• Title/Summary/Keyword: Pre-Pressure

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Morphologic Changes of the Pulmonary Arteries after Stent Implantation on Branch Pulmonary Artery Stenosis - Impact of Pulmonary Insufficiency - (폐동맥 분지협착에 스텐트 삽입 후 유발되는 폐동맥의 형태변화 - 폐동맥 폐쇄 부전의 역할 -)

  • Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.67-75
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    • 2003
  • Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.

Role of p-38 MAP Kinase in apoptosis of hypoxia-induced osteoblasts (저산소 상태로 인한 조골세포 고사사기전에서 p-38 MAP kinase의 역할에 관한 연구)

  • Yoon, Jeong-Hyeon;Jeong, Ae-Jin;Kang, Kyung-Hwa;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.169-183
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    • 2003
  • Tooth movement by orthodontic force effects great tissue changes within the periodontium, especially by shifting the blood flow in the pressure side and resulting in a hypoxic state of low oxygen tension. The aim of this study is to elucidate the possible mechanism of apoptosis in response to hypoxia in MC3T3El osteoblasts, the main cells in bone remodeling during orthodontic tooth movement. MC3T3El osteoblasts under hypoxic conditions ($2\%$ orygen) resulted in apoptosis in a time-dependent manner as estimated by DNA fragmentation assay and nuclear morphology stained with fluorescent dye, Hoechst 33258. Pretreatment with Z-VAD-FMK, a pancaspase inhibitor, or Z-DEVD-CHO, a specific caspase-3 inhibitor, completely suppressed the DNA ladder in response to hypoxia. An increase in caspase-3-like protease (DEVDase) activity was observed during apoptosis, but no caspase-1 activity (YVADase) was detected. To confirm what caspases are involved in apoptosis, Western blot analysis was performed using anti-caspase-3 or -6 antibodies. The 10-kDa protein, corresponding to the active products of caspase-3, and the 10-kDa protein of the active protein of caspase-6 were generated in hypoxia-challenged cells in which the processing of the full length form of caspase-3 and -6 was evident. While a time course similar to this caspase-3 and -6 activation was evident, hypoxic stress caused the cleavage of lamin A, which was typical of caspase-6 activity. In addition, the stress elicited the release of cytochrome c into the cytosol during apoptosis. Furthermore, we observed that pre-treatment with SB203580, a selective p38 mitogen activated protein kinase inhibitor, attenuated the hypoxia-induced apoptosis. The addition of SB203S80 suppressed caspase-3 and -6-like protease activity by hypoxia up to $50\%$. In contrast, PD98059 had no effect on the hypoxia-induced apoptosis. To confirm the involvement of MAP kinase, JNK/SAPK, ERK, or p38 kinase assay was performed. Although p38 MAPK was activated in response to hypoxic treatment, the other MAPK -JNK/SAPK or ERK- was either only modestly activated or not at all. These results suggest that p38 MAPK is involved in hypoxia-induced apoptosis in MC3T3El osteoblasts.

Geochemical Characteristics of Granodiorite and Arenaceous Sedimentary Rocks in Chon-Ashuu Area, Kyrgyzstan (키르키스스탄 촌아슈 지역 화강섬록암질암 및 사질원 퇴적암의 지화학적 특징)

  • Kim, Soo-Young;Chi, Sei-Jung;Park, Sung-Won
    • Economic and Environmental Geology
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    • v.44 no.4
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    • pp.273-288
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    • 2011
  • Chon-Ashuu copper mining claim area is located, in terms of the geotectonic setting, in the northern part of the suture line which is bounded with the marginal part of Issik-kul micro-continent on the southern part of North Tien-Shan terrane. The geological blocks of Chon-Ashuu districts belong to the southern tip of Kazakhstan orocline. The rock formation of this area are composed of the continental crust or/and arc collage and the paleo-continental fragments-accretionary wedge complex of pre-Altaid orogenic materials. ASI(Alumina Saturation Index) of Paleozoic plutonic rocks in Chon-Ashuu area belong to the peraluminous and metaluminous rocks which were generated from fractional crystallization of Island and volcanic arc crusts in syn-post collisional plate. The geology of the ChonAshuu area consists of upper Proterozoic and Paleozoic rock formations. According to Harker variation diagrams for Chon-Ashuu arenaceous sedimentary rocks, the silty sandstone of Chon-Ashuu area showing the mineralogical immaturity were derived from Island arc or the marginal environments of active continent in Cambro-Carboniferous period. Numerous intrusive rocks of Chon-Ashuu area are distributed along north east trending tectonic structures and are bounded on four sides by the conjugate pattern. The most common type of the plutonic rocks are granodiorite and monzodiorite. According to the molecular normative An-Ab-Or composition (Barker, 1979), the plutonic rocks in Chon-Ashuu area are classified into tonalite - trondhjemite - granodiorite (TTG) series which are an aggregation of rocks which is the country rock of copper mineralization, that are formed by melting of hydrous mafic crust at high pressure.

An Outlier Detection Using Autoencoder for Ocean Observation Data (해양 이상 자료 탐지를 위한 오토인코더 활용 기법 최적화 연구)

  • Kim, Hyeon-Jae;Kim, Dong-Hoon;Lim, Chaewook;Shin, Yongtak;Lee, Sang-Chul;Choi, Youngjin;Woo, Seung-Buhm
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.33 no.6
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    • pp.265-274
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    • 2021
  • Outlier detection research in ocean data has traditionally been performed using statistical and distance-based machine learning algorithms. Recently, AI-based methods have received a lot of attention and so-called supervised learning methods that require classification information for data are mainly used. This supervised learning method requires a lot of time and costs because classification information (label) must be manually designated for all data required for learning. In this study, an autoencoder based on unsupervised learning was applied as an outlier detection to overcome this problem. For the experiment, two experiments were designed: one is univariate learning, in which only SST data was used among the observation data of Deokjeok Island and the other is multivariate learning, in which SST, air temperature, wind direction, wind speed, air pressure, and humidity were used. Period of data is 25 years from 1996 to 2020, and a pre-processing considering the characteristics of ocean data was applied to the data. An outlier detection of actual SST data was tried with a learned univariate and multivariate autoencoder. We tried to detect outliers in real SST data using trained univariate and multivariate autoencoders. To compare model performance, various outlier detection methods were applied to synthetic data with artificially inserted errors. As a result of quantitatively evaluating the performance of these methods, the multivariate/univariate accuracy was about 96%/91%, respectively, indicating that the multivariate autoencoder had better outlier detection performance. Outlier detection using an unsupervised learning-based autoencoder is expected to be used in various ways in that it can reduce subjective classification errors and cost and time required for data labeling.

The Effect of Small-Scale Chemistry (SSC) Lab Program with Respect to High School Students' Extroversions and Introversions (고등학생의 내.외향성에 따른 SSC(Small-Scale Chemistry) 실험 수업의 효과)

  • Yoo, Mi-Hyun;Kim, Mi-Young;Hong, Hun-Gi
    • Journal of The Korean Association For Science Education
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    • v.29 no.2
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    • pp.179-192
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    • 2009
  • The purpose of this study was to examine the effects of Small-Scale Chemistry (below SSC) Lab Program with respect to students' extroversions and introversions. For this study, an SSC Lab Program was developed on the basis of analyzing the chemistry part of the high school science textbook in the 7th curriculum. The experimental group received SSC experiment lessons, and the comparison group received traditional experiment lessons based on textbook for 5 class periods. Afterwards, students were grouped into extrovert and introvert according to their personality test scores, the differences between the two groups were investigated using 2-way ANCOVA. Prior to the instructions, three test regarding the scientific attitude and academic self-efficacy were administered. After the instructions, the scientific attitude, academic self-efficacy, and students' perceptions on SSC Lab Program were examined. The scores in mid-term and end-of-term science exams were used as pre-test and post-test science achievement scores, respectively. Two-way ANCOVA results revealed that there were effects in the score of the academic achievement score, but there was no interactive effect between extroversion/introversion and treatment. In addition, a significant interactive effect was found in the scientific attitude, but there was no significant main effect. It was interpreted that extrovert students had many opportunities in SSC experiment classes and were able to experiment with initiative, but introverts would feel the responsibility and the pressure owing to the small group experiment. There were no main and interactive effects in the score of the academic self-efficacy test. Survey of students' perceptions on SSC Lab Program revealed that both over 90% extrovert and introvert students showed very positive perceptions in 'three-membered small group composition,' 'understanding,' and 'convenience' items. It was found to be a very different perception between extrovert and introvert students in 'comparing result with other students' item.

Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

Improvement in Regional Contractility of Myocardium after CABG (관상동맥 우회로 수술 환자에서 심근의 탄성도 변화)

  • Lee, Byeong-Il;Paeng, Jin-Chul;Lee, Dong-Soo;Lee, Jae-Sung;Chung, June-Key;Lee, Myung-Chul;Choi, Heung-Kook
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.4
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    • pp.224-230
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    • 2005
  • Purpose: The maximal elastance ($E_{max}$) of myocardium has been established as a reliable load-independent contractility index. Recently, we developed a noninvasive method to measure the regional contractility using gated myocardial SPECT and arterial tonometry data. In this study, we measured regional $E_{max}(rE_{max}$ in the patients who underwent coronary artery bypass graft surgery (CABG), and assessed its relationship with other variables. Materials and Methods: 21 patients (M:F=17:4, $58{\pm}12$ y) who underwent CABG were enrolled. $^{201}TI$ rest/dipyridamole stress $^{99m}Tc$-sestamibi gated SPECT were performed before and 3 months after CABG. For 15 myocardial regions, regional time-elastance curve was obtained using the pressure data of tonometry and the volume data of gated SPECT. To investigate the coupling with myocardial function, preoperative regional $E_{max}$ was compared with regional perfusion and systolic thickening. In addition, the correlation between $E_{max}$ and viability was assessed in dysfunctional segments (thickening <20% before CABG). The viability was defined as improvement of postoperative systolic thickening more than 10%. Results: Regional $E_{max}$ was slightly increased after CABG from $2.41{\pm}1.64 (pre)\;to\;2.78{\pm}1.83 (post)$ mmHg/ml. $E_{max}$ had weak correlation with perfusion and thickening (r=0.35, p<0.001). In the regions of preserved perfusion (${\geq}60%$), $E_{max}$ was $2.65{\pm}1.67$, while it was $1.30{\pm}1.24$ in the segments of decreased perfusion. With regard to thickening, $E_{max}$ was $3.01{\pm}1.92$ mmHg/ml for normal regions (thickening ${geq}40%$), $2.40{\pm}1.19$ mmHg/ml for mildly dysfunctional regions (<40% and ${\geq}20%$), and $1.13{\pm}0.89$ mmHg/ml for severely dysfunctional regions (<20%). $E_{max}$ was improved after CABG in both the viable (from $1.27{\pm}1.07\;to\;1.79{\pm}1.48$ mmHg/ml) and non-viable segments (from $0.97 {\pm}0.59\;to\;1.22{\pm}0.71$ mmHg/ml), but there was no correlation between $E_{max}$ and thickening improvements (r=0.007). Conclusions: Preoperative regional $E_{max}$ was relatively concordant with regional perfusion and systolic thickening on gated myocardial SPECT. In dysfunctional but viable segments, $E_{max}$ was improved after CABG, but showed no correlation with thickening improvement. As a load-independent contractility index of dysfunctional myocardial segments, we suggest that the regional $E_{max}$ could be an independent parameter in the assessment of myocardial function.

The Effect of Pulmonary Rehabilitation in Patients with Chronic Lung Disease (만성 폐질환 환자에서의 호흡재활치료의 효과)

  • Choe, Kang Hyeon;Park, Young Joo;Cho, Won Kyung;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.736-745
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    • 1996
  • Background : It is known that pulmonary rehabilitation improves dyspnea and exercise tolerance in patient with chronic lung disease, although it does not improve pulmonary function. But there is a controversy whether this improvement after pulmonary rehabilitation is due to increased aerobic exercise capacity. We performed this study to evaluate the effect of pulmonary rehabilitation for 6 weeks on the pulmonary function, gas exchange, exercise tolerance and aerobic exercise capacity in patients with chronic lung disease. Methods : Pulmonary rehabilitations including education, muscle strengthening exercise and symptom-Umited aerobic exercise for six weeks, were performed in fourteen patients with chronic lung disease (COPD 11, bronchiectasis 1, IPF 1, sarcoidosis 1 ; mean age $57{\pm}4$ years; male 12, female 2). Pre- and post-rehabilitaion pulmonary function and exercise capacity were compared. Results: 1) Before the rehabilitation, FVC, $FEV_1$ and $FEF_{25-75%}$ of the patients were $71.5{\pm}6.4%$. $40.6{\pm}3.4%$ and $19.3{\pm}3.8%$ of predicted value respectively. TLC, FRC and RV were $130.3{\pm}9.3%$, $157.3{\pm}13.2%$ and $211.1{\pm}23.9%$ predicted respectively. Diffusing capacity and MVV were $59.1{\pm}1.1%$ and $48.6{\pm}6.2%$. These pulmonary functions did not change after pulmonary rehabilitation. 2) In the incremental exercise test using bicycle ergometer, maximum work rale ($57.7{\pm}4.9$) watts vs. $64.8{\pm}6.0$ watts, P=0.036), maximum oxygen consumption ($0.81{\pm}0.07$ L/min vs. $0.96{\mu}0.08$ L/min, P=0.009) and anaerobic threshold ($0.60{\pm}0.06$ L/min vs. $0.76{\mu}0.06$ L/min, P=0.009) were significantly increased after pulmonary rehabilitation. There was no improvement in gas exchange after rehabilitation. 3) Exercise endurances of upper ($4.5{\pm}0.7$ joule vs. $14.8{\pm}2.4$ joule, P<0.001) and lower extremity ($25.4{\pm}5.7$ joule vs. $42.6{\pm}7.7$ joule, P<0.001), and 6 minute walking distance ($392{\pm}35$ meter vs. $459{\pm}33$ meter, P<0.001) were significantly increased after rehabilitation. Maximum inspiratory pressure was also increased after rehabilitation ($68.5{\pm}5.4$ $CmH_2O$ VS. $80.4{\pm}6.4$ $CmH_2O$, P<0.001). Conclusion: The pulmonary rehabilitation for 6 weeks can improve exercise performance in patients with chronic lung disease.

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