• Title/Summary/Keyword: 심장박동수

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The Objective Measurement of the Lung Parenchyma Motion for Planning Target Volume Delineation (폐 부위 Planning Target Volume(PTV)설정시 폐 움직임의 객관적 측정)

  • Chung, Weon-Kyu;Cho, Jeong-Gill
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.387-392
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    • 1997
  • Purpose : To quantify the movement of lung Parenchyma for ICRU 50 Planning Target Volume (PTV) delineation of the lung region. Materials and Method : Fluoroscopic observations and measurements are Performed on 10 patients with chest region cancer who have normal putmonary functions We have divided the lung region into 12 parts for the right lung, 10 parts for the left lung and four to five Points of lung parenchyma were selected for anatomical analysis Points, Fluoroscopic images are sent to a computer and then movements are measured. Results : Both lowe lobes showed the longest longitudinal movements because of breathing (average 14.1mm, maximum 22.1mm), while anteroposterior displacement showed the smallest value. Lateral movements of the lung parenchyma averaged 6.6mm, and the maximum value was 9.1mm, (both hilar regions showed maximum values because of cardiac motion) Conclusion : We could quantify the lung movements by measuring parenchyma displacements. The movements of both upper lobes were less than those of the middle and upper lobes in longitudinal and transverse movements. Optimal margins can be selected for PTV delineation using these results.

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Analysis of High School Students' Conceptual Change in Model-Based Instruction for Blood Circulation (혈액 순환 모형 기반 수업에서 고등학생들의 개념 변화 분석)

  • Kim, Mi-Young;Kim, Heui-Baik
    • Journal of The Korean Association For Science Education
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    • v.27 no.5
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    • pp.379-393
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    • 2007
  • The purpose of this article is to analyze the conceptual change of nine 11th graders after implementing the model-based instruction of blood circulation by multidimensional framework, and to find some implications about teaching strategies for improving conceptual understanding. The model-based instruction consisted of 4 periods: (1) introduction for inducing students' interests using an episode in the science history of blood circulation, (2) vivisectional experiment on rats, (3) visual-linguistic model instruction using the videotape of heartbeat, and (4) modeling activity on the path of blood flow. Based on the data from pre-test, post-test and interviews, we classified students' models on the path of blood flow, and investigated their ontological features and the conceptual status of blood circulation. Most students could describe the path of blood flow and the changes of substances in blood precisely after the instructions. However, the modeling activity were not sufficient to improve students' understanding of the mechanisms of the blood distribution throughout various organs and the material exchanges between blood and tissues. From the interview of 9 students, we acquired informative results about conceptual status elements that were helpful to, preventing from, or not used for students' understanding. It was also found that conceptual status of students depended on the ontological categories into which students' conceptions of blood circulation fell. The results of this study can help design the effective teaching strategy for the understanding of concept of the equilibrium category.

Biocompatibility and Histopathologic Change of the Acellular Xenogenic Pulmonary Valved Conduit Grafted in the Right Ventricular Outflow Tract (우심실 유출로에 이식한 무세포화 이종 폐동맥 판막도관의 생체 적합성 및 조직병리학적 변화양상에 대한 연구)

  • 허재학;김용진;박현정;김원곤
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.482-491
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    • 2004
  • Background: The xenogenic or allogenic valves after in Vitro repopulation with autologous cells or in vivo repo-pulation after acellularization treatment to remove the antigenicity could used as an alternative to synthetic polymer scaffold. In the present study, we evaluated the process of repopulation by recipient cell to the acellu-larized xenograft treated with NaCl-SDS solution and grafted in the right ventricular outflow tract. Material and Method: Porcine pulmonary valved conduit were treated with. NaCl-SDS solution to make the grafts acellularized and implanted in the right ventricular outflow tract of the goats under cardiopulmonary bypass. After evaluating the functions of pulmonary valves by echocardiography, goats were sacrificed at 1 week, 1 month, 3 months, 6 months, and 12 months after implantation, respectively. After retrieving the implanted valved conduits, histopathologic examination with Hematoxylin-Eosin, Masson' trichrome staining and immunohistochemical staining was performed. Result: Among the six goats, which had been implanted with acellularized pulmonary valved conduits, five survived the expected time period. Echocardiographic examinations for pulmonary valves revealed good function except mild regurgitation and stenosis. Microscopic analysis of the leaflets showed progressive cellular in-growth, composed of fibroblasts, myofibroblasts, and endothelial cells, into the acellularized leaflets over time. Severe inflammatory respon-se was detected in early phase, though it gradually decreased afterwards. The extracellular matrices were regenerated by repopulated cells on the recellularized portion of the acellularized leaflet. Conclusion: The acellularized xenogenic pulmonary valved conuits were repopulated with fibroblasts, myofibroblasts, and endothelial cells of the recipient and extracellullar matrices were regenerated by repopulted cells 12 months after the implantation. The functional integrity of pulmonary valves was well preserved. This study showed that the acellularized porcine xenogenic valved conduits could be used as an ideal valve prosthesis with long term durability.

Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.373-378
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    • 1999
  • Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

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Biological Clock and Ultradian Metabolic Oscillation in Saccharomyces cerevisiae (Saccharomyces cerevisiae의 생물시계와 초단기 대사진동)

  • Kwon, Chong Suk;Sohn, Ho-Yong
    • Journal of Life Science
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    • v.28 no.8
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    • pp.985-991
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    • 2018
  • Biological clocks are the basis of temporal control of metabolism and behavior. These clocks are characterized by autonomous free-running oscillation and temperature compensation and are found in animals, plants, and microorganisms. To date, various biological clocks have been reported. These include clocks governing hibernation, sleep/wake, heartbeat, and courtship song. These clocks can be differentiated by the period of rhythms, for example, infradian rhythms (> 24-hr period), circadian rhythms (24-hr period), and ultradian rhythms (< 24-hr period). In yeast (Saccharomyces cerevisiae), at least five different autonomous oscillations have been reported; (1) glycolytic oscillations (T = 1~30 min), (2) cell cycle-dependent oscillations (T = 2~16 hr), (3) ultradian metabolic oscillations (T = 15~50 min), (4) yeast colony oscillations (T = a few hours), and (5) circadian oscillations (T = 24 hr). In this review, we discuss studies on oscillators, pacemakers, and synchronizers, in addition to the application of biological clocks, to demonstrate the nature of autonomous oscillations, especially ultradian metabolic oscillations of S. cerevisiae.

Tumor Motion Tracking during Radiation Treatment using Image Registration and Tumor Matching between Planning 4D MDCT and Treatment 4D CBCT (치료계획용 4D MDCT와 치료 시 획득한 4D CBCT간 영상정합 및 종양 매칭을 이용한 방사선 치료 시 종양 움직임 추적)

  • Jung, Julip;Hong, Helen
    • Journal of KIISE
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    • v.43 no.3
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    • pp.353-361
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    • 2016
  • During image-guided radiation treatment of lung cancer patients, it is necessary to track the tumor motion because it can change during treatment as a consequence of respiratory motion and cardiac motion. In this paper, we propose a method for tracking the motion of the lung tumors based on the three-dimensional image information from planning 4D MDCT and treatment 4D CBCT images. First, to effectively track the tumor motion during treatment, the global motion of the tumor is estimated based on a tumor-specific motion model obtained from planning 4D MDCT images. Second, to increase the accuracy of the tumor motion tracking, the local motion of the tumor is estimated based on the structural information of the tumor from 4D CBCT images. To evaluate the performance of the proposed method, we estimated the tracking results of proposed method using digital phantom. The results show that the tumor localization error of local motion estimation is reduced by 45% as compared with that of global motion estimation.

The Effect of a Target Controlled Infusion of Low-Concentration Ketamine on the Heart Rate Variability of Normal Volunteers (정상인 자원자에서 목표농도조절주입법으로 투여한 저농도의 케타민이 심장박동수변이도에 미치는 영향)

  • Jung, Jai Yun;Lee, Jun Ho;Lee, Jeong Seok;Kim, Yong Ik
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.39-46
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    • 2009
  • Background: Ketamine has an indirect sympathetic stimulation effect. We investigated heart rate variability (HRV) as a marker of cardiac autonomic function after a target controlled infusion (TCI) of ketamine with a plasma concentration of 30 or 60 ng/ml. Methods: In 20 adult volunteers, the mean of the R wave to the adjacent R wave interval (RRI), the range of RRI, the root mean square successive difference of intervals (RMSSD), the total power, the low frequency (LF, 0.04-0.15 Hz) power, the high frequency (HF, 0.15-0.4 Hz) power, the normal unit HF (nuHF), the normal unit LF (nuLF), the LF/HF ratio and the SD1 and the SD2 in the Poincare plot were measured before and after a TCI of ketamine. We observed for any psychedelic symptoms or sedation. Results: There were no differences in the mean and range of the RRI, RMSSD, total power, LF power, HF power, nuHF, nuLF, LF/HF ratio, SD1 and SD2 between before and after ketamine administration. The OAA/S score was higher and there were more psychedelic symptoms with a 60 ng/ml plasma concentration than with a 30 ng/ml plasma concentration. Conclusions: This study did not show any effect of a low plasma concentration of ketamine on the autonomic nervous system.

Effects of Jeju Samdasu Forest Bathing on Saliva Cortisol and Vascular Conditions (제주 삼다수 숲 산림욕이 타액 코르티솔과 혈관 상태에 미친 효과)

  • Sin, Bang Sik;Lee, Jae H.;Song, Kyu J.;Hong, Geum-Na;Shin, Aran
    • Journal of Naturopathy
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    • v.10 no.1
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    • pp.19-25
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    • 2021
  • Purposes: This study investigated how saliva cortisol, blood vessel health type, and blood vessel health index changed after forest bathing with subjects in the Samdasu Forest. Methods: After the forest bathing, we measured cortisol change in saliva and heart rate variability with subjects. Results: In the experimental group who took forest bathing for two hours in the Samdasu Forest, the stress cortisol content secreted in saliva decreased significantly compared to the control group (p<.05). Besides, the vascular age type significantly increased (p<.03), and the vascular age index significantly decreased (p<.032).There were no significant results in the control group. Conclusions: It is evaluated that forest bathing in Samdasu Forest in Jeju Island had the effect of reducing saliva cortisol and increasing blood vessel age.

The Influences of Perfusion Temperature on Inflammatory and Hematologic Responses during Cardiopulmonary Bypass (체외순환시 염증과 혈액학적 반응에 대한 관류온도의 영향)

  • 김상필;최석철;박동욱;한일용;이양행;조광현;황윤호
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.817-826
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    • 2004
  • Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26~28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.

Predictors of Long-term Mortality after Hospitalization for Acute Exacerbation of COPD (만성폐쇄성폐질환의 급성악화로 입원했던 환자에서 장기간 사망의 예측인자)

  • Jung, Hae-Seon;Lee, Jin Hwa;Chun, Eun Mi;Moon, Jin Wook;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.205-214
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    • 2006
  • Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.