• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.59-66
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• 2007

Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.422-427
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• 1999

Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.929-939
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• 1999

The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

• Journal of Trauma and Injury
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• v.29 no.1
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• pp.14-21
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• 2016

Purpose: The purpose of this research was to analyze the results of the combined and posterior approaches for treating thoracolumbar and lumbar burst fractures and to find an adequate method of treatment. Methods: We retrospectively analyzed the cases of 46 patients with unstable thoracolumbar and lumbar burst fractures who had been surgically treated. All cases were divided into two groups based on the operation method used. Eleven patients had undergone the combined approach, while 35 patients had undergone the posterior approach. Radiological and clinical evaluations were performed before surgery, after surgery, and at the final follow-up. Results: The stenotic ratios of the area occupied by the retropulsed bony fragments to the estimated area of the original spinal canal were 68.2% and 45.6% for the combined and the posterior approaches, respectively. No significant differences in the neurological improvement or the corrected state of the sagittal index were noted, but the patients who had been treated with the combined approach group had better results than those who had been treated with the posterior approach group in terms of correction and maintenance of the sagittal index. The average kyphosis corrections at the final follow-up were 15.3 degrees for the patients in the combined approach group and 10.0 degrees for those in the posterior approach group. Surgical time and estimated blood loss were all significantly higher for patients in the combined approach group. Conclusion: The combined and the posterior approaches showed similar results in the improvements of the neurologic state and the corrected state of the sagittal index. However, use of the combined approach is recommended for patients with severe kyphosis and with severe canal encroachment.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.220-225
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• 2019

Purpose: Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures. Methods: We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV. Results: In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572-0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546-0.889; p=0.031). Conclusions: This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.119-130
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• 2002

The purpose of this study was to evaluate hemodynamics of intracranial blood flow for obtain clinically useful reference values and assess cerebral hemodynamics change with aging. 81 normal Korean subjects(age, 14$\thicksim\∼\thicksim$70 years) examined who han no history of neurologic disease and the subjects divided into group A(age, 14$\∼$39 years), group B(age, 40$\∼$59 years) and group C(age, 60$\∼$70 years). Transcranial doppler was use for measured the maximum velocity(Vmax), mean velocity(Vmean), pulsatility index(PI), resistive index(RI), stenosis index(SI) and depth of sample volume. Vmax was 99.1 1cm/s, Vmean was 63.57cm/s, PI was 0.85, RI was 0.56, SI was 31.94 and depth of sample volume was 52.35 in middle cerebral artery. Vmax was 85.54cm/s, Vmean was 52.52cm/s, PI was 0.82, RI was 0.55, SI was 34.48 and depth of sample volume was 73.62 in anterior cerebral artery. Vmax was 75.45cm/s, Vmean was 45.60cm/s, PI was 0.82, RI was 0.58, SI was 36.14 and depth of sample volume was 62.35 in posterior cerebral artery. Vmax was 70.44cm/s, Vmean was 47.07cm/s, PI was 0.87, RI was 0.58, SI was 29.83 and depth of sample volume was 75.23 in basilar artery Vmax was 63.92, Vmean was 42.42, PI was 0.89, RI was 0.58, SI was 29.89 and depth of sample volume was 66.65 in vertebral artery. Vmax and Vmean was significantly decreased with increasing age in middle cerebral artery, anterior cerebral artery, posterior cerebral artery, basilar artery and vertebral artery And PI and RI was significantly increased with increasing age in basilar artery and vertebral artery. And I suggest that transcranial doppler sonography can be used as one of useful clinical tool for detection of cerebral hemodynamics.

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.367-372
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• 2008

Purpose: Prevention of acute rejection in skin allografts without continuous immunosuppression lacks reports in worldwide literature. Needs for chronic immunosuppression preclude the use of tissue allograft as a routine surgical reconstructive option. Recently dendritic cells(DC) gained considerable attention as antigen presenting cells that are also capable of immunologic tolerance induction. This study assesses the effects of alloantigen-pulsed dendritic cells in induction of survival increase in a rat skin allograft model. Methods: Recipient-derived dendritic cells were harvested from rat whole blood and cultured with GM-CSF(200 ng/mL) and IL-4(8 ng/mL) for 2 weeks. Then donor-specific alloantigen pulsed dendritic cells were reinjected into tail vein before skin graft. The rat dorsal skin allografts were transplanted in 5 subgroups. Groups: I) untreated, II) anti-lymphocyte serum(ALS, 0.5 mL), III) FK-506(2 mg/kg), IV) DCp, VI) DCp and FK-506. Graft appearance challenges were assessed postoperatively. Results: The group V(DC and FK-506 treated) showed longest graft survival rate(23.5 days) than other groups; untreated(5.8 days), ALS(7.2 days), FK-506 (17.5 days), DCp(12.2 days). Conclusion: Donor antigen pulsed host dendritic cell combined with short-term immunosuppression prolong skin allograft survival and has potential therapeutic application for induction of donor antigen specific tolerance.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.1-5
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• 2016

Septic tenosynovitis of the digital flexor tendon sheath (DFTS) is a potentially career-ending and life-threatening problem in horses. This study aimed to describe the outcomes of tenoscopy for the treatment of acute septic digital flexor tenosynovitis in horses. Tenoscopy was performed on 13 Thoroughbred horses with acute septic tenosynovitis of the DFTS. Surgical time was 56-148 min (mean 85.6 min, median 84.0 min). In the synovial fluid analysis, mean white blood cell count, mean neutrophil proportion, and mean total protein were $42.9{\times}10^3cells/{\mu}l$ (range, $7.2-109.5cells/{\mu}l$), 89.5% (range, 68-97%), and 4.0 g/dl (range, 2.5-5.2 g/dl), respectively. Microbial growth in the synovial fluid culture was detected in 2 of 11 horses. All horses survived and returned to their intended use without complications. The present study demonstrated that the tenoscopy is useful for treating acute septic tenosynovitis of the DFTS in horses.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.179-185
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• 2017

Background: The use of leeches can effectively increase the salvage rate of flap congestion. However, the first reaction from patients and carers in using leeches in clinical fields is strong aversion. This can be due to the fact that development of our culture from agriculture to industrial society, coming across leeches became fairly rare. Also because of the biological traits that leeches carry; staying attached to a leg or other body parts of the host, sucking blood, and leaving wounds. Methods: This study was conducted through questionnaires, divided into many subgroups. We scaled the compliance of the two therapies, with or without leech. Maximum scale of 10 showing no rejective response to the therapy and minimum scale of 0 showing the greatest rejective response. Results: Overall subjects' compliance was improved after explaining the benefits of hirudotherapy. Irrelevant to the explanation, there was no significant difference in general compliance between male and female. Young-aged group and medical personnel or people studying medicine showed higher compliance over older-aged group and the general public. Conclusion: In the terms of general social cognition, recognizing leech as a therapeutic material may not be welcomed at first, but provided with proper information and explanations, overall compliance of patients and carers can be improved and consequently result in superior outcomes in flap salvage.

• Korean Circulation Journal
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• v.53 no.10
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• pp.655-676
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• 2023

Interest in sex differences in coronary artery disease (CAD) has been steadily increasing. Concurrently, most of the data on these differences have primarily been Western-oriented. The KoRean wOmen'S chest pain rEgistry (KoROSE), started in 2011, has since published numerous research findings. This review aims to summarize the reported differences between men and women in CAD, integrating data from KoROSE. Cardiovascular risk in postmenopausal women escalates dramatically due to the decrease in estrogen levels, which normally offer cardiovascular protective effects. Lower estrogen levels can lead to abdominal obesity, insulin resistance, increased blood pressure, and endothelial dysfunction in older women. Upon analyzing patients with CAD, women are typically older and exhibit more cardiovascular risk factors than men. Diagnosing CAD in women tends to be delayed due to their symptoms being more atypical than men's. While in-hospital outcome was similar between sexes, bleeding complications after percutaneous coronary intervention occur more frequently in women. The differences in long-term prognosis for CAD patients between men and women are still a subject of ongoing debate. Pregnancy and reproductive factors also play a significant role as risk factors for cardiovascular disease in women. A notable sex disparity exists, with women found to use fewer cardiovascular protective drugs and undergo fewer interventional or surgical procedures than men. Additionally, women participate less frequently than men in clinical research. Through concerted efforts to increase awareness of sex differences and mitigate sex disparity, personalized treatment can be provided. This approach can ultimately improve patient prognosis.