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Effect of Pyruvate and Aspartate Enriched University of Wisconsin Solution on Myocardial Protection (피루브산염과 아스파라진산염을 첨가한 위스콘신대학 용액의 심근보호 효과)

  • 이정렬;김준석;한재진;강문철
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.11-19
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    • 2002
  • Background: Ischemia-reperfusion myocardial injury is an important factor to determine the early and the late mortality of transplanted patients. Recently, modulation of the cytosolic NADH/NAD+ ratio by Pyruvate and aspartate was tested to Protect the heart from ischemia-reperfusion injury. Material and Method: We added pyruvate and aspartate to the University of Wisconsin solution, and evaluated their effect on myocardial protection. We used 16 piglet(age 1 to 3 days) hearts. Eight hearts were arrested with and stored in the University of Wisconsin solution(UW solution) for 24 hours(control group), and the other eight hearts were arrested with and stored in the modified UW solution added pyruvate(3mmol/L) and aspartate(2 mmol/L)(test group). All hearts underwent modified reperfusion with blood cardioplegic solution followed by conversion to a left-sided working model with perfusion from a support pig. And then, we measured stroke work index(SWI), high-energy phosphate stores, and myocardial water content of the hearts. SWI was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mmHg after 60 and 120 minutes reperfusion, respectively, Result: At 60 minutes and 120 minutes after reperfusion, SWI was higher in the test group than in the control group significantly. The levels of AMP, ADP, ATP of the test group were also higher. But, the creatine phosphate level and myocardial water content were similar in the two groups. Conclusion: From these results, we could Prove that pyruvate and aspartate enhance cardiac contractility and high-energy phosphate stores after ischemia.

The outcome of surfactant replacement therapy in above nearterm neonates with severe pulmonary disease (준 만삭 이상아에서 폐표면 활성제 보충요법의 성적)

  • Shon, Su-Min;Lee, Bo-Young;Kim, Chun-Soo;Lee, Sang-Lak;Kwon, Tae-Chan
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1200-1205
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    • 2007
  • Purpose : We performed this study to investigate the outcome of surfactant replacement therapy (SRT) in above nearterm neonates who were required mechanical ventilatory care due to meconium aspiration pneumonia (MAP), respiratory distress syndrome (RDS) or other severe pneumonia (PN). Methods : 48 patients, gestational period ${\geq}36weeks$, who were admitted in NICU of Dongsan Medical Center, Keimyung University between July 1999 and June 2004 were enrolled. They were divided into three groups, MAP group (15 cases), RDS group (27 cases) and PN group (6 cases). All patients were received SRT and evaluated several clinical data (gestational age, oxygen index, duration of ventilator care) and outcome (complications and mortality rate) between pre-SRT and post-SRT. The mean dose of surfactant (modified bovine surfactant, Newfacten, Yuhan Co., Seoul, Korea) was 120 mg/kg. Results : Among each groups, mean pre-SRT OI was higher in MAP group ($21{\pm}3.2$) than other groups, mean duration (days) of ventilatory care and oxygen therapy were similar distributions. Compared with pre-SRT values, significant improvements (P<0.05) in mean values for FiO2 and oxygenation index were documented at 12 hours after SRT. Early complications (persistent pulmonary hypertension of newborm, pneumothorax) and survival rate were lower in MAP group. Within RDS group, earlier SRT (given before 12 hours of life) revealed significantly lower early complication rate than later SRT (given after 12 hours of life) (13.3% vs 58.3%, P<0.05) Conclusion : Our study suggested that SRT seems to be an effective therapy in above nearterm neonates with severe pulmonary disease, and earlier SRT tends to reduce complications in RDS group than later therapy.

Infliximab: The Benefit for Refractory Crohn Disease and Top-down Induction Therapy in Severe Crohn Disease (Infliximab: 불응성 크론병 치료법으로서의 유용성과 Top-down 관해 유도 요법으로서의 가능성)

  • Lee, Jee-Hyun;Lee, Hae-Jeong;Park, Sung-Eun;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.28-35
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    • 2008
  • Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

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Type A behavior pattern and social control of parents (A형행동양상과 부모의 사회적인 통제)

  • Lee, Choong-Won;Yoon, Nung-Ki;Suh, Suk-Kwon;Shin, Dong-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.1 s.29
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    • pp.22-32
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    • 1990
  • Associations between type A behavior Pattern (TABP) and parental social control were examined by a questionnaire survey in a sample of 803 undergraduates of the three universities in Daegu city in 1988. TABP was assessed by the Student Jenkins Activity Survey (SJAS, short form) and social control of parents by Bernstein and Brandis' Index of control and communication which were both dichotomized by median. The mean age of the sample was 20.7 (standard deviation, 2.2) and mean of total score of SJAS was 5.6 with its standard deviation and median, 2.7 and 5, respectively. In stratified analysis for TABP-social control association by the native place, sex and socioeconomic status (SES), males of rural origin with low SES showed odds ratio (OR), 2.49 but those with high SES 0.40. For females of rural origin, those with low SES showed OR, 1.02, whereas those with high SES did 0.35. For those who was of urban origin, males with low SES had OR 1.27, and those with high SES did 1.29. Females with high SES showed 0.85 and those with low SES 0.67. None of the TABP-social control associations among the strata showed confidence intervals not including unity. In multiple logistic regression by native place, for those with rural origin the only term showed a statistically significance was the social control-SES of parents interaction, OR 3.99 (95% confidence interval, $1.03{\sim}15.46$). For those of urban origin, none of the terms are statistically significant. These results suggest a social upward mobility by education of the rural disadvantaged group and a Confucian idea that regards academic achievement as one of social virtues, both of which may reflect the different sociocultural structures from the West.

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Anger-coping types and hypertension in some employed men (일부 남자 고용집단에서 분노 대응형태와 고혈압)

  • Lee, Choong-Won;Park, Jong-Won;Lee, Se-Youp
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.462-472
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    • 1995
  • This study examined the relation between anger-coping types and hypertension in employed men aged $40\sim60$ who consented to participate during the biannual physical checkup in the department of health management in 1988. The subjects analyzed were five hundred thirteen excluding those having hypertension history and/or current antihypertensive medications. Anger-coping types were constructed from the Harburg's model with two hypothetical anger-provoking situations involving wife and boss. Hypertensives were defined more than 140mmHg systolic blood pressure and/or 90mmHg diastolic blood pressure. Hypertensives were one hundred fifty two(29.6%) and those who suppressed their anger were 61.6% and 62.8% in wife and boss situations respectively. Items of anger, guilt, protest, and suppressed anger in wife situation showed odds ratios of 0.78-0.94 without statistical significance. But four items in boss situation showed odds ratios more than 1, especially anger-in types of anger item had 1.58 times the prevalence of hypertension of anger-out types(95% confidence intervals(CI) $1.06\sim2.35$) and subjects who indicated that suppressed their anger had 1.55 times the prevalence of hypertension of those who expressed their anger(95% CI $1.03\sim2.32$). For anger suppressed vs. expressed types of total suppressed anger index, prevalence of hypertension was 1.31 (95% CI $0.83\sim2.08$). After adjusting for age, body mass index, smoking and drinking, the odds ratios were slightly increased in both situations except guilt items compared with univariate analysis. These results suggest that the relation between Harburg's anger-coping model and hypertension is replicated partially in this subjects.

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A Study on Concentration of the Airbrone Copper and Biological Exposure Index in the Workplaces Manipulating the Copper (동(銅) 취투(取投) 작업장(作業場) 공기중(空氣中) 동(銅) 농도(濃度)와 생물학적폭로지수(生物學的暴露指數))

  • Jeung, Jae Yeal;Kim, Jung Man;Kim, Doo Hie
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.3 no.1
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    • pp.78-90
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    • 1993
  • This study was designed obtain and early detection the workers exposed to excessive copper dust and also to present biological exposure index. The exposed group consisted of 62 male workers at the metallurgy workplaces. To evaluate the degree of individual exposure the copper dust, each personal air sampling was collected. Biological exposures in the exposed group was quantified for the blood and urine copper levels using flameless atomic absorption spectrophotometer. The control group consisted of 70 male adults with the history of nonexposure to copper by the inhalation occupationally. The average concentration of copper in blood and urine of the exposed group was $49.44{\pm}8.90(29.05-80.63){\mu}g/dl$, $39.99{\pm}11.04(29.62-80.63){\mu}g/l$ respectively. The average concentration of air borne copper was $0.48{\pm}0.31(0.03-1.18)mg/m^3$. The average concentration of blood and urine copper in the control group was $42.93{\pm}5.84(25.05-57.85){\mu}g/dl$, $33.02{\pm}13.38(12.00-82.05){\mu}g/l$ respectively. The difference observed in the average concentration of blood and urine copper of the exposed and control groups was statistically significant seperately (blood copper, p<0.05 ; urine copper, p<0.05). The relationship between the individual exposure concentration of air borne copper and the concentration of the blood and urine copper was statistically significant, respectively (blood copper, r=0.54, p<0.05 ; urine copper, r=0.37, p<0.05). The relationship between the working duration and the concentration of blood and urine was not statistically significant respectively (blood copper, r=0.14 ; urine copper, r=0.12). The relationship between the age and the concentration of blood and urine copper was statistically not significant respectively (blood copper, r=013 ; urine copper, r=-0.06). The relationship between blood and urine copper concentration in the exposed group was statistically significant (r=0.62, p<0.05), and the relationship between blood and urine copper concentration in the control group was also statistically significant (r=0.39, p<0.05).

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Impact of Pulmonary Vascular Compliance on the Duration of Pleural Effusion Duration after Extracardiac Fontan Procedure (수술 전 폐혈관 유순도가 심장 외 도판을 이용한 Fontan 수술 후 늑막 삼출 기간에 미치는 영향)

  • Yun Tae-Jin;Im Yu-Mi;Song Kwang-Jae;Jung Sung-Ho;Park Jeong-Jun;Seo Dong-Man;Lee Moo-Song
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.579-587
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    • 2006
  • Background: Preoperative risk analysis for Fontan candidates is still less than optimal in that patients with apparently low risks may have poor surgical outcome; prolonged pleural drainage, protein losing enteropathy, pulmonary thromboembolism and death. We hypothesized that low pulmonary vascular compliance (PVC) is a risk factor for prolonged pleural effusion drainage after the Fontan operation. Material and Method: A retrospective review of 96 consecutive patients who underwent the Extracardiac Fontan procedures (median age: 3.9 years) was performed. Fontan risk score (FRS) was calculated from 12 categorized preoperative anatomic and physiologic variables. PVC $(mm^2/m^2{\cdot}mmHg)$ was defined as pulmonary artery index $(mm^2/m^2)$ divided by total pulmonary resistance $(W.U{\cdot}/m^2)$ and pulmonary blood flow $(L/min/m^2)$ based on the electrical circuit analogue of the pulmonary circulation. Chest tube indwelling time was log-transformed (log indwelling time, LIT) to fit normal distribution, and the relationship between preoperative predictors and LIT was analyzed by multiple linear regression. Result: Preoperative PVC, chest tube indwelling time and LIT ranged from 6 to 94.8 $mm^2/mmHg/m^2$ (median: 24.8), 3 to 268 days (median: 20 days), and 1.1 to 5.6 (mean: 2.9, standard deviation: 0.8), respectively. FRS, PVC, cardiopulmonary bypass time (CPB) and central venous pressure at postoperative 12 hours were correlated with LIT by univariable analyses. By multiple linear regression, PVC (p=0.0018) and CPB (p=0.0024) independently predicted LIT, explaining 21.7% of the variation. The regression equation was LIT=2.74-0.0158 PVC+0.00658 CPB. Conclusion: Low pulmonary vascular compliance is an important risk factor for prolonged pleural effusion drainage after the extracardiac Fontan procedure.

One Anchor Double Fixation (OADF) Technique for Arthroscopic Bony Bankart Repair (두가닥의 봉합사를 가진 봉합나사못을 이용한 새로운 관절경적 골성 방카르트 병변 봉합술)

  • Choi, Eui-Sung;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Shon, Hyun-Chul;Cho, Byung-Ki;Bae, Seung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.40-46
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    • 2010
  • Purpose: The aim of this study was to evaluate the usefulness of arthroscopic Bony Bankart repair using a One Anchor Double Fixation Technique. Materials and Method: Seventeen patients with a Bony Bankart lesion were treated using the One Anchor Double Fixation Technique (OADF Technique). There were 13 males and 4 females. The average age was 24 years (range 17-42). The average follow-up period was 22.3 months. One 3.0 mm suture anchor with doubly loaded sutures was inserted into the glenoid rim. One suture strand was passed the around the small bony fragment and tied first. Another suture strand was passed through the capsule and tied over the bony fragment. The result was measured using Rowe's evaluation index & KSS score. The glenoid defect & bony fragment were measured by 3D-CT scan. Results: Rowe's evaluation index on the final follow-up showed an overall improvement from an average of 54 (range, 23-71) to 83.4 (range 71-90). Of the 17 cases, 13 were excellent, 3 were good, and 1 was fair. KSS scores showed improvement from an average of 71 (range 49-82) to 92.5 (range 82-94). There were no cases where pain continued to the final follow-up, and no cases being re-dislocated during the follow-up period. For six cases, we confirmed the bony healing of the bony Bankart lesion by CT. Conclusion: Bony Bankart lesion repair using this new method achieves excellent clinical results with low recurrence rates and is considered another choice for bony Bankart lesions.

Correlation between Body Fat Percent Estimated by Bioelectrical Impedance Analysis and Other Variable Methods (생체전기 저항법에 의한 체지방율과 다른 계측치간의 상관성 연구)

  • Yom, Hye Won;Kim, Su Jung;Whang, Il Tae;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.751-757
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    • 2003
  • Purpose : Obesity is a significant health problem with medical and psychological consequences for children and adolescents. The purpose of this study was to assess the correlation between body fat percent using bioelectrical impedance(BI) and other variable methods. Methods : We measured height, weight, body mass index(BMI) and body fat percent by skinfold thickness(ST) and BI in 1,035(496 male; 539 female) children from seven to 18 years of age. The correlation coefficients between BI and each of the other different methods were obtained. The sensitivity and specificity to predict obesity by these several methods were studied. Results : Fat percent estimated by BI analysis and BMI showed a strong correlation(r=0.749). Fat percent estimated by BI analysis and ST showed a very strong correlation(r=0.835). At the 95th percentile cut-off point for BI, ST showed a sensitivity of 57.7%, and a specificity of 97.6% for estimating body fat. At the 95th percentile cut-off point for BI, BMI showed a sensitivity of 84.9%, and a specificity of 99.3% for estimating body fat. Conclusion : The fat percent estimated by BI analysis correlated strongly with ST or BMI. BI analysis is an objective and accurate method for estimating body fat in childhood obesity.

Effect of Red clay(Hwangto) on Growth Performance and Carcass Characteristics in Growing-Fattening Hanwoo Steers (육성비육 거세한우에 대한 황토 급여가 성장 및 도체특성에 미치는 효과)

  • Kang, S.W.;Kim, J.S.;Cho, W.M.;Chung, H.Y.;Ki, K.S.;Choe, S.B.
    • Journal of Animal Science and Technology
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    • v.44 no.3
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    • pp.315-326
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    • 2002
  • This study was conducted to examine the effects of Red clay(Hwangto) as feed additives with 26 Hanwoo steers at two regions for 540 days from six to 24 months of age on feed efficiency, meat quantity and meat quality. Feeding trial 1 was conducted with two treatment groups by five heads/treatment which were T1(Control) and T2(Control+ad libitum Hwangto) at National Livestock Research Institute. Feeding trial 2 was conducted with four treatment groups by four heads/treatment which were T1(Control), T2(Control+2% Hwangto), T3(Control+5% Hwangto) and T4(Control+ad libitum Hwangto) at a private Hanwoo breeding farm. In feeding trial 1, average daily gains by growing, fattening, finishing and over-all periods were 0.572, 0.866, 0.869 and 0.769kg in T1, and 0.537, 0.904, 0.857 and 0.766kg in T2, respectively. Average daily gain for growing and finishing period was high in T1 but in T2 for fattening period, which were not statistically significant. Also concentrates and TDN intakes per kg gains were not statistically significant by treatments. In carcass characteristic, dressed carcass and red meat percentage were high in T1 but in T2 for retailed cut percentage without significant difference. The yield index and shear force was 69 and 70, 4.4 and 6.1 kg/$cm^2$ in T1 and T2, respectively. In palatability traits, the panel test scores of juiciness, tenderness and flavor were 4.08 and 4.64, 3.42 and 3.96, 4.58 and 4.80 in T1 and T2, respectively. which showed a tendency to improvement in Hwangto feeding groups. In feeding trial 2, the range of average daily gains were 0.656(T6) to 0.772(T3), 0.937(T6) to 1.009(T5), 0.592(T3) to 0.675kg(T6) in growing, fattening and finishing period, respectively. Although it was high in T3, T5 and T6 at growing, fattening and finishing period, respectively, it was not significantly different by treatments. The ranges of concentrates and TDN intakes per kg gains were 8.71 to 9.50(average 9.05) and 7.52 to 7.64kg(average 7.55kg), they all were lower in Hwangto feeding groups than in control about 4.5 to 8.3% and 1.2 to 1.6%, respectively. In carcass characteristics, back-fat thickness, loin eye muscle area and yield index were not difference by treatments, but marbling scores were high in T5 and T6 than in percent. Summarizing above results, it may be concluded that the use of unprocessed Hwangto as feed additives for growing-fattening steers seems to improve meat quality but not red meat quantity and feed efficiency, and may be required to feed ad libitum during the finishing period.