• Title/Summary/Keyword: mortality function

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The Heart Rate and ECG Changes after Endoscopic Thoracic Sympathectomy in Patients with Primary Hyperhidrosis (원발성 다한증 환자에서 흉부 교감 신경 차단술 후의 심박동수 및 심전도 변화)

  • Kim, Jae-Jun;Kim, Young-Du;Park, Chan-Beom;Moon, Seok-Whan;Cho, Deog-Gon;Sa, Young-Jo;Seo, Jong-Hee;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.214-219
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    • 2009
  • Background: Primary focal hyperhidrosis is characterized by overactivity of the sympathetic nervous function, and this has been effectively treated with endoscopic thoracic sympathetic denervation (ESD). The imbalance of sympathetic and parasympathetic nervous system that's created by ESD may affect the heart, lung and other thoracic organs. We analyzed the heart rate and ECG changes after performing ESD at our hospital, and this is the first such study that has been conducted on this. Material and Method: Of the 263 patients who underwent ESD between October 1996 and October 2006, 130 had ECG before and after ESD, and they were classified into 3 groups according to the level of ESD: Group I (n=40) patients underwent ESD at the 2nd rib (T2ESD), Group II (n=80) at the 3rd rib (T3ESD) and Group III (n=10) at the 4th rib (T4ESD). Result: There was no mortality or major morbidity. Heart rate (HR) was significantly decreased from $71.6{\pm}10.6/min\;to\;66.8{\pm}10.2/min$ after ESD (p<0.01); however, the PR (from $148.6{\pm}21.2$ msec to $152.8{\pm}20.5$ msec) and QTc (from $399.2{\pm}15.4$ msec to $404.0{\pm}15.1$ msec) intervals were significantly increased after ESD in the patients who suffered with primary hyperhidrosis (p<0.01). According to the level of ESD, there were significant changes in the HR and QTc interval in group I (T2ESD), the HR and PR interval in group II and the QTc interval in Group III. Conclusion: There were significant changes in the heart rate and ECG findings after ESD. The thoracic sympathetic denervation of T2, T3 and T4 affected the electrical activity of the heart at the resting state.

Development and Adult Life Span of Aphidoletes aphidimyza (Rondani) (Diptera: Cecidomyiidae) Fed on the Melon Aphid, Aphis gossypii Glover or the Green Peach Aphid, Myzus persicae($S\"{u}lzer$) (Homoptera: Aphididae) (목화진딧물(Aphis gossypii)과 복숭아혹진딧물(Myzus persicae) (Homoptera: Aphididae)을 먹이로 한 진디혹파리[Aphidoletes aphidimyza (Rondani)] (Diptera: Cecidomyiidae)의 발육 및 성충수명)

  • Kim Tae-Heung;Kim Ji-Soo
    • Korean journal of applied entomology
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    • v.43 no.4 s.137
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    • pp.297-304
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    • 2004
  • The development of Aphidoletes aphidimyza, an aphidophagous gall midge, was studied at various constant temperatures ranging from 15 to $35^{\circ}C$, with $65{\pm}5\%$ RH, and a photo-period of 16L:8D. When A. aphidimyra was fed either on Aphis gossypii or Myzus persicae, it took 43.9 and 44.5 days, respectively, to develop from egg to pupa at $15^{\circ}C$, whereas at $25^{\circ}C$, 14.3 and 15.8 days. The developmental zero was 10.7 and $10.0^{\circ}C$, respectively, while the effective accumuative temperatures were 210.8 and 245.5 day-degrees. The nonlinear shape of temperature-dependent development, shown by A. aphidimyza when fed on either species of the aphids, was well described by the modified Sharpe and DeMichele model. When distribution model of completion time of development for each growth stage was expressed as physiological age and fitted to the Weibull fuction, the completion time of development gradually shortened from egg to larva, and to pupa. In addition, the coefficient of determination $r^2$ ranged between 0.86-0.93 and 0.85-0.94, respectively providing a good approximation of cumulative developmental rates. The life span of adult was 8.7 and 9.2 days at $15^{\circ}C$, and 3.1 and 2.7 days at $30^{\circ}C$, respectively. Egg incubation period was relatively short at $35^{\circ}C$ but hatchability was less than $50\%$ and the mortality of the larva at $35^{\circ}C$ reached $100\%$. At $30^{\circ}C$, the time of development lengthened and the adult longevity was short suggesting ill effect of high temperatures. Even though the life span of adults at $15^{\circ}C$ was relatively long, none moved freely in the rearing cage and no oviposition occurred. Accordingly, in case A. aphidimyza is adopted to suppress phytophagus aphid populations, it could be applicable to cropping systems with ambient temperatures above $20^{\circ}C$ and below $30^{\circ}C$. Within this range, A. aphidimyza adults was observed to be active and oviposit fully.

Construction of a Transgenic Tobacco Expressing a Polydnaviral Cystatin (폴리드나바이러스 유래 시스타틴 유전자 발현 형질전환 담배 제작)

  • Kim, Yeongtae;Kim, Eunsung;Park, Youngjin;Kim, Yonggyun
    • Korean journal of applied entomology
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    • v.54 no.1
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    • pp.7-15
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    • 2015
  • CpBV (Cotesia plutellae bracovirus) is a polydnavirus and encodes a cystatin (CpBV-CST1) gene. Its overexpression suppresses insect immunity and alters insect developmental processes. This study aimed to construct a genetically modified (GM) tobacco to further explore the physiological function of the viral cystatin and to apply to control insect pests. To this end, the transgenic tobacco lines were screened in expression of the target gene and assessed in insecticidal activity. A recombinant vector (pBI121-CST) was prepared and used to transform a bacterium, Agrobacterium tumefasciens. The transformed bacteria were used to generate transgenic tobacco lines, which were induced to grow callus and resulted in about 92% of shoot regeneration. The regenerated plants were screened by PCR analysis to confirm the insertion of the target gene in the plant genome. In addition, the expression of the target gene was assessed in the regenerated plants by quantitative real-time PCR (qRT-PCR). The qRT-PCR analysis showed that the transgenic line plant expressed the target gene about 17 times more than the control tobacco, indicating a stable insertion and expression of the target gene in the transgenic tobacco line. The insecticidal activity was then analyzed using the screened transgenic tobacco lines against the teneral 1st instar larvae of the oriental tobacco budworm, Helicoverpa assulta. Though there was a variation in the insecticidal efficacy among transgenic lines, T9 and T12 lines exhibited more than 95% mortality at 7 days after feeding treatment. These results suggest that CpBV-CST1 is a useful genetic resource to be used to generate GM crop against insect pests.

Population Ecological Study of Cultured Sea Squirt (Halocynthia roretzi) and Management Implications (양식 우렁쉥이(Halocynthia roretzi)의 자원 생태학적 분석 및 적정관리 방안)

  • Zhang Chang Ik;Lim Hyun Sig
    • Journal of Aquaculture
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    • v.3 no.1
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    • pp.49-63
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    • 1990
  • A population ecological study was carried out to estimate survival and growth rates, biomass, biological production and turnover ratio of cultured sea squirt, Halocynthia roretzi, by growth stages, using data from in situ culture experiment off Hansando in the southern part of Korea from February 1985 to July 1986. The squirt population followed an exponential decay function and the instantaneous coefficient of total mortality (Z) was estimated to be 0.0614 $month^{-1}$(Var (Z) = 0.000126). Growths in total weight and meat weight of squirts were expressed as linear functions during the period of culture experiment. The growth of squirts showed a negative correlation with the water temperature. The mean biomass per string ranged from 2.14 kg for March of the first year to 16.26 kg for March of the next year. The biological production per string was estimated to range from 3.28 kg for the first summer (June - July) to 6.46kg for the first late winter (February-March). The peak of turnover ratio occurred in the late winter (February-March) as 3.013 and the ratios sharply declined thereafter. Based on the results of this study, management implications for culturing sea squirts were also suggested. The optimum harvest time ($t_{mb}$) when the peak biomass in terms of total weight occurred was estimated to be late June of the second year, which corresponded to 16.7 months after the main hanging. However, the time when the peak biomass in terms of meat weight was occurred was early July of the second year. The maximum harvest biomass was 17.4 kg per string in terms of total weight and 6.3 kg per string in terms of meat weight. In conclusion, the process of culture should be conducted on the basis of the knowledge of population ecological theories as shown in this study.

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Early Results of Coronary Bypass Surgery in Patients with Severe Left Ventricular Dysfunction (심한 좌심실 기능저하를 동반한 환자에서의 관상동맥 우회로 조성수술의 조기성적)

  • 정윤섭;김욱성
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.383-389
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    • 1997
  • From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

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Clinical Application of Compressed Spectral Array During Deep Hypothermia (초저체온하 대동맥수술 환자에서 완전 순환차단의 안전한 체온 및 기간에 대한 연구 - 뇌파 Compressed Spectral Array의 임상적 응용 -)

  • 장병철;유선국
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.752-759
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    • 1997
  • Profound hypothermia protects . cerebral function during total circulatory arrest(TCA) in the surgical treatment of a variety of cardiac and aortic diseases. Despite its importance, there is no ideal technique to monitor the brain injury from ischemia. Since 1994, we have developed compressed spectral array(CSA) of electroencephalography(EEG) and monitored cerebral activity to reduce ischemic injury. The purposes of this study are to analyse the efficacy of CSA and to establish objective criteria to consistently identify the safe level of temperature and arrest time. We studied 6 patients with aortic dissection(AD, n=3) or aortic arch aneurysm(n=3, ruptured in 2). Body temperatures from rectum and esophagus and the EEG were monitored continuously during cooling and rewarming period. TCA with cerebral ischemia was performed in 3 patients and TCA with selective cerebral perfusion was performed in 3 patients. Total ischemic time was 30, 36 and 56 minutes respectively for TCA group and selective perfusion time was 41, 56 and 92 minutes respectively for selective perfusion group. The rectal temperatures for flat EEG were between 16.1 and 22. $1^{\circ}C$ (mean: 18.4 $\pm$ 2.0): the esophageal temperatures between 12.7 and $16.4^{\circ}C$ (mean $14.7\pm1.6).$ The temperatures at which EEG reappeared $5~15.4^{\circ}C$ for esophagus. There was no neurological defic t and no surgical mortality in this series. In summary, the electrical cerebral activity Teappeared within 23 minutes at the temperature less than $16^{\circ}C$ for rectum. It seemed that $15^{\circ}C$ of esophageal temperature was not safe for 20 minutes of TCA and continuous monitoring the EEG with CSA to identify the electrocerebral silence was useful.

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Early Hemodynamic Changes and Short-term Outcomes of Mitral Valvuloplasty versus Replacement with Chordal Preservation for Patients with Mitral Regurgitation (승모판막폐쇄부전 환자에서 판막성형술과 판막대치술이 수술 후 혈역학과 단기 예후에 미치는 영향 비교)

  • Choi, Yong-Seon;Kwak, Young-Lan;Chang, Byung-Chul;Kim, Ji-Ho;Hong, Yong-Woo;Bang, Sou-Ouk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.659-666
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    • 2007
  • Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.

A Pilot Study of Bone Mineral Density in Men with Chronic Obstructive Pulmonary Disease (남자 만성폐쇄성폐질환 환자들의 골밀도에 대한 예비연구)

  • Bae, Yun Oh;Han, Minsoo;Lee, Seong-Kyu;Kim, Jeong Nyum;Kim, Jeong Sik;Kim, Jinho;Cho, Yongseon;Lee, Yang Deok
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.395-402
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    • 2003
  • Background : Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. Methods : We checked BMD, $FEV_1$(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. Results : Mean(${\pm}$) age was $69{\pm}9$ yrs, body mass index(BMI) $21{\pm}3kg/m^2$, $FEV_1$ $50{\pm}18%$ of predicted, lumbar spine T-score $-3.0{\pm}1.2$, lumbar spine Z-score $-2.0{\pm}1.2$, and lumbar spine BMD $0.76{\pm}0.13g/cm^2$. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-score between -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationship between BMD and $FEV_1$(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to $FEV_1$(% of predicted) (group1 : ${\geq}65%$, group2 : 50-64%, group3 : ${\leq}49%$), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. Conclusion : BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

Clinical Characteristics of Aspergilloma (국균종의 임상적 고찰)

  • Kim, Ki-Up;Gil, Hyo-Wook;Lee, Suk-Ho;Kim, Do-Jin;Na, Moon-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.46-53
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    • 2002
  • Background: Pulmonary aspergilloma is relatively common in korea. It arises from the colonization and proliferation of Aspergillus in preexisting lung parenchymal cavities, in particular tuberculosis. The most common symptom in this disorder is hemoptysis, which mayor may not be massive and life threatening. A routine chest radiography and computed tomography (CT) are the most important diagnostic procedures. A surgical resection of the aspergilloma has recently been recommended, because of the relatively low incidence of postoperative complications than in the past. A more concentrated sample of patients with aspergilloma, who either underwent a thoracotomy or tested positive for aspergillus antibodies, were reviewed. Method : The medical records of twenty-two patients with aspergilloma, who had a proven thoracotomy (9 cases), or who tested positive for the diagnostic procedure and/or aspergillus antibodies (13 cases) from January 1995 to December 2000, were reviewed retrospectively. Results : The most common underlying lung disease was a current or old healed tuberculosis, and 3 patients had cultures of mycobacterium other than tuberculosis (MOTT). The mean time until the aspergilloma was detected 5.91 years in the healed tuberculosis cases. The others cases involved a lung abscess, bronchiectasis and without lung disease. The extrapulmonary disease was alcoholism and diabetes. Hemoptysis was most common in 72.7%. A computed tomography (CT) is useful for diagnosis. The right upper lobe, especially the posterior segment, is the most common location. Bronchial artery embolization is ineffective for a long term follow-up. A lobectomy is most common in a thoracotomy, and intra-operative and post-operative complications are rare. During follow-up, the mortality rate, not from the aspergilloma but from respiratory failure, was 13.6%. Conclusion : Aspergilloma is a common cavitary lung disease, It mainly arises from tuberculosis, either current or healed, but extra-pulmonary disease including alcoholism or diabetes are other possible risk factors. Their most common problem in aspergilloma is hemoptysis. Surgery has a low risk of post-operative complications and is recommended in relatively preserved lung function or healthy patients. Medical maneuvers including embolization, and the local insertion of certain materials needs to be studied more closely.