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Long-term Follow-up of Children with Idiopathic Hypercalciuria (혈뇨를 동반한 소아 특발성 고칼슘뇨증에 관한 장기 추적 관찰)

  • Lee Young-Seok;Shin Won-Hye;Ko Cheol-Woo;Koo Ja-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.34-40
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    • 1998
  • Present study was conducted to determine the frequency, clinical characteristics and long-term outcome of children with idiopathic hypercalciuria. Study patients consisted of 150 children with isolated hematuria (recurrent gross or persistent microscopic), and hypercalciuria was defined as urinary calcium excretion over 4 mg/kg/day. During follow-up period up to $6{\sim}8$ years, serial check-up of renal sonogram for stone formation and Dipstick examination for hematuria were done. Forty-four (29%) out of 150 cases were diagnosed as idiopathic hypercalciuria, and in hypercalciuric children compared to normocalciuric children boys were more common than girls (9:35) and gross hematuria was more common than microscopic hematuria (37:7) (P<0.05). Oral calcium loading test showed renal type in 29 cases, absorptive type in 8 cases and in 7 cases type could not be definable. Among 3 types no differences could be found in 24 hour urinary calcium excretion and in clinical or laboratory data. Urolithiasis developed in 4 out of 44 cases (2 at the time of initial diagnosis and 2 within $1{\sim}2$ years of follow-up periods) and these children showed lower chronologic age ($3.7{\pm}2.7\;vs\;7.2{\pm}2.9\;yr$) and more girl than boys (3:1 vs 6:34) (P<0.05) compared to the rest of the hypercalciuric children. Follow-up urinalysis showed disappearance of hematuria in 56, 50, 66 and 75% of children at $1{\sim}2,\;2{\sim}4,\;4{\sim}6$ and $6{\sim}8$ years after initial diagnosis respectively. In conclusion, present study demonstrates that idiopathic hypercalciuria is a major cause of isolated hematuria in children so that in these children 24 hour urinary calcium excretion test seems to be an essential test to be performed. And serial renal sonography should be done to detect development of nephrolithiasis. However, clinical significance of dividing hypercalciuric children into two pathophysiologically distinct subtypes by oral calcium loading test seems to be in doubt and further study is needed to solve this problem.

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The Characteristics and Medical Utilization of Migrant Workers (외국인 노동자의 특성과 의료이용 실태)

  • Ju, Sun Me
    • Korean Journal of Occupational Health Nursing
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    • v.7 no.2
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    • pp.164-176
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    • 1998
  • This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

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Specific antibody response of olive flounder Paralichthys olivaceus by water temperature (수온에 따른 넙치의 특이 항체 반응)

  • Kim, Wi-Sik;Jang, Min-Seok;Jung, Sung-Ju;Kim, Seok-Ryel;Park, Myoung-Ae;Lee, Jeong-Ho;Myeong, Jeong-In;Oh, Myung-Joo
    • Journal of fish pathology
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    • v.24 no.1
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    • pp.39-45
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    • 2011
  • The specific antibody response of olive flounder, Paralichthys olivaceus to different water temperature were tested by enzyme-linked immunosorbent assay (ELISA). In the rearing temperature of $15^{\circ}C$, first anti-bovine serum albumin (BSA) antibody titer was appeared after 14 days of immunization, whereas 24~48 days post-immunization (PI) resulted maximum antibody titer in all 5 experimental fish with optical density (OD) values 1.94~3.04. At the end of the experiment (84 days), 0.03~1.28 OD values were observed. In the rearing temperature of $12{\sim}13^{\circ}C$, first antibody titer was found 28 days PI in 2 out of 5 fish. Three fish shown high OD titer (1.88~2.68) between 56 and 70 days and OD values of 0.49 to 2.35 were observed at 84 days. However, the anti-BSA antibodies of two fish showed less than 0.8 OD values until 84 days. In the rearing temperature of $10^{\circ}C$, specific antibody appeared at 56 days, maximum antibody titer was observed at 70 days in 2 out of 5 fish (OD values: 1.37~1.53) and 1.00 to 1.11 OD values were observed at 84 days. Rest 3 fish showed OD values of 0.12 to 0.68 much below to that of other 2 fish, throughout the experimental period. In conclusion, specific antibody response of olive flounder at high temperature was much faster, higher and longer than that at lower temperature.

The Profile of Milling Plants in Korea (우리나라 양곡가공공장의 현황분석)

  • 정창주;금동혁;강화석
    • Journal of Biosystems Engineering
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    • v.3 no.1
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    • pp.47-63
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    • 1978
  • This study was conducted to obtain a basic information necessary to assess present rice milling technology in Korea The profiles for milling plants was analyzed by survey work.For the private custom-work mills, which process about 80 percent of domestic rice consumption ,their actual milling test for the identical samples as used for filed mills was conducted. Two rice varieties Japonica and Tongil-type were associated with the experiments. The results are summarized as follows: 1. Analyses for private custom-work mills showed their general aspects as; about 91 percent of the mills belonged to an individual owner ship ; more than 93 percent of the mills was established earlier than 1950 ; about 80 percent of the mills was powered with electric motor; mills having less than two employees were about 75 percent; about 45 percent of the mills provided for warehouse in storing customers cereal grains. 2. The polishers installed in 1,255mills within the surveyed area (7 counties) have been supplied by 44 different domestic manufacturers ;in but about 60 percent of which was supplied by 6major manufacturers. The polishers could be classified into two categories in terms of principles of their polishing actions ;jet-pearler and friction types. About 51 percent of the mills was equipped with the former which has been recognized as giving greater milling recovery than the friction types. 3. Reason for owners of private mills to supplement new machines was due mainly to pgrading their mills to meet the requirements that established by the Government. However, about 60 percent of the mill owners intended to replace with new pearler by their own needs to meet with new high yielding varieties. 4. Processing systems of each previate rice mills surveyed could be classified into three categories, depending upon whether the systems posessed such components as precleaner and paddy separator or not. Only 36.7 percent of mills was installed with both precleanr ad paddy seperrator, 5.0 percent of mills did have neither percleaner nor paddy seperator, and rest of them equipped only one of the two. Hence,it is needed for about 63% of rice miils to be supplemented with these basic facilities to meet with the requirements for the standaized system. 5. Actual milling capacity measured at each field rice mills was shown a wide variation, having range from about 190 to 1,210 kg/hr. The percentages of mills classified according to daily milling capacity based on this hourly capacity were 24.3% for the capacity less than 3 M/T a day; 20.0% for 3-4 M/T; 15.6% for 4-5 M/T; 6.7% for 5-6 M/T; 22.3% for 6-7 M/T; and 11.0% for more than 7 M/T a day. 6. Actual amount of rice processed was about 310 M/T a year in average. About 42% of total milled rice was processed during October to Decembear, which formed a peak demand period for rice mills. The amount of rice milled during January to May was relatively small, but it had still a large amount compared to that during June to September. 7. Utilization rate of milling facility, i. e., percentage of the actual amount of milled rice to the capacity of rice mills, was about 18% on the year round average, about 41% in the peak demand season, and about 10% during June to September. Average number of operating days for mills surveyed was about 250 days a year, and about 21 days a month. 8. Moisture contents of paddy at the time of field mill tests were ranged 14.5% to 19.5% for both Japonica and Tong-i] varieties, majority of paddy grains having moisture level much higher than 1530. To aviod potential reduction of milling recovery while milling and deterioration of milled rice while storage due to these high grain mJisture contents, it may be very important for farmers holding rice to dry by an artificial drying method. 9. Milling recovery of JapJnica varieties in rice mills was 75.0% in average and it was widely ranged from 69.0% to 78.0 % according to mills. Potential increase in milJing recovery of Japonica variety with improvement of mill facilities was estimated to about 1.9%. On the other hand, milling recovery of Tong-il varieties in the field mill tests was 69.8% in average and it ranged from 62% to 77 %, which is much wider than that of Japonica varieties. It is noticed that the average milling recovery of Tong-il variety of 69.8% was much less than that of the Japonica-type. It was estimated th3.t up to about 5.0% of milling recovery for Tong-il variety could be improved by improving the present lo'.ver graded milling technology. 10. Head rice recoveries, as a factor of representing the quality of commercial goods, of Japonica and Tong-il varieties were 65.9% and 53.8% in average, and they were widely ranged from 52% to 73% and from 44% to 65% , respectively. It was assessed that head rice recovery of Japonica varieties can be improved up 3.3% and that of Tong-il varieties by 7.0% by improving mill components and systems.

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Open Heart Surgery of Congenital Heart Diseases -Report of Four Cases- (선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) -)

  • Kim, Kun Ho;Park, Young Kwan;Jee, Heng Ok;Kim, Young Tae;Rhee, Chong Bae;Chung, Yun Chae;Oh, Chull Soo
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.1-9
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    • 1976
  • The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

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Characteristics of Titanium Dioxide-Impregnated Fibrous Activated Carbon and Its Application for Odorous Pollutant (이산화티타늄 담지 섬유형 활성탄소의 특성 및 악취오염물질 제어를 위한 응용)

  • Jo, Wan-Kuen;Hwang, Eun-Song;Yang, Sung-Bong
    • Clean Technology
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    • v.17 no.1
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    • pp.48-55
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    • 2011
  • The application of fibrous activated carbon (FAC)-titanium dioxide ($TiO_2$) hybrid system has not been reported yet for the control of malodorous dimethyl sulfide (DMS) at residential environmental levels. Accordingly, the current study was designed not only to characterize this hybrid system using x-ray diffraction method, particulate surface measurement and Fourier transform Infrared (FTIR) method, but also to evaluate its adsorptional photocatalytic activity (APA) for the DMS removal. The physical/surface characteristics of FAC-$TiO_2$ which was prepared in this study suggested that the hybrid material might have certain APA for DMS. The Brunauer-Emmett-Teller (BET) specific area, total pore volume, micropore volume and mesopore volume decreased all as the $TiO_2$ amounts coated on FAC increased, whereas the reverse was true for average pore diameter. $TiO_2$ coated onto FAC did not influence the adsorptional activity of FAC for the DMS input concentration of 0.5 ppm. The APA test of the hybrid material presented that the initial removal efficiencies of DMS were 93, 78, 71 and 57% for the flow rates of 0.5, 1.0, l.5 and 2.0 L/min, respectively, and they decreased somewhat 2 h after the experiment started and kept almost constant for the rest experimental period. Under this pseudo-equilibrium condition, the DMS removal efficiencies were 78, 58, 53 and 36% for the four flow rates, respectively. Meanwhile, there were no significant byproducts observed on the surfaces of the hybrid material. Consequently, this study suggests that, under the experimental conditions used in the present study, the hybrid material can be applied for DMS at residential environment levels without being interfered by any byproducts.

현대여성(現代女性)의 의복의식(衣服意識)에 관한 조사(調査) 연구(硏究) - 서울 지역(地域)의 양복(洋服) 착용자(着用者)를 중심(中心)으로 -

  • Lee, Hee-Myung
    • Journal of the Korean Society of Costume
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    • v.2
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    • pp.73-88
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    • 1978
  • This article is an attempt to explain, at least in part, the contemporary Korean women's consciousness of Western Dreasses. As time changes, the role of clothing undergoes varisous transitions, while values and ways of life are constantly in change. It is, therefore, proper and appropriate to recognize as among the major aspects of social psychology such phenomenon as interests, understanding of clothing, the choice of a dress, and attitudes toward clothing, etc. The purpose of this study is to discover problems concerning and their clothing and their solutions, by means of a surveying approach. The method of research used is based upon questionares distributed to parents of first-year pupils in elementary schools and to female clerks working in offices, covering the period from August through October, 1976. The number of the questionares distrubuted totalled 600, and 526 were returned to the research to be utilized for analysis. The contents of the survey included such things as values concerning clothing, kinds of clothing and their practical use, the selection of clothing and the method of purchase, fashions, etc. The classification of aquisition are self-made clothing, clothing made to order and ready-made materials. It is composed of 25 items, including affirmative reasons as well as negative ones. The processing of the material returned was made by using the computer, and based upon classifications such as ages, monthly income, occupations; thus diagraming the result in percentages. The conclusion made and the improvements proposed are as follows: 1. The values of clothing were placed on the expression of the wearer's personality (32.7) and on eauty(28. 6%). The lower age group places is stress upon the expression of personality, while the higher age group stresses beauty. About 50% of wearers are contented with their clothing, their clothing, the rest of whom them indicating their dissatisfaction with what they wear. As to designs at the time of selection, about 46% indicated their preference of personal expression, 31.8% on usefulness. In selecting material, practicality is emphasized; in selecting patterns, single color is preferred. In short, personal expression and esthetic values are primary, with consideration of practicality in mind. 2. The classification of clothing according to their uses indicates the highest numbers in normal wear (home wears) and clothings to be worn outside home. As to evening dresses, (party dress) only one or two articles were checked by many, and no such article was clamed to be possessed by most. The highest ratio of wearing was shown in the case of home wear (47.3%) and clothing to be worn outside the home, which is 55.8%. The budget for one article of clothing was greatest in the case of home wear, and clothing worn outside the home. Many used both kinds of articles for the same purpose. It is desirable, therefore, that the kinds of clothing should be varied according to the purpose for which they are worn, and that clothing appropriate for that purpose should be worn. 3. The motivation for purchasing clothing was highly chosen in the item of seasonal change, which was 55.7%; Clothing deliberately made was indicated by 45.2%. In the mothods of purchasing clothing, clothing made to order and ready-made was indicated by 44.4%, which is the highest; Clothing made to order was 25.4%, and self-sewing was 1.1%, which is the lowest. (1) In the case of self-sewing, "I like it but it is very hard," was checked by 43.6%; "It is so difficult that I cannot wear such clothing" was checked by 13.3%. From these, we can conclude that the questionees are willing to make clothing by themselves, but techniques involved in sewing and at her problems involved in the skill are complicated but when those problems are eliminated there is a possibility for practice. The response checked by questionees concerning the self-sewing was, "It's economical", which is a clear indication that many questionees are positive for self-sewing. It is generally believed that ready-made clothing is cheaper, but it is not necessarily so. In consideration of the quality of clothing, self-sewing is a necessity, and it is desirable that it should be encouraged. (3) Problems involved in ready-made clothing, such as designs, skills, size (fitting) should be eliminated. When these problems are scientifically gotten rid of, it is possible that affirmative returns will be expected. Affirmative responses such as "Ready-made clothing is economical," "You can select there on the spot," are good signs that many women expect to wear ready-made clothing. It is in this sense that the prospect for ready-made clothing is brighter when much development for ready-made clothing is on the way. 4. Much concern for fashion are checked in such item of questions as "Fashionable clothing in the show window," "Clothes worn by women." The first item was checked by 50.1 %, and the second was checked by 48.6%. The reason for following fashion is "Because many people wear them," which was indicated by 30.4%. The reason for not following fashion is "It is too expensive," which was checked by 29.6%. The 26.2% of the answers indicated that "Fashionable clothing is devoid of personality," The influences of fashion over the development of fashion over the development of clothing are two-fold: Esthetic and active. It is not to be deniable that people follow fashion more or less. 1978.9>

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Mid-term Results of the Ross Procedure (Ross 술식의 중단기 성적)

  • Kang Seong-Sik;Jung Sung-Ho;Lee Sang-Gwon;Joo Suk-Jung;Song Hyun;Song Meong-Gun;Lee Jae-Won
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.23-28
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    • 2005
  • Ross procedure is ideal aortic valve replacement method with several merits of hemodynamic superiority and durability without the need of anticoagulation. Based upon this presumption, we studied its procedure performed in our hospital and tried to get the mid-term results Material and Method: From Jan 1999 to Oct 2001, 22 patients underwent the Ross procedure. The mean age of experimented (including 17 men and 5 women) was $30.9{\pm}8.1(17\~44)$. The diagnosis before the surgery had shown 20 as accompanied with AR and the rest 2 as with ASR. The follow-up period ranged from 0.6 to 40.6 months, mean of $38.9{\pm}1.6\;months,\;and\;follow-up\;rate\;was\;100{\%}$. Result. There was no operative death and two late deaths, one of whom was cardiac originated and the other, non-cardiac relate The survival rate was $94.1{\pm}5.7{\%}$(40.6 months). Postoperatively there were 2 exploration for bleeding, 3 low cardiac output patients. The pulmonary autograft technique was root replacement in 14 and inclusion technique in 8. Pulmonary homografts were used at the pulmonary position in all cases. There was no patient with significant aortic regurgitation. Conclusion: These showed that the mortality and morbidity of the Ross procedure were acceptable and postoperative AR was not significant. However, further long-term follow-up will be necessary for the improvement of the function of pulmonary autograft and homograft.

Surgical Treatment of Acyanotic Tetralogy of Fallot (비청색성 팔로사징의 외과적 치료)

  • 천종록;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.749-755
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    • 1998
  • Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.

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Clinical Analysis on the Closed Thoracostomy -2341 cases (폐쇄식 흉강 삽관술에 대한 임상적 고찰)

  • Kim, Cheon-Seog;Kim, Yeun-Gue;Park, Jin;Lee, Kyong-Woon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.991-1000
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    • 1997
  • Closed thoracostomy with UWSD* which is the most utilized procedure in chest surgery applies general thoracic disorders, trauma and after-thoracic surgery. The University hospital was involved on operating 2341 cases of closed thoracostomy with UWSD except chest tubing after-thoracic surgery for a full six years from January, 1991 to December, 1996. The rate of men and women out of the total 2341 cases was 3.5 : 1, the distribution by age showed that men were 36.6 $\pm21.0$ years old, women were $47.0\pm20.2$ years old and so that the total were 40.0 $\pm$ 20.5 years old. As for indication, spontaneous, secondary and traumatic pneumothorax were the most common, in addition to hemothorax hemopneumothorax, hydrothorax, hydropneumothorax, empyema, chylothorax. The most indwelling period of chest tubing is between eight and fourteen days for 974 cases and the average is 13.7 $\pm$ 6.3 days, The average drainage amount immediately after thoracostomy was 537 $\pm$ 88m1, and in 694 cases(46.0%), the drain amount was 201 ~ 500 ml. The rate of right and left tubing was 52.4 47.6, in 2071 cases(88.5%), the thoracostomy was the first chance and 2210 cases(94.4%) were treated with a single tube drainage. Almost all the patients complained of tube site pain, besides tube site infection, intercostal neuralgia, loss of tube function by the pleural adhesion, intrathoracic infection, incomplete reexpansion of defective lung, hemorrhage caused by the rupture of a blood vessel, subcutaneous emphysema, lung parenchymal rupture, diaphragmatic and intraabdominal trauma, reexpansionary pulmonary edema of one side lung and cellulitis were relapsed. 84.6% of all patients recovered with only clo ed thoracostomy and the rest of patient needed additional some necessary managements and so on to have successful results. There were two deaths(0.1%), caused by reexpansionary pulmonary edema, the cellulitis were complicated by thoracostomy with UWSD on an empyema patients to come to death(due to sepsis). t UWSD = under water seal drainage

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