Background: Occlusive complications after arterial revascularization are difficult to treat and have high recurrence rate. This study was performed to establish an effective treatment modality and to evaluate the factors affecting the occlusive complications by analysis of clinical data. Material and Method: During the period of 5 years. 33 patients (55 reoperations) were studied at the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital following 173 arterial revascularization surgeries. The clinical characteristics, operating methods, the time intervals of reoperation, used graft, and the results of treatment were evaluated retrospectively. Result: All the patients were men except one and the mean age was 63.5 years old. The mean time internal from first operation to reoperation was 11.9 months. The cause of arterial occlusive diseases were 28 atherosclerosis and 5 Burger's diseases, Associated diseases were Hypertension $(57.6\%)$, Diabetes mellitus $(33.3\%)$, heart failure $(18.2\%)$, and so on. The mean rate of reoperation was 1.67 times and the most common type of first operation was femoro-popliteal bypass grafting $(57.6\%)$. The graft that used revascularization surgery were 25 cases of PTFE and 6 case were Dacron. There was no statistical difference between two groups. The kinds of reoperations were thrombectomy in 20 cases, angioplasty 18 cases, re-bypass surgery in 13 cases, and lumbar sympathectomy in 4 cases. The results of reoperation were 15 cases of functional recovery, 7 cases of limb salvage, 5 cases of above-knee amputation. 3 cases of below-knee amputation and 3 deaths. Conclusion: The main cause of occlusive complications are occlusion of inflow or outflow artery. Treatments were different according to the first operation methods and graft used. The most frequent time of reoperation was within one year after the first operation. We believe that graft surveillance especially during the first year is very important factor in observing the patient. We can look forward to improving limb salvage rate to perform additional treatment such as radiological interventions and lumbar sympathectomy.
This study was contemplated about an aspects of modernity that was discovered of ImcheonByeolgok(林川別曲) written by Okgukjae Lee, Un-young in 18th Century. It was composed time that unprecedented state in the 18th century. So, I considered that Modernity was the most appeared at 18th Century. During this period, Changes has happened in ideology and system in terms of politics, economy, society and culture. This change is the beginning of a new modern consciousness. There is also a tendency to think of Imcheonbyeolgok as the autobiographical story of Lee, Yun-young. It seems that Lee, Yun-young has a progressive scholarly thought, but he did not reveal his own situation by insulting him. Therefore, I am not realistically valid for being able to see it as an autobiographical story that he actually experienced. Also, although ImcheonByeolgok is known as a love song, it is hard to see it as a love song because its satirical features are strong. and It is characterized by the peculiar form of narrative being described as a dialogue. I picked two aspects of modernity in ImcheonByeolgok. One is resistance to love and desire, and the other is disintegration of the order of identity. The two aspects of this paper were presented as Greimas's Actant Model. ImcheonByeolgok is the result of efforts to show the changing modern Joseon Dynasty's elements in the form of resistance and resistance to Joseon's feudal society, such as Confucian ideology and identity systems. Thus, I suggested the corrupt ruling class of Joseon's feudal society and the exploited working class life as an old living and a grandmother instead of 'resistance' and 'disposal' in the 18th century. The criticism of traditional feudal societies that emerged in the 18th century turned out to be a hegemony that distinguishes the Middle Ages from the Modern Age, which resulted in differences between the ages before and after the 18th century. Although these hegemony were not clearly distinguished in household literature in the 18th century, it was established and developed in the 19th century. I suggested that Lim's Star Song was an important work that played an important role in bringing about this change.
The purpose of this study is to check if group art therapy is effective in improving self esteem and self integrity of rural elderly women. Study subjects are forty seven rural elderly women in A-city who have participated in producing specialized products in their rural area. They are divided into experimental group (EG, n=25) who wish to participate in the group art therapy program, a part of the A-city sponsored program named 'Making the Rural Elderly Happy', to improve and enhance the elderly's self esteem and self integrity, and control group (CG, n=22) with no wish to participate. However, only forty four elderly women are selected as the final study subjects for data analysis, due to those who either missed the program session more than once or died of old age during the program period. The group art therapy program was given from March 16 to May 18 of 2010, every Tuesday between 1pm through 3pm for a total of 12 sessions, with the help of two college student assistants in the region and one staff member for the city program. SPSS WIN version 12.0 is adopted to evaluate and analyze the effects of the therapy program, independent t-test for equivalence check of pretests, and frequency check for general characteristics of each group. The study results are obtained by the mean and standard deviation to grasp the changes between pretest and post-test on both groups, together with ANCOVA to evaluate effects of the therapy program with the pre-test as covariant. The results are as follows. First, self esteem of EG is significantly improved than that of CG after intervention of group art therapy. Second, self integrity is significantly higher in EG than CG after the group art therapy intervention. Therefore, it can be claimed that group art therapy is effective in improving and enhancing self esteem and self integrity of the rural elderly women.
Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.
Purpose: The purpose of this study was to evaluate the mechanism of injury in the anterior cruciate ligament tears sustained in participation in soccer. Materials and methods: 50 patients whose knees were injured during playing soccer were enrolled in this study. The mean age was 27 years old, 47 were male and 3 female. 15 of them were either professional or amateur soccer players, the rest were non-professional. The injury mechanism was investigated by evaluation of the medical records or by telephone interview. Results: The injury mechanism involved contact injuries in 17 patients and non-contact in 33. 41 patients were bearing weight on the involved side at the time of injury, and 9 patients were not. In cases of contact injury, 9 of the 17 patients had sustained a valgus force to the knee, and 5 patients had varus force, 11 patients had their foot planted, and 6 did not. Among those patients with a planted foot, 3 patients were injured by the rotation of the thigh, 1 patient was injured by hyperextension, and there were no deceleration mechanism injuries. In non-contact injuries, 30 out of 33 patients had their foot planted at time of injury and only 3 patients did not. Of these 30 patients, 16 were injured by the rotation of thigh, 6 sustained a varus force on the knee joint and 5 had a valgus force, 5 were injured by hyperextension, and 2 by deceleration. 3 patients, who did not have their foot planted, were injured while kicking with the involved leg. Conclusions: For soccer players in this series, the most common mechanisms resulting in anterior cruciate ligament tears were non-contact, most often by rotation of the torso over a planted foot. In contact injuries, the most common mechanism was the application of valgus force by tackle.
Kim, Jeong-Won;Lee, Jong-Tae;Cho, Joon-Yong;Kim, Kyu-Tae;Kim, Gun-Jik
Journal of Chest Surgery
/
v.41
no.5
/
pp.573-579
/
2008
Background: Composite valve graft replacement is currently the treatment of choice for a wide variety of the lesions of aortic root disease. The purpose of this study was to explore the results of aortic root replacement after using the Cabrol technique over a 13-year period at our institution, and we analyzed the results to help surgeons make better decisions when repairing aortic root disease. Material and Method: Between January 1994 and December 2006, twenty-five patients underwent a Cabrol technique operation at our institution. The mean patient age was $43.7{\pm}14.1$ years old (range: $6{\sim}65$ years) and the male and female ratio was 21:4 (84% : 16%). The patients' follow-up was 100% complete, and the mean follow-up period was $60.7{\pm}50.4$ (range:$1{\sim}162$) months. Annuloaortic ectasia (n=18) was the most frequent cause of aortic disease in this series, followed by aortic dissection (n=7). The mean cardiopulmonary bypass time was $177.2{\pm}44.9$ minutes and the mean aortic cross clamping time was $123.4{\pm}34.1$ minutes. Nine patients were checked with MDCT (Multidetector computed tomography) for evaluating a well functioning secondary graft and the coronary anastomosis site. Result: The early mortality rate was 4% (1 of 25 patients). A significant stenosis, kinking or occlusion of the secondary graft was detected by MDCT in 4 patients. The overall survival rate was 88%. Conclusion: The Cabrol technique demonstrated a significant incidence of long-term complications such as secondary graft stenosis or obstruction. It could be used when the modified Bentall technique is not feasible.
Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
/
v.10
no.3
/
pp.189-197
/
2012
Geochemical composition of fracture filling minerals and groundwater was investigated to characterize geochemical characteristics of groundwater system at the KURT site. Minerals such as calcite, illite, laumontite, chlorite, epidote, montmorillonite, and kaolinite, as well as I/S mixed layer minerals were detected in the minerals extracted from the fracture surfaces of the core samples. The groundwater from the DB-1, YS-1 and YS-4 boreholes showed alkaline conditions with pH of higher than 8. The electrical conductivity (EC) values of the groundwater samples were around $200{\mu}S/cm$, except for the YS-1 borehole. Dissolved oxygen was almost zero in the DB-1 borehole indicating highly reduced conditions. The Cl- concentration was estimated around 5 mg/L and showed homogeneous distribution along depths at the KURT site. It might indicate the mixing between shallow groundwater and deep groundwater. The shallow groundwater from boreholes showed $Ca-HCO_3$ type, whereas deep groundwater below 300 m from the surface indicated $Na-HCO_3$ type. The isotopic values observed in the groundwater ranged from -10.4 to -8.2‰ for ${\delta}^{18}O$ and from -71.3 to -55.0‰for ${\delta}D$. In addition, the isotope-depleted water contained higher fluoride concentration. The oxygen and hydrogen isotopic values of deep groundwater were more depleted compared to the shallow groundwater. The results from age dating analysis using $^{14}C$ indicated relatively younger (2000~6000yr old) groundwater compared to other european granitic groundwaters such as Stripa (Sweden).
The Journal of Korean Orthopaedic Ultrasound Society
/
v.2
no.2
/
pp.79-84
/
2009
Purpose: Medial or Lateral epicondylitis is one of the most common causes of elbow pain and recently ESWT (Extracorporeal Shockwave Therapy) is welcomed as a new treatment modality and has been performed in many clinics. The purpose of this study is to report the clinical result after the ESWT treatment for the lateral or medial epicondylitis of the elbow. Materials and Methods: From Nov. 2005 to Jan. 2009, seventy four cases of seventy two (11 male, 61 female) patients diagnosed as medial or lateral epicondylitis of the elbow are included in this study. The average age was 52.4 years old. Authors used visual analogue scale (VAS) to assess the degree of pain at rest and during work, comparing the score before the ESWT treatment with that of $6^{th}$, $12^{th}$ and $24^{th}$ week after the treatment. Authors also checked the number of awakeness during sleep due to pain and compared them before and after the ESWT treatment. Results: Average resting pain score improved from 4.60 before the treatment to 2.01 at $6^{th}$ week, 0.43 at $12^{th}$ week and 0.16 at $24^{th}$ week. Average pain score during working also showed quite an improvement with time from 7.20 before the treatment to 4.05 at $6^{th}$ week, 2.01 at $12^{th}$ week and finally 0.36 at $24^{th}$ week. We checked the frequency of sleep arousal during a week, and also found similar significant treatment efficacy as the average frequency decreased from 9.64 per week before the treatment to 1.21, 0.08 and 0.09 per week at $6^{th}$ week, $12^{th}$ week and $24^{th}$ week, respectively. Conclusion: ESWT for medial or lateral epicondylitis is thought to be one of the effective treatment modalities for those patient group not quite responsive to other conservative treatment.
Kim, Cheol-Min;Song, Jun-Young;Kim, Ja Hyung;Kim, Ki Soo;Hong, Soo-Jong
Clinical and Experimental Pediatrics
/
v.45
no.9
/
pp.1134-1140
/
2002
Purpose : Childhood accidents have been increasing recently. Accidents rank as the leading cause of childhood mortality and morbidity. We performed this study to evaluate the causes of childhood accidents. Methods : The authors analysed retrospectively the medical records of 6,410 cases of childhood accidental injuries who visited the emergency room of Asan Medical Center from January 1990 to December 1999. Results : The most common type of accidents was trauma which accounted for 5,038 cases of the total accidents, followed by falls, burns, foreign body aspiration, and poisoning. The most common age of foreign body aspiration was under two years old and the male to female ratio was 2 to 1. The most common site of foreign body aspiration was the esophagus and the stomach, followed by the respiratory tract. In airways, the right and left main bronchus were the most common site for foreign body aspiration and were accompanied by the highest mortality. The most common foreign body in the gastrointestinal tract and respiratory tract were coins and peanuts, respectively. Conclusion : The most common cause of accidents was trauma, followed by falls, burns, foreign body aspiration, and poisoning. The incidence of foreign body aspiration and poisoning is increasing in infants. In cases of foreign bodies in airways, proper management is needed because of the high mortality rate.
The experiment was carried out to observe whether the route of administration of allantoic aminiotic fluid obtained from the chicken embryo infected with $B_1$ virus would affect the protectivity of brids against the challenge exposure of a virulent strain of ND virus. Four groups of birds of 30 days of age were immunized intranassally (0.1 $m\ell$), intramuscularly (1.0 $m\ell$), by spray administration (0.00015 $m\ell$/1㎤) or via drinking water(10.0 $m\ell$), with 1 in 100 dilution of th. fluid containing $B_1$ virus titre of 10$\^$8.5/ELD$\_$50/ per $m\ell$ and all the immunized birds, after 15 days of vaccination, were challenged intramuscularly with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. The results obtained are summerized as follows: 1. Good immunity was induced when 1 in 100 dilution of allantoaminiotic fluid with $B_1$ virus titre of 10$\^$8.5/ELD$\_$50/$m\ell$was applied to 30 day old chicks intramuscularly, intranasally and by spray application, but it was not the case when the allantomiotic fluid was diluted to 1 in 1,000. The ID$\_$50/ of birds immunized with 1 in 100 dilution of allantoaminiotic fluid by various routes of administration such as intramuscular Injection, spray application and intranasal instillation were 10$\^$2.8/>10$\^$4.l and/>10$\^$4.2/ 2. The high protectivity against the challenge exposure with a virulent Newcastle disease virus with 10,000 MLD/$m\ell$ were observed when the birds were immunized with a live vaccine of 10$\^$8.5/ ELD$\_$50/$m\ell$ by intramuscular injection, intranasal instillation or spray application, and the rates by different routes of application were 92.62%, 95.33% and 93.75%, respectively. On the contrary, no good immunity was induced in the groups of birds immunized via drinking water with the live vaccine, the rate of protection against the challenge exposure being 47.18%.
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