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The effect of local rifampicin instillation on the treatment of suppurative BCG lymphadenitis (BCG 접종에 따른 화농성 림프절염의 rifampicin 국소투여 효과)

  • Kim, Min Son;Jo, Dae Sun;Kang, Mi Kyung;Kim, Sang Jae;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.40-45
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    • 2006
  • Purpose : The purpose of this study was to evaluate the types of lymphadenitis after BCG vaccination and the effect of local rifampicin instillation on the treatment of suppurative BCG lymphadenitis. Methods : A total of 32 otherwise healthy infants with suppurative BCG lymphadenitis, who visited the Department of Pediatrics of Chonbuk National University Hospital, from March 2002 through June 2004, were enrolled in this study. They were treated with needle aspiration and local rifampicin instillation. We investigated the time the lymphadenitis took to be suppurative, accompanying clinical manifestations, and the treatment effects. Results : Of the 32 infants, 19 were male and 13 were female. They were full term babies and one preterm baby with a gestational age of 30 weeks. They received intradermal administration, with the BCG vaccine of $Pasteur^{(R)}$(French) strain mostly on the left deltoid area(96.9 percent). Regional lymphadenitis occurred in 1 to 11 months after BCG vaccination, mostly 1-5 months after vaccination (78.1 percent). Among the infants, 87.5 percent had unilocular lesion but 12.5 percent had more than one enlarged lymph node cares. Most of the lymphadenitis presented in the left axillary area(77.8 percent), and the left supuraclavicular area(11.1 percent). After one to three times of needle aspiration with rifampin instillation, all infants recovered completely without surgical excision or severe complication. Conclusion : The regional lymphadenitis is the most common complication in infants who receive intradermal BCG vaccination. This study supports that in suppurative BCG lymphadenitis the needle aspiration and local rifampicin instillation is very effective and can be a more economical treatment modality.

Tissue Failure of the Low-Profile lonescu-Shiley Pericardial Valve in Mitral Position (승모판에서의 단고형 이오네스큐판막의 조직실패)

  • 김종환
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.670-676
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    • 1997
  • The structural failure of the glutaraldehyde-treated xenograft valves has been the primary concern about the limited durability as predicted from the begimling of clinical use, and long-term follow-up has shown a significant incidence of primary tissue failure(PTF) from both biological and mechanical reasons. Twenty-seven patients with the low-profile lonescu-Shiley valves explanted from mitral position for PTF(Group III) were studied on the patient characteristics and valve pathology, and the results were compared with the matched observations of the Haycock(Group I) and of the standard-profile lonesiu-Shiley valves(Group II). Patients were aged 16 to 56 years(mean, 38.0$\pm$ 11.0 years), and the size of the failed mitral bioprosthesis was 30.8$\pm$ 1.3 mm. The hemodynamic consequences were stenosis in 29.6%, insufficiency in 44.4%, mixed steno-insufficiency in 14.8%, together with normal function for the rest of patients of prophylactic re-replacement. Pathology revealed calcification with or without tissue damage in 63.0% and tissue damage with or without calcification in 58.l%, in contrast with the observations of predominant tissue damage(76.8%) over calcification in Group I and of calcification(76.1%) over tissue damage in group II. Although dystrophic calcification has long and repeatedly dealt with patient's young age as a determinant of valve durability, such a characteristic evidence was not reached even in patients with calcified valves. Moreover, the prolonged explantation p riods from the studied on the previous report suggested strongly yet possibly evolving destructive processes among the valves in the remaining patients, and awaits further follow-up. In conclusion, PTF of the xenograft valves seems to result from more complicated biologic and metabolic reasons as well as more complex mecharical factors than the reported, and newer generation prostheses, with tissue preservation with glutaraldehyde, do not likely to provide decisive improvement in the occurrence of structural failurebioprostheses is generally limited to the highly aged.

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Laparoscopy Assisted versus Open Distal Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: Design and Rationale of a Phase II Randomized Controlled Multicenter Trial (COACT 1001)

  • Nam, Byung Ho;Kim, Young-Woo;Reim, Daniel;Eom, Bang Wool;Yu, Wan Sik;Park, Young Kyu;Ryu, Keun Won;Lee, Young Joon;Yoon, Hong Man;Lee, Jun Ho;Jeong, Oh;Jeong, Sang Ho;Lee, Sang Eok;Lee, Sang Ho;Yoon, Ki Young;Seo, Kyung Won;Chung, Ho Young;Kwon, Oh Kyoung;Kim, Tae Bong;Lee, Woon Ki;Park, Seong Heum;Sul, Ji-Young;Yang, Dae Hyun;Lee, Jong Seok
    • Journal of Gastric Cancer
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    • v.13 no.3
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    • pp.164-171
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    • 2013
  • Purpose: Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Materials and Methods: Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopyassisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Discussion: Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Trial Registration: NCT01088204 (international), NCCCTS-09-448 (Korea).

Nationwide Survey of Laparoscopic Gastric Surgery in Korea, 2004 (2004년 전국 복강경 위 수술 현황)

  • Kim, H.H.;Kim, K.H.;Kim, D.H.;Kim, M.C.;Kim, B.S.;Kim, Y.W.;Kim, Y.I.;Kim, Y.H.;Kim, W.;Kim, W.W.;Kim, J.J.;Kim, T.B.;Ryu, S.Y.
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.295-303
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    • 2005
  • The Korean laparoscopic Gastrointestinal Surgery Study Group made a survey of laparoscopic gastric surgeries which were performed in Korea during 2004. Thirty-eight surgeons from 36 Institutions responded to the questionnaires. One thousand eighty-nine laparoscopic gastric operations were performed during 2004. The cumulative number from 1995 to 2004 was about 2,386. Seven hundred fifty-four operations for a gastric adenocarcinoma were performed during 2004 which is almost two times the number performed during 2003. Laparoscopic radical procedures, such as a laparoscopy-assisted distal gastrectomy or total gastrectomy (LADG and LATG) have increased rapidly since 2001 (55 cases in 2001, 150 cases in 2002, 364 cases in 2003 and 738 cases in 2004). Especially, laparoscopic total gastrectomies were explosively adopted last year (20 cases in 2003 and 112 cases in 2004). However, laparoscopic function-preserving gastrectomies, which included one laparoscopy-assisted pylorus-preserving gastrectomy and laparoscopy-assisted proximal gastrectomy, are rarely performed at this time. One hundred forty-two wedge resections for a gastric submucosal tumor were performed during 2004. Hand-assisted laparoscopic surgery (HALS) was performed in 39 cases in 2001, 55 in 2002, and 49 in 2003; however, only 5 such surgeries were performed during 2004. In 2003, laparoscopic bariatric surgery began, and during 2004, 49 operations were performed. In terms of indications of laparoscopic gastric surgery for adenocarcinoma, 19 surgeons performed a LADG only for a T1 lesion, and 7 surgeons extended their indications to T2N0 lesions. In the near future, laparoscopic procedures for gastric cancer will be widely adopted in Korea if the medical-insurance obstacle is overcome, and the long-term survival results are verified.

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A Study on groundwater and pollutant recharge in urban area: use of hydrochemical data

  • Lee, Ju-Hee;Kwon, Jang-Soon;Yun, Seong-Taek;Chae, Gi-Tak;Park, Seong-Sook
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2004.09a
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    • pp.119-120
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    • 2004
  • Urban groundwater has a unique hydrologic system because of the complex surface and subsurface infrastructures such as deep foundation of many high buildings, subway systems, and sewers and public water supply systems. It generally has been considered that increased surface impermeability reduces the amount of groundwater recharge. On the other hand, leaks from sewers and public water supply systems may generate the large amounts of recharges. All of these urban facilities also may change the groundwater quality by the recharge of a myriad of contaminants. This study was performed to determine the factors controlling the recharge of deep groundwater in an urban area, based on the hydrogeochemical characteristics. The term ‘contamination’ in this study means any kind of inflow of shallow groundwater regardless of clean or contaminated. For this study, urban groundwater samples were collected from a total of 310 preexisting wells with the depth over 100 m. Random sampling method was used to select the wells for this study. Major cations together with Si, Al, Fe, Pb, Hg and Mn were analyzed by ICP-AES, and Cl, N $O_3$, N $H_4$, F, Br, S $O_4$and P $O_4$ were analyzed by IC. There are two groups of groundwater, based on hydrochemical characteristics. The first group is distributed broadly from Ca-HC $O_3$ type to Ca-C1+N $O_3$ type; the other group is the Na+K-HC $O_3$ type. The latter group is considered to represent the baseline quality of deep groundwater in the study area. Using the major ions data for the Na+K-HC $O_3$ type water, we evaluated the extent of groundwater contamination, assuming that if subtract the baseline composition from acquired data for a specific water, the remaining concentrations may indicate the degree of contamination. The remainder of each solute for each sample was simply averaged. The results showed that both Ca and HC $O_3$ represent the typical solutes which are quite enriched in urban groundwater. In particular, the P$CO_2$ values calculated using PHREEQC (version 2.8) showed a correlation with the concentrations of maior inorganic components (Na, Mg, Ca, N $O_3$, S $O_4$, etc.). The p$CO_2$ values for the first group waters widely ranged between about 10$^{-3.0}$ atm to 10$^{-1.0}$ atm and differed from those of the background water samples belonging to the Na+K-HC $O_3$ type (<10$^{-3.5}$ atm). Considering that the p$CO_2$ of soil water (near 10$^{-1.5}$ atm), this indicates that inflow of shallow water is very significant in deep groundwaters in the study area. Furthermore, the P$CO_2$ values can be used as an effective parameter to estimate the relative recharge of shallow water and thus the contamination susceptibility. The results of our present study suggest that down to considerable depth, urban groundwater in crystalline aquifer may be considerably affected by the recharge of shallow water (and pollutants) from an adjacent area. We also suggest that for such evaluation, careful examination of systematically collected hydrochemical data is requisite as an effective tool, in addition to hydrologic and hydrogeologic interpretation.ion.ion.

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The Extended Site Assessment Procedure Based on Knowledge of Biodegradability to Evaluate the Applicability of Intrinsic Remediation (자연내재복원기술(Intrinsic Remediation)적용을 위한 오염지역 평가과정 개발)

  • ;Robert M. Cowan
    • Journal of Korea Soil Environment Society
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    • v.2 no.3
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    • pp.3-21
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    • 1997
  • The remediation of contamiated sites using currently available remediation technologies requires long term treatment and huge costs, and it is uncertain to achieve the remediation goal to drop contamination level to either back-ground or health-based standards by using such technologies. Intrinsic remediation technology is the remediation technology that relies on the mechanisms of natural attenuation for the containment and elimination of contaminants in subsurface environments. Initial costs for the intrinsic remediation may be higher than conventional treatment technologies because the most comprehensive site assessment for intrinsic remediation is required. Total remediation cost, however may be the lowest among the presently employed technologies. The applicability of intrinsic remediation in the contaminated sites should be theroughly investigated to achieve the remedial goal of the technology. This paper provides the frame of the extended site assessment procedure based on knowledge of biodegradability to evaluate the applicability of intrinsic remediation. This site assessment procedure is composed of 5 steps such as preliminary site screening, assessment of the current knowledge of biodegradability, selecting the appropriate approach, analyzing the contaminant fate and transport and planning the monitoring schedule. In the step 1, followings are to be decided 1) whether to go on the the detailed assessment or not based on the rules of thumb concerning the biodegradability of organic compounds, 2) which protocol document is selected to follow for detailed site assessment according to the site characteristics, contaminants and the relative distance between the contamination and potential receptors. In the step 2, the database for biodegradability are searched and evaluated. In the step 3, the appropriate biodegradability pathways for the contaminated site is selected. In the step 4, the fate and transport of the contaminants at the site are analyzed through modeling. In the step 5, the monitoring schedule is planned according to the result of the modeling. Through this procedure, users may able to have the rational and systematic informations for the application of intrinsic remediation. Also the collected data and informations can be used as the basic to re-select the other remediation technology if it reaches a conclusion not to applicate intrinsic remediation technology at the site from the site assessment procedure.

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Clinical Experiences of redo-CABG (관상동맥우회 재수술의 임상적 고찰)

  • Lim, Sang-Hyun;Kwak, Young-Tae;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick;Cho, Bum-Koo;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.779-784
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    • 2002
  • Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F=12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

Growth of the Tilapia, Oreochromis niloticus, in the Closed Aquaculture System (폐쇄식 사육 장치내에서 틸라피아(Oreochromis niloticus)의 성장)

  • KIM In-Bae;SON Maeng-Hyun;MIN Byung-Suk
    • Journal of Aquaculture
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    • v.4 no.1
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    • pp.1-12
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    • 1991
  • A series of rearing experiments were conducted to determine the growth rates and feed conversion efficiencies of tilapia in accordance with body size or age in nearly total closed system glass aquariums ($270\;\ell$ each in water volume) and concrete tanks ($4000\;\ell$) from April 10 to October 16, 1987. The fish used for the experiments was a Japanese strain of Oreochromis niloticus, and the size of the fish ranged from 7 g to more than 1,000 g in body weight. The starting stocking rates for each experimental lot were 10 to 20 kg in the glass aquarium ($3.7{\%}$ to $7.4{\%}$ of water volume) and 200 kg in the concrete tank ($5{\%}$ of water volume). A single experimental rearing term was 14 days with slight variations on occasions. Water temperature was designed to be kept at $26^{\circ}C$ but slight fluctuations were inevitable. Dissolved oxygen level was designed to be maintained at around $3\;mg/\ell$, but it also showed some variations. The ammonia level in the glass aquarium section once reached up to $18\;mg/\ell$, but generally remained at around $4\;mg/\ell$, and in the concrete tank section it was maintained at around $1\;mg/ell$. The feed was composed of mainly soybean meal with a small amount of fish meal as the protein source, and the crude protein content was about $32{\%}$. Mean daily growth rate was $3.5{\%}$ of body weight with 0.9 in food conversion ratio in the glass aquarium when the mean weight of fish was around 10 g with gradually reduced performances as the fish grew bigger. When the mean weight was 800 g, mean daily growth rate was $0.5{\%}$ with about 1.5 in food coversion for fish in the glass aquarium, and $0.8{\%}$ and 1.6 for fish in the concrete tank, respectively. According to the mean growth rate obtained from this experiment, it was calculated that the fish reared in the concrete tank require 223 days from 50 g to reach 1,000 g which is the ideal size for market in Korea, at the conditions provided as above, and 302 days from 10 g fingerlings to 800 g fish in the glass aquarium conditions of the closed recirculating water system.

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THE EFFECT OF THE REMOVAL OF CHONDROITIN SULFATE ON BOND STRENGTH OF DENTIN ADHESIVES AND COLLAGEN ARCHITECTURE (비교원성 단백질이 상아질 접착제의 결합강도와 교원질의 형태에 미치는 영향)

  • Kim, Jong-Ryul;Park, Sang-Jin;Choi, Gi-Woon;Choi, Kyoung-Kyu
    • Restorative Dentistry and Endodontics
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    • v.35 no.3
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    • pp.211-221
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    • 2010
  • Proteoglycan is highly hydrophilic and negatively charged which enable them attract the water. The objective of study was to investigate the effects of Proteoglycan on microtensile bond strength of dentin adhesives and on architecture of dentin collagen matrix of acid etched dentin by removing the chondroitin sulphate attached on Proteoglycan. A flat dentin surface in mid-coronal portion of tooth was prepared. After acid etching, half of the specimens were immersed in 0.1 U/mL chondroitinase ABC (C-ABC) for 48 h at $37^{\circ}C$, while the other half were stored in distilled water. Specimens were bonded with the dentin adhesive using three different bonding techniques (wet, dry and re-wet) followed by microtensile bond strength test. SEM examination was done with debonded specimen, resin-dentin interface and acid-etched dentin surface with/without C-ABC treatment. For the subgroups using wet-bonding or dry-bonding technique, microtensile bond strength showed no significant difference after C-ABC treatment (p > 0.05). Nevertheless, the subgroup using rewetting technique after air dry in the Single Bond 2 group demonstrated a significant decrease of microtensile bond strength after C-ABC treatment. Collagen architecture is loosely packed and some fibrils are aggregated together and relatively collapsed compared with normal acid-etched wet dentin after C-ABC treatment. Further studies are necessary for the contribution to the collagen architecture of noncollagenous protein under the various clinical situations and several dentin conditioners and are also needed about long-term effect on bond strength of dentin adhesive.

A Study of Unregistered Manufacturing Plants: Their Problems and Alternative Policies (首都圈 無登錄工場 問題와 對策에 관한 硏究)

  • Hwang, Man-Ik
    • Journal of the Korean Geographical Society
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    • v.31 no.3
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    • pp.489-507
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    • 1996
  • The purpose of this study is to examine the increasing number of unregistered manufacturing plants and related problems, and to recommend alternative solutions to the problems. Data are obtained from a field survey of randomly selected small scale manufacturing plants in Seoul and its suburban cities. A total number or respondents are 533, and 416 of them are unregistered plants. The Capital Regional Planning has had a goal during last three decades to lead a balanced regional economic development by restriction manufacturing plants in the Capital Region and by encouraging them in other regions in the nation. It was 1984 when a comprehensive planning was established to achieve this goal. Sets of various regulations, by-laws and codes have been implemented to regulate manu-facturing activities in the Capital Region to achieve the goal. The region is divided into three sub-regions, and a different degree of regulations is applied to each sub-region. Only a certain types of industries are allowed in a particular sub-region. For instance, a plant manufacturing high-technology products could be allowed in the most urbanized sub-region. All manu-facturing plant in the Capital Region which has ares size of larger than 200"\;"$m^2$ is compulsory to register to the local government office. In practice, however, it is not common or sometimes almost impossible to get approval for many applicant manufacturers because of strict regulations. There have been increasing number of plants in the Capital Region during last several decades, despite the strict regulations. Many of those newly established plants are without formal registration at the local administration office. howerver. These are so called 'unregisterd' plants. Surveyed data and many government official data show that many of unregistered plants have been established in recent years. which indicate that current regulations are no longer effective. The number of unregistered plants are increasing tin the Capital Region because of many locational advantages in the region for plants, particularly those in small scale. Unregistered plants are the source of many problems, such as local water pollution or noise pollution in residential areas. There are also many administration problems, bed\cause they are not registered. The central government has attempted to cure the problems of unregistered plants. For example, the government allowed a unregistered plant to remain at present site for three ydars, if it met certain conditions in three years. However, this program was unsuccessful because many of those plants were not able to meet the concitions. Three times the government renewed the term for those which did not meet conditions since 1989, but it was afraid to be without success. There are many evidences that current policies to control manufacturing plants are not effective. The Capital Region must face mounting problems if ploicies are not reformed soon. This study suggests that the policy of the Capital Regional Planning has to be reoriented to provide more favorable policies for manufacturing plants in the Capital Region than current regulations which is aimed to restrict manufacturing activities. It is time to improve many existing problems in the region through reforms and of current regulations to foster unregistered plants. This study also proposes many smaller-area sub-divisions instead of current three large area sub-regions which is too broad to apply single kind of regulation, or codes. Flexible regulations and codes can be applied to such a small-area sub-divivisions based on location and industrial characteristics of the individual sub-divisions. It is necessary to provide decent industrial environment in the Capital Region, which is best equipped to provide many favorable industrial locational factors in the nation, thus this nation can be further prepared to compete in an inter-national market at an era of globalization in manufacturing.

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