• Journal of Chest Surgery
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• 제37권4호
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• pp.307-312
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• 2004

With the development of cardiac surgical technique, we need more prosthetic materials for repairing the intra- and extracardiac defects. Although bovine pericardial bioprosthesis treated with glutaraldehyde (GA) solution is one of the most popular materials, it has a drawback of later calcific degeneration. The purpose of this study is to investigate the effectiveness of several materials and methods in reducing the calcific degeneration of bovine pericardium. Material and Method: Forty square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L MgCl$_2$ㆍ6$H_2O$ as a control group (group 1). Other 40 pieces pre-treated with 1 % SDS(group 2) and 40 pieces post-treated with 8% glutamate (group 3) and 2% chitosan (group 4) were also fixed in the same GA solution. Other 40 pieces pre-treated with 1% SDS and post-treated with 8% glutamate and 40 pieces post-treated with 2% chitosan were also fixed in the same GA solution (group 5, 6). The pericardial pieces were implanted into the belly of 40 Fisher 344 rats subdermally and were extracted 1 month, 2 months, 3 months, and 6 months after the implantation. With an atomic absorption spectrophotometry, we measured the calcium amount deposited and examined the tissue with microscope. Result: The calcium deposition in 1 month was less in group 2, 5, 6 than that in group 1 (p＜0.05). It was most prominent in group 5 (p＜0.01). This finding continued in 2 month. In 3 month, the calcium deposition was less in group 3 and 4 as well as group 2, 5, and 6 than in group 1. In 6 month, the calcium deposition in group 2, 3, 4, 5, and 6 was less than that in group 1 and the difference was more than that of 1, 2, and 6 month. The microscopic calcium deposition was also less in group 2 and 5. Calcium deposition developed in the whole layer of pericardium, beginning with the surrounding the collagen fiber and progressing inwardly. Conclusion: Pre-treatment with SDS, post-treatment with glutamate or chitosan, and SDS pre-treatment and post-treatment with glutamate or chitosan were effective in reducing the calcium deposition in bovine pericardium. Moreover, the combined method of SDS pre-treatment and glutamate post-treatment was more effective than other methods.

• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.3-15
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• 1977

In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.

• Journal of Chest Surgery
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• 제33권6호
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• pp.494-501
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• 2000

Background: Transmyocardial laser revascularization(TMLR) for revascularizing ischemic myocardium in patients was originally based on the assumption that laser channels remain their patency much longer. But recent studies show that laser channels did not remain open and that TMLR could achieve treatment benefits without long-term channel patency. The angiongencesis is currently thought to be induced by non-specific inflammatory response to mechanical tissue injury. This study is to evaluate hypothesis that various transmyocaridal mechanical revascularization(TMMR) may induce the angiogenic responses similar to that seen with TMLR, and transmyocaridal polymer stent revascularization(TMSR), the polymer stent in the myocardial tissue is hydrolyzed in 2 weeks, may enhance the non-specific inflammatory reaction resulting angiogenesis. Furthermore, polymer myocaridal stent channels remain long-term patency. Material and Method: Eight domestic pigs underwent ligation of the proximal circumflex artery, and 2 weeks later they were randomized to undergo transmycardial acupunctural revascularization (TMPR, Group I) of the left lateral wall with 18-G needle(n=2), to undergo transmyocardial (TMDR, Group II) with industrial 2mm steel drill(n=2), to undergo transmyocardial polymer stent revascularization (TMSR, Group III) after drilling the infarcted myocardium(n=2), the stent is poly(lactic acid-co-glycolic acid), which is self-degradated in the myocardium, and to a control group the ischemic zone was unterated(n=2). All the pigs were sacrificed after 4 weeks TMMR. Sections from the ischemic zone were submitted for vascular endothelial growth factor (VEGF) ELISA and histology. Result: There were makedly increase in the VEGF immunoassay in the ischemic zone of the TMMR group compared to the ischemic zone of the control group(control: each 30.85 and 43.15pg/mg protein, TMPR: each 44.14 and 68.61 pg/mg protein, TMDR: each 65.92 and 78.65 pg/mg protein, TMSR: each 177.39 and 168.87 pg/mg protein). TMSR channels caused greatest VEGF expression than channels made by other group and the polymer stent channels remained vacuole after 4 weeks. Conclusion: Transmyocardial polymer stent revascularization promoted the most angiogenci response by the VEGF immunoassay, although our study did not show the statistical significancy. The channels remained but the flow patency was not verified. Transmyocardial polymer stent revascularization (TMSR) is desirable in future experimental trials and in view of the significant cost implications comparable to that of laser.

• Journal of Chest Surgery
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• 제34권7호
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• pp.515-523
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• 2001

배경: 당뇨병 환자에서 사망률과 이환률의 원인은 70%이상 혈관계의 합병증에 기인한다. 이러한 합병증은 혈관 내피세포 이완 작용 이상과 연관되어 있으며 이는 oxygen free radical의 직접적인 독성으로 추정되어 본 연구는 당뇨를 유발시킨 백서 복부 대동맥 운동성에 대한 Vit C의 보호효과를 연구 목적으로 한다. 대상 및 방법: 백서 60마리를 실험군(n=33)과 대조군(n=27)으로 나누고 실험 군은 streptozotocin을 투여하여 당뇨를 유발시켰다. 각각 실험 군과 대조군을 ascorbic acid를 투여한 군과 투여하지 않은 군으로 세분한 후 ascorbic acid투여 직후, 6주, 9주, 12주후의 복부 대동맥 혈관근육의 운동성을 측정하였다. 결과: 대조군의 경우 6주째 복부 대동맥 절편에서 acetylcholine투여 후 정상적인 이완반응이 나타났으나 실험군의 경우 현저히 저하됨이 관찰되었다. 9, 12주 째 절편에서는 실험군 중 ascorbic acid투여군에서 acetylcholine에 의한 이완반응이 거의 대조군에서의 결과와 일치할 정도로 회복되었다. 결론: 이상의 결과로 당뇨병을 유발한 백서에서 내피세포 의존적인 장애가 나타남을 확인할 수 있었으며 이러한 장애는 ascorbic acid의 투여로 회복됨을 알 수 있었으며 그 효과는 항산화 작용에서 비롯된 것으로 생각되므로 ascorbic acid가 당뇨환자의 혈관성 질환에 대해 보호적 효과를 보일 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제37권2호
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• pp.113-118
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• 2004

혈관재건술에 사용되는 냉동 보존된 동종동맥편에 대한 지금까지의 연구는 주로 냉동방법, 냉동전처치, 보존온도에 관심이 집중되어 있었으나, 최근에 해동방법이 균열발생의 중요한 인자가 된다는 연구가 있었다. 이에 저자들은, 같은 조건으로 냉동 보존된 대동맥조직을 서로 다른 두 가지 방법으로 해동시켜, 조직손상 정도를 비교함으로써 이상적인 조직의 해동방법을 알아보고자 하였다. 대상 및 방법: 2,500 g의 토끼에서 대동맥편을 획득한 후, 일반적인 방법에 따라 냉동 보존한 뒤 37$^{\circ}C$의 온수에 급속 해동한 군(RT)과 1$^{\circ}C$/min의 속도로 완속 해동시킨 군(ST)으로 나누고, 각 군에서 apoptosis 발생을 평가하기 위해 각 군의 전체 세포 중 TUNEL (＋) 세포의 비를 비교하였고, 광학현미경하에서 해동된 조직편의 조직학적 특성을 비교 관찰하였다. 결과: 1. TUNEL test상, RT군에서 ST군에 비해 TUNEL (＋) 세포의 비가 유의하게 높았다. 2. 광학현미경하 조직소견상, RT군에서 세포부종과 혈관내피층의 박탈, 소수포 형성, 그리고 이형성세포 등의 소견이 ST군에 비해 더 많이 관찰되었다. 결론: 냉동 보존된 토끼의 대동맥조직에 대한 해동방법의 차이에서, 완속 해동방법이 조직의 형태학적 손상과 apoptosis발생을 감소시켰다. 따라서, 향후 냉동조직을 이용한 이식술에서 술 후 합병증의 발생을 감소시키고 예후를 개선하기 위해서는 기존의 급속 해동하는 방법보다 완속 해동하는 방법의 사용을 고려해야 할 것이다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2005년도 제30회 춘계학술대회
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• pp.59-63
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• 2005

호흡 움직임은 종양에 대한 방사선치료의 부정확한 방사선조사가 유도되도록 복부 및 흉부에서 움직임을 야기한다. 그러므로 치료시 이러한 움직임에 대한 정확한 계산은 정상조직에는 저 선량을 조사되도록 CTV의 마진을 줄일 수 있고 방사선치료에 발생되는 부작용을 줄일 수 있다. Intrafraction motion을 고려하는 기술로는 호흡 멈춤, 호흡동조, 4차원 또는 종양추적 기술이 있다. 호흡동조 방법은 환자의 호흡 신호가 호흡주기의 일정한 범위에 위치할 때 주기적으로 빔을 조사하고 그 범위를 벗어날 때는 빔을 조사하지 않는 방법이다. 이러한 기술은 내부장기 움직임과 상관관계가 있는 호흡 움직임 신호의 획득이 요구된다. 호흡동조 방사선치료를 위한 예비연구로 본 연구자들은 호흡 움직임 신호 측정을 수행하였다. 환자의 호흡 움직임 신호 측정을 위해서, 호흡측정시스템을 3 가지 센서, 4 채널 데이터 획득 시스템, 신호처리용 컴퓨터로 구성하였다. 2명의 환자를 대상으로 본 연구자들은 호흡측정시스템을 가지고 호흡주기 및 파형을 평가하였다. 그 결과 호흡주기는 시간의 함수에 따라 일반적으로 정확한 대칭 형태는 아니지만 주기적인 형태로 측정되었다. 호흡측정 시스템은 기대했던 만큼 환자의 호흡을 잘 추적하였으며 실험에 적용하기 위해 쉽게 컨트롤 할 수 있었다.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.218-226
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• 2009

Purpose: In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician' and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room. Methods: In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis. Results: Of blunt trauma patients, 9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) < 14, Revised Trauma Score (RTS) < 11, white blood cell count (WBC) < 4000 or > 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS < 14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors. Conclusion: In our study, systolic blood pressure (SBP) < 90 mmHg, old age > 65 years, hemoglobin < 13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR > 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.

• Journal of Chest Surgery
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• 제33권4호
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• pp.290-300
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• 2000

Background: To evaluate the diagnostic accuracy of EBT(Electron Beam Tomography) in the diagnosis of conotruncal anomaly and to determine whether it can be used as a substitute for cardiac angiography. Material and Method: 20 patients(11M & 9F) with TOF(n=7, pulmonary atresia 2), DORV(n=7), complete TGV(n=4), & corrected TGV(n=2) were included. The age ranged from 7 days to 26 years(median 60 days). We analyzed the sequential chamber localization, the main surgical concenrn in each disease category (PA size, LVED volume and coronary artery pattern for TOF & pulmonary atresia, the LV mass, LVOT obstruction, coronary artery pattern for complete TGV, and type of VSD and TV-PV distance for DORV, etc) and other associated anomalies(e.g., VSD, arch anomalies, tracheal stenosis, etc). Those were compared with the results of echocardiography(n=19), angiography (n=9), and surgery(n=11). The interval between EBT and echocardiography/angiography was within 20/11 days, respectively except for an angiography in a patient with corrected TGV (48 days). Result: EBT correctly diagnosed the basic components of conotruncal anomalies in all subjects, compared to echocardiography, angiography or surgery. These included the presence, type and size of VSD(n=20), pulmonic/LV outflow tract stenosis(n=15/2), relation of great arteries and the pattern of the proximal epicardial coronary arteries(16 out of 20). EBT proved to be accurate in quantitation of the intrapericardial and hilar pulmonary arterial dimension and showed high correlation and no difference compared with echocardiography, angiography, or surgery(p>0.05) except for left pulmonary arterial & ascending arterial dimension by echocardiography. LVED volume in seven TOF(no difference: p>0.05 & high correlation: r=0.996 with echocardiography), and LV mass in 4 complete TGV were obtained. Additionally, EBT enabled the cdiagnosis of subjlottic tracheal stenosis and tracheal bronchus in 1 respectively. Some peripheral PA stenosis were not detected by echocardiography, while echocardiography appeared to be slightly more accurate than EBT in detecing ASD or PDA. Conclusion: EBT can be a non-invasive and accurate modality of for the evaluation of most anatomical alteration including peripheral PS or interruption in patients with conotruncal anomalies. Combined with echocardiography, EBT study provides sufficient information for the palliative or total repair of anomalies.

• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.153-161
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• 1989

Authors studied on the prevalence of 94 cases of pneumoconiosis who were found out through the screening test on 1,062 workers engaged in welding process at 36 shipyard in Pusan area from March 1st, 1986 to November 30th, 1986. The result were as follows; 1. Dust concentration was measured $4.49{\pm}0.54mg/m^3$ in the small scale shipyard while it was $6.25{\pm}1.08mg/m^3$ in the large one. 2. The prevalence of welder's lung was 8.9% (male:8.5%, female:12.0%) and this is consist of 4.9% suspected pneumoconiosis and 4.0% pneumoconiosis more than category 1/0. 3. The prevalence was significantly increased according to the duration of dust exposure(p<0.05), and it showed the increasing tendency by the age group. 4. The prevalence was significantly higher in the large scale shipyard than is the small scale one(p<0.01). 5. The type and shape of opacities were 71.4% of p type and 28.6% of q type, however no pneumoconiosis with r type observed in this study. 6. The main subjective symptoms were the sputum(29.8%), coughing(25.5%), shortness of breath(20.2%), fatique(6.4%), and chest pain(5.3%). In other hand, 57.4% of pneumoconiosis were asymptomatic. 7. The prevalence of pulmonary tuberculosis was radiologically 1.7% in all subjects including 5.3% in pneumoconiosis and 1.3% in no pneumoconiosis(p<0.01).

• Journal of Chest Surgery
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• 제29권5호
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• pp.487-494
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• 1996

기도평활근을 전장 자극하면 콜린성 수축에 이은 느리고도 지속적 인 이완성 반응이 유발된다. 지속적 인 이완성 반응은 억제성인 비아드레날린성 비콜린성 신경 섬유에 의해서 야기되는 것으로 알려져있다. 그러나 이러한 신경 말단에서 분비되는 신경 전달물질에 대해서는 아직도 실험한 동물 및 사용 조직에 따라 다르게 보고되고 있다. 본 실험은 기 니피그 기도 평 활근에서 전장 자극을 주어 이완성 반응에 관여 하는 인자 및 그 작용 기전을 알아보고자 하였다. 전장 자극으로 유발된 이완성 반응은 L-NAME에 의 해서 억제되 었으며 L-arginine에 의 해서 부분적으로 회복되 었다. 또한 L-WAME은 기초장력을 증가시켰 다. Hitroprusside는 윤상근의 기초 장력을 완전히 억제하였으며, methylene blue는 전장 자극으로 유발 된 이완성 반응을 억제함과 동시에 기초장력을 증가시켰다 Forskolin과 isoprenaline는 nitroprusside와 똑같이 기도 평활근의 기초 장력을 크게 억제하였다. TEA와 apamin은 기도 평활근 기초 장력 및 전장 자극으로 유발된 이완성 반응을 모두증가시켰다. 이상의 실험 결과로 보아 기니피그 기도 평활근 비교 감성 비콜린성 신경 섬\ulcorner 말단에서는 K' 통로와 관련하여 WO가 분비되며 이외에도 CAMP를 매개로 하는다른억제성 신경 전달물질(ex. WP,만Tl)이 분비되리라사료된다.