• Title/Summary/Keyword: prospective study

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A Prospective Clinical Trial of Histidine-Tryptophan Ketoglutarate Solution in Congenital Heart Surgery (히스티딘을 함유한 결정성 심정지액(Histidine-Tryptophan Ketoglutarate solution)과 혈성 심정지액을 사용한 선천성 심기형 환자에서의 심근보호 효과에 대한 전향적 비교연구)

  • Lee, Cheul;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.483-488
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    • 2003
  • There are still debates in the literature on the relative benefits of blood cardioplegia and crystalloid cardioplegia in pediatric cardiac surgery. We performed a clinical trial to compare the myocardial protective effect between HTK solution and blood cardioplegic solution in congenital heart surgery. Material and Method: 15 patients who underwent HTK solution cardioplegia (group 1) and 15 patients who underwent blood cardioplegia(group 2) were included in this study. Preoperative and postoperative serial serum cardiac enzyme levels (troponin I, CK-MB, LDH) were measured in all patients. Clinical data were analyzed and compared between the two groups. Result: There were no differences in age and body weight between the two groups. Operative diagnosis included ventricular septal defect (VSD, n=4), atrial septal defect (ASD, n=1), tetralogy of Fallot (TOF, n=4), and other complex heart diseases (n=6) in group 1, VSD (n=7), ASD (n=5), and TOF (n=3) in group 2. Cardiopulmonary bypass times were 99.1$\pm$48.1 minutes in group 1, and 69.3$\pm$27.3 minutes in group 2 (p=0,02). Aortic clamping times were 52.1$\pm$23.6 minutes in group 1, and 37.9$\pm$20.5 minutes in group 2 (p=0.07). There was no mortality and spontaneous defibrillation was possible in all patients. No differences were observed in the serial enzyme levels between the two groups. There were no differences in the duration of inotropic support and ventilator time between the two groups. Conclusion: HTK solution provided comparable myocardial protection compared with blood cardioplegic solution. A single high dose of HTK solution may be safely and conveniently used for an extended periods as well in congenital heart surgery.

Effects of Feeding Eucommia ulmoides Leaves Substituted for Rice Straw on Growth Performance, Carcass Characteristics and Fatty Acid Composition of Muscle Tissues of Hanwoo Steers (볏짚을 두충잎으로 대체급여 시 거세한우의 생산성, 도체특성 및 육의 지방산 조성에 미치는 영향)

  • Kim, J.H.;Kim, Y.M.;Lee, M.D.;Shin, J.H.;Ko, Y.D.
    • Journal of Animal Science and Technology
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    • v.47 no.6
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    • pp.963-974
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    • 2005
  • This study was conducted to examine the growth performance, carcass characteristics, physico-chemical properties and fatty acid composition of muscle tissues of Hanwoo steers when they were fed diets containing four levels of E. ulmoides leaves. Steers were allotted to one of four dietary treatments, which were designed to progressively substitute Eucommia ulmoides for 0, 3, 5 and 10% of the rice straw in the basal diet. Seventy two Hanwoo steers (321±13kg) were used. Average daily gain (0.81-0.86kg) and feed conversion (10.05-10.59) were not changed by feeding E. ulmoides leaves. Emission of fecal ammonia gas was decreased by increasing substitution levels of E. ulmoides leaves. Emission of ammonia gas in feces of steers were significantly (p<0.05) decreased in the 5% and 10% treatments at 40℃ compared with in control (30.6ppm) and 3% treatment (29.8ppm), respectively 20.3 and 21.6ppm. Back fat thickness was higher (p<0.05) in steers fed control diet (15.0mm) than 5 and 10% E. ulmoides diets (10.2 and 10.5mm respectively). The grade ‘A’ appearances of meat yield of steers were increased up to 20% by the 3% substitution of E. ulmoides leaves, and the grades ‘1+’ and ‘1’ appearances of meat quality were significantly improved (p<0.05) by the 5 and 10% Eucommia ulmoides feeding. There was no statistical difference in meat color of loin and top round among all treatments. It appeared that the 5% and 10% E. ulmoides leaves feeding affected (p<0.05) a increase in oleic acid concentration in loin and top round muscles. The concentration of serum cholesterol was lower (p<0.05) in steers fed 10% E. ulmoides (53.3mg/100g) than that of the other treatments (55.7-57.0mg/100g). The diarrhea incidence was about 20.26% in control, while it was lower (p<0.05) in the 5 and 10% E. ulmoides leaves treatments (10.4-12.5%) than control. There was no statistical difference in the occurrences of respiratory disease among all treatments. It is concluded that E. ulmoides leaves should be a prospective feed additive because it contains various functional substances. It is likely that air-dried E. ulmoides leaves can reduce the back fat thickness of Hanwoo steers and the occurrences of diarrhea. Therefore, the 5 and 10% substitution of E. ulmoides for roughage are highly recommended to be used in practice.

A Study on the Current Rotation System of Hunting Ground (현행(現行) 순환수렵장(循環狩獵場) 제도(制度)에 관(關)한 연구(硏究))

  • Byun, Woo Hyuk
    • Journal of Korean Society of Forest Science
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    • v.74 no.1
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    • pp.47-55
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    • 1986
  • During the past 4 years, I have made a careful analysis of the present rotating system of hunting areas, on the one hand, by asking a group of hunters to fill out a questionnaire, and on the other hand, by referring to the written documents on the subject. And, as a result, it is concluded that this system, by varying the hunting grounds each year, contains in itself several problems as follows. 1. The hunters find it quite inconvenient to use a different hunting ground year after year and they also complain that the present hunting ground charge is more than it is worth. Therefore, it is expected that the number of hunters will explosively increase in the future with the betterment of hunting conditions. 2. The hunters have almost no information about game and they are, as a whole, lacking in the ethics of hunting. 3. The allotment of time in hunting training courses is not so sufficient that it is next to impossible to improve the quality of hunters. 4. As a rule, the population density of wildlife is so sparse that it falls short of the proper standard of it. 5. The present hunting system does not seem to contribute to the advancement of tourism. 6. It is absolutely necessary to make a general survey of the situation of wildlife for the legal protection of it. Besides, the interests of hunters are so closely tied up with those of farmers and foresters that dreastic measures should be taken to settle their conflicting differences. For the purpose of solving the above-mentioned problems and at the same time, of developing sound hunting practices in the long run, I hereby make two suggestions. 1. The Establishment of the Hunting License Test System It is desirable to issue a license to a prospective hunter after he has met a special qualification and then passed a test so that he may have bits of information needed for his hunting activities. 2. The Introduction of The Revier System The fundamental concept of this system is based on the assumption that the private landowner should reserve a right to the pursuit of game and take responsibility for wildlife management.

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Preoperative Prediction of Ductal Carcinoma in situ Underestimation of the Breast using Dynamic Contrast Enhanced and Diffusion-weighted Imaging (역동적 유방 자기공명 영상 및 확산 강조영상을 이용한 관상피내암종 저평가 수술전 예측)

  • Park, Mina;Kim, Eun-Kyung;Kim, Min Jung;Moon, Hee Jung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Objective: To investigate roles of dynamic contrast enhanced magnetic resonance (DCE MR) and diffusion-weighted (DW) imaging in preoperative prediction of underestimation of ductal carcinoma in situ (DCIS) ${\geq}2cm$ on US guided core needle biopsy. Materials and Methods: Twenty two patients with DCIS on US-guided 14 gauge core needle biopsy were included. Patients were divided into a group with and without DCIS underestimation based on histopathology. MR images including DCE and DW imaging were obtained with a 3.0-T MR. The lesion type (mass or non-mass), enhancement pattern, peak enhancement, and apparent diffusion coefficient (ADC) values of proven malignant masses were generated using software of CADstream and compared between two groups using Fisher's exact test and Mann Whitney test. Results: Eight patients were in the group with underestimation and 14 patients were in the group without underestimation. The lesion type and enhancement pattern were not different between two groups (P values = 1.000 and 0.613, respectively). The median peak enhancement of lesions with underestimation was 159.5%, higher than 133.5% of those without underestimation, but not significant (P value = 0.413). The median ADC value of lesions with underestimation was $1.26{\times}10^{-3}mm^2/sec$, substantially lower than $1.35{\times}10^{-3}mm^2/sec$ of those without underestimation (P value = 0.094). Conclusion: ADC values had the potential to preoperatively predict DCIS underestimation on US-guided core needle biopsy, although a large prospective series study should be conducted to confirm these results.

Correlation Between Major Satisfaction and Further Career Choices of the Students in the Department of Health Administration College (일개지역 전문대학 보건행정과 학생들의 전공 만족과 향후 진로 선택의 상관성)

  • Lee, Yeo-Jin;Shin, Joon-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.2
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    • pp.725-733
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    • 2012
  • This research, targeting the college students majoring in health administration science in Kwangju & Chonnam, is aimed at understanding their satisfaction with majors according to general, relationship, consciousness, and subject satisfaction, and looking into the correlation between the satisfaction and further career choices. This research set the 270 prospective graduates its study subjects based on convenience sampling. It was found that the number of students who want to choose their further major-related careers as medical records technician was greatest among the research subjects, of whom 62.4% were satisfied with their major subject while there existed a little difference in major satisfaction by further career. In addition, the students who want to choose the career of medical records filer showed higher satisfaction with their major subject than those who want to choose other-major-related careers. In general characteristics among the influential factors of major satisfaction in major-related career choices of a students of health administration science department, the 2nd year classes' major satisfaction was found to be 4.13 times as high as the 3rd year classes while the major satisfaction of the group choosing their major subject spontaneously was found to be 8.04 times as significantly high as the group choosing their major subject involuntarily. As a result of the analysis of the influence on major satisfaction among the sub-province of major satisfaction, it was found that the group having high consciousness satisfaction was 3.93 times as significantly high as the group having low consciousness satisfaction. A logistic analysis of the influence of major satisfaction on further career choices, the major satisfaction of those wishing to choose their major-related career as a medical records technician was 2.06 times as significantly high as those who didn't choose a medical records filer as their career choice while the major satisfaction of the group spontaneously choosing the career of a medical records technician was 4.51 times as significantly high as that of the group involuntarily choosing the career of a medical records technician. There should be a plan for enhancing major satisfaction by each major-related career in consideration of the characteristics of health administration science department having diverse career choices.

Relationship between Intussusception and Vitamin C Concentrations of Whole Blood and Plasma (소아 장중첩증과 혈중 비타민 C의 관계에 관한 연구)

  • Seo, Ji-Hyoun;Kim, Jeum-Su;Hwang, Ji-Young;Jun, Jin-Su;Park, Ji-Hoe;Kim, Eun-A;Lim, Jae-Young;Choi, Myoung-Bum;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.167-174
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    • 2001
  • Purpose: Adenovirus infection with swollen Peyer patches in the ileum, known as one of the causes of intussusception, may cause vitamin C depletion in human body because vitamin C is a first line antioxidant. Or low vitamin C status in human body makes the man more susceptible to infection of adenovirus in the ileum with a markedly swollen lymph node. In this study, we tried to find out the relationship between pediatric intussusceptions and vitamin C concentrations of whole blood and plasma. Methods: Whole blood and plasma vitamin C concentrations of fifty-seven patients with intussusceptions from May 1995 to December 1998 at the Gyeongsang National University Hospital were compared with those of 256 normal healthy children. Vitamin C was measured by the 2, 4-dinitrophenylhydrazine methods. Results: The average age of patients (male=39, female=18) with intussusceptions was fifteen months of age. Whole blood vitamin C concentrations of patients and healthy children were $1.49{\pm}0.64$ mg/dL, and $2.18{\pm}0.49$ mg/dL, respectively. Plasma vitamin C concentrations of patients and healthy children were $0.59{\pm}0.36$ mg/dL, $1.47{\pm}0.56$ mg/dL, respectively. But no differences in the vitamin C concentrations of whole blood and plasma according to age, degree of leukocytosis, fever, interval from onset, hematochezia, and need for operation were found. Conclusion: Whole blood and plasma vitamin C concentrations of patients with intussusceptions were lower than those of healthy children (P=0.0001). Prospective studies are needed to elucidate whether these results were consequences or causes of intussusceptions.

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Hepatitis Complicated with Mycoplasma pneumoniae Infection (Mycoplasma pneumoniae 폐렴에 합병된 간염)

  • Lee, Jin-Tae;Kim, Hee-Sup;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.207-212
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    • 2001
  • Purpose: Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has not been studied yet until now in Korea. Methods: We performed the prospective study of 19 cases that had AST and ALT>50 IU/L respectively without evidence of hepatitis A, B, C, cytomegalovirus, and Ebstein-Barr virus infections amongst 143 patients with M. pneumoniae pneumonia who were admitted to the Department of Pediatrics, Seoul Red Cross Hospital from Jan. 1999 to Dec. 2000. Results: 1) Hepatitis occurred in 13.3% of Mycoplasma pneumoniae infection, especially in fall and winter times. The average age was 4.86 years and male to female ratio was 2.2:1. 2) Vomiting was developed in 21.1%, diarrhea in 36.8%, and hepatomegaly in 21.1%, respectively. And leukocytosis was noted in 21.1%, eosinophilia in 15.4%, anemia in 10.5%, and thrombocytosis in 5.3%, respectively. The average level of C-reactive protein was $6.34{\pm}4.82$ mg/dl. 3) There was no hyperbilirubinemia, but hypoalbuminemia was detected in 42.1%. The average serum levels of AST and ALT were $214.05{\pm}183.22$ IU/L and $284.16{\pm}286.84$ IU/L, respectively. 4) Chest radiology showed lobar or lobular consolidation in 73.7%, bronchial infiltration in 26.3%, and pleural effusion in 31.6%. 5) The average length of hospitalization was 7.9 days, and the average length of normalization of serum transaminases was 8.8 days. All patients recovered within 2 weeks completely. Conclusion: The prognosis of M. pneumoniae hepatitis is good. However, its incidence is not so low that liver function should be considerately checked in case of M. pneumoniae infection.

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A Trial of Aerosolized Colistin for the Treatment of Nosocomial Pneumonia due to Multidrug-resistant Acinetobacter baumannii (다제내성 A. baumannii에 의한 병원획득폐렴에서 Colistin 분무치료의 시도)

  • Kim, Changhwan;Kim, Dong-Gyu;Kang, Hye-Ryun;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Shin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Choi, Young-Jin;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.102-108
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    • 2008
  • Background: Recently, multidrug-resistant (MDR) A. baumannii has been implicated for a significant proportion of nosocominal pneumonia in many intensive care units (ICUs), and its acquisition may increase mortality and the length of stay in the ICU. Aerosolized colistin has been successfully used in patients with cystic fibrosis, but there is a lack of data regarding the use of aerosolized colistin in patients with nosocomial pneumonia. Methods: We conducted the present study to assess the effectiveness of aerosolized colistin for the treatment of MDR A. baumannii nosocomial pneumonia. We retrospectively reviewed the medical records of 10 patients who had been hospitalized in the medical ICU and had received aerosolized colistin as a therapy for MDR A. baumannii pneumonia. Results: The mean duration of aerosolized colistin therapy was $12.7{\pm}2.4$ days. Nine (90%) of 10 patients showed a favorable response to the therapy. Follow-up cultures were available for all patients, and the responsible pathogen was completely eradicated. One patient suffered from bronchospasm, which resolved after treatment with nebulized salbutamol. Conclusion: Our results corroborate previous reports that aerosolized colistin may be an effective and safe choice for the treatment of nosocomial pneumonia caused by MDR A. baumannii. Larger prospective controlled clinical studies are warranted to validate further the effectiveness and safety of aerosolized colistin therapy.

Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Effects of Knee Position during the Graft Fixation of the Arthroscopic Anterior Cruciate Ligament Reconstruction with Autogenous Hamstring Graft (이식 건 고정 시 슬관절 위치가 자가 슬괵건을 이용한 관절경적 전방 십자 인대 재건술 후 결과에 미치는 영향)

  • Lee, Churl-Woo;Yoo, Jae-Doo;Roh, Kwon-Jae;Park, Seong-Pil
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.143-147
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    • 2005
  • Purpose: In case of anterior cruciate ligament (ACL) reconstruction, graft tendon is generally fixed in tibial tunnel with knee extended. When reconstructing ACL using hamstring tendon, the authors aim to find out the effect of knee joint position during graft fixation on postoperative knee joint stability and range of motion. Materials and Methods: Prospective study was done on patients who have undergone ACL reconstruction using hamstring tendon from May 2002 to January 2003 We used Rigifix system (Mitek Product, Johnson and Johnson, USA) and Intrafix system for fixation. Thirty nine patients received ACL reconstruction during this period. Excluding 2 patients lost in the follow-up, 37 patients were analyzed. The mean follow-up period was 14 months $(13{\sim}25months)$. Knee position was decided alternatively without any bias. Clinical evaluation was based on Lachman test, pivot shift test, Lysholm score, IKDC(international knee documentation committee) assessment and side to side KT-1000 maximal manual arthrometer difference. Results: After the last follow-up, average postoperative Lysholm score was 93.1 poins(65-98points). According to IKDC score, 26 cases were normal, 10 cases were nearly normal, 1 case was abnormal and we had no case of severe abnormality. The mean difference from the normal side was 2.5 mm under maximal manual loading KT-1000 arthrometer. According to postoperative Lachman test, 32 cases were normal,2 cases were grade I and 1 case was grade II. There were 34 cases of normal, 2 cases of grade I and 1 case of grade II. When using maximal manual KT-1000 arthrometer side to side difference, the difference from the normal side while fixing the tibia at 20'knee flexion was 2.3 mm and at full extention the difference was 2.7 mm. The range of motion at postoperative 1 year showed 5 degree flexion contracture in 1 case at 20 degrees knee flexion and 10 degrees of flexion limitation was observed in 2 cases at full extension. Conclusion: When ACL reconstruction using autogenous hamstring tendon, anterior laxity showed no difference in its stability between two groups. Tibial side fixation at full extension may be helpful in preventing flexion contracture due to overconstrained graft tendon.

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