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Diagnostic Approach to a Patient with a Pleural Effusion Including Ultrasound-guided Paracentesis Performed by a Medical Resident (내과 전공의가 시행한 초음파 이용 흉수천자를 포함한 흉수의 진단적 접근)

  • Lee, Yun Young;Choi, Won Je;Yu, Chang Min;Suh, Seong O;Kim, Eun Sil;Ahn, Seok- in;Chung, Jun-Oh;Park, Sang Joon;Kim, Yun Kwon;Kim, Soyon;Kim, Young Jung;Lee, Se Han;Heo, Heon
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.439-444
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    • 2008
  • Background: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. Methods: We studied 89 cases of pleural effusions from March 2003 to June 2005. A "blind" thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a "blind" thoracentesis. Results: "Blind" thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. Conclusion: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.

New Methods for Separation of Crude Ginseng Saponins (인삼 조사포닌의 새로운 분리 방법)

  • Shin, Ji-Young;Choi, Eon-Ho;Wee, Jae-Joon
    • Korean Journal of Food Science and Technology
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    • v.33 no.2
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    • pp.166-172
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    • 2001
  • In order to increase ginsenoside content, to reduce chemical change, to shorten extracting procedure, new methods of extraction and fractionation of crude ginseng saponin were established and compared for their chemical composition. Those are hot MeOH extraction/n-BuOH fractionation (BuOH method) and hot MeOH extraction/Diaion HP-20 adsorption/MeOH elution (HP-20 method), which are already known methods, and additional three new methods: hot MeOH extraction/cation AG 50W $adsorption/H_2O$ elution/n-BuOH extraction (AG 50W method), cool MeOH extraction/Diaion HP-20 adsorption/MeOH elution (cool extraction method) and direct extraction with EtOAc/n-BuOH (direct extraction method). AG 50W method provided a crude saponin showing the highest content of ginsenosides of 61.5% and the lowest contents of protein and free amino acids of 0.93% and 0.19%, respectively. The protein content was the highest as 14.18% in the crude saponin by HP-20 method, while free sugar content was the highest as 13.5% by BuOH method, indicating that these are factors that lower the rate of ginsenoside in crude saponins by those methods. On the other hand, it was revealed that AG 50W method produced large amount of prosapogenins during the pass through the cation exchange resin (AG 50W) column being strongly acidic. Crude saponin from direct extraction method showed relatively higher composition of ginsenoside $Rg_1$ and Re. The results suggest that contents and composition of ginsenosides and other chemical components in crude ginseng saponin greatly depend on the condition of the extraction and fractionation.

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Screening of Hyaluronidase Inhibitor in Korean Medicinal Plants (천연물로부터 히알루로니다아제 저해제 검색)

  • Hwang, Seon Gu;Yang, Anna;Kim, Soo Jung;Kim, Min Kee;Kim, Sung Soo;Oh, Hyun Jung;Lee, Jung Dae;Lee, Eun Ju;Nam, Kung-Woo;Han, Man-Deuk
    • Journal of Life Science
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    • v.24 no.5
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    • pp.498-504
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    • 2014
  • Mammalian hyaluronidases (HAase, EC 3.2.1.35) are a family of enzymes that hydrolyse N-acetyl-D-glucosamine (1-4) glycosidic bonds in hyaluronic acid, which is found in skin, cartilage, and the vitreous body. Although HAase is generally present in an inactive form within subcellular lysosomes, it is released in an active form in some types of inflammation and tissue injuries, thereby contributing to the inflammatory response. The HAase inhibitory activity of 500 methanolic extracts of 500 species from medicinal plants was screened using a Morgan microplate assay. The viscosity of the hyaluronic acid was measured with an Ubbelohde viscometer. Three MeOH extracts inhibited more than 50% of HAase activity at a concentration of 2 mg/ml. HAase inhibitory rates (%) of three species of medicinal plant extracts, Styrax japonica, Deutzia coreana, and Osmanthus insularis were 57.28%, 53.50%, and 53.19%, respectively. The rate of HAase inhibition of the extracts was dose dependent. In the HAase inhibitory assay using the Ubbelohde viscometer, the results were in good agreement with the results from the Morgan assay. The results suggest that HAase inhibitory compounds extracted from the stem of S. japonica, D. coreana, and O. insularis might be multifunctional and prevent the degradation of hyaluronic acid and the induction of allergic reactions and inflammation.

Application of Remote Sensing and Geographic Information System in Forest Sector (원격탐사와 지리정보시스템의 산림분야 활용)

  • Lee, Woo-Kyun;Kim, Moonil;Song, Cholho;Lee, Sle-gee;Cha, Sungeun;Kim, GangSun
    • Journal of Cadastre & Land InformatiX
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    • v.46 no.2
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    • pp.27-42
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    • 2016
  • Forest accounts for almost 64 percents of total land cover in South Korea. For inventorying, monitoring, and managing such large area of forest, application of remote sensing and geographic information system (RS/GIS) technology is essential. On the basis of spectral characteristics of satellite imagery, forest cover and tree species can be classified, and forest cover map can be prepared. Using three dimensional data of LiDAR(Light Detection and Ranging), tree location and tree height can be measured, and biomass and carbon stocks can be also estimated. In addition, many indices can be extracted using reflection characteristics of land cover. For example, the level of vegetation vitality and forest degradation can be analyzed with VI (vegetation Index) and TGSI (Top Grain Soil Index), respectively. Also, pine wilt disease and o ak w ilt d isease c an b e e arly detected and controled through understanding of change in vegetation indices. RS and GIS take an important role in assessing carbon storage in climate change related projects such as A/R CDM, REDD+ as well. In the field of climate change adaptation, impact and vulnerability can be spatio-temporally assessed for national and local level with the help of spatio-temporal data of GIS. Forest growth, tree mortality, land slide, forest fire can be spatio-temporally estimated using the models in which spatio-temporal data of GIS are added as influence variables.

Effect of Redox Processes and Solubility Equilibria on the Behavior of Dissolved Iron and Manganese in Groundwater from a Riverine Alluvial Aquifer (만경강 하천변 충적 지하수의 용존 Fe와 Mn 거동에 대한 산화-환원 과정과 용해 평형의 효과)

  • Choi, Beom-Kyu;Koh, Dong-Chan;Ha, Kyoo-Chul;Cheon, Su-Hyun
    • Economic and Environmental Geology
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    • v.40 no.1 s.182
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    • pp.29-45
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    • 2007
  • Biogeochemical characteristics involving redox processes in groundwater from a riverine alluvial aquifer was investigated using multi-level monitoring wells (up to 30m in depth). Anaerobic conditions were predominant and high Fe ($14{\sim}37mg/L$) and Mn ($1{\sim}4mg/L$) concentrations were observed at 10 to 20 m in depth. Below 20 m depth, dissolved sulfide was detected. Presumably, these high Fe and Mn concentrations were derived from the reduction of Fe- and Mn-oxides because dissolved oxygen and nitrate were nearly absent and Fe and Mn contents were considerable in the sediments. The depth range of high Mn concentration is wider than that of high Fe concentration. Dissolved organics may be derived from the upper layers. Sulfate reduction is more active than Fe and Mn reduction below 20 m in depth. Disparity of calculated redox potential from the various redox couples indicates that redox states are in disequilibrium condition in groundwater. Carbonate minerals such as siderite and rhodochrosite may control the dissolved concentrations of Fe(II) and Mn(II), and iron sulfide minerals control for Fe(II) where sulfide is detected because these minerals are near saturation from the calculation of solubility equilibria.

Radiation Therapy in Malignant Tumors of the Parotid Gland (이하선암의 방사션 치료)

  • Park K.R.;Oh W.Y.;Suh C.O.;Kim G.E.;Loh J.K.;Park J.S.;Min J.S.
    • Radiation Oncology Journal
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    • v.4 no.1
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    • pp.21-27
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    • 1986
  • From 1970 to 1982, thirty one patients with malignant tumors of the parotid gland were treated with radiation therapy at department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center. Indication for radiotherapy were as follows: 1) when there were microscopic or gross residual diseases (6 patients), 2) when the patients considered to have high risk factors (15 patients), 3) when the tumor found to be inoperable (6 patients), 4) when there was recurrence after surgery (4 patients). Most patients were treated with a total of 5,000 to 6,500cGy in 5 to 6 weeks except when there were gross diseases, in which patients received slightly higher dose up to 7,000 cGy in 7 weeks. Locoregional failure rate was $43\%$ in patients with microscopic or gross residual disease and high risk factors (postoperative radiotherapy group) and 20 in patients with inoperable tumor and recurrence after surgery (Primary radiotherapy group). There was no difference in the failure rates amen!1 the various histological types. Eight patients failed distantly, Severe complications appeared only in 2 patients irradiated for inoperable advanced diseases.

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A Microscope Study of Fluoride Effects on the Rat Incisor Enamel Formation (흰쥐 절치의 법랑질 형성에 미치는 불소의 효과에 관한 현미경적 연구)

  • Lim, Do-Seon;Chang, Byung-Soo;Jeong, Je-O;Jeong, Soon-Jeong;Jeong, Moon-Jin
    • Applied Microscopy
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    • v.34 no.2
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    • pp.145-157
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    • 2004
  • The aim of the present study was to examine in detail, both at light and electron microscopical levels, the morphological variations in ameloblast of the fetal rat incisor enamel organ. Rats were started on distilled water at the beginning of pregnancy. The pups were sacrificed 11 days after delivery and animals were perfused intravascularly with glutaraldehyde and the incisors were removed. To examine on the ultrastructure of the ameloblast, the study employed primary light microscopy but electron microscopy was used to clarify some of the light microscopic finding. Longitudinal sections through the incisors of the rat show a continuous layer of ameloblasts on the labial surface of the tooth. This layer contains the entire sequence of developmental stages in enamel production. The ameloblast layer was divided into three main zones: 1) Presecretory zone, region of ameloblasts facing pulp. 2) Secretory zone, region of inner and outer enamel secretion. 3) Maturation zone, region of reduced ameloblasts. In particularly, the present study has shown that two distinctively different types of ameloblasts appear in the enamel organ during enamel maturation in the rat incisor. These two types have been designated ruffle-ended ameloblasts (rAB) and smooth-ended ameloblasts (sAB). The fluoride produces marked alteration in the fine structure of ameloblast from teeth of young rats, such as large confluent distensions of the endoplasmic reticulum and swelling of isolated mitochondria. This experimental data suggested that exposure prolonged of animal to high level of fluoride appears to induce a few dramatic changes in the normal appositional growth and initial mineralization of enamel created during amelogenesis.

Association of Estrogen Receptor Alpha and Interleukin 6 Polymorphisms with Lymphovascular Invasion, Extranodal Extension, and Lower Disease-Free Survival in Thai Breast Cancer Patients

  • Sa-Nguanraksa, Doonyapat;Suntiparpluacha, Monthira;Kulprom, Anchalee;Kummalue, Tanawan;Chuangsuwanich, Tuenjai;Avirutnan, Panissadee;O-Charoenrat, Pornchai
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2935-2940
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    • 2016
  • Breast cancer is the most frequent type of cancer diagnosed among women worldwide and also in Thailand. Estrogen and estrogen receptors exert important roles in its genesis and progression. Several cytokines have been reported to be involved in the microenvironment that promotes distant metastasis via modulation of immune and inflammatory responses to tumor cells. Estrogen receptor genetic polymorphisms and several cytokines have been reported to be associated with breast cancer susceptibility and aggressiveness. To investigate roles of genetic polymorphisms in estrogen receptor alpha (ESR1) and interleukin 6 (IL6), breast cancer patients and control subjects were recruited from the Division of Head, Neck and Breast Surgery (Siriraj Hospital, Bangkok, Thailand). Polymorphisms in ESR1 (rs3798577) and IL6 (rs1800795 and rs1800797) were evaluated by real-time PCR in 391 breast cancer patients and 79 healthy controls. Associations between genetic polymorphisms and clinicopathological data were determined. There was no association between genetic polymorphisms and breast cancer susceptibility. However the ESR1 rs3798577 CT genotype was associated with presence of lymphovascular invasion (OR=2.07, 95%CI 1.20-3.56, p=0.009) when compared to the TT genotype. IL6 rs1800795 CC genotype was associated with presence of extranodal extension (OR= 2.30, 95%CI 1.23-4.31, p=0.009) when compared to the GG genotype. Survival analysis showed that IL6 rs1800797 AG or AA genotypes were associated with lower disease-free survival. These findings indicate that polymorphisms in ESR1 and IL6 contribute to aggressiveness of breast cancer and may be used to identify high risk patients.

Analysis of the Necessary Mechanical Properties of Embroiderable Conductive Yarns for Measuring Pressure and Stretch Textile Sensor Electrodes (생체 신호 측정 압력 및 인장 직물 센서 전극용 자수가 가능한 전도사의 필요 물성 분석)

  • Kim, Sang-Un;Choi, Seung-O;Kim, Joo-Yong
    • Science of Emotion and Sensibility
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    • v.24 no.2
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    • pp.49-56
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    • 2021
  • In this study, we investigated the necessary mechanical properties of conductive multifilament yarns for fabricating the electrodes of biosignal measurement pressure and stretch textile sensors using embroidery. When electrodes and circuits for smart wearable products are produced through the embroidery process using conductive multifilament yarns, unnecessary material loss is minimized, and complex electrode shapes or circuit designs can be produced without additional processes using a computer embroidering machine. However, because ordinary missionary threads cannot overcome the stress in the embroidery process and yarn cutting occurs, herein, we analyzed the S-S curve, thickness, and twist structure, which are three types of silver-coated multifilament yarns, and measured the stress in the thread of the embroidery simultaneously. Thus, the required mechanical properties of the yarns in the embroidery process were analyzed. In the actual sample production, cutting occurred in silver-coated multifilament rather than silver-coated polyamide/polyester, which showed the lowest S-S curve. In the embroidery process, the twist was unwound through repetitive vertical movement. Further, we fabricated a piezoresistive pressure/tension sensor to measure gauge factor, which is an index for measuring biological signals. We confirmed that the sensor can be applied to the fabrication of embroidery electrodes, which is an important process in the mass production of smart wearable products.

Synergistic effect of ionizing radiation and $\beta$-lapachone against tumor in vitro and in vivo

  • Park, Eun-Kyung;Kim, Young-Seok;Lee, Sang-wook;Ahn, Seung-Do;Shin, Seong-Soo;Park, Heon-Joo;Song, Chang-Won
    • Proceedings of the Korean Biophysical Society Conference
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    • 2003.06a
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    • pp.80-80
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    • 2003
  • ${\beta}$-lapachone(${\beta}$-Lap), a natural o-naphthoquinone, presents in the bark of the Lapacho tree. ${\beta}$-Lap is cytotoxic against a variety of human cancer cells and it potentiates the anti-tumor effect of Taxol. In addition, ${\beta}$-Lap has been reported to radiosensitize cancer cells by inhibiting the repair of radiation-induced DNA damage.In the present study, we investigated the cytotoxicity of ${\beta}$-Lap against RKO human colorectal cancer cells as well as the combined effect of ${\beta}$-LaP and ionizing radiation. An incubation of RKO cells with 5 ${\mu}$M of ${\beta}$-Lap for 4 h killed almost 90% of the clonogenic cells. An incubation of RKO cells with 5 ${\mu}$M of ${\beta}$-Lap for 4 h or longer also caused massive apoptosis. Unlike other cytotoxic agents, ${\beta}$-Lap did not increase the expression of p53 and p21 and it suppressed the NFkB expression. The expression of Caspase 9 and 3 was minimally altered by ${\beta}$-Lap. Radiation and ${\beta}$-Lap acted synergistically in inducing clonogenic cell death and apoptosis in RKO cells when ${\beta}$-Lap treatment was applied after but not before the radiation exposure of the cells. Interestingly, a 4 h treatment with 5 ${\mu}$M of ${\beta}$-Lap starting 5 h after irradiation was as effective as that starting immediately after irradiation. The mechanisms of ${\beta}$-Lap-induced cell killing is controversial but a recent hypothesis is that ${\beta}$-Lap is activated by NAD(P)H: quinone-onidoreductase (NQO1) in the cells followed by an elevation of cytosolic Ca$\^$2+/ level and activation of proteases leading to apoptosis. It has been reported that NQO1 level in cells is markedly up-regulated for longer than 10 h after irradiation. Indeed, using immunological staining of NQO1, we observed a significant elevation of NQO1 expression in RKO cells 5h after 2-4 Gy irradiation. Such a prolonged elevation of NQO1 level after irradiation may be the reasons why the ${\beta}$-Lap treatment applied S h after irradiation was as effective as that applied immediately after irradiation in killing the cells. In view of the fact that the repair of radiation-induced damage is usually completed within 1-2 h after irradiation, it is highly likely that the ${\beta}$-Lap treahment applied 5 h after irradiation could not inhibit the repair of radiation-induced damage. For in vivo study, RKO cells were injected S.C. into the hind-leg of Nu/Nu mice, and allowed to grow to 130 mm3 tumor. The mice were i.p. injected with ${\beta}$-lapachone or saline 2 h after irradiation of tumors with 10 Gy of X-rays. The radiation induced growth delay was increased by 2.4 $\mu\textrm{g}$/g of ${\beta}$-lapachone. Taken together, we may conclude that the synergistic interaction of radiation and ${\beta}$-Lap in killing cancer cells is not due to radiosensitization by ${\beta}$-Lap but to an enhancement of ${\beta}$-Lap cytotoxicity by radiation through an upregulation of NQO1. The fact that NQO1 is elevated in tumors and that radiation causes prolonged increase of the NQO1 expression may be exploited to preferentially kill tumor cells using ${\beta}$-Lap in combination with radiotherapy.

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