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Analysis of Postpneumonectomy Complication without Balanced Chest Bottle (흉관 삽입술 없이 시행한 전폐절제술 후 발생한 합병증에 대한 분석)

  • Kim, Tae-Gyun;Chung, Won-Sang;Kang, Jung-Ho;Kim, Young-Hak;Kim, Hyuck;Jee, Heng-Ok;Lee, Chul-Bum;Ham, Shi-Young
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.290-295
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    • 2002
  • Backgroud: Pneumonectomy carries the possibility of numerous dangerous complications as well as the vast effect the operation itself has on the cardiopulmonary function. Most of operations are done with the insertion of the chest tubes upon completion, but because of the high incidence of pyothorax as its complications, we have tried to analyze and compare the cases without inserting the chest tubes. Material and Method: During a 5 year period from January, 1996 to December 2000, 100 cases, which were operated at the Hanyang University Hospital, were selected using the patient's charts. The age, gender, indication of operation, associated diseases, and operation site(left or right) were classified accordingly and the postoperative complications and mortality were statistically analyzed using the $\chi$ 2-test. After resecting the lung, the intrathoracic pressure was set at -15 ~ -20cm $H_2O$ using the nelaton catheter, and the thoracotomy site was then closed. The gradual collection of the fluid and blood in the thorax of the operated side, as well as the mediastinum location, were observed carefully for 4~5 days postoperatively with the aid of the simple chest x-rays. Result: Of the 100 cases, 16 cases of pulmonary tuberculosis(16%), 81 cases of lung tumor(81%), 2 cases of bronchiectasis(2%), and 1 case of aspergilloma associated bronchiectasis were noted. There were 8 mortality cases(8%), and of the 34 cases(34%), 44 complications were noted. The age, sex, and operation site(left or right) were not statistically significant with the complications. 7 of the 16 cases of pulmonary tuberculosis(44%) and 27 of the 81 cases of lung tumor(33%) had complications, but they were found not to be statistically significant. The increase of the complication rate in the pulmonary tuberculosis patients was 3.86. The evidence of postoperative bleeding was observed in 6 cases with the 3 cases being the pulmonary tuberculosis patients and the 3 cases were others. This shows that the increase in postoperative bleeding in the pulmonary tuberculosis is statistically significant(p=0.019). Of the 100 cases, there were 8 mortality cases(8%), with 5 cases from the 81 cases of the lung tumor group(6.1%), 3 cases from the 16 cases of pulmonary tuberculoses group(18.7%).

Hematologic Changes and Factors Related to Postoperative Hemorrhage Following Cardiopulmonary Bypass (체외순환에 따른 혈액학적 변화와 술후 출혈에 관계하는 인자에 관한 연구)

  • 김하늘루;황윤호;최석철;최국렬;김승우;조광현
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.952-963
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    • 1998
  • Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

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Determination of shear wave velocity profiles in soil deposit from seismic piezo-cone penetration test (탄성파 피에조콘 관입 시험을 통한 국내 퇴적 지반의 전단파 속도 결정)

  • Sun Chung Guk;Jung Gyungja;Jung Jong Hong;Kim Hong-Jong;Cho Sung-Min
    • 한국지구물리탐사학회:학술대회논문집
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    • 2005.09a
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    • pp.125-153
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    • 2005
  • It has been widely known that the seismic piezo-cone penetration test (SCPTU) is one of the most useful techniques for investigating the geotechnical characteristics including dynamic soil properties. As the practical applications in Korea, SCPTU was carried out at two sites in Busan and four sites in Incheon, which are mainly composed of alluvial or marine soil deposits. From the SCPTU waveform data obtained from the testing sites, the first arrival times of shear waves were and the corresponding time differences with depth were determined using the cross-over method, and the shear wave velocity profiles (VS) were derived based on the refracted ray path method based on Snell's law and similar to the trend of cone tip resistance (qt) profiles. In Incheon area, the testing depths of SCPTU were deeper than those of conventional down-hole seismic tests. Moreover, for the application of the conventional CPTU to earthquake engineering practices, the correlations between VS and CPTU data were deduced based on the SCPTU results. For the empirical evaluation of VS for all soils together with clays and sands which are classified unambiguously in this study by the soil behavior type classification Index (IC), the authors suggested the VS-CPTU data correlations expressed as a function of four parameters, qt, fs, $\sigma$, v0 and Bq, determined by multiple statistical regression modeling. Despite the incompatible strain levels of the down-hole seismic test during SCPTU and the conventional CPTU, it is shown that the VS-CPTU data correlations for all soils clays and sands suggested in this study is applicable to the preliminary estimation of VS for the Korean deposits and is more reliable than the previous correlations proposed by other researchers.

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Analysis of User Behavior for the Revitalization of Small Parks near Stations by the Location Types in Influential Subway Area (역세권내 역 인접 소공원의 유형별 이용행태분석을 통한 활성화 방안 연구)

  • Lee, Joo-Hee;Park, Jin-A.
    • Journal of the Korean Institute of Landscape Architecture
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    • v.36 no.3
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    • pp.9-20
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    • 2008
  • The government is planning to link a small park with the soon to be ready subway line 9 as a part of Seoul's policy, "The standard or plan for making a water-friendly space by water use" (2007). However, the specified concepts and instructions of the small parks need further work. Therefore, the policy is expected to expand to neighboring small parks near the subway station, but these are not supported by research or data which suggests the needs or actual user behavior and utilization of small parks. our country added the specified concept of small parks and theme parks to the classification of urban parks in the Urban Park Act Revision (2005.3.31), but the concept of small parks is not clearly settled in the law in the scopes of its function, scale, promotion nor particularly defined plans for small park projects. This study examines as small park near a subway station. The characteristics of there region and users vary from the characteristics of the station and region. In the "directions for concrete standards under the types of urban parks and green zones" (2007.2) the types of small parks are classified by "regional characteristics" and "user characteristics". Therefore, this study classifies the subject of neighboring small parks near subway stations as the neighborhood and small urban parks according to the Urban Park Act. The study was paralleled with observation and questionnaires on the analysis of the neighborhood and small urban parks. The actual conditions of park utilization and user behavioral characteristics were deducted by observation, while the questionnaire determined actual user utilization, importance and satisfaction level as well as the small park environment. This study largely focused on three aspects: park facility, design of this sentence isn't even complete. The second aspect isn't finished and the third isn't here.

Risk Factor's Affecting long-term Outcome of Alport syndrome (Alport 증후군의 예후와 관련된 위험요인 분석)

  • Byun Ji-Yoon;Baek Seoung-Yon;Lee Young-Mock;Kim Ji-Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo;Kim Soon-Il;Kim Yu-Seun;Park Ki-Il
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.164-175
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    • 2001
  • Purpose : Alport syndrome is a hereditary nephrotic disease characterized by progressive nephrotic symptom, sensorineural hearing loss, ophthalmic abnormality, typical microscopic findings, and familial occurrence. In this study, we tried to find the risk factors related with its prognosis by taking a close observation on clinical symptoms of children with Alport syndrome reviewing retrospectively. Materials & methods : We chose children diagnosed as Alport syndrome in renal biopsy during 20 years(from 1980, Jan. until 1999, Dec.) who could receive follow up studies in tile department of pediatrics. They were divided into two groups by comparing renal function at the time of diagnosis and at current status. We compared several clinical aspects in them, and applied nonparametric test for statistical analysis. Results : The sex ratio(male:female) of 24 children was 3:1. The most common clinical symptom presented at their first visit was gross hematuria. Among those 24 children, 11 cases($46\%$) of progressing into chronic renal failure(Group II) were observed. Hypertension, proteinuria and edema were seen much frequently in group II. The level of serum protein, albumin, and creatinine clearance were decreased while BUN, creatinine were relatively increased. All the results were statistically significant. Conclusion Clinically significant risk factors related to prognosis in Alport syndrome were the presence of hypertension, edema, and proteinuria at the time of diagnosis. Also, the level of serum protein, albumin, BUN, creatinine, and glomerular filtration rate were proved to be important factors in predicting prognosis. We believe that studies on these possible risk factors would be of great help in treating and predicting prognosis of children suffering with Alport syndrome. (J Korean Soc Pediatr Nephrol 2001;5 : 164-75)

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Biocompatibility and Histopathologic Change of the Acellular Xenogenic Pulmonary Valved Conduit Grafted in the Right Ventricular Outflow Tract (우심실 유출로에 이식한 무세포화 이종 폐동맥 판막도관의 생체 적합성 및 조직병리학적 변화양상에 대한 연구)

  • 허재학;김용진;박현정;김원곤
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.482-491
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    • 2004
  • Background: The xenogenic or allogenic valves after in Vitro repopulation with autologous cells or in vivo repo-pulation after acellularization treatment to remove the antigenicity could used as an alternative to synthetic polymer scaffold. In the present study, we evaluated the process of repopulation by recipient cell to the acellu-larized xenograft treated with NaCl-SDS solution and grafted in the right ventricular outflow tract. Material and Method: Porcine pulmonary valved conduit were treated with. NaCl-SDS solution to make the grafts acellularized and implanted in the right ventricular outflow tract of the goats under cardiopulmonary bypass. After evaluating the functions of pulmonary valves by echocardiography, goats were sacrificed at 1 week, 1 month, 3 months, 6 months, and 12 months after implantation, respectively. After retrieving the implanted valved conduits, histopathologic examination with Hematoxylin-Eosin, Masson' trichrome staining and immunohistochemical staining was performed. Result: Among the six goats, which had been implanted with acellularized pulmonary valved conduits, five survived the expected time period. Echocardiographic examinations for pulmonary valves revealed good function except mild regurgitation and stenosis. Microscopic analysis of the leaflets showed progressive cellular in-growth, composed of fibroblasts, myofibroblasts, and endothelial cells, into the acellularized leaflets over time. Severe inflammatory respon-se was detected in early phase, though it gradually decreased afterwards. The extracellular matrices were regenerated by repopulated cells on the recellularized portion of the acellularized leaflet. Conclusion: The acellularized xenogenic pulmonary valved conuits were repopulated with fibroblasts, myofibroblasts, and endothelial cells of the recipient and extracellullar matrices were regenerated by repopulted cells 12 months after the implantation. The functional integrity of pulmonary valves was well preserved. This study showed that the acellularized porcine xenogenic valved conduits could be used as an ideal valve prosthesis with long term durability.

Germ Cell Differentiations during Spermatogenesis and Ultrastructural Characteristics of Mature Sperms in Male Protothaca (Notochione) jedoensis (Bivalvia: Veneridae) (수컷 살조개, Protothaca (Notochione) jedoensis (Bivalvia: Veneridae)의 정자형성과정 중 생식세포 분화와 성숙정자의 미세구조적 특징)

  • Kim, Jin-Hee;Park, Young-Jae;Lee, Ki-Young;Choi, Moon-Sul;Seo, Won-Jae;Chung, Ee-Yung
    • Development and Reproduction
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    • v.14 no.4
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    • pp.269-279
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    • 2010
  • Some characteristics of germ cell differntiations and the function of accessory cells during spermatogenesis, and mature sperm ultrastructure in male Protothaca (N.) jedoensis were investigated by transmission electron microscope observations. The morphology of the spermatozoa of this species has a primitive type and is similar to those of other species in the subclass Heterodonta. Accessory cells, which are connected to adjacent germ cells, are involved in the supplying of the nutrients for germ cell development. The morphologies of the sperm nucleus and the acrosome of this species are the cylindrical type and cap shape, respectively. Spermatozoa are approximately $46{\sim}50{\mu}m$ in length including a long sperm nucleus (about $2.44{\mu}m$ in length), an acrosome (about $0.45{\mu}m$ in length), and tail flagellum (about $42{\sim}46{\mu}m$). The axoneme of the sperm tail shows a 9+2 structure. As some characteristics of the acrosomal vesicle structures, the basal and lateral parts of basal rings show electron opaque part (region), while the anterior apex part of the acrosomal vesicle shows electron lucent part (region). These characteristics of the acrosomal vesicle were found in the family Veneridae and other several families in the subclass Heterodonta. These common characteristics of the acrosomal vesicle in the subclass Heterodonta can be used for phylogenetic and systematic analysis as a taxonomic key or a significant tool. The number of mitochondria in the midpiece of the sperm of this species are four, as one of common characteristics appear in most species in the family Veneridae and other families in the subclass Heterodonta. However, exceptionally, only three species in Veneridae of the subclass Heterodonta contain 5 mitochondria. The number of mitochondria in the sperm midpiece can be used for the taxonomic analysis of the family or superfamily levels as a systematic key or an important tool.

Biological Activities of Extracts from Cornus kousa Fruit (산딸나무(Cornus kousa) 열매 추출물의 생리활성)

  • Lee, Eun-Ho;Lee, Seon-Ho;Cho, Young-Je
    • Journal of Applied Biological Chemistry
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    • v.58 no.4
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    • pp.317-323
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    • 2015
  • The extracted phenolic compounds from Cornus kousa fruit for biological activities as functional resources were examined. The phenolic compounds which were extracted with water and 40% ethanol from Cornus kousa fruit were $7.04{\pm}0.27$ and $4.47{\pm}0.18mg/g$, respectively. The 1,1-diphenyl-2-picrylhydrazyl free radical scavenging activity of water and ethanol extracts were 84% and 86% at $50{\mu}g/mL$phenolics, respectively. The 2,2'-Azinobis-(3-ethylbenzothiazoline-6-sulfonic acid radical decolorization activity of water and ethanol extracts were 84 and 95% at $100{\mu}g/mL$ phenolics, respectively. Antioxidant protection factor in water and ethanol extracts at $50{\mu}g/mL$ phenolics were 1.93 and 1.82 PF, respectively. Thiobarbituric acid reactive substance were 69% in water extracts and 89% in ethanol extracts at $150{\mu}g/mL$ phenolics. The inhibition activity on xanthine oxidase in water and ethanol extracts was 34 and 60%, respectively. The inhibition activity on ${\alpha}$-glucosidase was 29% in water extracts and 87% in ethanol extracts. The tyrosinase inhibitory activity was 19% in ethanol extracts. The collagenase inhibition activity of anti-wrinkle effect showed an excellent wrinkle improvement effect as 53% in water extracts and 77% in ethanol extracts at $200{\mu}g/mL$ phenolics. The hyaluronidase inhibition activity as antiinflammation effect of water extracts was confirmed to 34% of inhibition at $200{\mu}g/mL$ phenolic. The results can be expected extracts from Cornus kousa fruit to use as functional resource for antioxidant, antigout, inhibitor of carbohydrate degradation, antiwrinkle activity and antiinflammation activity.

Evaluation of the Efficiency of the Foxtail Millet Vacuum Cushion in Skin Cancer Radiation Treatment (자체 제작한 Foxtail Millet Vacuum Cushion의 광자선 피부암 치료 시 유용성 검증)

  • Choi, Shin-Cheol;Lee, Kyung-Jae;Jung, Sung-Min;Oh, Tae-Seong;Park, Jong-Il;Shin, Hyun-Kyo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.189-196
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    • 2012
  • Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

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Capsaicin induced apoptosis and the enhanced anticancer effect of anticancer drugs in cancer cells (종양세포에서의 capsaicin에 의한 apoptosis 유도와 항암제의 항암효과의 증가)

  • Kim, Sun Young;Lee, You Jin;Park, Eun Hye;Yi, Ho Keun;Jo, Dae Sun;Kim, Jung Soo;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.307-314
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    • 2008
  • Purpose : Capsaicin, the major pungent ingredient in red pepper, has long been used in spices and food additives. It has been recently shown to induce apoptosis in several cell lines through a not well known mechanism. The aim of this study was to investigate the apoptosis-inducing effect of capsaicin on gastric cancer cells, and to provide valuable information concerning the application of capsaicin for therapeutic purposes. Methods : Cultured SNU-668 cells were treated with capsaicin. We analyzed cell survival by trypan blue and crystal violet analysis, cell cytotoxicity by MTT assay, apoptosis by nuclear condensation and DNA fragmentation, bcl-2 and bax mRNA expression by RT-PCR, and the expression of apoptosis related proteins by Western immunoblot analysis. In order to assess whether the growth inhibitory effect of anticancer drugs is enhanced by capsaicin, we investigated the effects of cell cytotoxicity and the expression of apoptosis related proteins of etoposide and adriamycin treated with capsaicin in cells. Results : Capsaicin inhibited growth of SNU-668 cells in a dose-dependent manner. This inhibitory effect of capsaicin on cell growth was mainly due to the induction of apoptosis as evidenced by DNA fragmentation, nuclear condensation and the expression of apoptosis related proteins. Furthermore, capsaicin prominently reduced the ratio of anti-apoptotic Bcl-2 to pro-apoptotic Bax and consequently increased caspase-3 activity. The cells treated with capsaicin were more sensitive to death induced by etoposide and adriamycin than the cells without capsaicin. Conclusion : These results demonstrate that capsaicin efficiently induced apoptosis in SNU-668 cells through a caspase-3-dependent mechanism and sensitizes cancer cells to anticancer drugs toward apoptotic cell death, which may contribute to its anticancer effect and chemosensitizer function against gastric cancer.