• Title/Summary/Keyword: Pt(II)

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Long Term Experience of Mitral Valve Replacement (승모판치환수술의 장기 임상성적)

  • 조용길;류지윤
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1102-1110
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    • 1996
  • Between Oct. 1985 and July 1995, 230 patients underwent mitral valve replacement. There were 77 men and 153 women whose mean age was 35.7 years, range 9 to 62 The concomitant operations were 40 aortic valve replacements(17.4%), 25 tricuspid annuloplasties(10.4%), 8 aortic valve replacements & tricuspid annuloplasties(3.5%), 2 tricuspid valve replacements(0.9%) and others, We used 139 mechanical (76 51. Jude medical, 33 CarboMedics, 30 Sorin) and 91 tissue 386 Carpentier-Edwards, 5 lonescu-Shiley) valves. The early postoperative complications occurred in 28 cases. There were 8 low cardiac output syndrome, 5 pleural effusion, 3 significant arrhythmia, 2 cardiac rupture and others. There were 6 early hospital deaths (2.6%) due to low cardiac output syndrome(2), arrhythmia(2) and ventricul r rupture(2). The cuAmulative notal follow-up period was 764. 4 patient-years with a mean of 4).9 months. The long term follow-up information was available for 212 patients(94.6%). There were 21 cases of valve-related complications. Prosthetic valve failure(10), anti-coagulation related bleeding (5), prosthetic valve endocarditis (4), and thromboembolism (2) occurred at rates of 1.3, 0.7, 0.5, and 0.3%Ipt-yr respectively. Late death occurred In 5 cases (0.7%/pt-yr) associated with prosthetic valve endocarditis (2), heart failure (2) and anti-coagulation related bleeding (1). There was no difference in the rate of freedom from prosthetic valve failure between the mechanical and tissue valve group at 6 years (100%), but there was significant difference at 9 years between the tissue (34.4%) and mechanical valve (100%) group (p=0.032). Actuarial survival rates were 98. 8% in tissue valve. 9).7% in mechanical valve group and 96.6% in total patients at 9 years.

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Hematological Aspects in A Endotoxemic Young Rabbit Model

  • Park, Seok-Cheol;Kwon, Heun-Young;Kim, Jai-Young;Hwang, Soo-Myung;Kim, Tae-Un;Seong, Hee-Kyung;Kim, Yang-Weon;Lee, Won-Jae
    • Biomedical Science Letters
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    • v.8 no.3
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    • pp.115-125
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    • 2002
  • Gram-negative septicemia, which continues to be a serious clinical problem, is one of the major causes of morbidity and mortality in hospitalized patients. Endotoxin of gram-negative bacteria is a pivotal pathogen of sepsis. To understand the effect of endotoxin on hematological aspect and the time course in early childhood, this study was designed with experimental septic model of young rabbits (8 week-old). Rabbits were divided into control (n=7) and endotoxin group (0.50 mg/kg of endotoxin). The endotoxin group was subdivided into six groups by the sampling times: 3, 6, 12, 24, 48 and 72 hr-group (E-G$_{3}$, E-G$_{6}$, E-G$_{12}$, E-G$_{24}$, E-G$_{48}$ and E-G$_{72hrs}$, each n=7). The evaluation of CBC, activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen concentration, coagulation factors and D-dimer were taken from the bloods. The number of leukocytes was lower in E-G$_{3}$ and E-G$_{6hrs}$ (due to pantocytopenia), whereas it was higher in E-G$_{24}$ and E-G$_{48}$ (due to neutrophilia and/or lymphophilia) than in control group (P<0.05). Platelet counts in E-G$_{3}$, E-G$_{6}$, E-G$_{12}$, E-G$_{24}$ and E-G$_{48hrs}$ were lower than those of control group (P<0.05). Normoblast counts in E-G$_{3}$, E-G$_{6}$, E-G$_{12}$, E-G$_{24}$ and E-G$_{48hrs}$ were higher than those of control group (p<0.01). APTT in E-G$_{3}$, E-G$_{6}$, E-G$_{12}$, E-G$_{24}$ and E-G$_{72hrs}$ were longer while PT in E-G$_{3}$, E-G$_{6}$, E-G$_{48}$ and E-G$_{72hrs}$ were higher than those of control group (p<0.05). Fibrinogen concentrations were lower in E-G$_{3}$, E-G$_{6}$ and E-G$_{12}$ but higher in E-G$_{48}$ and E-G$_{72hrs}$ than those of control (p<0.05). Intrinsic coagulation factors (XII, XI, IX, VIII) in all endotoxin groups were significantly lower than those of control group (p<0.05). Extrinsic coagulation factor (X, VII, V, II) were lower in E-G$_{3}$, E-G$_{6}$, E-G$_{12}$ and E-G$_{24hrs}$ whereas they were higher in E-G$_{48}$ and E-G$_{72hrs}$ than in control group (p<0.05). D-dimer concentrations in E-G$_{48}$ and E-G$_{72hrs}$ were higher than those of control group (P<0.001). We concluded that endotoxin led to extensive hematological disturbances including disseminated intravascular coagulation in the young rabbits and that this pathologic condition in the infant and childhood groups will cause the grave results.

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Acute Normovolemic Hemodilution Effects on Perioperative Coagulation in Elderly Patients Undergoing Hepatic Carcinectomy

  • Guo, Jian-Rong;Jin, Xiao-Ju;Yu, Jun;Xu, Feng;Zhang, Yi-Wei;Shen, Hua-Chun;Shao, Yi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4529-4532
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    • 2013
  • Background: Acute normovolemic hemodilution (ANH) has been widely used to prevent the massive blood loss during hepatic carcinoma. The influences of ANH on coagulation function are still controversy, especially in elderly patients. The study observed ANH effects on coagulation function and fibrinolysis in elderly patients undergoing the disease. Materials and Methods: Thirty elderly patients (aged 60-70 yr) with liver cancer (ASA I or II) taken hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n=15) and control group (n=15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (130/0.4) and Ringer's solution, respectively. Blood samples were drawn from patients in both groups at five different time points: before anesthesia induction (T1), 30 min after ANH (T2), 1 h after start of operation (T3), immediately after operation (T4), and 24 h after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (CD62P and activated GP IIb/GP IIIa) were measured. Results: The perioperative blood loss and allogeneic blood transfusion were recorded during the surgery. The perioperative blood loss was not significantly different between two groups (p>0.05), but the volume of allogeneic blood transfusion in ANH group was significantly less than in control group ($350.0{\pm}70.7$) mL vs. ($457.0{\pm}181.3$) mL (p<0.01). Compared with the data of T1, the prothrombin time (PT) and activated partial thromboplastin time (APTT) measured after T3 were significantly longer (p<0.05) in both groups, but within normal range. There were no significant changes of thrombin time (TT) and D-dimer between two groups at different time points (p>0.05). SFMC and F1+2 increased in both groups, but were not statistically significant. PAC-1-positive cells and CD62P expressions in patients of ANH group were significantly lower than those at T1 (p<0.05) and T2-T5 (p>0.05). Conclusions: ANH has no obvious impact on fibrinolysis and coagulation function in elderly patients undergoing resection of liver cancer. The study suggested that ANH is safe to use in elderly patients and it could reduce allogeneic blood transfusion.

Heparin-Protamin Sulfate 상호작용의 실험적 연구

  • Kim, Chi-Kyung;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.13-20
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    • 1980
  • Heparin would have been used for preventing clotting of blood during extracorporeal circulation and subsequent use of protamine sulfate and made possible the neutralization of heparin. This procedure has been adopted for eliminating one of the great causes of bleeding, especially in cardiac surgery. In this experiment, the hypocoagulability of blood induced by heparin followed by neutralization with treatment of protamine sulfate were estimated by the Lee-White clotting time [CT], partial thromboplastin time [PTT] and protamine titration test. The results were as follows: 1] Comparison of clotting time between the heparinized [2.0 mg/kg] and non-heparinized dogs was done using CT and PT`I` of the blood. In heparinized group [Group I], the CT lasted infinitively and prolongation of PTT [4 times than normal] until 60 minutes. The CT [2 times] and PTT [3 times] has been shortened after 90 minutes, however they returned to normal limit level within 180 minutes. 2] The determination of appropriate ratio of heparin and protamine In vivo were performed. The group II [heparin 2.0 mg/kg, protamine 1.0 mg/kg] revealed rapid decrease of CT and PTT, but returned to normal after 120 minutes. The group III [heparin 2.0 mg/kg, protamine 2.0 mg/kg] returned rapidly to normal within 15 minutes. The group IV [heparin 2.0 mg/kg, protamine 3.0 mg/kg] recovered its normal level after 60 minutes. The group V [heparin 2.0 mg/kg, protamine 4.0 mg/kg] recovered its normal level after 90 minutes. 3] In the combined experimental study In vivo and vitro, the protamine titration test was done using the dog which were given 2.0 mg/kg and 3.0 mg/kg of heparin, respectively and coagulation time were checked after 15, 30, 60 and 120 minutes. The complete neutralization was showed to be heparin-protamine ratio of 1:1 to 1.5. 4] In vitro study, fresh blood was drawn into known amount of heparin content [20, 40, 60 and 100/ug per 1 ml of blood] syringe, thereafter protamine titration test was done. In all cases, the complete neutralization was found in heparin-protamine ratio of 1:0.85 to 1.5. 5] It was found by the present experiment that the ideal heparin-protamine ratio was 1:1 within 60 minutes and 1:0.5 after 60 minutes for avoiding the serious side effect due to overadministration of protamine sulfate.

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The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture (비골 골절 교정 후 Rolled Silastic Sheet를 이용한 비강 충진의 효과)

  • Son, Kyung-Min;Yang, Jeong-Yeol;Kim, Gyu-Bo;Han, Yun-Ju;Cheon, Ji-Seon
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.602-608
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    • 2011
  • Purpose: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. Methods: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I (n=92), $Merocel^{(R)}$ was used for nasal packing, for Group II (n=152) vaseline gauze was used, and Rolled silastic sheet (RSS) with vaseline gauze packing (VGP) was used for Group III (n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. Results: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased ($p$ <0.05) and the postoperative complication (deviation) were decreased comparing to vaseline gauze packing and $Merocel^{(R)}$ packing, however, these differences were not statistically significant ($p$ >0.05). Conclusion: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.

INFLUENCE OF LIGHT IRRADIATION OVER SELF-PRIMING ADHESIVE ON DENTIN BONDING (상아질접착제에 대한 광조사가 접착에 미치는 영향)

  • 류현욱;김기옥;김성교
    • Restorative Dentistry and Endodontics
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    • v.26 no.5
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    • pp.409-417
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    • 2001
  • The purpose of this study was to investigate the influence of light irradiation over self-priming adhesive on dentin bonding. After acid etching the exposed dentin, a self-priming adhesive (Prime&Bond$^{\circledR}$NT dental adhesive system Dentsply DeTrey, GmbH, Konstanz, Germany) was applied and light irradiation was done for 20 sec with regular intensity (600 mW/$\textrm{cm}^2$) in group I and for 3 sec with ultra-high intensity (1930 mW/$\textrm{cm}^2$) in group III. No light irradiation was done over self-priming adhesive in groups II and IV. Composite resin was added on the self-priming adhesive and irradiated for 40 sec with regular intensity (600 mW/$\textrm{cm}^2$) in groups I and II and for 3 sec with ultra-high intensity (1930 mW/$\textrm{cm}^2$) in groups III and IV. To see the effect of light curing time on dentin bonding, another 3 group specimens were prepared. Without light-irradiation over self-priming adhesive, added composite resin was irradiated for 3, 6, or 12 sec with ultra-high intensity light. After bonded specimens were stored in 37$^{\circ}C$ distilled water for 24 hours, shear bond strength were measured using a universal testing machine (4202, Instron, Instron Co., U.S.A.) and fractured surfaces were examined under a stereomicroscope (SZ-PT Olympus, Japan). Statistical analysis were done with one-way, two-way ANOVA and chi-square test. The results were as follows : 1. The shear bond strengths from the groups irradiated over self-priming adhesive were significantly higher than those from the groups without irradiation (p<0.05). 2. There was no significant shear bond strength difference between regular intensity light irradiation groups and ultra-high intensity ones (p>0.05). 3. There was no significant shear bond strength difference among various irradiation time groups with ultra-high intensity ones (p>0.05). 4. In stereomicroscopic examination of fractured surfaces, adhesive-cohesive mixed failure mode was mostly seen in all groups, and there was no significant difference in failure mode among groups (p>0.05).

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EFFECT OF LIGHT IRRADIATION MODES ON THE MARGINAL LEAKAGE OF COMPOSITE RESIN RESTORATION (광조사 방식이 복합레진 수복물의 변연누출에 미치는 영향)

  • 박은숙;김기옥;김성교
    • Restorative Dentistry and Endodontics
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    • v.26 no.4
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    • pp.263-272
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    • 2001
  • The aim of this study was to investigate the influence of four different light curing modes on the marginal leakage of Class V composite resin restoration. Eighty extracted human premolars were used. Wedge-shaped class Y cavities were prepared on the buccal surface of the tooth with high-speed diamond bur without bevel. The cavities were positioned half of the cavity above and half beyond the cemento-enamel junction. The depth, height, and width of the cavity were 2 mm, 3 mm and 2 mm respectively. The specimens were divided into 4 groups of 20 teeth each. All the specimen cavities were treated with Prime & Bond$^{R}$ NT dental adhesive system (Dentsply DeTrey GmbH, Germany) according to the manufacturer's instructions and cured for 10 seconds except group VI which were cured for 3 seconds. All the cavities were restored with resin composite Spectrum$^{TM}$ TPH A2 (Dentsply DeTrey GmbH, Germany) in a bulk. Resin composites were light-cured under 4 different modes. A regular intensity group (600 mW/${cm}^2$, group I) was irradiated for 30 s, a low intensity group (300 mW/${cm}^2$, group II) for 60 s and a ultra-high intensity group (1930 mW/${cm}^2$, group IV) for 3 s. A pulse-delay group (group III) was irradiated with 400 mW/${cm}^2$ for 2 s followed by 800 mW/${cm}^2$ for 10 s after 5 minutes delay. The Spectrum$^{TM}$ 800 (Dentsply DeTrey GmbH, Germany) light-curing units were used for groups I, II and III and Apollo 95E (DMD, U.S.A.) was used for group IV. The composite resin specimens were finished and polished immediately after light curing except group III which were finished and polished during delaying time. Specimens were stored in a physiologic saline solution at 37$^{\circ}C$ for 24 hours. After thermocycling (500$\times$, 5-55$^{\circ}C$), all teeth were covered with nail varnish up to 0.5 mm from the margins of the restorations, immersed in 37$^{\circ}C$, 2% methylene blue solution for 24 hours, and rinsed with tap water for 24 hours. After embedding in clear resin, the specimens were sectioned with a water-cooled diamond saw (Isomet$^{TM}$, Buehler Co., Lake Bluff, IL, U.S.A.) along the longitudinal axis of the tooth so as to pass the center of the restorations. The cut surfaces were examined under a stereomicroscope (SZ-PT Olympus, Japan) at ${\times}$25 magnification, and the images were captured with a CCD camera (GP-KR222, Panasonic, Japan) and stored in a computer with Studio Grabber program. Dye penetration depth at the restoration/dentin and the restoration/enamel interfaces was measured as a rate of the entire depth of the restoration using a software (Scion image, Scion Corp., U.S.A.) The data were analysed statistically using One-way ANOVA and Tukey's method. The results were as follows : 1. Pulse-Delay group did not show any significant difference in dye penetration rate from other groups at enamel and dentin margins (p>0.05) 2. At dentin margin, ultra-high intensity group showed significantly higher dye penetration rate than both regular intensity group and low intensity group (p<0.05). 3. At enamel margin, there were no statistically significant difference among four groups (p>0.05). 4. Dentin margin showed significantly higher dye penetration rate than enamel margin in all groups (p<0.05).

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The Effects of Functional Tea (Mori Folium, Lycii Fructus, Chrysanthemi Flos, Zizyphi Fructus, Sesamum Semen, Raphani Semen) Supplement with Medical Nutrition Therapy on the Blood Lipid Levels and Antioxidant Status in Subjects with Hyperlipidemia (고지혈증 환자에서 의학영양치료와 병행하여 섭취한 기능성차(상엽, 구기자, 국화, 대추, 참깨, 나복자)의 혈중 지질 농도 저하 및 항산화 효과)

  • Lim, Hyun-Jung;Cho, Kum-Ho;Choue, Ryowon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.1
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    • pp.42-56
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    • 2005
  • Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.