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Clinical Results alter Pulmonary Endarterectomy as a Curative Surgical Method in Chronic Thromboembolic Pulmonary Hypertension: an Approach to Operative Classification of Thromboembolic Disease (만성 폐동맥 색전증의 치료로서 내막제거술의 임상적 결과: 색전증 분류에 따른 접근)

  • Lim, Ju-Yong;Lee, Jae-Won;Kim, Jeong-Won;Jung, Sung-Ho;Je, Hyoung-Gon;Song, Hyun;Chung, Cheol-Hyun;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.591-597
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    • 2008
  • Background: Pulmonary endarterectomy is widely accepted as a treatment for chronic thromboembolic pulmonary hypertension. Based on our experiences, we sought to find ways to reduce perioperative complications and to improve surgical outcomes in patients undergoing pulmonary endarterectomy. Material and Method: This study was designed as a retrospective analysis of 20 patients with pulmonary hypertension who underwent pulmonary endarterectomy between January 1998 and March 2008. All patients presented with chronic dyspnea. Deep vein thrombosis (DVT) was the major cause of chronic pulmonary thromboembolism (55%). Seventeen patients (85%) underwent inferior vena cava (IVC) filter placement. Thirteen patients underwent surgery under total circulatory arrest, while the others underwent surgery while on low flow cardiopulmonary bypass. Concomitant tricuspid annuloplasty was done in 6 patients (66%) whose tricuspid regurgitation was as severe as grade IV/IV. The mean follow-up duration was $45{\pm}32$ months. Result: Using of University of California, San Diego (UCSD), thromboembolism classification, 4 patients (20%) were type 1, 8 patients (40%) were type II, and 8 patients (40%) were type III. Right ventricular systolic pressure was reduced significantly from $77{\pm}29$ mmHg to $37{\pm}19$ mmHg after pulmonary endarterectomy (p<0.001). The degree of tricuspid regurgitation and the NYHA functional class were all improved postoperatively. Reperfusion edema occurred in 7 cases (35%). The incidence of reperfusion edema was higher in the UCSD type III group than in the other group (25% vs 50%, p=0.25) and the length of postoperative intensive care unit stay was longer in type III group ($5{\pm}2$ days vs $9{\pm}7$ days, p=0.07). The early mortality rate was 10%, and the late mortality rate was 15% (n=3); one death was due to progression of underlying non-Hodgkin's lymphoma, and the other deaths were related to recurrent thromboembolism and persistent pulmonary hypertension, respectively. Conclusion: Pulmonary endarterectomy, as a curative surgical method for treating chronic thromboernbolic pulmonary hypertension, should be performed aggressively in patients diagnosed with chronic thromboembolic pulmonary hypertension, and an effort should be made to reduce the frequency of perioperative complications and to improve surgical outcomes.

Tributyltin Increases Adipogenesis and Apoptosis of Rat Testicular Interstitial Cells (Tributyltin에 의한 흰쥐 정소 내 간질세포의 지방세포 유도와 세포자연사 증가)

  • Song, Yeon-Hwa;Jung, Ji-Eun;Lee, Hyun-A;Hong, Ji-Hee;Yang, Hyun-Won
    • Development and Reproduction
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    • v.14 no.4
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    • pp.297-306
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    • 2010
  • Tributyltin (TBT), an endocrine disrupting chemical, has been reported to decrease testicular function by causing apoptosis in the testis, but this mechanism is not fully understood. Thus, in this study we examined whether TBT induces adipogenesis of the Leydig cells to find out the correlation between adipogenesis and apoptosis in the testis. Three week old SD male rats were orally administrated with sesame oil, 1 mg/kg of TBT, or 10 mg/kg of TBT daily for 1 week and weighed after administration. The testes obtained on day 8 were weighed and stained with BODIPY and TUNEL kit. Using total RNA extracted from the isolated Leydig cells, adipogenesis and apoptosis-related genes were analyzed by real-time PCR. The testicular weights of the rats treated with 10 mg/kg TBT were significantly decreased compared to those in the control rats treated with sesame oil. As a result of BODIPY staining, the number of Leydig cells stained with BODIPY was increased in the rats treated with 10 mg/kg TBT compared with the control rats. Similar to BODIPY staining results, the TUNEL assay showed that the apoptosis of Leydig cells was increased in TBT treated rats. The results of the gene expression analysis in the Leydig cells showed that the expression of adipogenesis-related genes (PPAR${\gamma}$, aP2, Perilipin, CD36) and apoptosis-related genes (TNFRSF1A, TNFSF10) was increased after TBT administration. The present study demonstrates that TBT induces the expression of adipogenesis-related and apoptosis-related genes in the Leydig cells leading to adipogenesis and apoptosis in the testes. These results suggest that the dysfunction of Leydig cells by TBT exposure may cause a loss in testicular function.

Evaluation of the Usefulness of the Self-developed Kw-infrared Reflective Marker in Non-coplanar Treatment (비동일면 치료 시 자체 제작한 Kw-infrared Reflective Marker의 유용성 평가)

  • Kwon, Dong-Yeol;Ahn, Jong-Ho;Park, Young-Hwan;Song, Ki-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.1
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    • pp.25-32
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    • 2010
  • Purpose: In radiotherapy that takes into account respiration using a RPM (Real time Position Management, Varian, USA) system, which can treat in consideration of the movement of tumor, infrared reflective markers supplied by manufacturers cannot obtain respiratory signal if the couch rotates at a certain angle or larger. In order to solve this problem, the author developed the 3D infrared reflective marker named 'Kw-marker' that can obtain respiratory signal at any angle, and evaluate its usefulness. Materials and Methods: In order to measure the stability of respiratory signal, we put the infrared reflective marker on the 3D moving phantom that can reproduce respiratory movement and acquired respiratory signal for 3 minutes under each of 3 conditions (A: $couch\;0^{\circ}$, a manufacturer's infrared reflective marker B: $couch\;0^{\circ}$, Kw-marker C: $couch\;90^{\circ}$, Kw-marker). By analyzing the respiratory signal using a breath analysis program (Labview Ver. 7.0), we obtained the peak value, valley value, standard deviation, variation value, and amplitude value. In order to examine the rotation error and moving range of the target, we placed a B.B phantom on the 3D moving phantom, and obtained images at a couch angle of $0^{\circ}$ and $90^{\circ}$ using OBI, and then acquired the X, Y and Z values (mm) of the ball bearing at the center of the B.B phantom. Results: According to the results of analyzing the respiratory signal, the standard deviation at the peak value was A: 0.002, B: 0.002 and C: 0.003, and the stability of respiration for amplitude was A: 0.15%, B: 0.14% and C:0.13%, showing that we could get respiratory signal stably by using the Kw-marker. When the couch rotated $couch\;90^{\circ}$, the mean rotation error of the ball bearing, namely, the target was X: -1.25 mm, Y: -0.45 mm and Z: +0.1 mm, which were within 1.3 mm on the average in all directions, and the difference in the moving range of the target was within 0.3 mm. Conclusion: When we obtained respiratory signal using the Kw-marker in non-coplanar treatment where the couch rotated, we could acquire respiratory signal stably and the Kw-marker was effective enough to substitute for the manufacturer's infrared reflective marker. When the rotation error and moving range of the target were measured, there was little difference, indicating that the displacement of the reflector movement in couch rotation is the cause of change in the scale and amplitude of respiratory signal. If the converted value of amplitude height according to couch angle is studied further and applied, it may be possible to perform non-coplanar phase-based gating treatment.

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학교도서관 발전의 저해요인에 관한 실증적 고찰 -일학교장의 학교도서관에대한 인식을 중심으로-

  • 김남석;김정소
    • Journal of Korean Library and Information Science Society
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    • v.7
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    • pp.1-55
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    • 1980
  • It has been observed that the purpose of education is poorly coordinated with the school library. Consequently a healthy growth of the library has been very rare, and educational process has been rather inefficient. Therefore this study attempts to define the role of a school library and the necessasity of its growth, examine principals' concepts of the library, find out the adverse causes for its growth, and make some suggestions to rectify them. A questionnaire was designed to get information on the principals' conceptions about the nature and the role of a school library, a librarian, and adverse causes for the growth of the library. This study is largely based on the analysis of this questionnaire. The results of this study may be summarized as. follows: 1) The school library is not generally considered as the center of educational activities. It is rather variously regarded as a subsidiary organization for education, a place where reading materials are offered, a place where books are kept, or a reading room. 2) This was largely due to the misconceptions of the principals as to the true nature and the role of the school library. 3) The degrees of their misconceptions varied depending on the amount of their exposure to the library science. Those principals who studied library science more hours had better understanding of the library. 4) Although the principals showed rather much concern for the library, the school library was not up to the expectation largely due to their misconception of it. 5) Most of the principals felt that they needed more knowledge on library science to carry out their job. This feeling was stronger for those who spent more hours in a library science course. 6) Most of the principals wanted to offer a position for a dual function: a librarian and a teacher. This was largely due to their lack of knowledge as to the duties of a librarian-which were considered as secondary to the duties of a teacher. 7) The majority of the principals thought the librarians were not paid well enough, but some of the principals o n.0, pposed their pay raise. The former generally took more courses in library science than the latter. 8) Many principals agreed that the adverse causes for the growth of the school library originated from the regional or governmental school authorities. This seemed to indicate that the legal requirements for the library were inadequate and that there was no administrative organization to take care of the library. 9) Most of the principals considered the insufficient funds as the major reason for the present poor condition of the library. But considering the fact that some libraries are better equi n.0, pped that others, financial matter cannot be the deciding factor. It rather seemed that there is some serious problems in the current educational system. For further studies in this field and for the libraries to function properly, the following suggestions are made here: 1) The major adverse cause for the healthy growth of the school library was found in the misconceptions on the school library by the principals, and these misconceptions were largely due to their lack of knowledge. Therefore they should be given more o n.0, pportunities to take courses in library science. 2) The librarian should not be overburdened with other duties than what his job duly calls for, and they should be properly compensated for their own job. They should also be encouraged to grow as librarians. 3) Education itself should be improved so that the library becomes the center of learning. 4) An administrative department should be created to oversee the school libraries, and legal measures should be enacted for better school libraries. 5) Financial su n.0, pport should be provided for a period of time in order to upgrade the school library to a certain level. Finally it is strongly felt that more detailed and inclusive studies in this field should be carried on and further experimental studies should be done.

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Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia (폐쇄성 무정자증과 비폐쇄성 무정자증에서 체외수정시술 후의 임신 결과 비교)

  • Park, Chan-Woo;Koong, Mi-Kyoung;Yang, Kwang-Moon;Kim, Jin-Young;Yoo, Keun-Jai;Seo, Ju-Tae;Song, Sang-Jin;Park, Yong-Seog;Kang, Inn-Soo;Jun, Jin-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.3
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    • pp.207-215
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    • 2003
  • Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.

A Survey on the Knowledge and Attitudes of Women in Taegu toward Weaning Diet for Infants (이유식에 대한 대구지역 여성들의 인식조사)

  • Kim, Kyung-Ah;Lee, Eun-Sil;Lee, Young-Hwan;Shin, Son-Moon;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.370-382
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    • 1997
  • Successful weaning is very important to provide adequate nutrients for normal growth and to induce a good diet habit. We conducted a survey on the knowledge and attitudes of women who live in Taegu toward weaning in infants, to figure out how much they know about weaning diet for the infants, which source they prefer to get the information about weaning diet, whether their knowledge affect their practice about weaning in infants, and the most effective way to educate them. A survey was conducted with the prepared questionnaire on women who responded at the residential area and market place, and those who visited Department of Pediatrics, Yeungnam University Hospital from July 25 to September 15, 1997. Statistical analysis was done with student t-test and ANOVA using SPSS program. Among total 303 responders, those who aged between 30 and 39 years were 37.2%. Scores for the six questions about weaning policy showed highest in the age group between 30 and 39 years. Higher score was recorded in the more educated group, in those who get informations about weaning diet from books, magazines and pediatricians. The majority of the responders had wrong concepts, such as feeding weaning diet using bottle(69.1%), feeding mixed with formula in the same bottle(64.5%), addition of salt(68.4%). Those who had higher educational level preferred books, magazines rather than neighbors or mother to get informations about weaning diet. Those who preferred books or magazines started weaning, stopped bottle feeding, and used spoon earlier, and their children had unbalanced diet habits less frequently. Home-made food was used most frequently, and commercial products were used less frequently. Those who were employed preferred home-made food rather than commercial products, it may be caused by the difference of the educational backgrounds from those of the unemployed. In conclusion, most responders ask neighbors and mother to get informations about weaning, and the incorrect knowledge from them could cause inadequate weaning practice and induce bad diet habit in their children. We have to find the reasons why they did not refer books or magazines frequently, and the way to resolve the problem.

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A survey on sex life behavior and factors of low back pain (요통환자들의 성생활 행태와 영향 요인 조사)

  • Nam, Chul-Hyun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.31-49
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    • 2002
  • The purpose of this study was to investigate discomforts and sexual life and to identify the relation between the discomforts and sexual life with low back pain. The data were collected from March 2 through July 31, 2001. Four hundred forty-two questionnaires were returned (response rate=88.0%). Analysis of the data was done with SPSS PC+ and use descriptive statistics, $x^2$-test, t-test, ANOVA. regression. The statistics shows that over than 80% of the adults experienced lumbago at least one time in their life, and Back pain is known as one of the most common complaints made by the patients of all ages in the general hospital or local medical clinics throughout. However, in certain case it leads to a chronic condition which can cause a great deal of problems in management and in financial burden to individuals and society. The result of this study was summarized as follows: 1) It appeared that regarding the distribution of gender, male was the higher(63.6%) then that of female, the portion of forties was 28.5%. Sitting for long time was 23.1% in men and 21.7% in women. Unknown reason including sexual behaviour was 12.9% in men and 15.5% in women. Patients treated medicine and physical therapy were 36.4%. In level of educational background, the rate of high school was 31.0%, technical college was 28.5%. The highest proportion by occupation was 18.3% of office workers, occupation posture was 41.9% of sitting. 2) Men(26.0%) and most of women(34.8%) were not satisfied in the explanation satisfaction rate of sex life concerned disease. 23.8% in men and 23.6% in women considered flexibility of waist good. Man(33.3%) and most of woman(35.0%) considered that Health education is necessary. 32.7% in men and 27.3% in women did't mind educator is whoever. Preventing of lower back pain(LBP) and proper Health education of sex life are demanded in daily life. 3) 58.0% of man and 64.0% of woman mostly had a posture which is man over woman. 28.5% in men and 27.8% in women considered that proper information finding of LBP and sex life was very few and few. 37.7% in men and 42.7% in women have acquired information about sex life flung their friends. 4) The number of sex life was decreased from 2.96 0.98 to 2.61 1.63 and also the time of sex life was decreased from 3.65 1.89 to 226 1.64. The satisfaction rate of sex life changed from 3.60 0.86 to 2.77 1.10. In the number of sex life, The non correct group was 2.62 1.91 and the correct group was higher in 2.68 1.65. In the time of sex life, The non correct group was 2.02 1.47 and the correct group was higher in 229 1.65. The satisfaction rate of sex life was 2.76 0.86 in non correct group and 2.88 1.10 in correct group. So there was a difference. 5) In the satisfaction rate of sex life, Men who have a lower back pain were higher than women and no attack group was higher than attack group. As they had many sex life, the satisfaction rate was higher significantly in statistics. As the time of sex life was short, the satisfaction rate was lower significantly in statistics. As the age was low, the demand rate of Health education was high and as means of patient who had a lower back pain was high, the demand rate of Health education was high. As the patient who had a lower back pain had a long married life, the demand rate of Health education was high and as education level was high, the demand rate of Health education was high. It is necessary to provide patients with conservative treatment, educational teaching, and training to prevent further injuries in the future. In general, it is important to educate the public how to prevent back injuries and how to treat themselves in an onset period to prevent further injuries sliding into a chronic state. Sexuality is an integral part of normal and healthy relationships, but patients are unable to enjoy sex because they are riot able to get into a comfortable position due to back pain. Many conditions of the spine can make certain positions uncomfortable. Health educator should make the education program of the discomforts and the sexual pattern for low back pain in workplace and/or hospital. Further study Is needed on how to integrate the educational program on sexuality into the total rehabilitation program.

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The Study on A Peculiarity of Mise-en-scene Found in Animation :Focused on Russian Animation (애니메이션 미장센 특성 연구 - 러시아 애니메이션을 중심으로)

  • Kim, MiRNaRae;Min, JunIl
    • Cartoon and Animation Studies
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    • s.44
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    • pp.1-31
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    • 2016
  • In this thesis, the movie with mise-en-scene established was compared with the peculiarity of the play that is the etymological source of the term to identify the peculiarity of mise-en-scene which was substituted into animation to find the peculiarity of mise-en-scene in animation. To emphasize the direct connection between the frame's visual peculiarity and the director's opinions, the mise-en-scene of director centered animation created under a restricted environment was reviewed. Mise-en-scene which started from movie critics theory does not simply mean the arrangement of images in a frame. Mise-en-scene emphasizes the exposure of the work's motive by the visual components. The animation's assuming the middle point of environmental share possessed by play and movie when schematizing the genre peculiarity of animation, play and movie was a noteworthy result. It can be said that the cause is that the animation's peculiarity yield different results depending on the making methods; we verified that this is a key factor in the analysis of animation's mise-en-scene. I emphasized that the peculiarity of animation mise-en-scene is in its making method and material and suggested identifying the work's making methods and analyzing the work's aesthetic results derived in this way. The russian animation which was perceived as peripheral arts was relatively free from the burden of censorship while receiving support from the Soviet as a media for propaganda. The russian animation's mise-en-scene which found the material for its works in the country's folklore was metaphorical, focused on new expression forms and achieved experimental elements. Russian animation pursues a unique aesthetic world through space expression based on the forms of opera or ballet and heavy motions formed static inbetweens.

Predictive indicators of coronary artery complications in Kawasaki disease (가와사키 병 환아에서 관상동맥 합병증의 예측인자)

  • Park, Min Jee;Jeon, In-sang;Tchah, Hann;Choi, Kang Ho;Jung, Mi-Jin;Choi, Deok Young
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1161-1166
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    • 2009
  • Purpose : Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. Methods : Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. Results : Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2-3-fold, respectively. Conclusion : The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.

Improving the Accuracy of Document Classification by Learning Heterogeneity (이질성 학습을 통한 문서 분류의 정확성 향상 기법)

  • Wong, William Xiu Shun;Hyun, Yoonjin;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.21-44
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    • 2018
  • In recent years, the rapid development of internet technology and the popularization of smart devices have resulted in massive amounts of text data. Those text data were produced and distributed through various media platforms such as World Wide Web, Internet news feeds, microblog, and social media. However, this enormous amount of easily obtained information is lack of organization. Therefore, this problem has raised the interest of many researchers in order to manage this huge amount of information. Further, this problem also required professionals that are capable of classifying relevant information and hence text classification is introduced. Text classification is a challenging task in modern data analysis, which it needs to assign a text document into one or more predefined categories or classes. In text classification field, there are different kinds of techniques available such as K-Nearest Neighbor, Naïve Bayes Algorithm, Support Vector Machine, Decision Tree, and Artificial Neural Network. However, while dealing with huge amount of text data, model performance and accuracy becomes a challenge. According to the type of words used in the corpus and type of features created for classification, the performance of a text classification model can be varied. Most of the attempts are been made based on proposing a new algorithm or modifying an existing algorithm. This kind of research can be said already reached their certain limitations for further improvements. In this study, aside from proposing a new algorithm or modifying the algorithm, we focus on searching a way to modify the use of data. It is widely known that classifier performance is influenced by the quality of training data upon which this classifier is built. The real world datasets in most of the time contain noise, or in other words noisy data, these can actually affect the decision made by the classifiers built from these data. In this study, we consider that the data from different domains, which is heterogeneous data might have the characteristics of noise which can be utilized in the classification process. In order to build the classifier, machine learning algorithm is performed based on the assumption that the characteristics of training data and target data are the same or very similar to each other. However, in the case of unstructured data such as text, the features are determined according to the vocabularies included in the document. If the viewpoints of the learning data and target data are different, the features may be appearing different between these two data. In this study, we attempt to improve the classification accuracy by strengthening the robustness of the document classifier through artificially injecting the noise into the process of constructing the document classifier. With data coming from various kind of sources, these data are likely formatted differently. These cause difficulties for traditional machine learning algorithms because they are not developed to recognize different type of data representation at one time and to put them together in same generalization. Therefore, in order to utilize heterogeneous data in the learning process of document classifier, we apply semi-supervised learning in our study. However, unlabeled data might have the possibility to degrade the performance of the document classifier. Therefore, we further proposed a method called Rule Selection-Based Ensemble Semi-Supervised Learning Algorithm (RSESLA) to select only the documents that contributing to the accuracy improvement of the classifier. RSESLA creates multiple views by manipulating the features using different types of classification models and different types of heterogeneous data. The most confident classification rules will be selected and applied for the final decision making. In this paper, three different types of real-world data sources were used, which are news, twitter and blogs.