• Journal of Chest Surgery
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• v.13 no.2
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• pp.85-91
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• 1980

Extracorporeal circulation by hemodilution technique has been currently used with its clinical safety and good peripheral tissue perfusion in open heart surgery. There is no doubt that $O_{2}$ carrying capacity of the blood is disturbed by decreased hemoglobin level resulting from hemodilution of the circulating blood. From the view point of the blood gas exchange, these experimental studies were undertaken to determined the sate limit of hemodilution in the condition of cardiopulmonary bypass with a constant perfusion flow rate. Twelve adult mongrel dogs weighing 10 to 13 Kg. were anesthetized with pentobarbital and then respiration was controlled with Harvard volume respirator using room air. The cardiopulmonary by pass was performed by use of Sarns heart lung machine (console 5000, 5 head and 2 roller pumps) and Travenol pediatric bubble oxygenator. The perfusion rate during bypass was maintained at a constant rate of 80 ml/min/Kg of body weight. The ratio of oxygen gas flow to blood flow was kept in 3 to 1 constantly. International hemodilution was attained by serial blood withdrawals and immediate infusion of equal volumes of diluants composed of Ringer's lactate, 5% dextrose in water and 25% mannitol solution, proportionally 60%, 30%, and 10%. Arterial and venous blood samples were obtained between 15 and 20 minutes following each hemodilution. Hematocrits and hemoglobin values, $PO_{2}$, $PCO_{2}$ and pH were measured. Oxygen and carbon dioxide contents oxygen consumption and carbon dioxide elimination were calculated groups according to different hematocrit values and the correlations were evaluated. Result were as follows. 1. the arterial $O_{2}$ tension and $O_{2}$ saturation were maintained at the physiological level irrespective of the hematocrit value. 2. The venous $O_{2}$ tension and $O_{2}$ saturation showed a tendency to decline with the decrease in hematocrit value and positive correlation between them (r = +0.49, r = +0.76), The mean values of venous $O_{2}$ tension and $O_{2}$ saturation, however, were not decreased when the hematocrit levels were lower than 20%. 3. The arterial $O_{2}$ content declined lineally in proportion to the fall of hematocrit level with a positive correlation between them (r = +0.95). 4. The venous $O_{2}$ contents were decreased gradually as the hematocrit value decreased with positive correlation between them ( r =+0.89). The trend of diminution of venous $O_{2}$ content, however, was became low according to progressive decrease of hematocrit level. 5. Systemic oxygen consumption was in higher range than $O_{2}$ requirement of basal metabolism when the hematocrit value was above 20%, but abruptly decreased when the hematocrit value became to below 20%. 6. The arterial $CO_{2}$ tension and $CO_{2}$ content showed trend of increasing with progressive decrease of hematocrit value but exhibited a rather broad range and there was no relationship between those value and the hematocrit value. 7. The venous $CO_{2}$ tension and $CO_{2}$ content have also no correlation with change of Ht. value but related directly to those value of arterial blood with positive correlation between them (r = +0.78, r = +0.95_. 8. A-V difference of $CO_{2}$ content and $CO_{2}$ elimination wasnot significantly influenced by Ht. value. From the results, we obtained that feasible limit in inteneional hemodilution is above the hematocrit value of 20% under the given experimental condition.

• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.449-453
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• 2002

Purpose : Arterial blood gas analysis is frequently performed in neonatal intensive care unit (NICU) to evaluate ventilation and the metabolic state of critically ill infants. In occasions when umbilical arterial catheterization is not available, frequent arterial puncture is mandatory. This requires some technical skill and may occasionally have side effects. So we studied the validity of capillary blood gas analysis which can be performed conveniently compared with arterial blood. Methods : Twenty-four neonates admitted to NICU during April to Aug. 2001 were studied. They were more than two weeks old without indwelling arterial catheters. Thirty-six times, simultaneous arterial, and capillary blood gases were drawn by puncture and the pH, $pCO_2$ and $pO_2$ of each sample was measured. Blood pressure and body temperature was checked before sampling to rule out impaired peripheral circulation. Capillary blood was collected from warmed heels. Results : There was a strong correlation between capillary and arterial pH(r=0.91, P<0.05). The absolute value of the difference between arterial and capillary pH was less than 0.05. Also capillary $pCO_2$ showed correlation with arterial $pCO_2$(r=0.77, P<0.05). Despite a statistically significant correlation between capillary and arterial $pO_2$(r=0.68, P<0.05), the absolute value of the difference was more than 10 mmHg in 92% of cases. Conclusion : Capillary blood gases accurately reflected arterial pH and $pCO_2$ and showed a relative correlation with $pO_2$. Capillary blood gas analysis can be a useful alternative to arterial blood when continuation of the umbilical arterial catheter is no longer available.

• Journal of Life Science
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• v.30 no.6
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• pp.542-549
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• 2020

A previous study reported that Ulmus macrocarpa Hance water extract (UME) can improve hyperlipid metabolism and the involvement of suppressed lipid synthesis through adenosine monophosphate-activated protein kinase (AMPK) pathway regulation was suggested. Further exploration of the lipid metabolism between liver and peripheral tissue was necessary to confirm that work, and so this study aimed to extend the possibility that UME can regulate serum lipids. After a 6-week in vivo trial of oral administration of UME to rats with induced hyperlipidemia, serum levels of triglyceride (TG) and total cholesterol (TC) were seen to decrease while HDL cholesterol increased. The UME administrations also decreased the TC and TG levels from the control in liver analysis. However, the suggestion that UME regulates the AMPK pathway to improve hyperlipid states through the suppression of hepatic lipogenesis seems to be only one part of the extract's effect. Indeed, serum concentrations of apolipoproteins A and B were returned to baseline levels of the control group in response to UME administration whilst the liver lipid content was much reduced; this cannot occur through the suggested suppression of hepatic lipogenesis alone. Therefore, a possible mechanism of UME could be that it improves blood circulation by modulating serum lipid levels through both the prior stimulation of lipid oxidation and the suppression of hepatic lipogenesis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.11
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• pp.3418-3426
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• 2009

The purpose of this study was to investigate the feasibility of field operation protocol for cardiopulmonary resuscitation(CPR) in person with non-traumatic arrest. This study was performed from May 1 through June 27, 2008, and subjects were 150 students who are attending the department of Emergency Medical Service in J and K universities which located in Jeollabuk-do and Jeollanam-do areas. Practical conformance was verified using by nonequivalent control group pretest-posttest design. This study divided into two groups; experimental group that employed field operation protocol and control group that applied conventional CPR protocol, and comparative analyzed statistically the necessary time of the items of each protocol. The results indicated that each performance time of 18 items was reduced over 3 seconds except 5 items(assessment of consciousness, airway control, two times of artificial respiration, check of circulation, and five cycles of CPR). And time of 6 items(intubation, peripheral intravenous line, reassessment of consciousness, pupil reaction, carotid artery pulse, and vital sign) was minimized more than 60 seconds, and total performing time was shortened 110.85 seconds. The results suggested that total performing time in pre and post test where the protocol was applied for two groups showed a statistically significant decrease(t=-6.580, p=.000). Consequently, field operation protocol for cardiopulmonary resuscitation(CPR) in person with non-traumatic arrest will be a available manual which support prompt and accurate decision making, and improve emergency medical service.

• YAKHAK HOEJI
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• v.57 no.2
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• pp.87-94
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• 2013

An analytical methodology based on solid-space extraction (SPE) with with Bond Elut Certify cartridge (Varian, 130 mg) has been developed for the qualification and quantitation of strychnine in blood. After the elution layer was evaporated, the residue was reconstituted with methanol for GC/MS. Internal standard was used 10 mg/l dextromethorphan. Strychnine is a potent central nervous stimulant and convulsant, and an alkaloid found in seeds of Strychnos nux-vomica. It was used therapeutically to improve circulation and muscle tone in oral or intramuscular doses of 0.05~8 mg. The fatal dose of strychnine for humans is 50~100 mg. A man was found dead lying curled up the corner of the large room in a roof house after the fire fighter opened a locked door inside to put out the fire. The postmortem blood and gastric contents were analyzed for toxicological testing. Strychnine and brucine were detected using GC/MS first in gastric contents extracts. The contents of strychnine was 0.083 mg/l in heart blood, 0.088 mg/l in peripheral blood and 4.0 mg/kg in gastric contents, respectively. Method validation was carried out in terms of linearity, accuracy, precision (intraday, interday) in blood. The assay is linear over 0.05~10 mg/l ($r^2$=0.999). Limit of detection (LOD) and limit of quantitation (LOQ) in blood were determined 0.02 mg/l (S/N=3) and 0.07 mg/l (S/N=10), respectively. Accuracy (bias%) of strychnine with 0.1, 1 and 10 mg/l was 12.0% (n=6), 9.3% (n=6) and 6.9% (n=6), respectively. Intraday precision (CV%) of strychnine with, 0.1, 1 and 10 mg/l were 6.4%, 10.4%, 1.2% (n=6), respectively. Interday precision (CV%) of strychnine with 0.1, 1 and 10 mg/l over three days were 24.0%, 18.5%, 13.8% (n=18), respectively. Relative recovery with 0.1, 1 and 10 mg/l (in blood) were 114.9%, 99.3% and 87.4% (n=6), respectively. The described method can be applied in forensic toxicology to determine strychnine in blood samples.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.24 no.1
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• pp.79-91
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• 2019

Long-term trends and recent variations of upwelling index (UI), which affects significantly ecosystem in southwestern part of the East Sea, were investigated. The UI was calculated with the NCEP/NCAR reanalysis data from January 1948 to September 2018. The mean UI has positive value that causes upwelling in April to August with a peak in July. The long-term reducing trend of UI was in statistically significant in June and July, and the sum of UI in May, June and July also showed same result. Through the atmospheric pressure analysis around the Korean peninsula, it was found that the trend of the UI was the influence of the pressure change trend in the northwestern region ($35-50^{\circ}N$, $114-129^{\circ}E$) of the southwestern part of the East Sea. Investigating UI in recent 7 years from 2012 to 2018, it was revealed that the UI was bigger than 3 times of standard deviation in July 2013. This was result from the sea level pressure difference became larger in the southwestern part of the East Sea than normal year due to the lowered air pressure in the northeastern region of China and the strengthened high air pressure of western peripheral of the North Pacific High. On the other hand, the UI in July 2018 was negative when the impact of the North Pacific High and the low air pressure in the northeastern China was weak. Due to the decreasing trend of UI and its large year-to-year variation in southwestern part of the East Sea, continuous monitoring is necessary to know the influence of coastal upwelling on the ecosystem.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.37 no.1
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• pp.12-22
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• 2019

This study derived the design aspects by carrying out the case study of Neunggok prehistoric remains park, Ansansingil historic park and Yongjuk historic park to which are taken measures to preserve undesignated cultural heritages after studying the related laws & regulations and the systems as the design conditions of historic park preserving buried cultural heritages. The results of the study are as follows. First, according to the laws & regulations related to the historical parks, the historic sites should be preserved and utilized at the same time and can have history-related facility spaces, squares, rest spaces, exercise spaces, education & culture space, and convenience spaces. Second, by the space organization and the circulation system emphasizing only the preservation of buried cultural heritages, the feature-preservation space and the functional space are separated and due to not accepting the usage behavior considering peripheral land use, the effectiveness of the historical park was low. Third, the passive feature-preservation methods such as the preservation of the exposed site in architectural methods, the reproduction of the dugout hut, and the planting Royal azaleas or displaying stone after covering up the location of the pit dwellings with soil and the usage mainly for viewing have weakened the identity of the historical park. Fourth, the fence preventing users' access interferes experiencing the features, and the vertical structure protecting the upper part of the exposed features has overwhelmed the landscape of the historical parks. Fifth, it was difficult to figure out the feature space only by the texts mainly on terminologies and the excavation photographs presented on the information signs which introduce the buried cultural heritages.

• Korean Circulation Journal
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• v.52 no.6
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• pp.429-440
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• 2022

Background and Objectives: Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in real-world practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors. Methods: From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention). Results: Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471; p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3-4 years. Conclusions: In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.119-124
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• 1997

Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.449-458
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• 2003

Background : The poor prognostic factors of far-advanced pulmonary tuberculosis(FAPTB) are lymphocytopenia in the peripheral blood(PB)(< $1,000/mm^3$) and $T_4$-cell count ${\leq}500/mm^3$. However, the cause of PB lymphocytopenia in FAPTB is unclear. The aim of this study was to analyze the lymphocyte proportion and cytokines of the bone marrow(BM) in FAPTB patients with peripheral lymphocytopenia in order to clarify whether the limiting step of the lymphocytopenia occurs in production, differentiation, or circulation. Methods : This study included patients with FAPTB between August 1999 and August 2002 who visited Gachon Medical School Gil Medical Center. The exclusion criteria were old age(${\geq}65years$), cachexia or a low body weight, shock, hematologic diseases, or BM involvement of tuberculosis. The distributions of cells in PB and BM were analyzed and compared to the control group. The interleukin(IL)-2, IL-7, IL-10, TNF-${\alpha}$, Interferon-${\gamma}$, and TGF-${\beta}$ levels in the BM were measured by ELISA. Result : Thirteen patients(male : female=9:4) were included and the mean age was $42{\pm}12$years. The proportion and count of the lymphocytes in the PB were significantly lower in the FAPTB group ($7.4{\pm}3.0%$, $694{\pm}255/mm^3$ vs. $17.5{\pm}5.8%$, $1,377{\pm}436/mm^3$, each p=0.0001 and 0.002). The proportion of immature lymphocyte in the BM showed a decreasing trend in the FAPTB group($9{\pm}4%$ vs. $12{\pm}3%$, p=0.138). The IL-2($26.0{\pm}29.1$ vs. $112.2{\pm}42.4pg/mL$, p=0.001) and IL-10($3.4{\pm}4.7$ vs. $12.0{\pm}8.0pg/mL$, p=0.031) levels in the BM were significantly lower in the FAPTB group than those in control. The levels of the other cytokines in FAPTB group and control were similar. Conclusion : These results suggest that the cause of lymphocytopenia in PB is associated with a abnormality IL-2 and IL-10 production in the BM. More study will be needed to define the mechanism of a decreased reservoir in BM.