Objective: To evaluate efficacy of assisted hatching by laser (AHL) and acidified Tyrode solution (AHA) in selected groups of IVF-ET patients who have a poor prognosis. Methods: From February 2006 to September 2006, total of 328 IVF-ET cycles with advanced female age (${\geq}38$ years), recurrent implantation failure (${\geq}3$ cycles), thick zona (${\geq}17{\mu}m$), and/or poor quality of embryo were randomly divided into assisted hatching by acidified Tyrode solution (AHA, n=180) and the assisted hatching using the ZILOS-tk laser (AHL, n=148) groups. Clinical outcomes were analyzed and compared between AHA and AHL group based on the patient characteristics. Results: In all AHL and AHA group, there were no significant differences in pregnancy (42.6%, 63/148 vs. 33.3%, 60/180) and implantation rates (17.4%, 82/470 vs. 16.0%, 89/556) However, in advanced female age group (Group 1), pregnancy (37.0%, 20/54 vs. 18.7%, 14/75) and implantation rates (14.4%, 23/160 vs. 7.1%, 15/210) in AHL group were significantly (p<0.05) higher than those of AHA, although there was no difference in patient parameters of both groups. And, the clinical outcome of groups with recurrent implantation failure (Group 2), thick zona pellucida (Group 3) and poor quality embryo (Group 4) were improved in AHL compared to those of AHA: 43.8% (21/48) and 31.6% (25/79) in Group 2, 43.8% (32/73) and 34.1% (28/82) in Group 3, 25.0% (7/28) and 14.6% (6/41) in Group 4, but no significance. Conclusion: The AHL improved the pregnancy and implantation rates in patients with advanced female age and recurrent implantation failure when compared to outcomes achieved from AHA. Therefore, this AHL technique may be a efficient and safe method for patients with poor prognosis.
Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Choi, Sang-Yeong
Journal of Korean Orthopaedic Sports Medicine
/
v.10
no.1
/
pp.27-34
/
2011
Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.
Background : In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low $FEV_1$ low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate if the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. Method : We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right strial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups ; group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor, pulmonale. Results : Poor, prognostic factors by univariate analysis were low $FEV_1$, $FEV_1$ % pred., VC % pred., DLco, DLco % pred., $PaO_2$ and $SaO_2$ high $PaCO_2$ presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long term use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05-1.23), DLco % pred. (risk ratio=0,97. 95% confidence interval 0.94-0.99), $PaO_2$ (risk ratio=0.95, 95% confidence interval 0.90-0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40-19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. Conclusion : These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.
Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.
Journal of the korean academy of Pediatric Dentistry
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v.37
no.1
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pp.44-52
/
2010
The objective of this in vitro study was to detect and monitor demineralization and remineralization of primary teeth according to restorative materials using quantitative light-induced fluorescence (QLF). A single bur hole was drilled on the each sound forty eight primary anterior teeth, and the specimens were divided into three groups. The cavity was restored with $Filtek^{TM}$ Z250(Group 1), F2000(Group 2), $Ketac^{TM}$ N100(Group 3) following the manufacturer's instructions. The teeth were subjected to the demineralizing buffer for 3 days, and then subjected to a remineralizing buffer for 14 days. The change of mineral loss(${\Delta}Q$) according to the stages was evaluated by QLF and the following results were obtained: 1. When demineralization was done, ${\Delta}Q$ was increased as follows. : Group 1 ($-110.79\;{\pm}\;27.77$) < Group 2 ($-104.84\;{\pm}\;28.95$) < Group 3 ($-90.16\;{\pm}\;21.87$) : Resistance to demineralization was statistically significant in Group 3. 2. There was a statistically significant increase in ${\Delta}Q$ of all groups since 1st day of remineralization 3. The rate of remineralization, ${\Delta}$(${\Delta}Q$)/day, showed significant high value in each group on the 1st day then decreased rapidly. 4. There was no statistically significant difference in the degree of remineralization among restorative materials.
An investigation for long-term strength characteristics of crushed sand concrete using crushed sands produced in Yang-san, Kim-hae and Jin-hae that can be assumed to respectively represent eastern, middle and western suburbs of Busan has been carried out. Concrete is composed of 70~80% of aggregates in whole volume so the effect of aggregates quality to the characteristics of concrete is very important. Since 1980s, aggregates used in concrete have already been substituted crushed stone because of the exhaustion of natural gravel and sand. Crushed sand tends to increase in using quantity because of the prohibition of sea sand picking and deterioration of river sand. Crushed sand is blended with river sand in order to investigate the quality changes and characteristics of concrete as variation of blend ratio of crushed sand (n, 50, 70, 80, 90, 100%). Slump and air content were measured to investigate the properties of fresh concrete. Unit weight, compressive strength and modulus of elasticity in age of 7, 28, 60, n, 180 days were measured to investigate properties of hardened concrete. Compressive strength, unit weight and modulus of elasticity were increased with a passage of time and they are expected to keep on increasing in long-term age as well. The experimental results of the qualifies of crushed aggregates in each producing area, were all satisfied with Korea Standard. The results of the measurement of slump exposed that slump preferably decreased as mixing rate increased till 70~80% but it increased to mixing rate 70~80%. The air content was exposed that it decreased by micro filler phenomenon according to that crushed sand b)ended ratio increased. According to the result of measuring unit weight in age of 7, 28, 60, 90, 180days, it increased in accordance with that blended ratio of crushed aggregates increases. As a result of measuring compressive strength and modulus of elasticity in age of 7, 28, 50, 90, 180days, compressive strength was highest when it is 70% of blended ratio.
This paper reports novel empirical results of a choice experiment that elicited the economic values that residents in the Seoul metropolitan area place on the amenity services realized from the landscape views and accessibilities to urban green spaces (i.e., mountains, rivers and urban parks). The 1,000 respondents in the sample were divided into two residential of housing types (apartments vs. houses) and occupancy types (owners vs. tenants). Residents living in apartments are willing to pay an average of 28% (5.0 million KRW per year) above the current housing prices per household for a mountain view, compared to an apartment view from their living room. Their willingness to pay values are about 22% (4.0 million KRW per year) and 10% (1.8 million KRW per year) respectively for a river view and a urban park view. Economic benefits of having access (i.e., a 10 minutes working distance) to mountains, rivers and urban parks are estimated to be an average of 16% (2.9 million KRW per year), 20% (3.6 million KRW per year) and 18% (3.2 million KRW per year), respectively, above the current housing prices per household. On the other hand, access benefits for those residing in houses are 18% (4.7 million KRW per year), 16% (4.1 million KRW per year) and 22% (5.6 million KRW per year) per household, respectively. They are also willing to pay an average of 35% (8.9 million KRW per year) above the current housing prices for keeping or having a garden or vegetation bed. Furthermore, a strong "greenspace premium" is centered around the three Gangnam districts for house-dwellers, whereas it is areas of "new real estate boom" for apartment dwellers.
Bae, Si Woo;Kim, Dongseon;Kim, Young Ok;Moon, Chang Ho;Baek, Seung Ho
Korean Journal of Environmental Biology
/
v.32
no.1
/
pp.35-48
/
2014
In order to estimate the effect of additional nutrients on phytoplankton growth and horizontal phytoplankton community distribution during the autumn season in 2010 and 2011, we investigated the abiotic and biotic factors of surface and bottom waters at 20 stations of inner and offshore areas in Gwangyang Bay, Korea. Also, nutrient additional experiments were conducted to assess additional nutrient effects on phytoplankton assemblage using the surface water. In both years, the total nutrients were high at the enclosed inner bay and the mouth of Seomjin River, whereas it was low at the St.15~20 where in influenced by the surface warm water current from offshore of the bay. On the other hand, nano- and pico-sized Chl. a were gradually increased towards the outer bay and their trends were significant in 2011 than in 2010. The cryptophyta species occupied more than 85% of total phytoplankton assembleges in 2010, whereas their abundance in 2011 remainds to be 1/10 levels of 2010. Following the cryptophata species, the diatom Chaetoceros spp. and Skeletonema-like spp. were found to be dominant species. Further the biosaasy experimental results shows that the phytoplankton biomass in the +N and +NP treatments was higher compared to control and +P treatments and its trend was significant at St.8 and St.20 where nutrient concentration were low. Based on the bioassay and field survey, providing the high nutrients may have stimulated to phytoplankton growth such as S. costatum-like spp.. In particular, opportunistic micro-algae such as Cryptomonas spp. were able to achieve the high biomass under the relatively mid nutrient condition from bottom after break down of seasonal stratification in the Gwangyang Bay.
This study aimed to assess the influence of different cross-sectional area on the cyclic fatigue fracture of Ni-Ti rotary files using a fatigue tester incorporating cyclical axial movement. Six brands of Ni-Ti rotary files (ISO 30 size with. 04 taper) of 10 each were tested: Alpha system (KOMET), HeroShaper (MicroMega), K3 (SybronEndo), Mtwo (VDW), NRT (Mani), and ProFile (Dentsply). A fatigue-tester (Denbotix) was designed to allow cyclic tension and compressive stress on the tip of the instrument. Each file was mounted on a torque controlled motor (Aseptico) using a 1:20 reduction contra-angle and was rotated at 300 rpm with a continuous, 6 mm axial oscillating motion inside an artificial steel canal. The canal had a $60^{\circ}$ angle and a 5 mm radius of curvature. Instrument fracture was visually detected and the time until fracture was recorded by a digital stop watch. The data were analyzed statistically. Fractographic analysis of all fractured surfaces was performed to determine the fracture modes using a scanning electron microscope. Cross-sectional area at 3 mm from the tip of 3 unused Ni-Ti instruments for each group was calculated using Image-Pro Plus (Imagej 1.34n, NIH). Results showed that NRT and ProFile had significantly longer time to fracture compared to the other groups (p < .05). The cross-sectional area was not significantly associated with fatigue resistance. Fractographycally, all fractured surfaces demonstrated a combination of ductile and brittle fracture. In conclusion, there was no significant relationship between fatigue resistance and the cross-sectional area of Ni-Ti instruments under experimental conditions.
Xenotransplantation in discordant species results in immediate and irreversible hyperacute rejection due to natural antibodies, IgM. With this, antibody depletion is one option to reduce hyperacute rejection, we investigated the effect of PCPP (postcentrifugal plasmapheresis) on the depletion of natural antibodies and the effect of antibody titer on xenograft survival. Material and Method: Outbred swines (n=4) weighing 10∼20 kg were used as donors and mongrel dogs (n=4) weighing 25∼30 kg were used as recipients. Recipient canines underwent plasmapheresis (COBE TPE Laboratories, Lakewood. CO, USA). Pre-transplantation PCPP was peformed on day -2 and day 0. There were three groups (Group 0: no PCPP, Group 1: 1 pla sma-volume (PV) at day -2 and 2 PV at day 0, Group 2: 2 PV at day -2 and 2 PV at day 0). A swine heart was heterotopically transplanted into a recipient's abdominal infrarenal aorta and inferior vena cava. Mean percent depletion of total IgM and IgG in plasma of the recipients was calculated. Serum albumin, electrolyte, complement activity and coagulation factors were measured. Histopathologic examination of heart specimens was performed. Result: Mean percent depletion of IgM and IgG were 95.7$\pm$1.2%, 80.5$\pm$2.4% in the group 2 at the end of PCPP. The percent depletion of serum albumin concentration was decreased from 2.8 to 1.4 g/㎗ in the group 1 and 3.0 to 1.5 g/㎗ in the group 2. Complement hemolytic activity was decreased in group 1 and 2, but returned to normal level within 24 hours. Complement hemolytic activity was reduced to 10% of pre-PCPP level in group 2. Serum fibrinogen decreased to 20% or less and was recovered within 24 hours in group 2. Antithrombin III decreased but less than fibrinogen. PT and aPTT were sometimes but not always prolonged during plasmapheresis. After plasmapheresis, PT and aPTT were prolonged beyond the measurable level. D-dimer was not found during PCPP, but appeared and maintained from 10 minutes after trasplantation. Graft Survival time was 5 min in group 0, and it was 90$\pm$0 min in the group 2. Histopathologic changes were more typically characterized by edema, hemorrhages, thrombosis in all groups at the end of experiment. Conclusion: PCPP effectively removed immuoglobulins and reduced the titer of natural antibodies, as a result, significantly prololonged swine heart xenograft survival.
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