• Title/Summary/Keyword: Less invasive

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Follicular Stimulation and Laparoscopic Ovum Pick-up (LOPU) in Repeatedly Superovulated Korean Black Goats (반복적인 과배란 처치 경험이 있는 한국흑염소에서 난포 자극 및 복강경을 이용한 난포란 채취(LOPU))

  • Lee, Yong-Boum;Lee, Doo-Soo;Cho, Sang-Cheol;Shin, Sang Tae
    • Journal of Embryo Transfer
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    • v.29 no.1
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    • pp.35-41
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    • 2014
  • Laparoscopic ovum pick-up (LOPU) is a convenient method for collecting oocytes in small ruminants. LOPU has the advantage of being a less invasive means of oocyte collection, thereby allowing for a repeated usage of the oocyte donor animals. A total of 25 Korean black goats were used in the winter season (December to February) and LOPU was applied to the goats which had been treated for superovulation more than two times during the last twelve months. Estrus was synchronized with an intravaginal insert containing 0.3 g progesterone for 10 to 12 days. Ovaries were hyperstimulated with eCG 1,000 IU oneshot, FSH with eCG (50 mg / 1,000 IU; 70 mg / 500 IU; 70 mg / 1,000 IU) oneshot or FSH multiple-shot with eCG oneshot ($20mg{\times}6/300IU$) given intramuscularly 72 h prior to LOPU. For these groups, the number of follicles (mean ${\pm}$ SEM) observed which developed to larger than 2 mm in diameter were $1.6{\pm}2.5$, $4.3{\pm}3.1$, $5.5{\pm}4.2$, $6.6{\pm}2.1$ and $8.8{\pm}7.8$, respectively. Oocytes were aspirated by using OPU needles and a vacuum pump. The overall oocyte retrieval rates were 41.4%. Oocytes were matured in TCM-199 supplemented with 10% (w/v) bovine serum albumin + $10{\mu}g/ml$ FSH + $1{\mu}g/ml$ $17{\beta}$-estradiol for 27 h at $39^{\circ}C$ in 5% $CO_2$ in air. Oocytes were parthenogenetically activated by ionomycin combined with 6-diethylaminopurine (6-DMAP). Total oocyte maturation and cleavage rate were 67.3% and 78.8%, respectively. In summary, LOPU is a useful oocyte collection method in Korean black goats that can provide immature oocytes for transgenesis or nuclear transfer.

Spontaneous Pneumomediastinum: Clinical Experience of 24 Patients in Two Medical Center (자연성 종격동 기종: 두 병원에서의 임상 경험 24예)

  • Moon, Hyeon-Jong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.663-668
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    • 2010
  • Background: Spontaneous pneumomediastinum is an uncommon disorder with few cases reported. It usually occurs in young males and has benign self-limiting course without any apparent concomitant factor. It is seen after intrathoracic pressure changes leading to alveolar rupture. The clinical experiences of two medical centers were reviewed to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with spontaneous pneumomediastinum patients was performed. Result: 24 patients were identified with a diagnosis of spontaneous pneumomediastinum. These 24 patients were comprised of 18 men and 6 women with mean age 18.9 years (range 10 ~ 33). The major initial complaints were chest pain (79.2%), throat pain (62.5%), and subcutaneous emphysema (41.7%). The triggering events were exercise (16.7%), coughing (12.5%) and vomiting (12.5%). No apparent triggering event was noted in 54.2% of patients. In all cases, chest radiograph and computed tomography was done. Diagnostic computed tomography was required in 25%. White blood cell counts and C-reactive protein (CRP) were checked, and their initial mean values were $9,790{\pm}3,240/{\mu}L$ Land $1.31{\pm}1.71mg/dL$, final mean values were $5,440{\pm}1,665/{\mu}L$ Land $0.72{\pm}0.73mg/dL$, respectively. 23 patients were admitted (average $5.0{\pm}1.8$) and the symptoms were self-limiting in all cases without complications. Conclusion: Spontaneous pneumomediastinum is a benign condition with mild inflammatory signs that often presents with chest or throat pain. Secondary causes must be ruled out to avoid an unfavorable outcome with less invasive study. Because of very rare complications and recurrence, outpatient basis and shortened hospitalization may be feasible.

The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient (비스포스포네이트 연관 악골괴사의 치료 방식과 투약 휴지기가 치료 예후에 미치는 영향)

  • Rhee, Seung-Hyun;Park, Kun-Hyo;Lee, Jae-Yeol;Kim, Yong-Deok;Shin, Sang-Hun;Chung, In-Kyo;Kim, Gyoo-Cheon;Kim, Uk-Kyu
    • The Journal of the Korean dental association
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    • v.53 no.2
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    • pp.120-131
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    • 2015
  • Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

Clinical Usefulness of Point-of-care Test Chemistry Analyzer in Neonatal Intensive Care Unit

  • Jang, Yeong-Uk;Kim, Su-Nam;Cho, Hye-Jung;Sun, Yong-Han;Shim, So-Yeon;Son, Dong-Woo;Park, Pil-Whan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.301-309
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    • 2011
  • Purpose: Point-of-care tests (POCTs) have the potential to significantly influence management of neonates. The aim of this study was to assess the clinical usefulness of the POCT chemistry analyzer in a neonatal intensive care unit (NICU). Methods: Blood samples of neonates admitted to the NICU were tested using a POCT chemistry analyzer (Piccolo Xpress Chemistry Analyzer, Abaxis, Union City, CA, USA) and a central laboratory chemical analyzer (Chemistry analyzer 7600-110, Hitachi Ltd., Tokyo, Japan) from March to September, 2010. Correlation of 15 analytes between the POCT and the central laboratory machine was evaluated. For consistency of the POCT, three consecutive samplings were performed. Differences among the three tests were recorded. The causes of performance errors were checked through log files. Results: One hundred of 112 pairs of tests for accuracy performed in 54 neonates showed a high correlation between the two machines. Twelve performance errors occurred during the 112 tests. The most common error was insufficient sample error. Eighteen triplet tests performed in 18 patients for consistency revealed a difference range of 3-10%, which was considered to be acceptable. No error occurred during the 54 tests. Conclusion: The POCT is capable of analyzing multiple analytes with a minimal amount of whole blood in a short time. The few performance errors noted presently are likely preventable. This POCT is concluded to be suitable for use as a simple and rapid diagnostic method in the NICU with a minimal amount of blood collected in a less invasive manner.

Reproducibility of non-invasive measurement for left ventricular contractility using gated myocardial SPECT (게이트 심근 SPECT를 이용한 비침습적 심실 수축력 측정방법의 재현성)

  • Kim, Kyeong-Min;Lee, Dong-Soo;Kim, Yu-Kyeong;Cheon, Gi-Jeong;Kim, Seok-Ki;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.152-160
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    • 2001
  • Purpose: We tried to establish the reproducibility of the measurement of maximal elastance (Emax) and to compare the degree of the reproducibility of two estimation methods: single pressure-volume loop method and parameter optimization method. Materials and methods: In 47 patients (42 males and 5 females, $53{\pm}10$ years old) with suspected coronary artery disease (election fraction; 22-68%), gated Tc-99m MIBI myocardial SPECT and arterial tonometry were acquired. In 11 patients among these 47 patients, gated SPECT and tonometry were performed twice consecutively with patients in situ. Emax and void volume (Vo) were estimated using single pressure-volume loop method of Lee and parameter optimization method based on linear approximation of Yoshizawa. Correlation between the consecutive measurements by each method and correlation between the two estimation methods were compared. Results: Reproducibility of Emax (r=0.96) and Vo (r=0.99) by single pressure-volume method was better than the reproducibility of Emax (r=0.89) and Vo (r=0.64) by parameter optimization method. Correlations of Emax and Vo were fair between the two methods. The correlation of Emax (r=0.77) was better than that of Vo (r=0.55). Conclusion: Reproducibility of Emax measurement by single pressure-volume loop method using gated myocardial SPECT and arterial tonometry was excellent. Reproducibility by parameter optimization method was also fair but was less than that achieved by single pressure-volume method.

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POTENTIAL OF NIRS FOR SUPPORTING BREEDING AND CULTIVATION OF MEDICINAL AND SPICE PLANTS

  • Schulz, Hartwig;Steuer, Boris;Kruger, Hans
    • Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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    • 2001.06a
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    • pp.1162-1162
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    • 2001
  • Whereas NIR spectroscopy has been applied in agriculture for more than 20 years, few studies refer to those plant substances occurring only in smaller amounts. Nevertheless there is a growing interest today to support efficiently activities in the production of high-quality medicinal and spice plants by this fast and non-invasive method. Therefore, it was the aim of this study to develop new NIR methods for the reliable prediction of secondary metabolites found as valuable substances in various plant species. First, sophisticated NIR methods were established to perform fast quality analyses of intact fennel, caraway and dill fruits deriving from single-plants [1]. Later on, a characterization of several leaf drugs and the corresponding fresh material has been successfully performed. In this context robust calibrations have been developed for dried peppermint, rosemary and sage leaves for the determination of their individual essential oil content and composition [2]. A specially adopted NIR method has been developed also for the analysis of carnosic acid in the leaves of numerous rosemary and sage gene bank accessions. Carnosic acid is an antioxidative substance for which several health promoting properties including cancer preservation are assumed. Also some other calibrations have been developed for non-volatile substances such as aspalathin (in unfermented rooibos leaves), catechins (in green tea) and echinacoside (in different Echinacea species) [3]. Some NIR analyses have also been successfully performed on fresh material, too. In spite of the fact that these measurements showed less accuracy in comparison to dried samples, the calibration equations are precise enough to register the individual plant ontogenesis and genetic background. Based on the information received, the farmers and breeders are able to determine the right harvest time (when the valuable components have reached their optimum profile) and to select high-quality genotypes during breeding experiments, respectively. First promising attempts have also been made to introduce mobile diode array spectrometers to collect the spectral data directly on the field or in the individual natural habitats. Since the development of reliable NIRS methods in this special field of application is very time-consuming and needs continuous maintenance of the calibration equations over a longer period, it is convenient to supply the corresponding calibration data to interested user via NIRS network. The present status of all activities, preformed in this context during the last three years, will be presented in detail.

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Comparative Analysis of T2 Sympaticotomy to T1 Sympathectomy in Treatment of Craniofacial Hyperhidrosis (안면부다한증에서의 T1 Sympathectomy와 T2 Sympathicotomy의 비교)

  • 윤용한;이두연;김해균;홍윤주
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1089-1093
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    • 1998
  • Background: In 1992, we first developed the technique for video-assisted thoracoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Clinically, patients suffereing from distressing hyperhidrosis in their heads and faces were observed. Materials and methods: From March 1997 to March 1998, the vidio-assisted thoracoscopic sympathectomy and sympathicotomy were performed in 60 patients suffering from craniofacial hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Thirty-nine patients underwent a conventional sympathectomy(T1 sympathectomy group), and twenty-one patients underwent division of the sympathetic nerve trunk above the T2 sympathetic ganglion(T2 sympathicotomy). The median follow up was 9 months. Results: All of the treated patients obtained satisfactory alleviation of craniofacial hyperhidrosis. No recurrence was observed in group T1 sympathectomy whereas one occurred in sympathicotomy. The global rate of compensatory sweating was about the same in both groups ; 76.9% in T1 sympathectomy and 76.2% in T2 sympathicotomy. The rate of embarrassing and disabling compensatory sweating was 38.5% in T1 sympathectomy and 38.1% in T2 sympathicotomy with no significant in the statistic analysis(p> 0.05). No transient Horner's syndrome was observed in group T2 sympathicotomy whereas seven occurred in T1 sympathectomy with improvement in follow-up. Only an overnight hospital stay was required in both group. Conclusions: The video-assist thoracoscopic sympathicotomy is minimally invasive and effective. Video-assisted thoracoscopic T2 sympathicotomy has proven to be effective method and less complicated in treating patients with distressing craniofacial hyperhidrosis and consistent in obtaining the same results as T1 sympathectomy.

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Clinical Outcomes and Risk Factors of Traumatic Pancreatic Injuries (외상성 췌장 손상의 임상 결과 및 예후인자)

  • Lee, Hong-Tae;Kim, Jae-Il;Choi, Pyong-Wha;Park, Je-Hoon;Heo, Tae-Gil;Lee, Myung-Soo;Kim, Chul-Nam;Chang, Surk-Hyo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.1-6
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    • 2011
  • Purpose: Even though traumatic pancreatic injuries occur in only 0.2% to 4% of all abdominal injuries, the morbidity and the mortality rates associated with pancreatic injuries remain high. The aim of this study was to evaluate the clinical outcomes of traumatic pancreatic injuries and to identify predictors of mortality and morbidity. Methods: We retrospectively reviewed the medical records of 26 consecutive patients with a pancreatic injury who underwent a laparotomy from January 2000 to December 2010. The data collected included demographic data, the mechanism of injury, the initial vital signs, the grade of pancreatic injury, the injury severity score (ISS), the revised trauma score (RTS), the Glasgow Coma Scale (GCS), the number of abbreviated injury scales (AIS), the number of associated injuries, the initial laboratory findings, the amount of blood transfusion, the type of operation, the mortality, the morbidity, and others. Results: The overall mortality rate in our series was 23.0%, and the morbidity rate was 76.9%. Twenty patients (76.9%) had associated injuries to either intra-abdominal organs or extra-abdominal organs. Two patients (7.7%) underwent external drainage, and 18 patients (69.3%) underwent a distal pancreatectomy. Pancreaticoduodenectomies were performed in 6 patients (23.0%). Three patients underwent a re-laparotomy due to anastomosis leakage or postoperative bleeding, and all patients died. The univariate analysis revealed 11 factors (amount of transfusion, AAST grade, re-laparotomy, associated duodenal injury, base excess, APACHE 11 score, type of operation, operation time, RTS, associated colon injury, GCS) to be significantly associated with mortality (p<0.05). Conclusion: Whenever a surgeon manages a patient with traumatic pancreatic injury, the surgeon needs to consider the predictive risk factors. And, if possible, the patient should undergo a proper and meticulous, less invasive surgical procedure.

Clipping of T2 Sympathetic Chain Block for Essential Hyperhidrosis (다한증 환자에서의 Clipping에 의한 T2 Sympathetic Chain Block의 효과)

  • 이두연;윤용한;백효채;신화균;이성수;강정신
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.745-748
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    • 1999
  • Background: A definitive cure for an essential hyperhidrosis can be obtained by an upper thoracic sympathectomy. However, this is offset by the occurrence of a compensatory hyper hidrosis as a side effect and it is irreversible. We performed a thoracoscopic sympathetic chain block using an endoscopic clip in order to avoid the compensatory hyperhidrosis. Material and Method: From Aug. 1998 to Nov. 1998, 42 cases of thoracoscopic clipping of the T2 sympathetic chain were performed. The sympathetic chain was clipped using an endoscopic clip instead of cutting. Result: Bilateral procedure took less than 40 minutes and occasionally necessitated one night in the hospital. There were no mortality nor life- threatening complications. Horners syndrome occurred in two cases. At the end of postoperative follow-up(median 3 months), 95.0% of the patients were satisfied with the results. Compensatory sweating occurred in 31 cases(77.5%) where nine of those cases were classified as either embarrassing(6 cases-15.0%) or disabling(3 cases-7.5%). Conclusion: Endoscopic thoracic T2 sympathetic chain block using endoscopic clipping is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis and the results were similar to those underwent T2 sympathicotomy. We recommend that patients receive endoscopic sympathetic chain block in summer.

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Videothoracoscopic Sympathectomy in Hyperhidrosis (다한증의 흉강경을 이용한 교감신경절 절제술)

  • 이재영;김명천;조규석
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.279-285
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    • 1998
  • Exessive sweating of the palms and soles, is a psychologically and occupationally distressing and sometimes disabling condition. Hyperhidrosis is one of the common abnormalities in autonomic nervous system. There were no specific treatment on hyperhidrosis, so invasive thoracic sympathectomy via axillary thoracotomy or cervical approach had been used. Video-assisted thoracic surgery(VATS) is now mostly performed for treating of the palmar and axillary hyperhidrosis. From March 1996 to March 1997, 15 patients with bilateral palmar hyperhidrosis had been treated by the bilateral thoracic sympathectomy(T2, T3, T4) with thoracoscopic resection. The patient were evaluated preoperative and postoperative Digital Infrared Thermographic Imaging (DITI) at Kyung-Hee University Hospital. There were no case of the thoracotomy conversion. There were 3 complications ; pulmonary edema in 1 case, Horner's syndrome in 1 case, and gustatory hyperhidrosis in 1 case. More than half of the patients also had compensatory sweating in the lower abdomen, the buttocks, the back and the thighs. In conclusion, most of the patients were satisfied with the postoperative results of the thoracoscopic sympathectomy, including no more palmar and axillary sweating, less pain, better cosmetic appearances, decreased sweating of the face and soles. In addition, intraoperative temperature monitoring of the hands could estimate the successful thoracoscopic sympathectomy and the preoperative and postoperative Digital infrared thermographic imaging(DITI) could especially be the technique for the objective manifestation of the successful results of the thoracoscopic sympathectomy.

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