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Comparison of the One-year Follow-up Results after Coronary Bypass Surgery versus Percutaneous Coronary Intervention with Drug-eluting Stents in Patients with Left Main Coronary Artery Disease (좌주간지 병변에 대한 약물방출스텐트시술과 관상동맥우회수술의 1년 추적결과 비교)

  • Choi, Jin-Ho;Lim, Cheong;Park, Kay-Hyun;Chung, Eui-Suk;Chung, Woo-Young;Chae, In-Ho;Choi, Dong-Ju
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.210-215
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    • 2008
  • Background: Drug-eluting stents are contributing to the exponential growth of percutaneous coronary intervention, and even in the patients with left main coronary artery disease, owing to the decreased restenosis rate. Our study aimed at comparing the one-year results after coronary artery bypass grafting versus percutaneous coronary intervention with drug-eluting stents in patients with left main coronary artery disease. Material and Method: Those patients who underwent coronary bypass surgery or stenting at our hospital under the diagnosis of left main coronary artery disease were divided in two groups. The variables for comparison were the preoperative disease severity, the length of the hospital stay, the early mortality and the cumulative incidence of mortality, myocardial infarction and repeated revascularization. Result: There were 101 cases in the surgery group and 78 cases in the stent group. Age, gender, the risk factors, the left ventricular ejection fraction and the proportion of acute coronary syndrome showed no significant differences between the two groups. The surgery group showed a more severe condition according to the Euroscore, a greater incidence of urgency, a longer hospital stay and a greater incidence of multi-vessel disease. The early mortality and one-year cumulative mortality were not different between the groups. The Euroscore-matched comparison for the surgery group (41 patients) and the stent group (78 patients) showed no significant differences in the Euroscore, age, gender, risk factors and the proportion of acute coronary syndrome. The surgery group in the Euroscore-matched comparison showed more multi-vessel disease and a longer hospital stay. The surgery group showed lower early mortality and lower one-year cumulative mortality, but this was statistically insignificant (0% vs 2.6%, respectively, p=0.55; 0% vs 6.6%, respectively, p=0.30). The rates of repeated revascularization and major adverse events (death or myocardial infarct) were lower in the CABG group, but this was not statistically significant (13.3% vs 6.3%, respectively, p=0.48; 10.0% vs 0%, respectively, p=0.09). Conclusion: Percutaneous coronary intervention using drug-eluting stents in low-risk patients with left main coronary artery disease resulted in a shortened length of the hospital stay, as compared with that of the CABG group of patients. However, the patients who underwent percutaneous coronary intervention using drug-eluting stents showed a tendency for an increased rate of repeated revascularization and higher one-year cumulative mortality. Further studies with large populations and longer follow-up will be necessary to reaffirm our findings.

Physio-Ecological Studies on Stevia(Stevia rebaudiana Bertoni) (스테비아(Stevia rebaudiana Bertoni)에 관한 생리 생태적 연구)

  • Kwang-He Kang;Eun-Woong Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.26 no.1
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    • pp.69-89
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    • 1981
  • Stevia (Stevia rebaudiana Bertoni) is a perennial herb widely distributed in the mountainous area of Paraguay. It belongs to the family Compositae and contains 6 to 12 percent stevioside in the leaves. Stevioside is a glucoside having similar sweetening character to surgar and the degree of sweetness is approximately 300 times of sugar. Since Korea does not produce any sugar crops, and the synthetic sweetenings are potentially hazardous for health, it is rather urgent to develop an economical new sweetener. Consequently, the current experiments are conducted to establish cultural practices of stevia, a new sweetening herbs, introduced into Korea in 1973 and the results are summarized as followings: 1. Days from transplanting of cuttings to the flower bud formation of 6 stevia lines were similar among daylengths of 8, 10 and 12 hours, but it was much greater at daylengths of 14 or 24 hour and varietal differences were noticable. All lines were photosensitive, but a line, 77013, was the most sensitive and 77067 and Suweon 2 were less sensitive to daylength. 2. Critical daylength of all lines seemed to be approximately 12 hours. Growth of plants was severely retarded at daylengths less than 12 hours. 3. Cutting were responded to short daylength before rooting. Number of days from transplanting to flower bud formation of 40-day old cuttings in the nursery bed was 20 days and it was delayed as duration of nursery were shorter. 4. Number of days from emergence to flower bud formation was shortest at short day treatment from 20 days after emergence. It was became longer as initiation of short day treatment was earlier or later than 20 days. 5. Plant height, number of branches, and top dry weight of stevia were reduced as cutting date was delayed from March 20 to May 20. The highest yield of dry leaf was obtained at nursery duration of 40-50 days in march 20 cutting, 30-40 days in April 20 cutting, and 30 days in May 20 cutting. 6. An asymptotic relationship was observed between plant population and leaf dry weight. Yield of dry leaf increased rapidly as plant population increased from 5,000 to 10,000 plants/10a with a reduced increasing rate from 10,000 to 20,000 plants/l0a, and levelled off at the plant population higher than 20,000 plants/l0a. 7. Stevia was adaptable in Suweon, Chengju, Mokpo and Jeju and drought was one of the main factors reducing yield of dry leaf. Yield of dry leaf was reduced significantly (approximately 30%) at June 20 transplanting compared to optimum transplanting. 8. Yield of dry leaf was higher in a vinyl house compared to unprotected control at long daylength or natural daylength except at short day treatment at March 20. Higher temperature ill a vinyl house does not have benefital effects at April 20 transplanting. 9. The highest content of stevioside was noted at the upper leaves of the plant but the lowest was measured at the plant parts of 20cm above ground. Leaf dry weight and stevioside yield was mainly contributed by the plant parts of 60 to 120cm above ground but the varietal differences were also significant. 10. Delayed harvest by the time of flower bud formation increased leaf dry weight remarkably. However, there were insignificant changes of yield as harvests were made at any time after flower bud formation. Content of stevioside was highest at the time of flower bud formation and earlier or later harvest than this time was low in its content. The optimum harvesting time determined by leaf dry weight and stevioside content was the periods from flower bud formation to right before flowering that would be the period from September 10 to September 15 in Suweon area. 11. Stevioside and rebaudioside content in the leaves of Stevia varieties were ranged from 5.4% to 14.3% and 1.5% to 8.3% respectively. However, no definit relationships between stevioside and rebaudioside were observed in these particular experiments.

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The Recovery of Left Ventricular Function after Coronary Artery Bypass Grafting in Patients with Severe Ischemic Left Ventricular Dysfunction: Off-pump Versus On-pump (심한 허혈성 좌심실 기능부전 환자에서 관상동맥우회술시 체외순환 여부에 따른 좌심실 기능 회복력 비교)

  • Kim Jae Hyun;Kim Gun Gyk;Baek Man Jong;Oh Sam Sae;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.116-122
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    • 2005
  • Background: Adverse effects of cardiopulmonary bypass can be avoided by 'Off-pump' coronary artery bypass (OPCAB) surgery. Recent studies have reported that OPCAB had the most beneficial impact on patients at highest risk by reducing bypass-related complications. The purpose of this study is to compare the outcome of OPCAB and conventional coronary artery bypass grafting (CCAB) in patients with poor left ventricular (LV) function. Material and Method: From March 1997 to February 2004, seventy five patients with left ventricular ejection fraction (LVEF) of $35\%$ or less underwent isolated coronary artery bypass grafting at our institute. Of these patients, 33 patients underwent OPCAB and 42 underwent CCAB. Preoperative risk factors, operative and postoperative outcomes, including LV functional change, were compared and analysed. Result: Patients undergoing CCAB were more likely to have unstable angina, three vessel disease and acute myocardial infarction among the preoperative factors. OPCAB group had significantly lower mean operation time, less numbers of total distal anastomoses per patient and less numbers of distal anastomoses per patient in the circumflex territory than the CCAB group. There was no difference between the groups in regard to in-hospital mortality $(OPCAB\; 9.1\%\;(n=3)\;Vs.\;CCAB\;9.5\%\;(n=4)),$ intubation time, the length of stay in intensive care unit and in hospital postoperatively. Postoperative complication occurred more in CCAB group but did not show statistical difference. On follow-up echocardiography, OPCAB group showed $9.1\%$ improvement in mean LVEF, 4.3 mm decrease in mean left ventricular end-diastolic dimension (LVEDD) and 4.2 mm decrease in mean left ventricular end-systolic dimension (LVESD). CCAB group showed $11.0\%$ improvement in mean LVEF, 5.1 mm decrease in mean LVEDD and 5.5 mm decrease in mean LVESD. But there was no statistically significant difference between the two groups. Conclusion: This study showed that LV function improves postoperatively in patients with severe ischemic LV dysfunction, but failed to show any difference in the degree of improvement between OPCAB and CCAB. In terms of operative mortality rate and LV functional recovery, the results of OPCAB were as good as those of CCAB in patients with poor LV function. But, OPCAB procedure was advantageous in shortening of operative time and in decrease of complications. We recommend OPCAB as the first surgical option for patients with severe LV dysfunction.

Dosimetric Comparison of One Arc & Two Arc VMAT Plan for Prostate cancer patients (Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석)

  • Kim, Byoung Chan;Kim, Jong Deok;Kim, Hyo Jung;Park, Ho Chun;Baek, Jeong Ok
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.107-116
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    • 2018
  • Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

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The Analysis of Radiation Exposure of Hospital Radiation Workers (병원 방사선 작업 종사자의 방사선 피폭 분석 현황)

  • Jeong Tae Sik;Shin Byung Chul;Moon Chang Woo;Cho Yeong Duk;Lee Yong Hwan;Yum Ha Yong
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.157-166
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    • 2000
  • Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

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Studies on the Germination Characteristics of Sesame (Sesamum indicum L.) (참깨의 발아특성(發芽特性)에 관(關)한 연구(硏究))

  • Kim, Choong Soo
    • Korean Journal of Agricultural Science
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    • v.10 no.1
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    • pp.28-60
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    • 1983
  • This study was carried out to define the effects of external factors including temperature, moisture, oxygen and light quality on the germination of sesame seeds and to investigate the change of major chemical constituents of seeds during germination. The results obtained are summarized as follows: 1. The average germination ratio was from 95.8% to 97.2% when it was tested every $5^{\circ}C$ intervals from $20^{\circ}C$ to $35^{\circ}C$ and no significant difference in germination ratio was found within $20^{\circ}C$ to $35^{\circ}C$. But the germination ratio dropped rapidly to 32.2% when seeds were germinated at $15^{\circ}C$ and the coefficient of variation become greater(77%) 2. The days required for germination ranged from 1.16 to 1. 64 at the temperatures of $35^{\circ}C$ to $25^{\circ}C$ and they were 3.07 and 10.4 at the temperatures of $20^{\circ}C$ and $15^{\circ}C$, respectively. 3. Considering the germination ratio and days needed, $15^{\circ}C$ was assumed to be the minimum temperature for germination practically and this temperature is recommended for testing low temperature tolerance of seed germination of sesame cultivars. 4. The varieties shown the highest low temperature tolerance were Shirogoma and Turkey. The next varieties shown some degree of low temperature germination were Suweon #29, Naebok and IS 58. The varieties with 70 to 80% of germination ratio were Maepo, Suweon #14, Kimpo, Moondeok, and Haenam. Among the 90 varieties tested, the varieties with comparatively high degree of low temperature tolerance were about 10%, and 70% of the low temperature tolerant varieties were domestic varieties. 5. At $12^{\circ}C$ the Shirogoma was the only variety which showed over 50% of germination ratio, 71.4% of the varieties showed less than 20% of germination ratio. When the temperature was raised to $27^{\circ}C$ 18 days after placement at $12^{\circ}C$ all the varieties showed over 90% of germination ratio within 2days. 6. The amounts of water imbibition needed for seed germination were 0.48 to 0.62 times of the seed dry weight at $25^{\circ}C$ and were significantly different among sesame cultivars. About 63% of water required for germination was imbibed in 2 hours after placement of seeds under the germination condition. 7. Under saturated moisture condition the average germination ratio was 0.42%. In the soil of which water potential was -0.4bar 64.8% of the seeds germinated and the most adequate soil water potential for sesame seed germination was about -0.4 to -5.5 bar. The germination ratio decreased as the soil water potential declined below -5.5 bar. 8. Six out of 10 varieties were not influenced by 5% of oxygen in air germination chamber, while varieties such as Yecheon, PI 158073, IS 103 and Euisangcheon showed 64 to 91% of germination under the 5% oxygen content. Under anaerobic condition, cotyledones were not emerged but only hypocotyl was emerged and elongated. The germination ratio of IS 103 decreased significantly under anaerobic condition. 9. When the seeds were dried for 24 hours after 12 hours imbibition of water, the seeds of Cheongsong did not lose their germination ability and 27.5% was germinated but Suweon #9 and Early Russian failed to germinate. However, the germination ratio of IS 103 decreased when the seed were dried 24 hours after 4 hours imbibition of water and the germination ability of IS 103 was maintained even though the seeds were dried for 24 hours after 24 hours imbibition of water. 10. During germination, sugar content of sesame seed increased rapidly and activity of ${\alpha}$-amylase increased gradually while starch content decreased significantly. The rates of increase in sugar content and enzyme activity and decrease in starch content were significantly lower at $15^{\circ}C$ compared with those at $25^{\circ}C$. 11. During germination of sesame seeds, lipid content in the seeds dropped rapidly and the activity of alkaline lipase increased significantly at early stage of germination. The rate of decrease in lipid content and increase in emzyme activity was lower at $15^{\circ}C$ than at $25^{\circ}C$. 12. Four out of 6 varieties were not affected in germination by light wave length. But Suweon #8 was inhibited in germination by 600-650nm. and IS 103 by 600 to 650nm and 500 to 550nm of light wave length. Suweon #8 showed high germination ratio under 650 to 760 nm and 500 to 560nm, and IS 103 under 400 to 470nm and complete darkness. 13. The germination ratios increased significantly in the seeds of which 1000 grain weight is heavier. When the seeds were placed at soil 4cm deep, Cheongsong and Early Russian failed to emerge their cotyledones, but Suweon #9 and IS 103 showed 32.5 and 50% cotyledone emergence, respectively. The extracts from sesame plant and soil where the sesame was cultivated previously did not affect in the-germination of sesame seeds. 14. The covering by black or transparent polyethylene films increased germination ratio compared with uncovered seeds. The covering was effective in shortening the days needed for germination and in improving the early seedling growth, number of capsules per plant and grain yield. Difference was not so seizable between the two polyethylene films but the transparent film appeared somewhat more effective than the black one. 15. Simcheon, Cheongsong. Suweon #9. PI 158073 and IS 103 showed lower rate of water absorbtion by seed during germination and Suweon #8, Suweon #26, Orotall and Euisangcheon showed high increase in seed weight after water absorbtion by seed.

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Studies on nutrient sources, fermentation and harmful organisms of the synthetic compost affecting yield of Agaricus bisporus (Lange) Sing (양송이 수량(收量)에 미치는 합성퇴비배지(合成堆肥培地)의 영양원(營養源), 발효(醱酵) 및 유해생물(有害生物)에 관((關)한 연구(硏究))

  • Shin, Gwan-Chull
    • The Korean Journal of Mycology
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    • v.7 no.1
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    • pp.13-73
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    • 1979
  • These studies were conducted to investigate nutrient sources and supplementary materials of synthetic compost media for Agaricus bisporus culture. Investigation were carried out to establish the optimum composition for compost of Agaricus bisporus methods of out-door fermentation and peakheating with rice straw as the main substrate of the media. The incidence and flora of harmful organisms in rice straw compost and their control were also studied. 1. When rice straw was used as the main substrate in synthetic compost as a carbon source. yields were remarkably high. Fermentation was more rapid than that of barley straw or wheat straw, and the total nitrogen content was high in rice straw compost. 2. Since the morphological and physico-chemical nature of Japonica and Indica types of rice straw are greatly dissimilar. there were apparent differences in the process of compost fermentation. Fermentation of Indica type straw proceeded more rapidly with a shortening the compost period, reducing the water supply, and required adding of supplementary materials for producing stable physical conditions. 3. Use of barley straw compost resulted in a smaller crop compared with rice straw. but when a 50%, barley straw and 50% rice straw mixture was used, the yield was almost the same as that using only rice straw. 4. There were extremely high positive correlations between yield of Agaricus bisporus and the total nitrogen, organic nitrogen, amino acids, amides and amino sugar nitrogen content of compost. The mycerial growth and fruit body formation were severely inhibited by ammonium nitrogen. 5. When rice straw was used as the main substrate for compost media, urea was the most suitable source of nitrogen. Poor results were obtained with calcium cyanamide and ammonium sulfate. When urea was applied three separate times, nitrogen loss during composting was decreased and the total nitrogen content of compost was increased. 6. The supplementation of organic nutrient activated compost fermentation and increased yield of Agaricus bisporus. The best sources of organic nutrients were: perilla meal, sesame meal, wheat bran and poultry manure, etc. 7. Soybean meal, tobacco powder and glutamic acid fermentation by-products which were industrial wastes, could be substituted for perilla meal, sesame meal and wheat bran as organic nutrient sources for compost media. B. When gypsum and zeolite were added to rice straw. physical deterioration of compost due to excess moisture and caramelization was observed. The Indica type of straw was more remarkable in increase of yield of Agricus bisporus by addition of supplementing materials than Japonica straw. 9. For preparing rice straw compost, the best mixture was prepared by 10% poultry manure, 5% perilla meal, 1. 2 to 1. 5% urea and 1% gypsum. At spring cropping, it was good to add rice bran to accelerate heat generation of the compost heap. 10. There was significantly high positive correlation (r=0.97) between accumulated temperature and the decomposition degree of compost during outdoor composting. The yield was highest at accumulated temperatures between 900 and $1,000^{\circ}C$. 11. Prolonging the composting period brought about an increase in decomposition degree and total nitrogen content, but a decrease in ammonium nitrogen. In the spring the suitable period of composting was 20 to 25 days. and about 15 days in autumn. For those periods, the degree of decomposition was 19 to 24%. 12. Compactness of wet compost at filling caused an increase in the residual ammonium nitrogen. methane and organic acid during peak heating. There was negative correlation between methane content and yield (r=0.76)and the same was true between volatile organic acid and yield (r=0.73). 13. In compost with a moisture content range between 69 to 80% at filling. the higher the moisture content, the lower the yield (r=0.78). This result was attributed to a reduction in the porosity of compost at filling the beds. The optimum porosity for good fermentation was between 41 and 53%. 14. Peak heating of the compost was essential for the prevention of harmful microorganisms and insect pests. and for the removal of excess ammonia. It was necessary to continue fer mentatiion for four days after peak heating. 15. Ten species of fungi which are harmful or competitive to Agaricus bisporus were identified from the rice compost, including Diehliomyces microsporus, Trichoderma sp. and Stysanus stemoites. The frequency of occurrance was notably high with serious damage to Agaricus bisporus. 16. Diehliomyces microsporus could be controlled by temperature adjustment of the growing room and by fumigating the compost and the house with Basamid and Vapam. Trichoderma was prevented by the use of Bavistin and Benomyl. 17. Four species of nematodes and five species of mites occured in compost during out-door composting. These orgnanisms could be controlled through peakheating compost for 6 hours at $60^{\circ}C$.

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