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Intraoperative Measurement and Analysis of Coronary Artery Bypass Graft Flow (수술중 측정한 관상동맥 우회도관 혈류량의 분석)

  • Park, Kye-Hyun;Chae, Hurn;Yun, Yang-Ku;Lee, Jae-Woong;Kim, Kwhan-Mien;Jun, Tae-Gook;Kim, Jhin-Gook;Shim, Young-Mog;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.760-769
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    • 1997
  • This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.

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The Relation between Collateral Circulation and $^{99m}Tc$-MIBI Heart SPECT (심근경색에서 측부순환 유무에 따른 $^{99m}Tc$-MIBI 심근 SPECT 소견)

  • Kim, Jae-Man;Na, Deug-Young;Park, Eun-Kyung;Yang, Hyung-In;Kim, Deog-Yoon;Kang, Heung-Sun;Choue, Chung-Whee;Kim, Kwon-Sam;Kim, Myung-Shick;Song, Jung-Sang;Bae, Jong-Hoa
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.37-43
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    • 1994
  • The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and $^{99m}Tc$-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The patients were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3: 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, $^{99m}Tc$-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with involvement of right coronary artery (RCA). The collateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I. 3) The presence of good collateral channels was more frequently $^{99m}Tc$-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences of left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of $^{99m}Tc$-MIBI reversible perfusion defect.

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Study on Production of In Vitro Embryos and Twin Calves by Embryo Transfer in Korean Native Cattle (한우 체외수정란의 생산과 이식후 쌍자 생산에 관한 연구)

  • 김용권;김진성
    • Korean Journal of Animal Reproduction
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    • v.24 no.1
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    • pp.97-108
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    • 2000
  • The objectives of this study were performed to increase the efficiency of the culture conditions of embryos produced in vitro, and to assess the developmental potential after transfer of those embryos into recipients. The mean number of folliclular oocytes recovered from an ovary was 10.7. The rates of maturation and fertilization in Grade I oocytes were significantly (P<0.05) higher than Graden and III. Developmental rate into blastocyst in the culture group of TCM-199 with BOEC were significantly higher (P<0.05) than the groups of TCM-199 and conditioned medium (24.7% vs. 12.4% and 18.2%). The survivability of post-thawed blastocysts equilibrated for 3 min in EFS solution was significantly (P<0.05) lower than l0 for 1 and 2 min (32.1% vs. 82.9% and 73.3%). Significantly higher (P<0.05) survival rate in blastocysts was seen after freezing than in morulae stage embryos. Out of all 105 recipients, 49 (46.7%) were confirmed in pregnant. On pregnancy of cattle, 48 calves were born from 40 recipients. The ratio of twin and single calves was 30.5% (32/40 and 7.6% (8/40), respectively. However, the others composed of abnormal, as judging as 6 (12.2%) for abortion and 3 (6.1%) for stillbirth during the pregnant period.

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Four months of magnetized water supplementation improves glycemic control, antioxidant status, and cellualr DNA damage in db/db mice (제2형 당뇨 모델 db/db 마우스에서 4개월의 자화수 섭취 후 혈당, 항산화 상태 및 세포 DNA 손상 개선 효과)

  • Lee, Hye-Jin;Kang, Myung-Hee
    • Journal of Nutrition and Health
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    • v.49 no.6
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    • pp.401-410
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    • 2016
  • Purpose: Water is magnetically charged upon contact with a magnet. Although magnetic water products have been promoted since the 1930's, they have not received wide acceptance since their effectiveness is still in question; however, some have reported their therapeutic effects on the body, especially the digestive, nervous, and urinary systems. Methods: In this study, the effect of magnetized water on glycemic control of 14 diabetic mice (CB57BK/KsJ-db/db) in comparison with 10 control mice (CB57BK/KsJ-db/+(db/+)) was investigated. Seven diabetic control (DMC) mice and seven diabetic mice + magnetized water (DM+MW) were kept for 16 weeks, followed by intraperitoneal glucose tolerance test (IPGTT). Weekly blood glucose was measured from tail veins. Blood obtained from heart puncture was used for HbA1c analysis. Results: Blood glucose level showed a significant difference starting from the $10^{th}$ week of study ($496.1{\pm}10.2mg/dl$ in DMC vs. $437.9{\pm}76.9mg/dl$ in DM+MW). Blood glucose followed by IPGTT showed no significant difference between groups at 0, 30, 60, 90, and 120 min, although glucose level at 180 min was significantly reduced in DM+MW mice. Plasma insulin level in DM+MW groups was only 39.5% of that of DMC groups ($5.97{\pm}1.69ng/ml$ in DMC vs. $2.36{\pm}0.94ng/ml$ in DM+MW). Levels of HbA1c were 12.4% and 9.7% in DMC and DM+MW groups, respectively. Conclusion: These results show the promising therapeutic effect of magnetized water in regulating blood glucose homeostasis; however, long-term supplementation or mechanistic study is necessary.

Submucosal CD4+ and CD8+T Lymphocyte Infiltrations in Asthma and Eosinophilic Bronchitis (천식과 호산구성 기관지염에서 CD4, CD8 림프구 침윤)

  • Lee, Sang Yeub;Lee, Sung Yong;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;Kang, Kyung Ho;Yoo, Se Hwa;In, Kwang Ho;Lee, Ji Hye;Jeong, Woon Yong;Kim, Han Kyeom
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.5
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    • pp.459-466
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    • 2003
  • Background : Asthma and eosinophilic bronchitis(EB) are eosinophilic inflammatory diseases of the airway. However, EB differs from asthma in that there is no variable airway obstruction or airway hyper-responsiveness. Pathologically, asthma is characterized by the accumulation of eosinophils and CD4+ T lymphocytes in the submucosa. A recent study showed that there was no significant difference between asthma and EB in terms of the submucosal eosinophil and T lymphocyte count. However, it is not known whether or not an infiltration of CD4+ and CD8+ T lymphocytes occurs in the airways of EB patients. The aim of this study was to identify the difference between the two conditions by measuring the submucosal CD4+ and CD8+ T lymphocyte count. Methods : Immunohistochemical analysis of bronchial-biopsy specimens was performed in 17 subjects with asthma and 24 subjects with EB. Results : The CD4+ T lymphocytes count in the asthma subjects and the EB subjects was similar (median, 58.6 vs 50.0 $cells/mm^2$, respectively; P=0.341). In contrast, the number of CD8+ T lymphocytes in the EB subjects was higher than that in the asthma subjects (median, 46.7 vs 11.8 $cells/mm^2$, respectively; P=0.003). Conclusion : The infiltration of submucosal CD8+ T lymphocytes may be associated with the pathophysiology of EB.

Esophagectomy for Esophageal Cancer in Elderly Patients Over 70 Years of Age (70세 이상의 식도암 환자에시 식도절제술 및 재건술)

  • Song Suk-Won;Lee Hyun-Sung;Kim Moon Soo;Lee Jong Mog;Zo Zae Ill
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.428-433
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    • 2005
  • Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. Material and Method: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. Result: The mean age was 63_4. There were 159 men. On histopathological examination, $93.1\%$ had squamous cell carcinoma. On the locations, $78.7\%$ were in mid and lower esophagus. Curative resections for esophageal cancer were possible in $162(93.1\%)$ patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients $(35.1\%)$. The most frequent morbidity was pulmonary complication in $30(17.2\%)$. Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. Conclusion: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.

Non-typhoidal Salmonella Gastroenteritis in Childhood: Clinical Features and Antibiotics Resistance (소아에서 비장티푸스성 살모넬라 위장관염의 임상양상과 항생제 내성률에 대한 연구)

  • Na, So-Young;Kim, Byung-Chan;Yang, Hye-Ran;Jung, Soo-Jin;Lee, Kyung-Hoon;Ko, Jae-Sung;Lee, Hoan-Jong;Kim, Eui-Chong;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.150-157
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    • 2002
  • Purpose: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we attempted to investigate clinical aspects of non-typhoidal salmonella gastroenteritis and antibiotics resistance. Methods: From January 2000 to June 2002, 99 children with positive stool culture of non-typhoidal salmonella were studied about clinical features, the incidence of antibiotics and multi-drug resistance and the difference of incidence of antibiotics resistance according to immune status. Results: There were 66 males and 33 females. The majority of them were under 5 years of age (71%). 25 children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%) and E (8%). Resistance rate of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim-sulfamethoxazole (TMP-SMX), 11% to cefotaxime and 8% to cefixime were obtained. All isolates were susceptible to ciprofloxacine. Resistance rate to cefotaxime and cefixime in immunocompromised patients was 24% and 14.3% respectively, which were significantly higher compared to that in immunocompetent patients (6.8%, 5.6%, p<0.05). 11 isolates were resistant to three or more antibiotics. The incidence of multi-drug resistant isolates was significantly higher in immunocompromised patients (24%) than that of immunocompetent patients (6.8%). Conclusion: Because of the high prevalence of non-typhoidal salmonella strains resistant to ampicillin, chloramphenicol and TMP-SMX, third-generation cephalosporin might be the treatment of choice in non-typhoidal salmonella gastroenteritis. In particular, antibiotics should be carefully selected in immunocompromised patients because non-typhoidal salmonellas from them showed the higher incidence of antibiotic resistance and multi-drug resistance.

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Validation of Electronic Foot Function Index in Patients with Foot and Ankle Disease: A Randomized, Prospective Multicenter Study (족부 족관절 질환 환자에서 전자식 족부 기능 지수의 인증: 임의 배정, 전향적, 다기관 연구)

  • Lee, Dong Yeon;Kim, Yu Mi;Lee, Jun Hyung;Kim, Jin;Kim, Ji-Beom;Kim, Bom Soo;Choi, Gi Won;Seo, Sang Gyo;Kim, Jun Beom;Park, Se-Jin;Kim, Yoon-Chung;Choi, Young Rak;Lee, Dong-Oh;Cho, Jae-Ho;Chun, Dong-Il;Kim, Hyong Nyun;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.24-30
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    • 2019
  • Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience

  • Soo Yong Lee;Seok Hyun Kim;Min Ho Ju;Mi Hee Lim;Chee-hoon Lee;Hyung Gon Je;Ji Hoon Lim;Ga Yun Kim;Ji Soo Oh;Jin Hee Choi;Min Ku Chon;Sang Hyun Lee;Ki Won Hwang;Jeong Su Kim;Yong Hyun Park;June Hong Kim;Kook Jin Chun
    • Korean Circulation Journal
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    • v.53 no.4
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    • pp.254-267
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    • 2023
  • Background and Objectives: Although the shortage of donor is a common problem worldwide, a significant portion of unutilized hearts are classified as marginal donor (MD) hearts. However, research on the correlation between the MD and the prognosis of heart transplantation (HTx) is lacking. This study was conducted to investigate the clinical impact of MD in HTx. Methods: Consecutive 73 HTxs during 2014 and 2021 in a tertiary hospital were analyzed. MD was defined as follows; a donor age >55 years, left ventricular ejection fraction <50%, cold ischemic time >240 minutes, or significant cardiac structural problems. Preoperative characteristics and postoperative hemodynamic data, primary graft dysfunction (PGD), and the survival rate were analyzed. Risk stratification by Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was performed to examine the outcomes according to the recipient state. Each group was sub-divided into 2 risk groups according to the IMPACT score (low <10 vs. high ≥10). Results: A total of 32 (43.8%) patients received an organ from MDs. Extracorporeal membrane oxygenation was more frequent in the non-MD group (34.4% vs. 70.7, p=0.007) There was no significant difference in PGD, 30-day mortality and long-term survival between groups. In the subgroup analysis, early outcomes did not differ between low- and high-risk groups. However, the long-term survival was better in the low-risk group (p=0.01). Conclusions: The outcomes of MD group were not significantly different from non-MD group. Particularly, in low-risk recipient, the MD group showed excellent early and long-term outcomes. These results suggest the usability of selected MD hearts without increasing adverse events.

MR T2 Map Technique: How to Assess Changes in Cartilage of Patients with Osteoarthritis of the Knee (MR T2 Map 기법을 이용한 슬관절염 환자의 연골 변화 평가)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.298-307
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    • 2009
  • By using the MR T2 map technique, this study intends, first, to measure the change of T2 values of cartilage between healthy people and patients with osteoarthritis and, second, to assess the form and the damage of cartilage in the knee-joint, through which this study would consider the utility of the T2 map technique. Thirty healthy people were selected based on their clinical history and current status and another thirty patients with osteoarthritis of the knee who were screened by simple X-ray from November 2007 to December 2008 were selected. Their T2 Spin Echo (SE hereafter) images for the cartilage of the knee joint were collected by using the T2 SE sequence, one of the multi-echo methods (TR: 1,000 ms; TE values: 6.5, 13, 19.5, 26, 32.5. 40, 45.5, 52). Based on these images, the changes in the signal intensity (SI hereafter) for each section of the cartilage of the knee joint were measured, which yielded average values of T2 through the Origin 7.0 Professional (Northampton, MA 01060 USA). With these T2s, the independent samples T-test was performed by SPSS Window version 12.0 to run the quantitative analysis and to test the statistical significance between the healthy group and the patient group. Closely looking at T2 values for each anterior and lateral articular cartilage of the sagittal plane and the coronal plane, in the sagittal plane, the average T2 of the femoral cartilage in the patient group with arthritis of the knee ($42.22{\pm}2.91$) was higher than the average T2 of the healthy group ($36.26{\pm}5.01$). Also, the average T2 of the tibial cartilage in the patient group ($43.83{\pm}1.43$) was higher than the average T2 in the healthy group ($36.45{\pm}3.15$). In the case of the coronal plane, the average T2 of the medial femoral cartilage in the patient group ($45.65{\pm}7.10$) was higher than the healthy group ($36.49{\pm}8.41$) and so did the average T2 of the anterior tibial cartilage (i.e., $44.46{\pm}3.44$ for the patient group vs. $37.61{\pm}1.97$ for the healthy group). As for the lateral femoral cartilage in the coronal plane, the patient group displayed the higher T2 ($43.41{\pm}4.99$) than the healthy group did ($37.64{\pm}4.02$) and this tendency was similar in the lateral tibial cartilage (i.e., $43.78{\pm}8.08$ for the patient group vs. $36.62{\pm}7.81$ for the healthy group). Along with the morphological MR imaging technique previously used, the T2 map technique seems to help patients with cartilage problems, in particular, those with the arthritis of the knee for early diagnosis by quantitatively analyzing the structural and functional changes of the cartilage.

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