• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.822-827
• /
• 2006

Background: Lung transplantation is a definitive therapy for a variety of end stage lung diseases. Since 1996, we have performed thirteen cases of lung transplantation including two retransplantations, and we analyzed the outcomes, complications, and survivals of these patients. Material and Method: We retrospectively analyzed the medical records of thirteen cases from July, 1996 to July, 2005. Result: During the period, 11 patients had undergone 43 lung and heart-lung transplantations, and two patients had retransplantation due to allograft failure. Mean age of recipients were $45.2{\pm}10.7$ years(range, $25{\sim}59$). Early complications were bleeding, reperfusion injury, and infection and late complications were mainly infection and post-transplantation lymphoproliferative disease. Excluding the operative mortality, the mean survival period was 16.5 months($2{\sim}60$ months). Two retransplantations had been performed 2 weeks and 13 months after single lung transplantations. Conclusion: In order to achieve long term survival, early detection of complications and proper treatment in addition to surgical skills are necessary, and these efforts can promote better lung transplantation programs in the near future.

• Advances in pediatric surgery
• /
• v.11 no.2
• /
• pp.150-156
• /
• 2005

Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to analyze our experience and develop conclusions regarding the presentation, diagnosis and treatment of urachal anomalies. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month). There were 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6 %), 10 urachal cyst (31.3 %), and 9 patent urchus (28.1 %). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a physical examination and an appropriate radiographic test. Ultrasound was the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and the rare development of carcinoma.

• Journal of Radiation Protection and Research
• /
• v.33 no.1
• /
• pp.1-12
• /
• 2008

International Standardization in all technical area is gaining its momentum as its impact and implication over global trade is directly linked. The worldwide competition to secure a dominant position in the standardization process is ever growing over the years. In 2005, the International Technical Committee on Nuclear Instrumentation, which is a subunit of International Electro-technical Commission (IEC), was held in Korea under the auspices of MOST (Ministry of Science and Technology). Korea has adopted its Rule and Regulation as the National Standard. As a part of a link to National Mid-and Long-term Atomic Energy R&D Program of MOST, the technical development of a performance test for the radiation monitors was carried out under mechanical environment and electromagnetic immunity conditions. The characteristics of the radiation fields were also evaluated under the conditions and introduced to a techniques of performance test for the radiation protection instrumentation adopted IEC61526 standards and it's results was analyzed. We would like to share the experience gained in these efforts, failure as well as success, and to discuss the problems encountered and serious consideration to be taken into account in the future endeavor.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.1
• /
• pp.72-77
• /
• 2004

Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.

• Journal of the Ergonomics Society of Korea
• /
• v.30 no.1
• /
• pp.99-108
• /
• 2011

Almost all companies have paid much attention to the safety management ranging from maintenance to operation even at the stage of designing in order to prevent accidents, but fatal accidents continue to increase throughout the world. In particular, it is essential to systematically prevent such fatal accidents as fire, explosion or leakage of toxic gas at factories in order to not only protect the workers and neighbors but also prevent economic losses and environmental pollution. Though it is well known that accident probability is very low in NPP(Nuclear Power Plants), the reason why many researches are still being performed about the accidents is the results may be so severe. HRA is the main process to make preparation for possibility of human error in designing of the NPP. But those techniques have some problems and limitation as follows; the evaluation sensitivity of those techniques are out of date. And the evaluation of human error is not coupled with the design process. Additionally, the scope of the human error which has to be included in reliability assessment should be expanded. This work focuses on the coincidence of human error and mechanical failure for some important performance shaping factors to propose a method for improving safety effectively of the process industries. In order to apply in these purposes into the thesis, I found 63 critical Performance Shaping Factors of the eight dimensions throughout studies that I executed earlier. In this study, various analysis of opinion of specialists(Personal Factors, Training, Knowledge or Experience, Procedures and Documentation, Information, Communications, HMI, Workplace Design, Quality of Environment, Team Factors) and the guideline for construction of PSF were accomplished. The selected method was AHP which simplifies objective conclusions by maintaining consistency. This research focused on the implementation process of PSF to evaluate the process of PSF at each phase. As a result, we propose an evaluation model of PSF as a tool to find critical problem at each phase and improve on how to resolve the problems found at each phase. This evaluation model makes it possible to extraction of PSF succesfully by presenting the basis of assessment which will be used by enterprises to minimize the trial and error of construction process of PSF.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.1
• /
• pp.3-11
• /
• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Korean Journal of Social Welfare
• /
• v.53
• /
• pp.75-104
• /
• 2003

This study was performed to analyze the process and develop the pattern of school dropout in the context of the Korean educational systems. Participants were 30 adolescents experiencing dropout one more times and their age ranged from 16 to 23. A major category derived and analysed from a grounded theory method of Strauss and Corbin(1990). The qualitative analysis indicated that dropout is contradictory experiences in Korea. Because it is emancipation from various distress of school systems as well as loss of various benefit as students, Main causes of dropout were identity problems, school frustrations(failure in school achievements), environmental disadvantaged and delinquencies. Sometimes these various causes are emerged at the same time. Most important condition of context which was decided was whether dropout was voluntary and considered. After dropout from school, it was important if there were resources such as emotional and informative supports. Especially informative support was critical to adjust after dropout. Dropout experience was divided largely into 4 patterns such as type of 'searching the identity', 'being disorganized', 'escaping' and 'frustration'. In chronological analysis resulted in 4 stages including 'stage I. loss of motivation', 'stage II. escaping from school', 'stage III. trial and error', 'stage IV changing the meaning of dropout in the life.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.610-617
• /
• 1995

Sleep apnea occurs in approximately 50% of patients with acromegaly, and sleep apnea is associated with increased cardiovascular diseases and mortality. In view of these findings, sleep apnea may be a factor in the increased incidence of cardiovascular deaths in acromegaly patients. We experienced a case of active acromegaly patient, 54-yr-old man, associated with obstructive sleep apnea syndrome, congestive heart failure with dilated cardiomyopathy and serious cardiac arrhythmias. He was treated for obstructive sleep apnea syndrome, diagnosed by overnight polysomnography, with nasal continuous positive airway pressure(CPAP) for 4 months, which successfully controlled his loud snoring, sleep apnea, nocturnal hypoxemia and apnea-related symptoms. And also he was treated for underlying acromegaly and cardiac complications with bromocriptine and cardiogenic drugs for 4 months, but still had elevated growth hormone(GH) and insulin like growth factor-1(IGF-1) levels and serious cardiac arrhythmias. We describe our experience about the effect of CPAP treatment in an active acromegaly patient associated with obstructive sleep apnea syndrome and cardiac complications with review of literature.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.2
• /
• pp.274-279
• /
• 1996

Pulmonary veno-occlusive disease is a rare cause of pulmonary hypertension in which the primary abnormality is obliterative obstruction of pulmonary veins, especially venules. Clinicaly, we should suspect this disease in the case of congestive cardiac failure with pulmonary hypertension, chronic interstitial pulmonary edema, and normal or elevated wedge pressure on cardiac catheterization. We experience a case of pulmonary hypertension due to pulmonary veno-occlusive disease. A 55-years -old woman developed progressive dry cough and dyspnea for 3 months. Physical examination showed normal heart sounds, diffuse crackles in the whole lung fields. The liver was not palpable and pitting edema was absent. The diagnosis was made by chest HRCT, 2-D echocardiography, normal pulmonary capillary wedge pressure on cardiac catheterization, and confirmed by thoracoscopic lung biopsy. This patient was treated with vasodilator(calcium antagonist) and with mild symptomatic improvement. We reported a case of pulmonary veno-occlusive disease with review of literatures.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.1
• /
• pp.54-61
• /
• 2002

Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.