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Postmortem Changes of the Protein and Amino Acid Composition of Muscles in the Partially Frozen Prawn, Pandalus japonica (보리새우육의 부분동결저장중 단백질 및 아미노산의 조성변화)

  • PYEUN Jae-Hyeung;CHOI Young-Joon;KIM Jeung-Han;CHO Kweon-Ock
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.17 no.4
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    • pp.280-290
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    • 1984
  • An extensive study has been made on the relationship between the freshness and the compositions of the muscle protein of prawn, Pandalus japonica during the storage under partially frozen condition. The variations of the subunit distribution for sarcoplasmic protein and myofibrillar protein extracted from the samples by changes of freshness were discussed by sodium dodecylsulfate-poly-acrylamide gel (SDS-PAG) electrophoresis. On the other hand, the denaturation constant ($K_D$) of the myofibrillar protein extracted from the prawn stored at $-3^{\circ}C\;and\;-20^{\circ}C$ were successively compared. The prawn muscle contained about $18\%$ of protein with the composition of $32\%$ in sarcoplasmic protein, $56\%$ in myofibrillar protein, $10\%$ in residual intracellular protein and $2\%$ in stroma. The indices for estimating freshness of the muscle were approached to the early stage of putrefaction on the 26th day of the storage with $25.29mg\%$ of total volatile basic nitrogen, $31.36\%$ of K-value and 8.83 of pH. The content of the myofibrillar protein was remarkably decreased with the time during the storage while that of residual intracellular protein was increased. The $K_D$ values of the myofibrillar protein were $9.03{\times}10^{-6}sec^{-1}\;at\;-3^{\circ}C\;and\;4.42{\times}10^{-6}sec^{-1}\;at\;-20^{\circ}C$. The results of the analysis of SDS-PAG electrophoretograms indicated that the sarcoplasmic protein and the myofibrillar protein were composed of 12 subunits and 17 subunits in the muscle of instantaneously killed prawn ana were changed into 8 subunits and 22 subunits in the muscle stored for 26 days, respectively. It is noticeable that 30,000, 41,000, 107,000, 136,000, 170,000 173,000, 185,000, and 198,000 daltons of the newly appeared 8 subunits were found in the myofibrillar protein from the prawn muscle stored for 26 days. The amino acid composition of the muscle protein showed that the most of amino acids were slightly decreased with the days of the storage. With respect to the free amino acid composition of the muscle of instantaneously killed prawn, glycine, proline, arginine, alanine and taurine comprised $93\%$ of the total free amino acids. Taurine, valine, leucine, phenylalanine, serine, lysine, methionine, isoleucine and histidine were increased during the storage period but exceptionally proline was decreased.

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APPROXIMATE ESTIMATION OF RECRUITMENT IN FISH POPULATION UTILIZING STOCK DENSITY AND CATCH (밀도지수와 어획량으로서 수산자원의 가입량을 근사적으로 추정하는 방법)

  • KIM Kee Ju
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.8 no.2
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    • pp.47-60
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    • 1975
  • For the calculation of population parameter and estimation of recruitment of a fish population, an application of multiple regression method was used with some statistical inferences. Then, the differences between the calculated values and the true parameters were discussed. In addition, this method criticized by applying it to the statistical data of a population of bigeye tuna, Thunnus obesus of the Indian Ocean. The method was also applied to the available data of a population of Pacific saury, Cololabis saira, to estimate its recuitments. A stock at t year and t+1 year is, $N_{0,\;t+1}=N_{0,\;t}(1-m_t)-C_t+R_{t+1}$ where $N_0$ is the initial number of fish in a given year; C, number o: fish caught; R, number of recruitment; and M, rate of natural mortality. The foregoing equation is $$\phi_{t+1}=\frac{(1-\varrho^{-z}{t+1})Z_t}{(1-\varrho^{-z}t)Z_{t+1}}-\frac{1-\varrho^{-z}t+1}{Z_{t+1}}\phi_t-a'\frac{1-\varrho^{-z}t+1}{Z_{t+1}}C_t+a'\frac{1-\varrho^{-z}t+1}{Z_{t+1}}R_{t+1}......(1)$$ where $\phi$ is CPUE; a', CPUE $(\phi)$ to average stock $(\bar{N})$ in number; Z, total mortality coefficient; and M, natural mortality coefficient. In the equation (1) , the term $(1-\varrho^{-z}t+1)/Z_{t+1}$s almost constant to the variation of effort (X) there fore coefficients $\phi$ and $C_t$, can be calculated, when R is a constant, by applying the method of multiple regression, where $\phi_{t+1}$ is a dependent variable; $\phi_t$ and $C_t$ are independent variables. The values of Mand a' are calculated from the coefficients of $\phi_t$ and $C_t$; and total mortality coefficient (Z), where Z is a'X+M. By substituting M, a', $Z_t$, and $Z_{t+1}$ to the equation (1) recruitment $(R_{t+1})$ can be calculated. In this precess $\phi$ can be substituted by index of stock in number (N'). This operational procedures of the method of multiple regression can be applicable to the data which satisfy the above assumptions, even though the data were collected from any chosen year with similar recruitments, though it were not collected from the consecutive years. Under the condition of varying effort the data with such variation can be treated effectively by this method. The calculated values of M and a' include some deviation from the population parameters. Therefore, the estimated recruitment (R) is a relative value instead of all absolute one. This method of multiple regression is also applicable to the stock density and yield in weight instead of in number. For the data of the bigeye tuna of the Indian Ocean, the values of estimated recruitment (R) calculated from the parameter which is obtained by the present multiple regression method is proportional with an identical fluctuation pattern to the values of those derived from the parameters M and a', which were calculated by Suda (1970) for the same data. Estimated recruitments of Pacific saury of the eastern coast of Korea were calculated by the present multiple regression method. Not only spring recruitment $(1965\~1974)$ but also fall recruitment $(1964\~1973)$ was found to fluctuate in accordance with the fluctuations of stock densities (CPUE) of the same spring and fall, respectively.

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The Demand and Supply of Nutritionist Workforce in Korea and Policy Recommendations (국민영양관리를 위한 영양사 인력의 적정수급에 관한 연구)

  • Oh, Young-Ho
    • Journal of Nutrition and Health
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    • v.43 no.5
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    • pp.533-542
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    • 2010
  • The objective of this study is to provide basic information and policy implications needed to balance the supply and demand for dietitian by projecting supply and demand for dietitian. The data from the Ministry of Health Welfare and Family on the number of licensed nutritionist, resident registration data of the Ministry of Public Administration and Security, and health insurance qualification data of the National Health Insurance Corporation were used to examine the current status of supply. To project the supply of nutritionist workforce, the in-out moves method and demographic method were used. The ratios of nutritionist to population and GDP, and that of other countries were applied as the demand projection method. According to the study results, the projection on the imbalance of supply and demand for dietitian by year 2021 differs depending on the method used. First, according to the results based on age-adjusted population ratio, there is an oversupply of 1,643 dietitians in year 2010, and 2,076 dietitians in year 2020. Second, although the projection on the imbalance of the supply and demand for dietitian differs depending on whether the GDD is calculated in won(₩) or dollar($). it is expected that there will be an oversupply in general. Third, as to the scenario using the nutritionist ratio in foreign countries, the oversupply of dietitian is likely in Korea, under any scenario, when comparing the nutritionist supply projection with the demand projection based on the nutritionist ratio in the United States. However, the projection of the supply and demand varies in each scenario when the European nutritionist ratio is applied. Under European 'scenario 1', an oversupply is expected, whereas under 'scenario 2', a shortage of supply is expected. A careful approach is required in interpreting the supply and demand projection using criteria of other countries, because dietitian assumes different roles and functions in each country. Although a slight oversupply of nutritionist workforce is projected, it does not cause a major problem as the demand for diet therapy is expected to rise due to aging and the increase of chronic diseases, and as the demand for clinical dietitians in hospitals increases. Accordingly, the demand for dietitians will rise and, in this context, the oversupply of nutritionist will not incur much problem. However, the nutritionist qualification is much too open in Korea, and this has a negative effect on the quality of the nutritionist workforce. Therefore, it is important that the nutritionist qualifications and requirements are reinforced in the future, enhance the quality level of the nutritionist supply, and maintain the balance between the supply and demand.

Future Changes in Global Terrestrial Carbon Cycle under RCP Scenarios (RCP 시나리오에 따른 미래 전지구 육상탄소순환 변화 전망)

  • Lee, Cheol;Boo, Kyung-On;Hong, Jinkyu;Seong, Hyunmin;Heo, Tae-kyung;Seol, Kyung-Hee;Lee, Johan;Cho, ChunHo
    • Atmosphere
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    • v.24 no.3
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    • pp.303-315
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    • 2014
  • Terrestrial ecosystem plays the important role as carbon sink in the global carbon cycle. Understanding of interactions of terrestrial carbon cycle with climate is important for better prediction of future climate change. In this paper, terrestrial carbon cycle is investigated by Hadley Centre Global Environmental Model, version 2, Carbon Cycle (HadGEM2-CC) that considers vegetation dynamics and an interactive carbon cycle with climate. The simulation for future projection is based on the three (8.5/4.5/2.6) representative concentration pathways (RCPs) from 2006 to 2100 and compared with historical land carbon uptake from 1979 to 2005. Projected changes in ecological features such as production, respiration, net ecosystem exchange and climate condition show similar pattern in three RCPs, while the response amplitude in each RCPs are different. For all RCP scenarios, temperature and precipitation increase with rising of the atmospheric $CO_2$. Such climate conditions are favorable for vegetation growth and extension, causing future increase of terrestrial carbon uptakes in all RCPs. At the end of 21st century, the global average of gross and net primary productions and respiration increase in all RCPs and terrestrial ecosystem remains as carbon sink. This enhancement of land $CO_2$ uptake is attributed by the vegetated area expansion, increasing LAI, and early onset of growing season. After mid-21st century, temperature rising leads to excessive increase of soil respiration than net primary production and thus the terrestrial carbon uptake begins to fall since that time. Regionally the NEE average value of East-Asia ($90^{\circ}E-140^{\circ}E$, $20^{\circ}N{\sim}60^{\circ}N$) area is bigger than that of the same latitude band. In the end-$21^{st}$ the NEE mean values in East-Asia area are $-2.09PgC\;yr^{-1}$, $-1.12PgC\;yr^{-1}$, $-0.47PgC\;yr^{-1}$ and zonal mean NEEs of the same latitude region are $-1.12PgC\;yr^{-1}$, $-0.55PgC\;yr^{-1}$, $-0.17PgC\;yr^{-1}$ for RCP 8.5, 4.5, 2.6.

Clinical Characteristics of Arthrogryposis, Renal Tubular Dysfunction, Cholestasis(ARC) Syndrome in Korea (ARC(Arthrogryposis, Renal Tubular Dysfunction, Cholestasis) 증후군의 발병양상에 관한 연구)

  • Lee Soon Min;Kim Ji Hong;Lee Jae Seung;Han Suk Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.222-230
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    • 2005
  • Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

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Comparison between phosphorus absorption coefficient and Langmuir adsorption maximum (전토양(田土壤) 인산(燐酸)의 흡수계수(吸收係數)와 Langmuir 최대흡착량(最大吸着量)과의 비교연구(比較硏究))

  • Ryu, In Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.8 no.1
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    • pp.1-17
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    • 1975
  • Laboratory experiments on the phosphorus adsorption by soil were conducted to evaluate the parameters for determination of phosphorus adsorption capacity of soil, which serve as a basis for establishing the amount of phosphorus required to improve newly reclaimed soil and volcanic ash soil. The calculated Langmuir adsorption maxima varied from 6.2-32.9, 74.7-90.4 and 720-915mg p/100g soil for cultivated soils, non-cultivated soils, and volcanic ash soils respectively. The phosphorus absorption coefficient ranged from 116-179, 161-259 and 1,098-1,205mg p/100g soil for cultivated soils, non-cultivated soils, and volcanic ash soils respectively. The ratio of the phosphorus absorption coefficient to Langmuir adsorption maximum was low in soils of high phosphorus adsorption capacity (1.3-1.5) and high in soils of low phosphorus adsorption capacity (2.2-18.7). Changes in the amount of phosphurus adsorption induced by liming and preaddition of phosphorus were hadly detected by the phosphorus absorption coefficient, which is measured using a test solution with a relatively high phosphorus concentration. The Langmuir adsorption maximum was a more sensitive index of the phosphorus adsorption capacity. The Langmuir adsorption maxima of the non-cultivated soils, which were treated with an amount of calcium hydroxide equivalent to the exchangeable Al and incubated ($25-30^{\circ}C$) for 40 days at field capacity, were lower than the original soils. The change in the adorption maximum on incubation following the liming of soils was insignificant for other soils. The secondary adsorption maximum of soils, which received phosphorus equivalent to the Langmuir adsorption maximum of the limed soils incubated ($25-30^{\circ}C$) for 50 days at held capacity, was 74.5, 5.6 and 23.8% of the primary adsorption maximum for volcanic ash soils, non-cultivated soils, and cultivated soils respectively. The amount of phosphorus adsorbed by soils increased quadratically with the concentration of phosphorus solution added to the soils. The amount of phosphorus adsorbed by 5-g soil samples from 100ml of 100- and 1,000mg p/l solution for the mineral soils and volcanic ash soils respectively was found to be close to the Langmuir adsorption maximum. The amount of the phosphorus adsorbed at these concentrations is defined as a saturation adsorption maximum and proposed as a new parameter for the phosphorus adsorption capacity of the soil. The evaluation of the phosphorus adsorption capacity by the saturation adsorption maximum is regarded as a more practical method in that it obviates the need for the various concentrations used for the determination of the Langmuir adsorption maximum.

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Potassium Availability and Physical Properties of Upland Soils (밭토양(土壤)의 물리성(物理性)과 가리(加里))

  • Yoo, S.H.
    • Korean Journal of Soil Science and Fertilizer
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    • v.10 no.3
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    • pp.189-201
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    • 1977
  • Some of basic aspects of soil potassium with special reference to soil physical properties were discussed. Data in the Official Soil Series Description(Korea) was analyzed according to soil type, land form, and soil texture to find soil potassium status which may explain different response to potassium application. Exchangeable potassium contents decreased with soil depth irrespective of soil type, land form and soil texture. Change in degree of potassium saturation within soil profile was not so clear as exchangeable potassium but the degree of potassium saturation of A horizon was highest among soil horizon. Soils of terrace and mountain foot slope showed high values both in exchangeable potassium and degree of potassium sauration and only these two soils were classified as soils having exchangeable potassium higher than 0.3 meq per 100g of soil and degree of potassium saturation higher than 5.0%. Exchangeable potassium of fine loamy and fine clayey soils is higher than 0.3 meq per 100g of soil but degree of potassium saturation is lower than 4.0%. Degree of potassium saturation of sandy soils exceeds 5.0% but exchangeable potassium is very low. Soils of rolling, hilly, unmatured and alpine land soils have lower exchangeable potassium and show lower degree of potassium saturation. The highest distribution of exchangeable potassium content irrespective of soil horizons was shown in the range of 0.1-0.2 meq per 100g of soil. The highest distribution of degree of potassium saturation was in the range of 2.0-3.0% in A horizon and 1.0-2.0% in B and C horizons. Of the soil series concerned in this analysis, 27.3% in A horizon, 11.1% in B horizon and 4.0% in C horizon had exchangeable potassium higher than 0.3 meq per 100g of soil and 18.0% in A horizon, 6.3% in B horizon, and 4.1% in C horizon showed degree of potassium saturation higher than 5.0%. The low response of potassium application only to soils in terrace and mountain foot slope may be resulted from the high exchangeable potassium content and high degree of potassium saturation. It is concluded that a great response of potassium application to soils is expected especially in dry season.

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A Study on Risk Factors for Early Major Morbidity and Mortality in Multiple-valve Operations (중복판막수술후 조기성적에 영향을 미치는 인자에 관한 연구)

  • 한일용;조용길;황윤호;조광현
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.233-241
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    • 1998
  • To define the risk factors affecting the early major morbidity and mortality after multiple- valve operations, the preoperative, intraoperative and postoperative informations were retrospectively collected on 124 consecutive patients undergoing a multiple-valve operation between October 1985 and July 1996 at the department of Thoracic and Cardiovascular Surgery of Pusan Paik Hospital. The study population consists of 53 men and 71 women whose mean age was 37.9$\pm$11.5(mean$\pm$SD) years. Using the New York Heart Association(NYHA) classification, 41 patients(33.1%) were in functional class II, 60(48.4%) in class III, and 20(16.1%) in class IV preoperatively. Seven patients(5.6%) had undergone previous cardiac operations. Atrial fibrillations were present in 76 patients(61.3%), a history of cerebral embolism in 5(4.0%), and left atrial thrombus in 13(10.5%). The overall early mortality rate and postoperative morbidity was 8.1% and 21.8% respectively. Among the 124 cases of multiple-valve operation, there were 57(46.0%) of combined mitral valve replacement(MVR) and aortic valve replacement(AVR), 48(38.7%) of combined MVR and tricuspid annuloplasty(TVA), 12(9.7%) of combined MVR, AVR and TVA, 3(2.4%) of combined MVR and aortic valvuloplasty, 2(1.6%) of combined MVR and tricuspid valve replacement, and others. The patients were classified according to the postoperative outcomes; Group A(27 cases) included the patients who had early death or major morbidity such as low cardiac output syndrome, mediastinitis, cardiac rupture, ventricular arrhythmia, sepsis, and others; Group B(97 cases) included the patients who had the good postoperative outcomes. The patients were also classified into group of early death and survivor. In comparison of group A and group B, there were significant differences in aortic cross-clamping time(ACT, group A:153.4$\pm$42.4 minutes, group B:134.0$\pm$43.7 minutes, p=0.042), total bypass time(TBT, group A:187.4$\pm$65.5 minutes, group B:158.1$\pm$50.6 minutes, p=0.038), and NYHA functional class(I:33.3%, II:9.7%, III:20%, IV:50%, p=0.004). In comparison of early death(n=10) and survivor(n=114), there were significant differences in age(early death:45.2$\pm$8.7 years, survivor:37.2$\pm$11.6 years, p=0.036), sex(female:12.7%, male:1.9%, p=0.043), ACT(early death:167.1$\pm$38.4 minutes, survivor:135.7$\pm$43.7 minutes, p=0.030), and NYHA functional class(I:0%, II:4.9%, III:1.7%, IV:35%, p=0.001). In conclusion, the early major morbidity and mortality were influenced by the preoperative clinical status and therefore the earlier surgical intervention should be recommended whenever possible. Also, improved methods of myocardial protection and operative techniques may reduce the risk in patients with multiple-valve operation.

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The Clinical Effects of Normocapnia and Hypercapnia on Cerebral Oxygen Metabolism in Cardiopulmonary Bypass (체외순환 시 뇌대사에 대한 정상 탄산분압과 고 탄산분압의 임상적 영향에 관한 비교연구)

  • 김성룡;최석철;최국렬;박상섭;최강주;윤영철;전희재;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.712-723
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    • 2002
  • Substantial alterations in cerebral blood flow(CBF) are known to occur during cardiopulmonary bypass(CPB). Many investigators have speculated that these changes may be responsible for both minor and major cerebral damages after CPB. More recently, these changes in CBF have been observed to be intimately related to the arterial carbon dioxide tension(Pa$CO_2$) maintained during CPB. The present study was prospectively designed to investigate the clinical effects of normocapnic and hypercapnic CPB on the cerebral oxygen metabolism in cardiac surgery Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to either normocapnic group (Pa$CO_2$35~40 mmHg, n=18) or hypercapnic group(Pa$CO_2$, 45~55 mmHg, n=18) with moderately hypothermic nonpulsatile CPB(nasopharyngeal temperature of 29~3$0^{\circ}C$). In each patient, middle cerebral artery blood flow velocity( $V_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v) $O_2$), cerebral oxygen extraction(COE), cerebral metabolic rate for oxygen(CMR $O_2$), cerebral oxygen transport( $T_{E}$ $O_2$), $T_{E}$ $O_2$/CMR $O_2$ ratio, cerebral desaturation(internal jugular bulb blood oxygen saturation $\leq$ 50%), and arterial and jugular bulb blood gas were evaluated throughout the operation. Postoperative neuropsychologic complications were assessed in all patients. All variables were compared between the two groups. Result: VMCA(169.13 $\pm$ 8.32 vs 153.11 $\pm$8.98%), TE $O_2$(1,911.17$\pm$250.14 vs 1,757.40$\pm$249.56), $T_{E}$ $O_2$,/CMR $O_2$ ratio(287.38$\pm$28.051 vs 246.77$\pm$25.84), $O_2$ tension in internal jugular bulb (41.66$\pm$9.19 vs 31.50$\pm$6.09 mmHg), and $O_2$saturation in internal jugular bulb(68.97$\pm$10.96 vs 58.12$\pm$12.11%) during CPB were significantly lower in normocapnic group(p=0.03), whereas hypercapnic group had lower C(a-v) $O_2$(3.9$\pm$0.3 vs 4.9$\pm$0.3 mL/dL), COE(0.3$\pm$0.03 vs 0.4$\pm$0.03), CMR $O_2$(5.8 $\pm$0.5 vs 6.8$\pm$0.6), and arterial blood pH(7.36$\pm$0.09 vs 7.46$\pm$0.07, p=0.04) during CPB. Hypercapnic group had lower incidence of cerebral desaturation than normocapnic group(3 vs 9 patients, p=0.03). Duration of the neuropsychologic complication(delirium) were shorter in hypercapnic group than in normocapnic group(36 vs 60 hrs, p=0.009). Conclusion: These findings suggest that hypercapnic CPB may have salutary effects on the cerebral oxygen metabolism and postoperative neurologic outcomes in cardiac surgery.surgery.

Multivessel Coronary Revascularization with Composite LITA-RA Y Graft (좌내흉동맥-요골동맥 복합이식편을 이용한 다중혈관 관상동맥우회술)

  • Lee Sub;Ko Mgo-Sung;Park Ki-Sung;Ryu Jae-Kean;Jang Jae-Suk;Kwon Oh-Choon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.359-365
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    • 2006
  • Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.