• Title/Summary/Keyword: functional failure

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Personalized Dietary SikdanOme Recommendation based on Obesity Related SNP Genotype and Phenotype (비만 관련 SNP genotype-phenotype 정보기반의 맞춤 식단옴 추천)

  • Shin, Ga-Hee;Lee, Sang-Min;Kang, Byeong-Chul;Jang, Dai-Ja;Kwon, Dae Young;Kim, Min-Jung;Kim, Ri-Rang;Kim, Jin-Hee;Yang, Hye Jeong
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.435-442
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    • 2016
  • Obesity extends the global economic burden and it causes that the failure of a reduction of physical activity, and diet management. In this work, nutritional information and personalized diet based on calorie supply system and is discriminatory utilized the obesity-related SNP information in order to recommend a personalized functional foods. This study performed a GWAS analysis for the excavation of a Korean-specific and obesity-related SNP, which utilizes genetic information were recommended by entering a personalized diet in accordance with the SNP genotype-phenotype information. In addition, we integrated Database with relation of nutrient for utilizing the USDA Food information and it was applied to recommend with Sickdanome. As a result, the obesity-related SNP information was confirmed in the sample which has the normal value BMI. In this study, we have recognized that the phenotype information related obesity, BMI is inconsistent with the SNP genotype information. This result is shown that it is necessary to provide the personalized dietary SickdanOme recommendation based on the both pheotype-genotype information.

Evaluation of Hot Mix Asphalt Properties using Complex Modifiers (복합개질제를 이용한 아스팔트 혼합물의 물성 평가)

  • Lee, Kwan-Ho;Kim, Seong-Kyum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.146-152
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    • 2018
  • In this study, to improve the performance of asphalt mixtures for plastic deformation occurring mainly in Korea, complex modifiers were prepared by mixing powders and liquid type modifiers. The main constituents were powdery diatomaceous earth, mica and carbon black, and liquid type solid 70% SBR latex. The tensile strength ratios for the two asphalt mixtures used in the test were above 0.80 for the Ministry of Land Transportation (2017) asphalt mixture production and construction guidelines. The effects of increasing the tensile strength in the dry state was more than 14% when the composite modifier was added. The deformation rate per minute by the wheel tracking test load was an average of 0.07 to 0.147 for each mixture. The strain rate per minute was improved by the modifier, and the dynamic stability was improved by almost 100% from 295 to 590. In addition, the final settling was reduced from 11.38 mm to 9.57 mm. A plastic deformation test using the triaxial compression test showed that the amount of deformation entering the plastic deformation failure zone at the end of the second stage section and in the third stage plastic deformation section was 1.76 mm for the conventional mixture and 1.50 mm for the complex modifier mixture. The average slope of the complex modifier asphalt mixture mixed with the multi-functional modifier was 0.005 mm/sec. The plastic deformation rate is relatively small in the section where the road pavement exhibits stable common performance, i.e. the traffic load.

Significances and Outcomes of Mechanical Thrombectomy for Acute Infarction in Very Elderly Patients : A Single Center Experience

  • Kim, Dong Hun;Kim, Sang Uk;Sung, Jae Hoon;Lee, Dong Hoon;Yi, Ho Jun;Lee, Sang Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.654-660
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    • 2017
  • Objective : Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ${\geq}80$ years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods : Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy. They were divided into a very elderly (${\geq}80$ years) and aged (60-79 years) group, with comparisons in recanalization rates, complications, death and disability on discharge be reported. Results : The mean age was 70.3 years in the aged group and 83.4 years in the very elderly group. Elderly patients had higher rates of mechanical thrombectomy failure than the younger group (40% vs. 14%; odds ratio [OR] 4.1; 95% confidence interval [CI] 1.4-11.9; p=0.012). Results from thrombolysis in cerebral ischemia and modified Rankin scale at discharge were worse in the older group (p=0.005 and 0.023 respectively). There were no differences in mortality rate or other complications, but infarction progression rates were significantly higher in the very elderly group. (15% vs. 2.2%; OR 8.0; 95% CI 1.2-51.7; p=0.038). The majority (92.3%) of the patients who failed in aged group were not successful after several trials. However, in half (4 of 8) of the very elderly group, the occlusion site could not be accessed. Conclusion : Patients older than 80 years of age undergoing mechanical thrombectomy for acute infarction were more difficult to recanalize due to inaccessible occlusion sites and had a higher rate of infarction progression, However, mortality and other complications were similar to those in younger patients.

Reinforcement of Collapsed Railway Subgrade and Line Capacity Increase Using Short Reinforcement with Rigid Wall (짧은 보강재와 일체형 강성벽체를 활용한 철도 붕괴노반 보강 및 선로용량 증대 기술)

  • Kim, Dae-Sang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.604-609
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    • 2016
  • This study evaluated the long-term performance of RSR (Reinforced Subgrade for Railways) technology which increases the railway line capacity without the need for additional land. Its characteristics include the use of a short reinforcement with rigid wall, which make it possible to apply it in confined spaces. The 7m high and 40m long testbed employed to evaluate the long-term performance was designed and constructed near Jupo station on the Chang-hang line. This line, located close to a local bus route, had collapsed at the subgrade following heavy rainfall. The performance of the new type of subgrade was verified with long term measurements over a 2 year period including the surface and ground settlement, horizontal displacement of the wall, tensile strain of the reinforcement, and settlement of the rail top on the side track. Based on the results of the measurements made until now, we concluded that it had sufficient safety and serviceability for use as a railway subgrade. It is expected that RSR technology could be frequently used at sites which lack the necessary construction materials for an embankment and are located close to functional railway lines and boundaries, in order to settle civil complaints.

Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

THE LONG-TERM CONSERVATIVE DRAINAGE CARE OF EXTENSIVE OSTEOMYELITIS ASSOCIATED WITH MANDIBULAR COMPOUND FRACTURE : REPORT OF A CASE (장기간의 보존적 배농술로 치료된 하악 복합골절 관련 광범위 골수염 치험 : 증례보고)

  • Kim, Ha-Rang;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Mo, Dong-Yub;Lee, Chun-Ui
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.544-549
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    • 2009
  • Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

Comparative Analysis of Drug Information Resources for Dose Adjustment in terms of Renal and Hepatic Function (신장 및 간 기능별 약물용량조절에 관한 국내외 약물문헌정보 비교)

  • Ryu, Ji Hyeon;Kyoung, Eun Jung;Lee, Hee Young;Oh, Mina;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.220-227
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    • 2012
  • Kidney and liver are the major organs of metabolism and excretion of drugs. Renal and Hepatic impairment may affect the pharmacokinetics/pharmacodynamics and the safety of drugs. Adjusting the dosage based on organ function is the essential role of pharmacists. However, differences have been noted on the recommended dosage among the literatures. We compared and analyzed the recommendations of 4 literature sources which are commonly used for dosage adjustment. From April, 2011 to August, 2011, we selected data on recommendations for dosage adjustment for impaired renal and hepatic function of 100 drugs through a protocol. We analyzed the definition terms of renal and hepatic impairment, recommendations for dosage adjustment, evidenced references in four literature sources: Korean National Formulary (KNF), American Hospital Formulary System Drug Information (AHFS), Micromedex (MM) and Drug Prescribing of Renal Failure (DPRF). We further examined the data homogeneity by comparing how drugs that required no adjustment according to one source were categorized by the other. Sources use different definition terms among themselves except DRPF. Presence or absence of evidenced references about renal/hepatic functional states are KNF (0%/0%), AHFS (78%/62.6%), MM (87.5%/65.6%) and DPRF (93.2%/no recommendation) respectively. Recommendations of specific dosage and dosing interval are KNF (24%/13%), AHFS (39.6%/12.1%), MM (50%/17.7%), and DPRF (55.4%/no recommendation) respectively. Regarding the data homogeneity, the differences were remarkable. Drugs with no adjustment according to AHFS were categorized to be adjusted/ contraindicated by KNF, MM, DPRF and the values were (44%/5.6%), (22%/0%), and (36%/0%) in renal function, (39%/6.5%), (19%/3.2%), and (no recommendation/no recommendation) in hepatic function respectively. Our study shows remarkable definite variation in definitions and recommendations about definition terms, information of dosage and interval, presence or absence of evidenced references. Especially for KNF, quantitative recommendations on dosages and dosing intervals should be made in the near future. To maximize the drug effect and safety and to minimize the heterogeneity of the literature sources, reviewing at least two sources are suggested when recommending the proper dosage adjustment based on organ function.

Re-establishment of occlusal plane in a patient with a failed implant prosthesis (실패한 임플란트 보철수복물을 가진 환자의 교합평면 재설정)

  • Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.141-153
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    • 2018
  • A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

Collagen-Induced Arthritis Analysis in Rhbdf2 Knockout Mouse

  • Lee, Min-Young;Kang, Ju-Seong;Go, Ryeo-Eun;Byun, Yong-Sub;Wi, Young Jin;Hwang, Kyung-A;Choi, Jae-Hoon;Kim, Hyoung-Chin;Choi, Kyung-Chul;Nam, Ki-Hoan
    • Biomolecules & Therapeutics
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    • v.26 no.3
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    • pp.298-305
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    • 2018
  • Rhomboid family member 2 gene (Rhbdf2) is an inactive homologue lacking essential catalytic residues of rhomboid intramembrane serine proteases. The protein is necessary for maturation of tumor necrosis factor-alpha ($TNF-{\alpha}$) converting enzyme, which is the molecule responsible for the release of $TNF-{\alpha}$. In this study, Rhbdf2 knockout (KO) mice were produced by CRISPR/CAS9. To see the effects of the failure of $TNF-{\alpha}$ release induced by Rhbdf2 gene KO, collagen-induced arthritis (CIA), which is the representative $TNF-{\alpha}$ related disease, was induced in the Rhbdf2 mutant mouse using chicken collagen type II. The severity of the CIA was measured by traditional clinical scores and histopathological analysis of hind limb joints. A rota-rod test and grip strength test were employed to evaluate the severity of CIA based on losses of physical functions. The results indicated that Rhbdf2 mutant mice showed clear alleviation of the clinical severity of CIA as demonstrated by the significantly lower severity indexes. Moreover, a grip strength test was shown to be useful for the evaluation of physical functional losses by CIA. Overall, the results showed that the Rhbdf2 gene has a significant effect on the induction of CIA, which is related to $TNF-{\alpha}$.

Musculocutaneus Island Flap Based on the Distal Vascular Pedicle of Gracilis Muscle (박근의 원위혈관경을 이용한 도서형 근피판술)

  • Chung, Duke-Whan;Lee, Yong-Wook;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.96-102
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    • 1997
  • The gracilis that is frequently used as a donor of free muscle trasfer is appropriate in the muscular shape and vascular position. This muscle is belonged to the second type of muscle group by the classification of the pattern of muscular nutrient vessel. The adductor branch or first perforating branch of deep femoral artery which supplies the proximal 1/3 of this muscle is a dominant one and this is used for the microscopic anastomosis of muscle or musculocutaneous flap. The minor vascular pedicles which enter the distal 1/3 of this of this muscle are branches of the superficial femoral artery and it is 0.5mm in diameter, 2cm in length with two venae comitantes. These minor pedicles supplies distal half of the gracilis muscle. This island musculocutaneous flap using distal vascular pedicle can be used to cover the defect of soft tissue around the distal femoral supra-condylar area, knee joint and proximal tibial condyle area which cause limitation of motion of knee joint, or in the cases that usual skin graft is impossible. The important operative procedure is as follows; The dissection is carried proximally and distally and the entire gracilis muscle including proximal and distal pedicle is completely dissected. After temporary blocking of the proximal vascular pedicle, the adequate muscle perfusion by the distal pedicle is identified and it is rotated to the recipient site around knee joint. The advantages of this procedure are simple, no need of microscopic vascular anastomoses and no significant functional loss of donor site. Especially in the cases of poor condition of the recipient vessel, this procedure can be used effectively. From 1991 to 1996, we performed 4 cases; complete survival of flap in 3 cases and partial survival of flap with partial necrosis in 1 case. This procedure is though to be useful in the small sized soft tissue defect of distal femoral supra-condylar area, knee joint and proximal tibial condylar area, especially in the defect of anterior aspect which expected to cause limitation of motion of knee joint due to scar contracture. But the problems of this procedure are the diameter of distal vascular pedicle is small and the location of distal vascular pedicle is not constant. To reduce the failure rate, identify the muscular perfusion of distal vascular pedicle after blocking the proximal pedicle, or strategic delay will be helpful.

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