blastocyst were not significantly (P<0.05) different among the culture media containing with BSA (75.0% and 40.5%), BCS (76.7% and 38.0%) and PVA (72.5% and 42.2%), respectively. Significantly (P<0.05) higher blastocysts rates were obtained in culturing of 30 and 40 embryos in each 50$\mu$l droplets of culture medium than in 5, 10 and 20 embryos. These results indicate that the optimal density of embryos is 30~40 embryos in a 50$\mu$l droplet of culture medium. Furthermore there is no effect of different protein sources on early embryonic development.

• 한국수정란이식학회지
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• 제9권1호
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• pp.1-6
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• 1994

This experiment was investigated the effect of presence of granulosa cells from follicles of different size on bovine oocyte maturation, cleavage and development to late stage. The nuclear and cytoplasmic maturation of oocytes in the IVM-IVF system are critical for subsequent embryo development. Granulosa cells when the co-cultured with oocytes may interact with cumulus-oocytes complexes and influence the development competence of the oocytes. Granulosa cells from medium (2~6 mm) and large(>1O mm) size follicles were recovered by aspiration, washed 3 times by centrifugation at 500 x g for 5 min. and used for co-culture at a concentration of 2~3 x 106 cells/mi. The oocytes were matured in vitro (IVM) for 24 hrs. in TCM-199 supplemented with 35 $\mu$g/ml FSH, 10 $\mu$g/ml LH, 1 $\mu$g/ml estradiol-17$\beta$ and granulosa cells at 39$^{\circ}C$ under 5% $CO_2$ in air. They were fertilized in vitro (IVF) by epididymal spermatozoa treated with heparin for 24 hrs., and then the zygotes were co-cultured in vitro (I VC) with bovine oviductal epithelial cells for 7 to 9 days. The assessment of maturation revealed that Grade J oocytes showed significantly(P

• Journal of Yeungnam Medical Science
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• 제31권2호
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• pp.89-93
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• 2014

Background: This study was conducted to investigate the epidemiological features, clinical courses, and diagnoses of neonates who are transferred to neonatal intensive care unit of Yeungnam University Hospital due to tachypnea soon after birth. Methods: Based on medical records, we performed a retrospective study of neonatal intensive care unit admissions due to tachypnea from January 2010 to December 2013. Results: A total of 311 neonates were included in this study. The patient characteristics showed male predominance at 2.65:1. Among the 311 neonates with tachypnea, 127 (40.8%) neonates needed oxygen supply, and 54 (17.4%) neonates needed assisted mechanical ventilation. Transient tachypnea of the newborns (TTN) (158, 50.8%) showed the highest incidence, followed by pneumonia (63, 20.3%), extrapulmonary infection (37, 11.9%), respiratory distress syndrome (21, 6.8%), air leak (16, 5.1%), meconium aspiration syndrome (12, 3.9%), congenital heart disease (5, 1.6%), metabolic acidosis (3, 1%), primary pulmonary hypertension of newborns (2, 0.6%) and anemia (2, 0.6%). Conclusion: Although the neonates with tachypnea showed no other respiratory distress symptom, clinicians should be aware of the possibility of other pulmonary diseases as well as TTN and their extra-pulmonary causes. If tachypnea does not improve within a few hours, the clinician should consider further evaluation and management as soon as possible.

• 한국임상수의학회지
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• 제38권3호
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• pp.159-162
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• 2021

A 5-year-old, intact male, poodle dog with right external auditory canal obstruction and subaural mass was presented. Physical examination revealed that right external auditory canal opening was absent and right head tilt was identified. Aspiration in right subaural mass revealed a small amount of dark brown exudate. Streptococcus canis and Staphylococcus spp. were identified on the microbial culture. Radiography of the skull was revealed absence of air-filled ear canal at the right external ear canal (EEC) level. Computed tomography (CT) revealed well capsulated, hypoattenuated mass in the right EEC region. On the contrast enhanced CT images, rim enhancement around the mass and ear canal obstruction were identified. Fluid attenuated material filled with right bulla. Mild thickening of the right tympanic bulla wall with mild lytic lesion of the ventral wall were found. Based on the images findings, the case was tentatively diagnosed as right external auditory canal atresia with otitis media. Total ear canal ablation and lateral bulla osteotomy was performed. The entire ear canal was removed, numerous hair in the canal and the thickening wall were founded. Right ear canal was sent for histopathological evaluation and found to otitis externa. The patient was followed up for two weeks and there were no complications. This report described the CT diagnosis of right EEC atresia with otitis media rarely reported in small breed dogs.

• 핵의학기술
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• 제20권2호
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• pp.62-68
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• 2016

1. 목적 자동분주기를 이용하여 검사한 Cyclosporine검사에서 표준액들이 curve를 벗어나고, 결과값의 재현성이 크게 떨어지는 것이 발견되었다. Cyclosporine검사는 다른 검사와 차이점이 methanol과 전혈을 혼합 후 원심분리 하여 methanol 추출액을 사용하여 검사를 한다는 것이다. 검사 결과 이상의 원인이 methanol 사용에 의한 것으로 파악되어 본 실험을 시작하였다. 본원에서 사용하는 분주기는 Perkin Elmer 사의 Multiprobe II plus 로, 분주하는 액체의 점도, 샘플링 tip의 size, 사용하는 모터의 속도에 따라 여러 설정값을 조정하라고 안내되어 있을 뿐 정확한 지침은 없었다. 이에 사용하는 액체별 분주성능을 측정하고 최적의 분주성능을 위한 설정값을 찾기 위해 연구하였다. 2. 대상 및 방법 분주력 측정을 위해 4가지 용액(water, serum, methanol, PEG 6000(25%))와 $TSH^{125}I$ tracer (515 kBq)을 사용 하였고, 실제 결과 값을 비교하기 위해 2016년 1월에 본원에 검사 의뢰된 Cyclosporine검체 29개를 측정하였다. 4가지의 용액을 multi pipette을 이용하여 각각 $400{\mu}l$ 분주하고 tracer $100{\mu}l$씩을 섞어 용액별로 8개의 검체를 준비하였다. 준비된 sample을 분주기로 $100{\mu}l$씩 분주하여 CPM을 측정하고, 용액별로 CV(%)를 계산하였다. 그리고 분주기의 air gap, 분주속도와 지연시간을 변경한 후 다시 분주하여 측정한 CPM을 CV(%)로 계산하여 설정 값 변경에 따른 CV(%)값의 변화를 측정하여 최적의 설정 값을 찾는다. Cyclosporine검체 29개를 (1)manual검사 (2)기존 설정 값으로 검사 (3)수정한 설정값으로 검사 했을 때의 결과를 비교하였다. 용액별 분주력 평가는 CV(%)를 이용하여 계산하였고, 실제 검사 결과 값의 비교는 manual검사 결과를 기준으로 기존 설정 값으로 검사 했을 때, 수정한 설정 값으로 검사 했을 때의 결과 값을 Difference(%)와 상대오차(%Relative error : %RE)로 비교해 보았다. 3. 결과 4가지 용액과 tracer를 섞어 분주한 CPM의 CV(%)는 water 0.88, serum 0.95, methanol 10.22, PEG는 0.68로 methanol을 제외한 용액들은 1% 이내였으나, methanol은 CPM 차이가 두드러졌다. methanol 분주를 기존 설정 값인 Transport air gap 0에서 2와 5로 변경하여 검사 시 CV(%)는 각각 20.16, 12.54, System air gap 0에서 2와 5로 변경 시 8.94, 1.36으로 나타났다. System air gap 2, Transport air gap 2로 변경 시 CV(%)는 12.96, System air gap 5, Transport air gap 5로 변경 시 1.33 이었고, Dispense speed를 300에서 100으로 변경 시 CV(%)는 13.32, Dispense delay를 200에서 100으로 변경 시는 13.55인 것으로 나타났다. 분주기를 이용하여 기존설정 값으로 검사 시에는 manual검사 결과 값에 비해 평균 99.44%증가 하였고, 상대오차는 93.59%로 나타났다. 수정된 설정 값(System air gap 0에서 5로 변경, 다른 설정은 기존과 동일)으로 검사 했을 때는 manual검사 결과 값에 비해 결과가 평균 6.75% 증가 하였고, 상대오차는 5.10%로 상대오차의 허용기준치 10%에 비하여 양호한 결과가 나왔다. 4. 결론 Transport air gap, Dispense speed, Delay time을 조정하였을 때는 CV(%)가 증가하였고, System air gap을 조정 하였을 때 CV(%)가 현저하게 감소하였다. 실제 검사결과에서도 이를 확인 할 수 있었다. methanol을 이용한 Cyclosporine검사 kit는 올해 2월에 단종이 되었지만, 분주기를 사용함에 있어 용액에 따른 분주성능에 차이가 있을 수 있음을 염두해 두어야 하고 새로운 용액을 분주해야 할때는 미량저울로 분주량을 측정하거나 CPM으로 분주성능을 측정하여 해당 용액이 분주기를 사용함에 적절한지 검증 후 사용하여야 할 것으로 사료되어 본 실험결과를 보고하고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제62권5호
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• pp.427-431
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• 2007

기관지 연관 림프조직 림프종은 비특이적인 호흡기 증상만을 나타내며, 전산화단층촬영에서 세기관지 폐포암, 림프구성 간질성 폐렴등과 뚜렷이 구분이 되지 않는 결절 외 림프종의 일종이다. 저자들은 비특이적인 호흡기 증상만을 나타내는 병변에 대해 침습적인 방법인 경피 미세흡입생검을 시행하여, 원발성 기관지 연관 림프조직 림프종으로 진단하였으며, 병리적 진단이 내려진 상태에서 치료를 목적으로 좌상엽 절제술을 시행하였다. 기관지 연관 림프조직 림프종은 서서히 진행되는 질환으로, 대부분 최종 진단이 늦어지는 경향을 보인다. 국소적 병변일 경우 외과적 수술로 완치가 가능한 질환이므로, 질환이 의심되는 경우 적극적 검사와 치료를 시도하는 것이 중요할 것으로 생각된다.

• The Korean Journal of Pain
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• 제9권2호
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• pp.399-402
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• 1996

Endoscopic transthoracic sympathectomy (ETS) has recently become estabilished as a successful treatment for severe palmar and axillary hyperhidrosis. Descriptions have been published of neurolytic, operative and alternative endoscopic procedures involving thermocoagulation, laser coagulation, or or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. All methods have advantage and disadvantages. A 19-year-old male who suffered from severe hyperhidrosis on face, palms and axillary areas, has been initially treated with stellate ganglion block in other pain clinic. He was transfered to our pain clinic for endoscopic thoracic sympathectomy. The patient was intubated left side 34 Fr. double lumen tube and positioned left semi-lateral position for right sympathectomy. Right side pneumothorax was created by clamping the ipsilateral side of the double lumen tube and aspiration of air. 11-mm trocar was introduced through incision at the third intercostal space in anterior axillary line, and then additional two 11-mm and 5-mm trocar was introduced through second and fifth intercostal space in mid axillary line. The lung was gently retracted and the parietal pleura over the heads of the appropriate ribs excised using 5-mm sharp insulated coagulating microprocesss. The T4, T3, and T2 ganglions, as well as accompanying rami communicantes, and other branchs arising from upper thoracic nerves to the brachial plexus and surrounding tissues were carefully dissected, coagulated. During sympathectomy, skin temperature of middle was continuously monitored. Elevation of palmar skin temperature intraoperatively indicated an adequate sympathectomy with a definite therapeutic effect. A No. 28 Fr. thoracotomy tube was introduced through a troca under video guidance, placed under water seal after the lung was reinflated. the controlateral side was performed same procedure. After bilateral sympathectomy, chest tubes were removed, and then, he was discharged 2 days after operation with great satisfaction. The ETS provides a well-tolerated, cost-effective alternative to thoracic sympathectomy for primary hyperhidrosis and sympathetic mediated neuropathic pain disorder. And T2 ganglion is considered the key ganglion for the treatment of primary hyperhidrosis. The low incidence of compensatory sweating may by explained by the limited extent of the sympathectomy.

• 한국수정란이식학회지
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• 제12권2호
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• pp.181-188
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• 1997

This study was carried out to determine the effect of bovine follicular fluid(bFF), hormones, and fetal bovine serum(FBS) supplemented in the medium on the in vitro fertilization and development of bovine embryos. The ovaries were obtained from a local abattoir and placed in physiological saline kept at 30~32˚C and brought to the laboratory within 3~4 hours. The oocytes and follicular fluid were collected by aspiration from visible follicles, and the oocytes of grades I on the basis of the morphology of cumulus cells attached and the homogeneity of cytoplasmic granules were selected and used for maturation. The basal media used for oocyte maturation, fertilization and embryo development in vitro were Ham' F-10, TALP and TCM-199, respectively. The hormones supplemented in maturation medium were consisted of 35 pg /ml FSH, 10 pg /ml LH and 1 pg/mi estradiol-l7$\beta$. The bFF collected from 5~9 mm follicles was centrifuged, filtered and inactivated by heat-treatment at 56˚C for 30 min. FBS also was inactivated with the same method and kept at -20˚C until use. The embryos were co-cultured with the monolayer of bovine oviductal epithelial cells at 39˚C under 5% $CO_2$ in air for 9 days. The results obtained were summarized as follows: The fertilization rate of oocytes was found 87.4% from 10% FBS and hormones treatment for IVM, and 37.1% of these TVF embryos were developed to blastocyst stage in 10% FBS groups. Compared with this control system, the fertilization rate was decreased significantly(P<0.05) in the maturation without either FBS or hormones. These IVF embryos were developed to morula stage at the similar rate, but to blastocyst at significantly(P<0.05) lower rate in the embryo culture with or without FBS supplementation. The fertilization rate(82.9%) in hormones and 10% inactivated bFF was similar with 10% FBS and hormone groups(87.4%), but decreased significantly(P<0.05) in 20 or 30% bFF (61.0 or 66.0%), respectively. In vitro developmental competence to blastocyst stage in 10% FBS and 20% inactivated bFF(37.1% and 31.4%) was higher than in 10 or 30% inactivated bFF(20.0 or 19.2%) or 10, 20 and 30% fresh bFF(19.1, 21.0 and 17.5%) The results indicated that the in vitro fertillzation and development rate of the embryos should be improved in 10% FBS or 20% inactivated culture system and 20% inactivated bFF might be available economically for bovine oocyte maturation and embryo culture instead of fetal bovine serum.