• Title/Summary/Keyword: cross protection.

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Use of Intermittent Antegrade Warm Blood Cardioplegia in CABG (관상동맥 우회로조성술에서 간헐적 전방 온혈 심정지액의 이용)

  • 김정택;백완기;김영삼;윤용한;김혜숙;이춘수;임현경;김현태;김광호
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.828-833
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    • 2003
  • Background: It has been reported that the recently developed intermittent antegrade warm blood cardioplegia (IAWBC) has better myocardial protective effects during coronary artery bypass surgery than cold blood cardioplegia or continuos retrograde cold blood cardioplegia. The aim of this study is to evaluate the safety and usefulness of IAWBC by comparing it retrospectively with intermittent retrograde cold blood cardioplegia (lRCBC). Material and Method: From April 2001 to Feb. 2003, fifty seven patients who underwent isolated coronary surgery were divided into two groups (IAWBC vs. IRCBC). The two group had similar demographic and angiographic characteristics. There were no statistical differences in age, sex, Canadian Cardiovascular Society Functional Classification for angina, ejection fraction, and number of grafts. Result: Aortic cross clamping time and total pump time in IAWBC (99$\pm$23 and vs. 126$\pm$32 min) were shorter than those of IRCBC (118$\pm$32 min. and 185$\pm$48 min.)(p<0.05). The reperfusion time (13$\pm$7 min) in IAWBC was shorter than that of IRCBC (62$\pm$109 min.)(p<0.05). CKMB at 12 hours and 24 hours (16$\pm$15 and 9$\pm$13) in IAWBC was lower than that of IRCBC (33$\pm$47 and 17$\pm$26)(p<0.05). The awakening time in IAWBC (2$\pm$1 hour) was shorter than that of IRCBC (4$\pm$3)(p<0.05). The number of spontaneous heart beat recovery in IAWBC (85%) was more than that of IRCBC (35%)(p<0.05). The cardiac index after discontinuing cardio-pulmonary bypass was significantly elevated in the IAWBC group. The prevalence of perioperative myocardial infarction in IAWBC (4%) was lower than that of IRCBC group (20%)(p<0.05). Conclusion: Intermittent antegrade warm blood cardioplegia is a safe, reliable, and effective technique for myocardial protection. It can also provide simpler and economic way than the retrograde cold cardioplegia by shortening of cardiopulmonary bypass time and avoiding retrograde cannulation for coronary sinus.

Clinical Experiences of Continuous Warm Blood Cardioplegia ; Valvular Heart Surgery (연속 온혈 심정지액의 임상경험 - 심장 판막 수술 환자 대상 -)

  • 이종국;박승일;조재민;원준호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.353-361
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    • 1998
  • Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

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Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.823-830
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    • 2001
  • Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

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Studies on the Nature and Pathogenicity of Nuclear Polyhedrosis Virus of the Fall Webworm, Hyphantria cunea (Drury) (흰불나방 핵다각체병바이러스의 성상과 병원성에 관한 연구)

  • Im Dae Joon;Hyun Jae Sun;Paik Woon Hah;Lim Jong Sung
    • Korean journal of applied entomology
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    • v.18 no.1 s.38
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    • pp.1-10
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    • 1979
  • An inclusion forming virus isolated from a fan webworm, Hyphantria cunea, in 1975 was identified as a nuclear polyhedrosis virus. With the virus isolated in Korea, it was considered that the virus would be one of the valuable microorganism in microbial control. In this connection, 1) the shape and size of the virus for identification, 2) susceptibility of the various instar larvae to the virus, 3) the effects of storage condition on the pathogenicity and the cross infection of the virus to the larvae of Bombyx mori were examined. The results are summarized as follows; 1. The polyhedron was tetrahedron or hexahedron of $2\mu$ in size and the rod-shaped virus particles consisting of $2\~14$ rods in a bundle were $330m{\mu}\times35m{\mu}$ in size. 2. The hexagonal nuclear polyhedra were found only in the nucleus of the midgut cells but were variable in size. 3. The $LD_{50}$ values for the various instar larvae of H. cunea were $8.377\times10^4\;PIBs/ml$ for the second, $4.974\times10^5\;PIBs/ml$ for the fifth instar larvae. The $LT_{50}values$ for $10^6\;PIBs/ml$ were 9.6 days for the second, 11.5 days for the third, 12.0 days for the fourth and 17 days for the fifth instar larvae. 4. The susceptibility of H. cunea to the nuclear polyhedrosis virus was greater in the first generation than in the second generation. 5. The effect of the storage conditions on the pathogenicity of the nuclear polyhedra was less in refrigerator $(5^{\circ}C)$ and in freezing $(-80^{\circ}C)$ than in room temperature $(18.5^{\circ}C)$, especially as air-dried polyhedra than as suspension. The pathogenicity of the polyhedra seemed to decrease by sunlight during storage as cadavers, since rather greater decrease in pathogenicity was found in sunny condition than in shady condition. 6. The effective spray concentration was $6.4\times10^7\;PIBs/ml$ in the field and its $LT_50$ values for the third and the fifth instar larvae were 4.8 days and 14.2 days, respectively. 7. No cross infections were found in the nuclear polyhedrosis virus between H. cunea and B. mori. larvae.

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A Study on the Formation of Lamellar Liquid Crystalline Using Skin Mimicking Surfactant (피부모사체 계면활성제를 사용한 라멜라 액정의 생성에 관한 연구)

  • Kim, In-Young;Nam, Eun-Hee;Shin, Moon-Sam
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.3
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    • pp.484-495
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    • 2020
  • This study is a mixed surfactant (MimicLipid-MSM1000) that forms the same structure as that of the stratum corneum, sucrose distearate, polyglyceryl-2 dioleate, fermented squalane, ergosterol, 10-hydroxystearic acid, mixture consisting of was synthesized. When using 2~5 wt% of this mixed surfactant, it was possible to make an artificial skin mimetic that forms a multi-layer lamellar structure of 5~30 layers. An emulsion was prepared using this mixed surfactant, and a multi-layered lamellar phase was formed and analyzed mechanically. The appearance of this surfactant was a light brown hard wax, the hydrophilic lipophilic balance (HLB) was 12.53, the critical parameter value was 0.987, and the acid value was 0.13. Stability according to pH change was also stable in acidic (3.8), neutral (7.2) and alkaline (10.8). The particle size of the liquid crystal was found to be the most stable maltese cross lamellar crystalline droplet at 5~25mm. The size of the emulsified particles according to the change in the speed of the homo agitator is 2500 rpm (17.9mm±2.6mm), 3500rpm (12.5mm±2.1mm), 4500rpm (6.2mm±1.8mm) particles were formed. Liquid crystal forming particles were observed through a polarization microscope, and the formation structure of the liquid crystal was precisely analyzed with a scanning electron microscope (cryo-SEM). As an application field, it is expected that it will be widely applicable to the development of various prescriptions, such as various skin care cosmetics, makeup care cosmetics, and scalp protection cosmetics, by using a skin-mimicking surfactant.

The Present Situation and Challenges of the Russian Music Industry: Centered on the Digital Sound Sources (러시아 음악 산업 현황과 과제 - 디지털 음원을 중심으로 -)

  • Kwon, ki-bae;Kim, Se-il
    • Cross-Cultural Studies
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    • v.50
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    • pp.395-424
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    • 2018
  • The purpose of this paper is to examine the current situation and background of the Russian consumer music market, where digital music sources are making great strides in the noted recent years. In addition, music storage technology, media and change are considered together in this report. Moreover, Russia is the 12th largest music market in the world. The Russian music industry is following the recent trend of the global music industry, where the digital music market is growing rapidly on many different levels. The explosive growth of the digital sound sources in Russia's music industry is attributed to the explosive increase in available consumer downloads, streaming sound source service, and the increase in the number of digital sound sources using mobile technologies due to the development of the Internet. In particular, the sales of the available and accessible streaming sound sources are expected to grow explosively by the year 2020, which is expected to account for more than 85% of total digital music sales. In other words, the spread of smartphones and the resulting changes in the lifestyle of the Russians have created these changes for the global consumer of music. In other words, the time has come for anyone to easily access music and listen to music without a separate audio or digital player. And the fact that the Russian government's strong policy on the eradication of illegal copying of music is becoming an effective deterrent, as is also the factor that led to the increase of the share of the digital sound source to increase sales in Russia. Today, the Russian music industry is leading this change through the age and process of simply adapting to the digital age. Music is the most important element of cultural assets, and it is the beneficial content, which drives the overall growth of the digital economy. In addition, if the following five improvements(First, strengthen the consciousness of the Russian people about copyright protection; Second, utilizing the Big Data Internet resources in the digital music industry; Third, to improve the monopoly situation of digital music distributors; Fourth, distribution of fair music revenues; and Fifth, revitalization of a re-investment in the current Russian music industry) are effective and productive, Russia's role and position in the world music market is likely to expand.

Brand Equity and Purchase Intention in Fashion Products: A Cross-Cultural Study in Asia and Europe (상표자산과 구매의도와의 관계에 관한 국제비교연구 - 아시아와 유럽의 의류시장을 중심으로 -)

  • Kim, Kyung-Hoon;Ko, Eun-Ju;Graham, Hooley;Lee, Nick;Lee, Dong-Hae;Jung, Hong-Seob;Jeon, Byung-Joo;Moon, Hak-Il
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.245-276
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    • 2008
  • Brand equity is one of the most important concepts in business practice as well as in academic research. Successful brands can allow marketers to gain competitive advantage (Lassar et al.,1995), including the opportunity for successful extensions, resilience against competitors' promotional pressures, and the ability to create barriers to competitive entry (Farquhar, 1989). Branding plays a special role in service firms because strong brands increase trust in intangible products (Berry, 2000), enabling customers to better visualize and understand them. They reduce customers' perceived monetary, social, and safety risks in buying services, which are obstacles to evaluating a service correctly before purchase. Also, a high level of brand equity increases consumer satisfaction, repurchasing intent, and degree of loyalty. Brand equity can be considered as a mixture that includes both financial assets and relationships. Actually, brand equity can be viewed as the value added to the product (Keller, 1993), or the perceived value of the product in consumers' minds. Mahajan et al. (1990) claim that customer-based brand equity can be measured by the level of consumers' perceptions. Several researchers discuss brand equity based on two dimensions: consumer perception and consumer behavior. Aaker (1991) suggests measuring brand equity through price premium, loyalty, perceived quality, and brand associations. Viewing brand equity as the consumer's behavior toward a brand, Keller (1993) proposes similar dimensions: brand awareness and brand knowledge. Thus, past studies tend to identify brand equity as a multidimensional construct consisted of brand loyalty, brand awareness, brand knowledge, customer satisfaction, perceived equity, brand associations, and other proprietary assets (Aaker, 1991, 1996; Blackston, 1995; Cobb-Walgren et al., 1995; Na, 1995). Other studies tend to regard brand equity and other brand assets, such as brand knowledge, brand awareness, brand image, brand loyalty, perceived quality, and so on, as independent but related constructs (Keller, 1993; Kirmani and Zeithaml, 1993). Walters(1978) defined information search as, "A psychological or physical action a consumer takes in order to acquire information about a product or store." But, each consumer has different methods for informationsearch. There are two methods of information search, internal and external search. Internal search is, "Search of information already saved in the memory of the individual consumer"(Engel, Blackwell, 1982) which is, "memory of a previous purchase experience or information from a previous search."(Beales, Mazis, Salop, and Staelin, 1981). External search is "A completely voluntary decision made in order to obtain new information"(Engel & Blackwell, 1982) which is, "Actions of a consumer to acquire necessary information by such methods as intentionally exposing oneself to advertisements, taking to friends or family or visiting a store."(Beales, Mazis, Salop, and Staelin, 1981). There are many sources for consumers' information search including advertisement sources such as the internet, radio, television, newspapers and magazines, information supplied by businesses such as sales people, packaging and in-store information, consumer sources such as family, friends and colleagues, and mass media sources such as consumer protection agencies, government agencies and mass media sources. Understanding consumers' purchasing behavior is a key factor of a firm to attract and retain customers and improving the firm's prospects for survival and growth, and enhancing shareholder's value. Therefore, marketers should understand consumer as individual and market segment. One theory of consumer behavior supports the belief that individuals are rational. Individuals think and move through stages when making a purchase decision. This means that rational thinkers have led to the identification of a consumer buying decision process. This decision process with its different levels of involvement and influencing factors has been widely accepted and is fundamental to the understanding purchase intention represent to what consumers think they will buy. Brand equity is not only companies but also very important asset more than product itself. This paper studies brand equity model and influencing factors including information process such as information searching and information resources in the fashion market in Asia and Europe. Information searching and information resources are influencing brand knowledge that influences consumers purchase decision. Nine research hypotheses are drawn to test the relationships among antecedents of brand equity and purchase intention and relationships among brand knowledge, brand value, brand attitude, and brand loyalty. H1. Information searching influences brand knowledge positively. H2. Information sources influence brand knowledge positively. H3. Brand knowledge influences brand attitude. H4. Brand knowledge influences brand value. H5. Brand attitude influences brand loyalty. H6. Brand attitude influences brand value. H7. Brand loyalty influences purchase intention. H8. Brand value influence purchase intention. H9. There will be the same research model in Asia and Europe. We performed structural equation model analysis in order to test hypotheses suggested in this study. The model fitting index of the research model in Asia was $X^2$=195.19(p=0.0), NFI=0.90, NNFI=0.87, CFI=0.90, GFI=0.90, RMR=0.083, AGFI=0.85, which means the model fitting of the model is good enough. In Europe, it was $X^2$=133.25(p=0.0), NFI=0.81, NNFI=0.85, CFI=0.89, GFI=0.90, RMR=0.073, AGFI=0.85, which means the model fitting of the model is good enough. From the test results, hypotheses were accepted. All of these hypotheses except one are supported. In Europe, information search is not an antecedent of brand knowledge. This means that sales of global fashion brands like jeans in Europe are not expanding as rapidly as in Asian markets such as China, Japan, and South Korea. Young consumers in European countries are not more brand and fashion conscious than their counter partners in Asia. The results have theoretical, practical meaning and contributions. In the fashion jeans industry, relatively few studies examining the viability of cross-national brand equity has been studied. This study provides insight on building global brand equity and suggests information process elements like information search and information resources are working differently in Asia and Europe for fashion jean market.

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Changes of Stream Water Quality and Loads of N and P from the Agricultural Watershed of the Yulmunchon Tributary of the Buk-Han River Basin (북한강 율문천 소유역에서 수질 변화와 농업활동에 의한 N, P 부하량)

  • Jung, Yeong-Sang;Yang, Jae E.;Park, Chol-Soo;Kwon, Young-Gi;Joo, Young-Kyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.31 no.2
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    • pp.170-176
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    • 1998
  • Nitrogen and phosphorus loads from an agricultural watershed of the Yulmun-chon tributary in the Buk-Han River Basin were quantified based on total amounts of water stream flow. The water quality and soil loss were estimated. Levels of the stream were recorded automatically using the water level meter. The flow velocities, along with the cross-sectional areas of the riverbed, were measured to estimate total amounts of water flow at three monitoring sites in this tributary. Water samples were collected at nine sites with two weeks interval from May to August and analyzed for the water quality parameters. Amounts of soil loss were estimated by the USLE. The size of the Yulmunchon watershed was 3,210 ha, of which paddy and upland soil areas were composed about 41%. The total amounts of soil loss from the watershed areas were estimated to be $13,273Mg\;year^{-1}$, showing 53%, 46% and 0.7% of the soil loss ratio from upland, forest, and paddy areas, respectively. Electrical conductivities and Nitrogen concentrations of the stream water were higher in the lower watershed area than in the upper area. Increments of N were higher for $NO_3-N$ than $NH_4-N$. Nitrate nitrogen was the major N form to pollute the water due to the agricultural activity. Total runoff was about 72% of the total precipitation in the watershed. The maximum loads of T-N and T-P due to the runoff were estimated to be 1,500 and $5kg\;day^{-1}$, respectively. Concentrations of $NO_3-N$ and $NH_4-N$ in the runoff were 13.5 and 1.8 times higher than those in precipitation. The N loads were mainly from soil loss, application of fertilizer, and livestock wastes, which were 52% of total N load. Results demonstrated that reduction of fertilizer use and the soil loss would be essential for water quality protection of the agricultural watershed.

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The Surgical Treatment of Atrial Fibrillation in Patients Undergoing Simultaneous Open Heart Surgery (심장세동의 수술요법)

  • Kim, Gi-Bong;Lee, Chang-Ha;Son, Dae-Won
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.287-292
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    • 1997
  • .Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.

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Use of Undiluted Potassium Solution in Intermittent Antegrade Warm Blood Cardioplegia (IAWBC) (간헐적 전방온혈심정지액에서 희석되지 않은 고농도 포타슘의 사용)

  • 백완기;손국희;김영삼;윤용한;김혜숙;임현경;이춘수;김광호;김정택
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.660-664
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    • 2004
  • Background: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. Material and Method: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4 : 1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. Result: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346$\pm$597 mL in dilutedplegia (mean$\pm$standard deviation, and 28$\pm$9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21$\pm$4% in dilutedplegia and 24$\pm$3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250$\pm$810 mL, 1689$\pm$548 mL) than in microplegia (959$\pm$410 mL, 1461$\pm$784 mL; p<0.05). Conclusion: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.