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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Studies on the Relationship between Silkworm Rearing and Tobacco Cultivation I. Tobacco Field Cultivated in Mulching System Affecting the Silkworm Rearing in Autumn Season (연초재배가 양잠에 미치는 영향에 관한 연구 I. 뽕밭 부근의 담배개량 Mulching 재배가 추잠작에 미치는 영향에 관한 시험)

  • 정태암;이상풍;김정배;홍기원;김계명;마영일
    • Journal of Sericultural and Entomological Science
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    • v.17 no.2
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    • pp.141-149
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    • 1975
  • Silkworm is known to be damaged under the unfavorable environmental conditions. Recently, it has been often argued that nicotine is a main factor to affect the silkworm nutritional balance and to result in decrease of quantitative characters, and unbalance of larval nutrition. Especially in spring season, there is tendency to produce nicotine damage to silkworm fed with the mulberry leaf near to tobacco field early cultivated in mulching system. In these connections, the trial was made in the different pots placing by the different distance 10rn, 20m, 40m, and 60m in the direction of east-north from the tobacco field. Location of pot near to the tobacco fold is 40m below the tobacco Held and gradually higher than the tobacco field by 10 degree of slope. In addition, when the mulberry field is divided into two areas from the east-south to west-north, southern east zone is lowering down below 10 degree of slope and has 36% of east-south wind, 21% of south-east wind and 16% of south wind, etc. Pots are left on the mulberry field from the completion of lower part leaf harvest to just before upper part leaf harvest is completed for 32 days. Then silkworm at 4th-5th stage was fed with the leaf grown during the period and larval characters are statistically analyzed. The results are summarized as follows: 1. 10-40m distant pot statistically at the same level has the longest larval duration and 60m distant pot is. not significant at 5% level. Whole larval duration has same tendency as in the 5th larval duration. 2. Percentage of delayed molting larvae at the 5th stage is increased in 10m distant pot and there is no significance statistically in other pots, as compared with that of control. 3. It is not showed that there is no damage to mortality of the old larvae in 60m distant pot. 4. 10-20m distant pot produces a low pupation and others are at the same level statistically at 5% significance, 5. It is showed that nicotine damage is occurred in single cocoon freight and cocoon shell weight up to 60m distant pot, rather higher damage in cocoon shell weight than in single cocoon weight. 6. It is showed that cocoon yield from 10, 000 molted larvae including double cocoon is decreased up to 40m distant pot far from the tobacco field in which 40% of cocoon yield in 10m distant pot by 7kg, 26% of cocoon yield in 20m distant pot by 3.9kg, 24% of cocoon yield in 40m distant pot by 3.6kg, and 12% of cocoon yield in 60m distant pot by 1.8kg, as compared with control. However, there is no significance statistically at 5% level in 60m distant pot. With these above results, it is concluded that nicotine da mage could be occurred in cocoon yield and cocoon quality up to 60m distant far from the tobacco field.

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Effect of Nitrogen Levels on Yield and Quality of 2nd Harvested Tea(Camellia sinensis var. sinensis) (질소 비료 시용량에 따른 두물차(Camellia sinensis var. sinensis)의 수량 및 품질)

  • Park, Jang-Hyun
    • Korean Journal of Soil Science and Fertilizer
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    • v.31 no.3
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    • pp.238-245
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    • 1998
  • The reasonable level of nitrogen fertilizer is a key factor to reduce environmental contamination as well as to increase crop yield and quality. The treatments are $N=42kg\;10a^{-1}$, $N=48kg\;10a^{-1}$, $N=54kg\;10a^{-1}$. $N=60kg\;10a^{-1}$. $N=72kg\;10a^{-1}$ and $N=150kg\;10a^{-1}$. Analytical results of yield and quality of tea leaves harvested the second time are summarized as follows: The soil of experimental field was higher in organic matter($49.9g\;kg^{-1}$) and available phosphate($937mg\;kg^{-1}$) compared to the general field but lower in pH(5.07) compared to the general field. When the amount of nitrogen fertilizer application was raised, the yield of tea leaves, the content of nitrogen, total free amino acids, caffeine and chlorophyll increased: however, the yield of tea leaves increased to excessive levels. On the other hand, the increased level of nitrogen fertilizer did not show any difference in the contents of vitamin C and tannin. Eleven kinds of amino acids were isolated from second harvested leaves of tea where the content of theanine occupied over 50%, and content of $665{\sim}763mg\;100g^{-1}$. The contents of fatty acids and catechin did not show correlation with application level of nitrogen fertilizer. The content of fatty acid was produced $1,742{\sim}2,643mg\;100g^{-1}$, and content of catechin was produced 12.47~13.54%. In scoring test, $N=60kg\;10a^{-1}$ treatment was 0.5~6.0 point higher compared to other treatments. Consequently, $N=60kg\;10a^{-1}$ is considered to be the best level of nitrogen fertilizer in terms of decreased environmental contamination as well as to increase crop yield and quality.

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The effects of the mulberry and silkworm intake on androgen receptor mRNA and myogenic regulatory factors expression of rats muscle for resistance exercise (오디와 누에 섭취가 rats의 저항성 운동에 따른 androgen receptor mRNA와 myogenic regulatory factors의 발현에 미치는 영향)

  • Yang, Sung Jun;Kim, Chang Yong;Lee, Jo Byoung;Kang, Sung Sun;Lee, Jong Jin
    • Journal of Sericultural and Entomological Science
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    • v.51 no.2
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    • pp.99-106
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    • 2013
  • The purpose of this study is to investigate the effects of supplementation of mulberry powder, mulberry extract and silkworm powder during the 8 weeks of resistance exercise on Androgen receptor(AR) mRNA and Myogenic regulatory factors(MRFs) expression of rats muscle. Fifty males, Sprague-Dawley rat, were randomly divided into 5 groups: CON(control group, n = 10), REG(resistance exercise group, n = 10), MP REG(mulberry powder intake and resistance exercise group, n = 10), ME REG(mulberry extract intake and resistance exercise group, n = 10) and SP REG(silkworm powder intake and resistance exercise group, n = 10). After climbing the ladder without weights during the 1 week of adaptation period, the rats in the resistance exercise group were trained to climb a 0.98-m vertical(80 degree incline) ladder with weights in their tail during 7 weeks(10 times each day, 2 days per week). After exercise, the skeletal muscle was extracted from the flexor hallucis longus. After separating the total ribonucleic acid (RNA) of each group, quantitative polymerase chain reaction was used to analyze RNA quantitatively. AR mRNA and MRFs expression revealed that all of the treated groups had significantly difference. AR mRNA expression increased in ME REG $6.24{\pm}1.85$ and SP REG $9.68{\pm}0.28$ fold compared to CON. Myod mRNA expression increased in MP REG $6.04{\pm}0.47$, ME REG $4.31{\pm}1.58$ and SP REG $8.11{\pm}0.57$ fold compared to CON. And myogenin mRNA expression increased in MP REG $4.11{\pm}0.42$, ME REG $4.12{\pm}0.45$ and SP REG $6.50{\pm}0.61$ fold compared to CON. In conclusion, during the resistance exercise, providing mulberry and silkworm gives positive effect on AR mRNA and MRFs expression increase.

The Change of Transforming Growth Factor ${\beta}1(TGF-{\beta}1)$ Expression by Melatonin in Irradiated Lung (방사선조사된 폐에서 Melatonin에 의한 TGF-${\beta}1$ 발현의 변화)

  • Jang, Seong-Soon;Choi, Ihl-Bohng
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.161-168
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    • 2005
  • Purpose: The changed expressions of $TGF-{\beta}1$, as a key cytokine in the fibrotic process, due to melatonin with potent antioxidative effects, were investigated in the irradiated lung using fibrosis-sensitive C57BL/6 mice. Materials and Methods: Female C57BL/6 mice were divided into control irradiation-only, and melatonin (300 mg/kg i.p. 1 hr before irradiation) pretreatment groups. The thoraces of the mice were irradiated with a single dose of 12 Gy. The mRNA expressions of $TGF-{\beta}1$ in the lung tissue 2 and 4 weeks after irradiation were quantified using semiquantitive RT-PCR, and the cellular origin and expression levels of $TGF-{\beta}1$ protein were identified using immunohistochemical staining. Results: The relative mRNA expression levels in the irradiation-only and melatonin pretreatment groups 2 and 4 weeks after irradiation were 1.92- and 1.80-fold (p=0.064) and 2.38- and 1.94-fold (p=0.004) Increased, respectively compared to those in the control group. increased expressions of $TGF-{\beta}1$ protein were prominently detected in regions of histopathologicai radiation injury, with alveolar macrophages and septal epithelial cells serving as important sources of $TGF-{\beta}1$ expression. At 2 and 4 weeks after irradiation, the expression levels of protein were $15.8\%\;vs.\;16.9\%$ (p=0.565) and $36.1\%\;vs.\;25.7\%$ (p=0.009), respectively. Conclusion: The mRNA and protein expressions of $TGF-{\beta}1$ in the lung tissue following thoracic irradiation with 12 Gy were significantly decreased by melatonin pretreatment at 4 weeks. These results indicate that melatonin may have a possible application as an antifibrotic agent in radiation-induced lung injury.

Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma (후복막 연조직 육종의 수술 후 외부 방사선 치료)

  • Jang, Na-Young;Kim, Il-Han;Choi, Jin-Hwa;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.135-141
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    • 2008
  • Purpose: To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. Materials and Methods: The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, $8{\sim}240$ months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, $3{\sim}50\;cm$). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. Results: The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Conclusion: Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.

Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer (유방암에서 유방보존수술 및 수술 후 방사선치료의 결과)

  • Chie, Eui-Kyu;Kim, Kyu-Bo;Choi, Jin-Hwa;Jang, Na-Young;Han, Won-Shik;Noh, Dong-Young;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.142-148
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    • 2008
  • Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

Evaluation of Butyltin Compounds and its Distribution Among Seawater, Sediment and Biota from the Kwangyang Bay (광양만내 유기주석화합물의 해수, 퇴적물, 생물중 농도 및 분포 상관관계)

  • KIM Gue Yoong;PARK Mi-Ok
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.4
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    • pp.291-298
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    • 2001
  • Seawater, sediment and biota in the Kwangyang Bay were analyzed by gas chromatography/quartz furnace atomic absorption spectroscopy (GC-QFAAS) to investigate concentrations and distribution pattern of butyltin compounds (TBT, DBT, MBT) during February, April and July, 1996, Marine biota analyzed were Tapes japcnicus and Crassostrea gigas. The concentrations of tributyltin (TBT) in seawater were in the range of ND-15.7 ng/L for the surface and ND-68.5 ng/L for the bottom. The highest concentration of TBT in seawater was detected in April for the both, surface and bottom water. The maximum value of $TBT_{(bottom)}/TBT_{(surface)}$, 3.6 in April showed the increased input of TBT from the surface water in April compared to February (2.1) and July (0.9). The concentrations of TBT in the sediment were in the range of ND-8.5 ng/g dry wt. The highest concentration of TBT in the sediment was measured in July, This result seems to attributed to the removal of TBT from water column via sorption onto particulate matters to the relatively undisturbed underlying sediment and increased input of TBT by increased fluxes of detritus of marine plankton after spring bloom, in July. The mean values of partitioning coefficient ($K_d$) of TBT between seawater and sediment were $3.0\times10^3$(February), $7.4\times10^3$(April) and $9.4\times10^3$(July). The concentrations of TBT in biosamples were in the range of ND-93.30 ng/g dru wt. (T. japonicus) and ND-138.53 ng/g dry wt. (C. gigas). The seasonal variation of TBT contents in biota was remarkable. The $K_d$ (biological concentration factor) was $7-41\times10^3$ for T. japonicus. and $5-34\times10^3$ for C. gigas. The measured TBT concentrations in seawater in the study area was sufficient to cause the imposex of shellfish and to retard the growth of aquatic organisms including oyster upon chronic exposure.

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Postoperative Stability and Occlusal Plane Alternation by Orthognathic Surgery of Skeletal Class III Malocclusion with Anterior Open Bite (전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구)

  • Shin, Soo-Jung;Hwang, Byung-Nam;Lee, Jung-Keun;Rhee, Seung-Hoon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.113-127
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    • 1999
  • The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

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Lead Pollution and Lead Poisoning among Children in China

  • Zheng, Yuxin
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2003.06a
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    • pp.24-25
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    • 2003
  • Lead is ubiquitous in the human environment as a result of industrialization. China's rapid industrialization and traffic growth have increased the potential for lead emissions. Lead poisoning in children is one of the most common public health problems today, and it is entirely preventable. Children are more vulnerable to lead pollution and lead in their bodies can affect their nervous, circulatory, and digestive systems. Children are exposed to lead from different sources (such as paint, gasoline, and solder) and through different pathways (such as air, food, water, dust, and soil). Although all children are exposed to some lead from food, air, dust, and soil, some children are exposed to high dose sources of lead. Significant sources of lead for China's children include industrial emissions (often close to housing and schools), leaded gasoline, and occupational exposure that occurs when parents wear lead-contaminated clothing home from work, burning of coal for home heat and cooking, contaminated food, and some traditional medicines. To assess the blood lead level in children in China, a large-scale study was conducted in 19 cities among 9 provinces during 1997 to 2000. There were 6502 children, aged 3-5 years, were recruited in the study The result indicates that the mean blood lead level was 8.83ug/dl 3-5 year old living in city area. The mean blood lead level of boys was higher than that of girls (9.1l ug/dl vs 8.73ug/dl). Almost 30 percent childrens blood lead level exceeded 10ug/dl. The average blood lead level was higher than that of in 1985 (8.83ug/dl vs 8.lug/dl). An epidemiological study was carried on the children living around the cottage industries recycling the lead from battery. Nine hundreds fifty nine children, aged 5-12 years, living in lead polluted villages where the lead smelters located near the residential area and 207 control children live in unpolluted area were recruited in the study. The lead levels in air, soil, drinking water and crops were measured. The blood lead and ZnPP level were tested for all subjects. The results show that the local environment was polluted. The lead levels both in the air and crops were much higher than that of in control area. In the polluted area, the average blood level was 49.6ug/dl (rang 19.5-89.3ug/dl). Whereas, in the unpolluted area, the average blood level was 12.4ug/dl (rang 4.6-24.8ug/dl). This study indicates that in some countryside area, some cottage industries induce seriously lead pollution and cause children health problem. For the introducing of unleaded gasoline in some large cities, such as Beijing and Shanghai, the blood lead level showed a declined trend since 1997. By 2000, the use of leaded gasoline in motor vehicles has been prohibited in China. The most recent data available show that levels of lead in blood among children in Shanghai decreased from 8.3ug/dl in 1997 to 7.6ug/dl in 1999. The prevalence rate of children lead poisoning (blood lead >10ug/dl) was also decreased from 37.8% to 24.8%. In children living in downtown area, the blood lead level reduced dramatically. To explore the relationship between gene polymorphisms and individual susceptibility of lead poisoning, a molecular epidemiological study was conducted among children living in lead polluted environment. The result showed that the subjects with ALAD2 allele has higher ZPP level, and the subjects with VDR B allele has larger head circumference than only with b allele. In the present study, we demonstrated that ALAD genotypes modify lead effects on heme metabolism and VDR gene variants influence the skull development in highly exposed children. The polymorphism of ALAD and VDR genes might be the molecular inherited factor modifying the susceptibility of lead poisoning. Recently, Chinese government pays more attention to lead pollution and lead poisoning in children problem. The leaded gasoline was prohibited used in motor vehicles since 2000. The government has decided to have a clampdown on the high-polluted lead smelters for recycling the lead from battery in countryside. It is hopeful that the risk of lead poisoning in children will be decreased in the further

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