Kim, Tae-Sik;Sun, Kyung;Lee, Kyu-Baek;Park, Sung-Young;Hwang, Jae-Joon;Son, Ho-Sung;Kim, Kwang-Taik;Kim. Hyoung-Mook
Journal of Chest Surgery
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v.37
no.3
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pp.201-209
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2004
Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.
Han, Seong Rok;Hyun, Dong Keun;Park, Chong Oon;Ha, Young Soo;Kim, Joon Mee
Journal of Korean Neurosurgical Society
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v.29
no.10
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pp.1296-1302
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2000
Objective : Traumatic brain injury including diffuse axonal injury has been shown to result in a decrease in brainfree magnesium concentration, an endogenous inhibitor of calcium entry into neuron, that is associated with the development of neurological motor deficits. The goal of this study is to establish the therapeutic window during which the therapy with $MgSO_4$ and/or hypothermia improve damaged neurons by TUNEL stain. Method : Moderate brain injury was induced in 64 adult Sprague-Dawley rats, weighing 350 to 450gm each, by using a simple weight-drop device(Marmarou model). The animals were randomly assigned to four groups(sixteen rats each, a control group, a group treated with $MgSO_4$, a group treated with hypothermia, and a group treated with $MgSO_4$ and hypothermia) and the rats in each group were sacrificed and studied after 12 hrs, 24 hrs, 1 wk, and 2 wks after insult. In hypothermic group, these rats were subjected to hypothermia after injury, with their rectal temperatures maintained at $32^{\circ}C$ for 1 hour. After 1-hour period of hypothermia, rewarming to normothermic level was accomplished over 30-minute period. In the groups treated $MgSO_4$, hypothermia and $MgSO_4$ were subsequently treated with $MgSO_4$($750{\mu}moles/kg$) infused intra-muscularly at 30 minutes after trauma. Result : In all treated groups, a significant reduction in TUNEL positive cells was found in comparison with the control group each time(p<0.001). Between treatment groups, No differnce was seen 12hrs, 24hrs, and 1wk. However, hypothermic group treated with or without $MgSO_4$ showed more significant reduction in apoptotic cells than group treated with $MgSO_4$ 2 weeks after trauma(p<0.05). However, hypothermic group treated with $MgSO_4$ showed no significant reduction in apoptotic cells compared with hypothermic group(p>0.05). Conclusion : These findings suggest that both hypothermia and $MgSO_4$ significantly improve pathological changes. Otherwise simultaneously $MgSO_4$ and hypothermia treatment groups is failed to provide additional neuroprotection. These results may be relevant to the design of future clinical trials of therapeutic hypothermia and $MgSO_4$ for traumatic brain injury.
Post-mortem computed tomography (PMCT) is commonly employed in the field of forensic pathology. PMCT was mainly performed using a whole-body scan with a wide field of view (FOV), which lead to a decrease in spatial resolution due to the increased pixel size. This study aims to evaluate the potential for developing a super-resolution model based on conditional generative adversarial networks (CGAN) to enhance the image quality of CT. 1761 low-resolution images were obtained using a whole-body scan with a wide FOV of the head phantom, and 341 high-resolution images were obtained using the appropriate FOV for the head phantom. Of the 150 paired images in the total dataset, which were divided into training set (96 paired images) and validation set (54 paired images). Data augmentation was perform to improve the effectiveness of training by implementing rotations and flips. To evaluate the performance of the proposed model, we used the Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM) and Deep Image Structure and Texture Similarity (DISTS). Obtained the PSNR, SSIM, and DISTS values of the entire image and the Medial orbital wall, the zygomatic arch, and the temporal bone, where fractures often occur during head trauma. The proposed method demonstrated improvements in values of PSNR by 13.14%, SSIM by 13.10% and DISTS by 45.45% when compared to low-resolution images. The image quality of the three areas where fractures commonly occur during head trauma has also improved compared to low-resolution images.
Kim, Hyunho;Yang, Seung-Bum;Kang, Yeonseok;Park, Young-Bae;Kim, Jae-Hyo
Korean Journal of Acupuncture
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v.33
no.3
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pp.102-113
/
2016
Objectives : This study is aimed at developing and discussing the prediction model of blood stasis pattern of traditional Korean medicine(TKM) using machine learning algorithms: multiple logistic regression and decision tree model. Methods : First, we reviewed the blood stasis(BS) questionnaires of Korean, Chinese, and Japanese version to make a integrated BS questionnaire of patient-reported outcomes. Through a human subject research, patients-reported BS symptoms data were acquired. Next, experts decisions of 5 Korean medicine doctor were also acquired, and supervised learning models were developed using multiple logistic regression and decision tree. Results : Integrated BS questionnaire with 24 items was developed. Multiple logistic regression models with accuracy of 0.92(male) and 0.95(female) validated by 10-folds cross-validation were constructed. By decision tree modeling methods, male model with 8 decision node and female model with 6 decision node were made. In the both models, symptoms of 'recent physical trauma', 'chest pain', 'numbness', and 'menstrual disorder(female only)' were considered as important factors. Conclusions : Because machine learning, especially supervised learning, can reveal and suggest important or essential factors among the very various symptoms making up a pattern identification, it can be a very useful tool in researching diagnostics of TKM. With a proper patient-reported outcomes or well-structured database, it can also be applied to a pre-screening solutions of healthcare system in Mibyoung stage.
Objective: In this study, we present a simple closed head injury model as a two-stage experiment. The height of the weight drop enables gradation of head trauma severity. Methods: The head injury device consists of three parts and there are three adjustable parameters-weight (100-600 g). height of fall (5-100 cm) and elasticity of the springs. Thirty male Wistar rats underwent monitoring of intracranial pressure with and without induction of the head injury. Results: The weight drop from 45 to 100 cm led to immediate seizure activity and early death of the experimental animals. Severe head injury was induced from 40 cm weight drop. There was 50% mortality and all surviving rats had behavioral deterioration. Intracranial pressure was 9.3${\pm}$3.76 mmHg. Moderate head injury was induced from 35 cm, mortality decreased to 20-40%, only half of the animals showed behavioral pathology and intracranial pressure was 7.6${\pm}$3.54 mmHg. Weight drop from 30 cm caused mild head injury without mortality and neurological deterioration. Intracranial pressure was slightly higher compared to sham group- 5.5${\pm}$0.74 mmHg and 2.9${\pm}$0.81 mmHg respectively. Conclusion: This model is an eligible tool to create graded brain injury with stepwise intracranial pressure elevation.
Kim, Joong Hee;Kim, Seong Chun;Kwon, Woon Yong;Suh, Gil Joon;Youn, Yeo Kyu
Journal of Trauma and Injury
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v.21
no.2
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pp.120-127
/
2008
Purpose: Many studies on the time course of inducible nitric oxide synthase (iNOS) gene expression have been performed in the LPS (Lipopolysaccharide)-induced endotoxemic model, but there have been few experimental approaches to continuous peritonitis-induced sepsis model. We conducted this study to establish basic data for future sepsis-related research by investigating the time course of iNOS gene expression and the relationship with the production of inflammatory mediators in the early sepsis model induced by cecal ligation and puncture (CLP). Methods: Male Sprague-Dawley rats were operated on by sing the CLP method to induce of peritonitis; and then, they were sacrificed and samples of blood and lung tissues were obtained at various times (1,2,3,6,9 and 12 h after CLP). We observed the expression of iNOS mRNA from lung tissues and measured the synthesis of nitric oxide, $IL-1{\beta}$, and $TNF-{\alpha}$ from the blood. Results: iNOS mRNA began to be expressed at 3 h and was maintained untill 12 h after CLP. The nitric oxide concentration was increased significantly at 6 h, reached its peak level at 9 h, and maintained a plateau untill 12 h after CLP. $TNF-{\alpha}$ began to be detected at 3 h, increased gradually, and decreased steeply from 9 h after CLP. $IL-1{\beta}$ showed its peak level at 6 h after CLP, and tended to decrease without significance. Conclusion: We observed that the iNOS gene was expressed later in peritonitis-induced sepsis than in LPS-induced sepsis. Nitric oxide and key inflammatory mediators were also expressed later in peritonitis-induced sepsis than in LPS-induced sepsis.
Purpose: This study aimed to evaluate the accuracy of bite registration using intraoral scanner based on data trimming strategy for fremitus teeth. Materials and Methods: A reference model was designed by Medit Model Builder software (MEDIT Corp., Seoul). Tooth number 24 and 25 were separated as dies and tooth number 26 was prepared for full-coverage crown. Those were printed using a 3D printer (NextDent 5100). The scanning procedure was performed by a single trained operator with one intraoral scanner (i700; MEDIT Corp.). The scanning groups were divided as follows: group 1 (G1), no fremitus; group 2 (G2), 0.5 mm buccal fremitus in the maxillary left first and second premolar; and group 3 (G3), 1.5 mm buccal fremitus in the maxillary left first and second premolar. Each group was scanned 10 times and were analyzed using the reference model data. Surface-based occlusal clearance was analyzed at the prepared tooth to evaluate accuracy. Result: Mean values of control group (G1) were 1.587±0.021 mm. G2 showed similar values to those from the control group (1.580±0.024 mm before trimming strategy and 1.588±0.052 mm after trimming strategy). G3 showed significantly greater values (1.627±0.025 mm before trimming strategy and 1.590±0.024 mm after trimming strategy) and the differences were found between trimming strategy (P=0.004). Conclusion: Bite trimming strategy for fremitus teeth is a reliable technique to reduce inaccuracies caused by the mobility at maximum intercuspation.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.15
no.1
/
pp.61-74
/
2004
Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.
El Sallah, Zagane Mohammed;Smail, Benbarek;Abderahmane, Sahli;Bouiadjra, B. Bachir;Boualem, Serier
Structural Engineering and Mechanics
/
v.60
no.3
/
pp.405-412
/
2016
Bone is a living material with a complex hierarchical structure that gives it remarkable mechanical properties. Bone constantly undergoes mechanical. Its quality and resistance to fracture is constantly changing over time through the process of bone remodeling. Numerical modeling allows the study of the bone mechanical behavior and the prediction of different trauma caused by accidents without expose humans to real tests. The aim of this work is the modeling of the femur fracture under static solicitation to create a numerical model to simulate this element fracture. This modeling will contribute to improve the design of the indoor environment to be better safe for the passengers' transportation means. Results show that vertical loading leads to the femur neck fracture and horizontal loading leads to the fracture of the femur diaphysis. The isotropic consideration of the bone leads to bone fracture by crack propagation but the orthotropic consideration leads to the fragmentation of the bone.
Proceedings of the Korean Society of Applied Pharmacology
/
1996.04a
/
pp.192-192
/
1996
Endothelin has $ET_{A}$ type and $ET_{B}$ type receptors, and it has been thought that ET-1 proves vasoconstriction effect via $ET_{A}$ receptor and vasodilation via $ET_{B}$ receptor. Recently, it has been reported that $ET_{B}$ receptor is also related to the vaso-constriction. Bosentan is a $ET_{A+B}$ receptor antagonist, and proves it's effect on trauma and ischemia. We already announced that the level of Endothelin-1 increase in the brain and spinal cord of EAE-induced lewis rat and showed the origin of ET-1 is activated macrophages. Intracisternal injection of Bosentan, $ET_{A+B}$ receptor antagonist, (300nmol/body) was done for observing the role of endothelin-1 on the pathogenesis of EAE. Bosentan ameliorated the severity of clinical score of EAE and decreased the histologically observed inflammatory region. The blocking effect on the progression of EAE model suggests that Bosentan is a physiological antagonist in terms of development of the sign of multiple sclerosis.
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