• Title/Summary/Keyword: Delayed rupture

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Comparison of Different Thawing Methods on Cryopreserved Aorta (냉동 보존된 대동맥의 해동방법)

  • 오영민;심성보;사영조;박재길;곽문섭;이선희
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.113-118
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    • 2004
  • The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. Material and Method: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37$^{\circ}C$ (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. Result: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. Conclusion: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopresewed arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.

Weaving the realities with video in multi-media theatre centering on Schaubuhne's Hamlet and Lenea de Sombra's Amarillo (멀티미디어 공연에서 비디오를 활용한 리얼리티 구축하기 - 샤우뷔네의 <햄릿>과 리니아 드 솜브라의 <아마릴로>를 중심으로 -)

  • Choi, Young-Joo
    • Journal of Korean Theatre Studies Association
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    • no.53
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    • pp.167-202
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    • 2014
  • When video composes mise-en-scene during the performance, it reflects the aspect of contemporary image culture, where the individual as creator joins in the image culture through the device of cell phone and computer remediating the former video technology. It also closely related with the contemporary theatre culture in which 1960's and 1970's video art was weaved into the contemporary performance theatre. With these cultural background, theatre practitioners regarded media-friendly mise-en-scene as an alternative facing the cultural landscape the linear representational narrative did not correspond to the present culture. Nonetheless, it can not be ignored that video in the performance theatre is remediating its historical function: to criticize the social reality. to enrich the aesthetic or emotional reality. I focused video in the performance theatre could feature the object with the image by realizing the realtime relay, emphasizing the situation within the frame, and strengthening the reality by alluding the object as a gesutre. So I explored its two historical manuel. First, video recorded the spot, communicated the information, and arose the audience's recognition of the object to its critical function. Second, video in performance theatre could redistribute perceptual way according to the editing method like as close up, slow motion, multiple perspective, montage and collage, and transformation of the image to the aesthetic function. Reminding the historical function of video in contemporary performance theatre, I analyzed two shows, Schaubuhne's Hamlet and Lenea de Sombra's Amarillo which were introduced to Korean audiences during the 2010 Seoul Theatre Olympics. It is known to us that Ostermeir found real social reality as a text and made the play the context. In this, he used video as a vehicle to penetrate the social reality through the hero's perspective. It is also noteworthy that Ostermeir understood Hamlet's dilemma as these days' young generation's propensity. They delayed action while being involved in image culture. Besides his use of video in the piece revitalized the aesthetic function of video by hypermedial perceptual method. Amarillo combined documentary theatre method with installation, physical theatre, and video relay on the spot, and activated aesthetic function with the intermediality, its interacting co-relationship between the media. In this performance theatre, video has recorded and pursued the absent presence of the real people who died or lost in the desert. At the same time it fantasized the emotional aspect of the people at the moment of their death, which would be opaque or non prominent otherwise. As a conclusion, I found the video in contemporary performance theatre visualized the rupture between the media and perform their intermediality. It attempted to disturb the transparent immediacy to invoke the spectator's perception to the theatrical situation, to open its emotional and spiritual aspect, and to remind the realities as with Schaubuhne's Hamlet and Lenea de Sombra's Amarillo.

Neutrophil to Lymphocyte Ratio and Serum Biomarkers : A Potential Tool for Prediction of Clinically Relevant Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

  • Osman Kula;Burak Gunay;Merve Yaren Kayabas;Yener Akturk;Ezgi Kula;Banu Tutunculer;Necdet Sut;Serdar Solak
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.681-689
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    • 2023
  • Objective : Subarachnoid hemorrhage (SAH) is a condition characterized by bleeding in the subarachnoid space, often resulting from the rupture of a cerebral aneurysm. Delayed cerebral ischemia caused by vasospasm is a significant cause of mortality and morbidity in SAH patients, and inflammatory markers such as systemic inflammatory response index (SIRI), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), and derived NLR (dNLR) have shown potential in predicting clinical vasospasm and outcomes in SAH patients. This article aims to investigate the relationship between inflammatory markers and cerebral vasospasm after aneurysmatic SAH (aSAH) and evaluate the predictive value of various indices, including SIRI, SII, NLR, and dNLR, in predicting clinical vasospasm. Methods : A retrospective analysis was performed on a cohort of 96 patients who met the inclusion criteria out of a total of 139 patients admitted Trakya University Hospital with a confirmed diagnosis of aSAH between January 2013 and December 2021. Diagnostic procedures, neurological examinations, and laboratory tests were performed to assess the patients' condition. The Student's t-test compared age variables, while the chi-square test compared categorical variables between the non-vasospasm (NVS) and vasospasm (VS) groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic accuracy of laboratory parameters, calculating the area under the ROC curve, cut-off values, sensitivity, and specificity. A significance level of p<0.05 was considered statistically significant. Results : The study included 96 patients divided into two groups : NVS and VS. Various laboratory parameters, such as NLR, SII, and dNLR, were measured daily for 15 days, and statistically significant differences were found in NLR on 7 days, with specific cut-off values identified for each day. SII showed a significant difference on day 9, while dNLR had significant differences on days 2, 4, and 9. Graphs depicting the values of these markers for each day are provided. Conclusion : Neuroinflammatory biomarkers, when used alongside radiology and scoring scales, can aid in predicting prognosis, determining severity and treatment decisions for aSAH, and further studies with larger patient groups are needed to gain more insights.

Extubation Time by Birth Weight and the Predictors for Success/Failure at the First Extubation in Extremely Low Birth Weight Infants (초극소저출생체중아에서 출생체중별 발관시기 및 첫 발관 시의 성공/실패 예측인자)

  • Choi, Chang Won;Park, Sung Eun;Jeon, Ga Won;Yoo, Eun Jung;Hwang, Jong Hee;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.488-494
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    • 2005
  • Purpose : To outline the aspects of extubation by birth weight and find the predictors for success/failure at the first extubation in extremely low birth weight infants. Methods : One hundred thirteen extremely low birth weight infants(<1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. Results : As the birth weight decreased, extubation success day was significantly delayed : $16{\pm}3day(d)$ in 900-999 g; $20{\pm}3d$ in 800-899 g; $35{\pm}4d$ in 700-799 g; $37{\pm}9d$ in 600-699 g; $49{\pm}12d$ in ${\leq}599g$. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. Conclusion : We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.

Emergency Coronary Artery Bypass Operation for Card iogen ic Shock (심인성 쇼크에 대한 응급 관상동맥 우회술)

  • 김응중;이원용
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.966-972
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    • 1997
  • Between June 1994 to August 1996, 13 patients underwent emergency coronary artery bypass operations. There were 3 males and 10 females and ages ranged from 56 to 80 years with the mean of 65.5 years. The indications for emergency operations were cardiogenic shock in 12 cases and intractable polymorphic VT(ve'ntricular tachycardia) in 1 case. The causes of cardiogenic shock were acute evolving infarction in 6 cases, PTCA failure in 4 cases, acute myocardial infarction in 1 case, and post-AMI VSR(ventricular septal rupture) in 1 case. Pive out of 13 patients could go to operating room within 2 hours. However, the operations were delayed from 3 to 10 hours in 8 patients due to non-medical causes. In 12 patients, 37 distal anastomoses were constructed with only 3 LITA's(left internal thoracic arteries) and 34 saphenous veins. In a patient with post-AMI VSR, VSR repair was added. In a patient with intractable VT and critical sten sis limited to left main coronary artery, left main coronary angioplasty was performed. Pive patients died after operation with the operative mortality of 38.5%. Three patients died in the operating room due to LV pump failure, one patient died due to intractable ventricular tachycardia on postoperative second day, and one patient died on postoperative 7th day due to multi-organ failure with complications of mediastinal bleeding, low cardiac output syndrome, ARF, and lower extremity ischemia due to IABP. In 8 survived patients, 3 major complications (mediastinitis, PMI, UGI bleeding) developed but eventually recovered. We think that the aggressive approach to critically ill patients will salvage some of such patients and the most important factor for patient salvage is early surgical intervention before irreversible damage occurs.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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