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The Effects of Endothelin Receptor Antagonist on Hemodynamic and Respiratory Mechanics in Experimental Acute Pulmonary Thromboembolism (실험적 급성 폐색전증에서 Endothelin 수용체 길항제가 혈류 및 호흡 역학에 미치는 영향)

  • Lee, Ji-Hyun;Jeon, Yong-Gam;Choe, Kang-Hyeon;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.210-222
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    • 2000
  • Background: Endothelin(ET) is the most potent vasoconstrictor and bronchoconstrictor. The plasma ET-1 level is elevated in patients with acute pulmonary thromboembolism(APTE). This finding suggest that ET-1 may be an important mediator in the cardiopulmonary derangement of APTE. But whether ET-1 is a pathogenic mediator or a simple marker of APTE is not known. The role of ET-1 in the pathogenesis of cardiopulmonary dysfunction in APTE(delete) was investigated through an evaluation of the effects of $ET_A$-receptor antagonist on APTE. The increase in local levels of preproET-1 mRNA and ET-1 peptide in the embolized lung was also demonstrated. Methods: In a canine autologous blood clot pulmonary embolism model, $ET_A$-receptor antagonist(10 mg/kg intravenously, n=6) was administered one hour after the onset of the embolism. Hemodynamic measurements, blood gas tensions and plasma levels of ET-1 immunoreactivity in this treatment group were compared with those in the control group(n=5). After the experiment., preproET-1 mRNA expression(using Northern blot analysis) and the distribution of ET-1(by immunohistochemical analysis) in the lung tissues were examined. Results: The increases in pulmonary arterial pressure and pulmonary vascular resistance of the treatment group were less than those of the control group. Decrease in cardiac output was also less in the treatment group. Complications such as systemic arterial hypotension and hypoxemia did not occur with the administration of $ET_A$-receptor antagonist The plasma level of ET-1 like(ED: what does 'like' mean?) immunoreactivity was increased after embolization in both groups but was significantly higher in the treatment group. The preproET-1 mRNA and ET-1 peptide expressions were increased in the embolized lung. Conclusion: ET-1 synthesis increases with embolization in the lung and may plays play an important role in the pathophysiology of cardiopulmonary derangement of APTE. Furthermore, $ET_A$-receptor antagonist attenuates cardiopulmonary alterations seen in APTE, suggesting a potential benefit of this therapy.

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Normal Predictive Values of Spirometry in Korean Population (한국인의 정상 폐활량 예측치)

  • Choi, Jung Keun;Paek, Domyung;Lee, Jeoung Oh
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.230-242
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    • 2005
  • Background : Spirometry should be compared with the normal predictive values obtained from the same population using the same procedures, because different ethnicity and different procedures are known to influence the spirometry results. This study was performed to obtain the normal predictive values of the Forced Vital Capacity(FVC), Forced Expiratory Volume in 1 Second($FEV_1$), Forced Expiratory Volume in 6 Seconds($FEV_6$), and $FEV_1/FVC$ for a representative Korean population. Methods : Based on the 2000 Population Census of the National Statistical Office of Korea, stratified random sampling was carried out to obtain representative samples of the Korean population. This study was performed as a part of the National Health and Nutrition Survey of Korea in 2001. The lung function was measured using the standardized methods and protocols recommended by the American Thoracic Society. Among those 4,816 subjects who had performed spirometry performed, there was a total of 1,212 nonsmokers (206 males and 1,006 females) with no significant history of respiratory diseases and symptoms, with clear chest X-rays, and with no significant exposure to respiratory hazards subjects. Their residence and age distribution was representative of the whole nation. Mixed effect models were examined based on the Akaike's information criteria in statistical analysis, and those variables common to both genders were analyzed by regression analysis to obtain the final equations. Results : The variables affecting the normal predicted values of the FVC and $FEV_6$ for males and females were $age^2$, height, and weight. The variables affecting the normal predicted values of the $FEV_1$ for males and females were $age^2$, and height. The variables affecting the normal predicted values of the $FEV_1/FVC$ for male and female were age and height. Conclusion : The predicted values of the FVC and $FEV_1$ was higher in this study than in other Korean or foreign studies, even though the difference was < 10%. When compared with those predicted values for Caucasian populations, the study results were actually comparable or higher, which might be due to the stricter criteria of the normal population and the systemic quality controls applied to the whole study procedures together with the rapid physical growth of the younger generations in Korea.

Evaluating the Dosimetric Characteristics of Radiation Therapies according to Head Elevation Angle for Head and Neck Tumors (두 경부 종양 치료 시 거상각도에 따른 치료기법 별 선량특성 평가)

  • Cheon, Geum-Seong;Kang, Seong-Hee;Kim, Dong-Su;Kim, Tae-Ho;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.27 no.1
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    • pp.14-24
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    • 2016
  • Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

Estimation of Jaw and MLC Transmission Factor Obtained by the Auto-modeling Process in the Pinnacle3 Treatment Planning System (피나클치료계획시스템에서 자동모델화과정으로 얻은 Jaw와 다엽콜리메이터의 투과 계수 평가)

  • Hwang, Tae-Jin;Kang, Sei-Kwon;Cheong, Kwang-Ho;Park, So-Ah;Lee, Me-Yeon;Kim, Kyoung-Ju;Oh, Do-Hoon;Bae, Hoon-Sik;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.269-276
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    • 2009
  • Radiation treatment techniques using photon beam such as three-dimensional conformal radiation therapy (3D-CRT) as well as intensity modulated radiotherapy treatment (IMRT) demand accurate dose calculation in order to increase target coverage and spare healthy tissue. Both jaw collimator and multi-leaf collimators (MLCs) for photon beams have been used to achieve such goals. In the Pinnacle3 treatment planning system (TPS), which we are using in our clinics, a set of model parameters like jaw collimator transmission factor (JTF) and MLC transmission factor (MLCTF) are determined from the measured data because it is using a model-based photon dose algorithm. However, model parameters obtained by this auto-modeling process can be different from those by direct measurement, which can have a dosimetric effect on the dose distribution. In this paper we estimated JTF and MLCTF obtained by the auto-modeling process in the Pinnacle3 TPS. At first, we obtained JTF and MLCTF by direct measurement, which were the ratio of the output at the reference depth under the closed jaw collimator (MLCs for MLCTF) to that at the same depth with the field size $10{\times}10\;cm^2$ in the water phantom. And then JTF and MLCTF were also obtained by auto-modeling process. And we evaluated the dose difference through phantom and patient study in the 3D-CRT plan. For direct measurement, JTF was 0.001966 for 6 MV and 0.002971 for 10 MV, and MLCTF was 0.01657 for 6 MV and 0.01925 for 10 MV. On the other hand, for auto-modeling process, JTF was 0.001983 for 6 MV and 0.010431 for 10 MV, and MLCTF was 0.00188 for 6 MV and 0.00453 for 10 MV. JTF and MLCTF by direct measurement were very different from those by auto-modeling process and even more reasonable considering each beam quality of 6 MV and 10 MV. These different parameters affect the dose in the low-dose region. Since the wrong estimation of JTF and MLCTF can lead some dosimetric error, comparison of direct measurement and auto-modeling of JTF and MLCTF would be helpful during the beam commissioning.

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Analysis of Infant Mortality Rate in Korea Concerning According to Birth Weight and Gestational Age from 2005 to 2009 (한국의 2005-2009년도 영아사망률 중에서 출생체중, 임신나이 별 구분에 따른 신생아 사망률의 비율 관찰)

  • Cho, Mi-Jin;Ko, Jin-Hee;Chung, Sung-Hoon;Choi, Yong-Sung;Hahn, Won-Ho;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.182-188
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    • 2011
  • Purpose: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. Methods: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. Results: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. Conclusion: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

The Study on the Ultrastructure and Distribution of Dopaminergic Cells in the Brain of Mongolian Gerbil after Water Deprivation (절수에 의한 Mongolain gerbil 뇌 Dopamine성 면역반응세포의 분포와 미세구조의 변화에 관한 연구)

  • Song, Chi-Won;Lee, Kyoung-Youl;Park, Il-Kwon;Kwon, Hyo-Jung;Kim, Moo-Kang;Lee, Kang-Lee
    • Applied Microscopy
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    • v.30 no.2
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    • pp.193-204
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    • 2000
  • Nowadays, mongolian gerbil is widely utilized in the research of brain and water deprivation because of congenitally incomplete Willis' circle, audiogenic seizure in low noise, and special cholesterol metabolism without water absorption for a long time. In this study, we intended to identify the time lapse changes in the general morphoogy and ultrastructure of the catecholaminergic neurons of mongolian gerbil brain in after long-term water deprivation. Fifteen mongolian gerbils were divided into 3 groups (5, 10, and 20-day water deprivation groups), each with 5 mongolian gerbils. Additional 5 mongolian gerbils which received water without limitation were used as a control. The brain sections were immunostained using tyrosine hysroxylase (TH), $ dopamine-\beta-hydroxylase$ (DBH), and phenylethanolamine-N-methyltrasferase (PMNT) antibodies. And immunoreactive cells were observed by electromicroscopy for the ultrastructural changes . The TH-immunoreactive (TH-IR) nerve cells were observed in the para- and peri-ventricular nucleus of the 3 rd ventricle in the hypothalamus and the substantia nigra. The number of TH-IR neurons in these areas was decreased from the 5th day of the water deprivation to the 10 th day and reincreased until 20 th day water deprivation. The shape and density of the dopamine-secreting cells identified by immunohistochemistry showed changes in the continuous water deprivation. Electron microscopy revealed a round nucleus in the neurons of control group but 5-day water deprivation group showed a dense and irregularly shaped nucleus. Also in the 5-day water-deprived group, mitochondria was decreased in number and junctins were disappered. Endoplasmic reticulum, Golgi complex did not show changes after water-deprivation. In this results, we can conclude that dopamine are involved in the water metabolism in mongolian gerbil, and mongolian gerbil could be used as an animal model for the researches of water deprivation.

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Effect of Clonorchis sinensis Excretory-secretory Product on the Cultured SD Rat Bile Duct Fibroblast (배양된 흰쥐 담관 섬유모세포에 대한 간흡충 분비배설 물질의 영향)

  • Kwon, Jung-Nam;Min, Byoung-Hoon;Lee, Haeng-Sook;Kim, Soo-Jin;Joo, Kyoung-Hwan
    • Applied Microscopy
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    • v.39 no.2
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    • pp.117-124
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    • 2009
  • Clonorchis sinensis is the most important widely distributed parasite of the human bile duct in East Asia and the most prevalent parasitic helminth in Korea. The prevalence rate of human clonorchiasis has remained at about 2.9% in Korea. C. sinensis induces dilatation of the duct, hyperplasia of the mucosa, metaplasia or neoplasia of the mucosal epithelium, periductal inflammation and fibrosis, and thickening of the ductal wall. Fibroblast are the most common cells in connective tissue and are responsible for the synthesis of extracellular matrix components. The fibrosis associated with chronic inflammation and injury may also contribute to cholangiocarcinoma pathogenesis, particularly through an increase in extracellular matrix components, which participate in the regulation of bile duct differentiation during development. In this study, ultrastructural changes, the distribution of lectin receptors and actin protein in cultured SD rat bile duct fibroblast after infection of C. sinensis were observed. Experimental group had been divided into four groups: normal bile duct fibroblast cultured in basal media (G1); C. sinensis infected bile duct fibroblast cultured in basal media (G2); normal bile duct fibroblast cultured in basal media containing excretory-secretory product (ESP) (G1-1); C. sinensis infected bile duct fibroblast cultured in basal media containing ESP (G2-1). Overall, once a host is infected by C. sinensis, it affects the host to the extent that sialic acid of ductal fibroblast is increased. Number of cytoplasmic process of SD rat bile duct fibroblast was increased. Actin protein and sialic acid were located in cell surface. Fibroblast induced by C. sinensis was not recovered to normal fibroblast. The cytoplasm bulk and cytoplasmic process were increased whereas the growth rate of the fibroblast of infected SD rat was reduced rather than that of normal fibroblast. In result, it inhibits fibroblast proliferation and increases actin protein on fibroblast cytoplasm, and so causes fibroblast metamorphosis and cellular mutation.

Upper Mesozoic Stratifraphic synthesis of Korean Peninsula (한반도 후기중생대층 층서종합)

  • Ki-Hong Chang
    • Economic and Environmental Geology
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    • v.32 no.4
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    • pp.353-363
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    • 1999
  • The Cretaceous and the Upper Jurassic strata of the Korean Peninsula, entirely of continental facies, form a sedimentary mega-unit subdivided into three unconformity-bounded units. The lower, Upper Jurassic-early Lower Cretaceous unit (Jasong Synthem) occurs profusely in North Korea and is characterized by volcanic rocks of intermediate to acidic, calc-alkaline to alkaline compositions; but strata of this unit is very rare in South Korea. The middle, Hauterivian-Lower Albian unit occurs commonly in the Korean Peninsula, but some alkalinesubalkaline basalt and andesite occur only in South Korea. A recently obtained U-Pb isochron age about 113.6 Ma (Chang et at, 1998) from the zircon grains of the Kusandong Tuff in the uppermost part of the Haman Formation has thrown much light on the age of this unit. The stratotype of this Hauterivian-L. Albian unit is the Sindong and Hayang Groups of the Kyongsang Basin, where the unit is about twice thick and has more conglomerates than in sedimentary basins in North Korea. The unit shows various sedimentary cycles in different basins showing that the cyclicity is controlled by local crustal motion. The upper, Upper Albian-Upper Cretaceous unit is abundant in South Korea with prolific volcanic rocks which are intermediate to acidic and notably calc-alkaline. In North Korea, however, this unit occurs in only one locality without volcanic rocks and is not voluminous. The distribution of these three unconformity-bounded units shows a stepwise younging toward the Pacific Ocean: the lower unit occurs mainly in N Korea, the middle unit occurs in both N and S Korea, and the upper unit occurs mainly in the southern part of S Korea. The Cretaceous sedimentary basins of S Korea were genetically controlled by paralleling sinistral strike-slip faults parallel to the Pacific margin.

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Characteristics of Geochemical Behaviors of Trace Metals in Drainage from Abandoned Sechang Mine (세창 폐금속광산 수계에서 미량원소의 지구화학적 거동특성 규명)

  • Kang Min-Ju;Lee Pyeong-Koo;Youm Seung-Jun
    • Economic and Environmental Geology
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    • v.39 no.3 s.178
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    • pp.213-227
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    • 2006
  • The geochemical evolution of mine drainage and leachate from waste rock dumps and stream water in Pb-As-rich abandoned Sechang mine area was investigated to elucidate mechanisms of trace metals. Total and sequential extractions were applied to estimate the distribution of trace metals in constituent phases of the waste rocks and to assess the mobility of trace metals according to physicochemical conditions. These discharged waters varied largely in chemical composition both spatially and temporally, and included cases with significant]y low pH (in the range 2.1-3.3), and extremely sulphate (up to 661 mg/l and metal contents (e.g. up to 169 mg/l for Zn, 27 mg/l for As, 3.97 mg/l for Pb, 2.99 mg/l for Cu, and 1.88 mg/l for Cd). Arsenic and heavy metal concentrations at the down-stream of Sechang mine have been decreased nearly to the background level in downstream sites (sites 8 and 16) without any artificial treatments. The oxidation of Fe-sulfides and the subsequent hydrolysis, of Fe(II), with precipitation of poorly crystallized minerals, constituted an efficient mechanism of natural attenuation which reduces considerably the transference of trace metals (i.e. Fe and As) to rivers. The dilution of drainage by mixing with pristine waters provoked an additional decrease of trace metal concentrations and a progressive pH increase. On the other hand, the most soluble cations (i.e. Zn) remained significantly as dissolved solutes until the pH was raised to approximately neutral values. With respect to ecotoxicity, it is likely that the Zn pollution is of particular concern in Sechang mine area. This was confirmed by the sequential extraction experiment, where Zn in wet waste-rock samples occurred predominantly in the exchangeable fraction (65-89% of total), while Pb was the highest in the reducible and carbonate fractions, and Cd, Cu and As in the residual fraction. Pb concentration in the readily available exchangeable fraction (34-48% of total) was dominated for dried waste rock samples. Considering the proportion of metals bound to the exchangeable and carbonate fractions, the comparative mobility of metals probably decreased in the order of Zn>Pb>Cd>As=Cu.

Sorption Behavior of $^{241}Am,\;^{152}Eu,\;^{160}Tb\;and\;^{60}Co$ in the Geological Materials: Eu as an Optimum Analogue for Fate and Transport of Am Behavior in Subsurface Environment (지질매체내에서의 $^{241}Am,\;^{152}Eu,\;^{160}Tb,\;^{60}Co$의 흡착특성비교: 지표지질내에서의 Am의 거동특성을 위한 최적 유사체로서의 Eu)

  • Lee, Seung-Gu;Lee, Kil-Yong;Cho, Soo-Young;Yoon, Yoon-Yeol;Kim, Yong-Je
    • Economic and Environmental Geology
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    • v.40 no.4
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    • pp.361-374
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    • 2007
  • Rare earth elements(REEs) have been used as an useful tool in understanding the various geological processes such as evolution and differentiation in the crust. The REEs also have been used as an analog of actinides for radioactive wastes at the water-rock interactions. Using physicochemical properties of the REEs and actinides, we have shown that Eu is an optimum analogue for understanding the behavior of Am in subsurface environments. Factors affecting sorption behavior of radioactive nuclides in groundwater were investigated by batch experiments. Four nuclides such as $^{241}Am,\;^{152}Eu,\;^{160}Tb\;and\;^{60}Co$ were selected to test our hypothesis, and $^{160}Tb$ and $^{60}Co$ were specifically used to compare to the sorption behavior between $^{241}Am-^{152}Eu$ and other radioactive nuclides. Four different rock samples and one groundwater were used in the batch experiments where solution pH for all experiments was fixed at 5.5. Our results demonstrate that $^{241}Am,\;^{152}Eu,\;and\;^{160}Tb$ show similar sorption behavior whereas $^{60}Co$ is different in sorption behavior at the mineral-water interface, suggesting that the sorption behavior of $^{60}Co$ is affected by different rock types. Our results also show that 1) Eu in REEs is optimum analogue of fate and transport of Am in subsurface environments, and 2) mineral compositions such as $SiO_2,\;TiO_2,\;P_2O_5$ and distribution of REEs such as Eu anomaly play key roles in affecting sorption behavior of radioactive nuclides even though physicochemical properties of geological materials such as specific surface area and cation exchange capacity can not be ruled out.