• Title/Summary/Keyword: 손상성 지수

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The Clinical Effects of Leukocyte-Depleting Filter on Cardiopulmonary Bypass (체외순환 시 백혈구 제거필터 사용의 임상효과)

  • 박경택;최석철;최국렬;정석목;최강주
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.454-464
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    • 2001
  • Background: It has been recognized that systemic inflammatory reaction and oxygen free radical formed by activated leukocyte in the procedure of cardiopulmonary bypass(CPB) frequently produce postoperative cardiac and pulmonary dysfunction. The purpose of this study was to evaluate the efficacy of leukocyte-depleting filters in the cardiopulmonary bypass circuit for patients undergoing open heart surgery(OHS). Material and method: The study involved 15 patients who underwent OHS with a Leukoguard-6 leukocyte filter placed in the arterial limbs of the bypass circuit(filter group, n=15) and 15 patients who did not have the filter(control group, n=15). We analyzed the differences between the groups in intraoperative changes of peripheral blood leukocyte and platelet counts, pre- and postbypass changes of malondialdehyde(MDA), troponin-T(TnT), 5'-nucleotidase(5'-NT) in coronary sinus blood, spontaneous recovery rate of heart beat after CPB, pre-and postoperative cardiac index(Cl) and pulmonary vascular resistance(PVR), and the amounts of postoperative bleeding and sternal wound complication. Result: During CPB, total leukocyte count of the filter group(9,567$\pm$ 842/㎣) was significantly less than that of the control group(13,573+1,167/㎣) (p<0.01), but there was no significant difference in platelet count between the groups. Postoperative levels of MDA(3.78+0.32 $\mu$mol/L vs 5.86+0.65 $\mu$mo1/L, p<0.01), TnT(0.40$\pm$0.04 ng/mL vs 0.59$\pm$0.08 ng/mL, p<0.05) and 5'-NT(3.88$\pm$0.61 U/L vs 5.80$\pm$0.90 U/L, p<0.05) were all significantly lower in the filter group than the control group. Postoperative Cl was higher in the filter group than the control group(3.26$\pm$0.18 L/$m^2$min vs 2.75$\pm$0.17 L/$m^2$/min, p=0.05). PVR of the filter group was lower than that of the control group(65.87$\pm$7.59 dyne/sec/cm$^{5}$ vs 110.80+12.22 dyne/sec/cm$^{5}$ , p<0.01). Spontaneous recovery rate of heart beat in the filter group was higher than that in the control group(12 patients vs 8 patients, p<0.05). Postoperative wound infection occurred in one case in the filter group and 4 case in the control group(p<0.05). Postoperative 24 hour blood loss of the filter group was more than that of the control group (614$\pm$107 mL vs 380+71 mL, p=0.05).

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Evaluation of the Modified Hybrid-VMAT for multiple bone metastatic cancer (다중표적 뼈 전이암의 하이브리드 세기변조(modified hybrid-VMAT) 방사선치료계획 유용성 평가)

  • Jung, Il Hun;Cho, Yoon Jin;Chang, Won Suk;Kim, Sei Joon;Ha, Jin Sook;Jeon, Mi Jin;Jung, In Ho;Kim, Jong Dea;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.161-167
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    • 2018
  • Purpose : This study evaluates the usefulness of the Modified Hybrid-VMAT scheme with consideration of background radiation when establishing a treatment plan for multiple bone metastatic cancer including multiple tumors on the same axis. Materials and Methods : The subjects of this study consisted of five patients with multiple bone metastatic cancer on the same axis. The planning target volume(PTV) prescription dose was 30 Gy, and the treatment plan was established using Ray Station(Ray station, 5.0.2.35, Sweden). In the treatment plan for each patient, two or more tumors were set as one isocenter. A volumetric modulated arc therapy(VMAT) plan, a hybrid VMAT(h) plan with no consideration of background radiation, and a modified hybrid VMAT(mh) with consideration of background radiation were established. Then, using each dose volume histogram(DVH), the PTV maximum dose($D_{max}$), mean dose($D_{mean}$), conformity index(CI), and homogeneity index(HI) were compared among the plans. In addition, the organ at risk(OAR) of each treatment site was evaluated, and the total MU(Monitor Unit) and treatment time were also analyzed. Results : The PTV $D_{max}$ values of VMAT, VMAT(h) and VMAT(mh) were 3188.33 cGy, 3526 cGy, and 3285.67 cGy, the $D_{mean}$ values were 3081 cGy, 3252 cGy, and 3094 cGy; the CI values were $1.35{\pm}0.19$, $1.43{\pm}0.12$, and $1.30{\pm}0.06$; the HI values were $1.06{\pm}0.01$, $1.14{\pm}0.06$, and $1.09{\pm}0.02$; and the VMAT(h) OAR value was increased 3 %, and VMAT(mh) OAR value was decreased 18 %, respectively. Furthermore, the mean MU values were 904.90, 911.73, and 1202.13, and the mean beam on times were $128.67{\pm}10.97$, $167.33{\pm}7.57$, and $190.33{\pm}4.51$ respectively. Conclusions : Applying Modified Hybrid-VMAT when treating multiple targets can prevent overdose by correcting the overlapping of doses. Furthermore, it is possible to establish a treatment plan that can protect surrounding normal organs more effectively while satisfying the inclusion of PTV dose. Long-term follow-up of many patients is necessary to confirm the clinical efficacy of Modified Hybrid-VMAT.

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Efficacy of Genetic Adjuvant (Plasmid-Expressed Chicken Interleukin-6) and Chemical Adjuvant (Levamisole) on the Protective Immunity of Genetic Vaccine against Infectious Bursal Disease Virus (닭의 전염성 F낭병 바이러스 유전자백신에 의한 방어 면역에 Genetic Adjuvant (Chicken Interleukin-6)와 Chemical Adjuvant (Levamisole)의 효과)

  • Park, Jeong-Ho;Sung, Haan-Woo;Yoon, Byung-Il;Pak, Son-Il;Kwon, Hyuk-Moo
    • Korean Journal of Microbiology
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    • v.45 no.2
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    • pp.91-98
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    • 2009
  • Infectious bursal disease (IBD) caused by the infectious bursal disease virus (IBDV) has an important economic impact on the poultry industry worldwide. This study examined the adjuvant effects of a plasmid encoding chicken interleukin-6 (pcDNA-ChIL-6) and levamisole (LMS) on in ovo prime-boost vaccination using a genetic vaccine (pcDNA-VP243) to prime in chicken followed by a killed-vaccine boost. A pcDNA-VP243 was injected into the amniotic sac alone or in combination with a pcDNA-ChIL-6 or LMS at embryonation day 18, followed by an intramuscular injection of killed IBD vaccine at 1 week of age. The chicken were orally challenged with very virulent IBDV (vvIBDV) strain at 3 weeks of age and observed for 10 days. No mortality was observed in the groups that received the pcDNA-VP243 alone and pcDNA-VP243 plus pcDNA-ChIL-6 or LMS compared to 100% mortality in unvaccinated challenge control group. However, as determined by bursal damage (the presence of IBDV RNA, B/B ratio, and lesion score), a pcDNA-VP243 alone group was superior to pcDNA-VP243 plus pcDNA-ChIL-6 or LMS groups in the protection against post-challenge. These findings suggest that in ovo priming with genetic vaccine and boosting with killed vaccine is an effective strategy for protecting chicken against vvIBDV and the addition of pcDNA-ChIL-6 or LMS did not enhance protective immunity.

Evaluating efficiency of Vertical MLC VMAT plan for naso-pharyngeal carcinoma (비인두암 Vertical MLC VMAT plan 유용성 평가)

  • Chae, Seung Hoon;Son, Sang Jun;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.127-135
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    • 2021
  • Purpose : The purpose of the study is to evaluate the efficiency of Vertical MLC VMAT plan(VMV plan) Using 273° and 350° collimator angle compare to Complemental MLC VMAT plan(CMV plan) using 20° and 340° collimator angle for nasopharyngeal carcinoma. Materials & Methods : Thirty patients treated for nasopharyngeal carcinoma with the VMAT technique were retrospectively selected. Those cases were planned by Eclipse, PO and AcurosXB Algorithm with two 6MV 360° arcs and Each arc has 273° and 350° of collimator angle. The Complemental MLC VMAT plans are based on existing treatment plans. Those plans have the same parameters of existing treatment plans but collimator angle. For dosimetric evaluation, the dose-volumetric(DV) parameters of the planning target volume (PTV) and organs at risk (OARs) were calculated for all VMAT plans. MCSv(Modulation complexity score of VMAT), MU and treatment time were also compared. In addition, Pearson's correlation analysis was performed to confirm whether there was a correlation between the difference in the MCSv and the difference in each evaluation index of the two treatment plans. Result : In the case of PTV evaluation index, the CI of PTV_67.5 was improved by 3.76% in the VMV Plan, then for OAR, the dose reduction effect of the spinal cord (-14.05%) and brain stem (-9.34%) was remarkable. In addition, the parotid glands (left parotid : -5.38%, right : -5.97%) and visual organs (left optic nerve: -4.88%, right optic nerve: -5.80%, optic chiasm : -6.12%, left lens: -6.12%, right lens: -5.26%), auditory organs (left: -11.74%, right: -12.31%) and thyroid gland (-2.02%) were also confirmed. The difference in MCSv of the two treatment plans showed a significant negative (-) correlation with the difference in CI (r=-0.55) of PTV_54 and the difference in CI (r=-0.43) of PTV_48. Spinal cord (r=0.40), brain stem (r=0.34), and both salivary glands (left: r=0.36, right: r=0.37) showed a positive (+) correlation. (For all the values, p<.05) Conclusion : Compared to the CMV plan, the VMV plan is considered to be helpful in improving the quality of the treatment plan by allowing the MLC to be modulated more efficiently

Allium hookeri Extract Improves Type 2 Diabetes Mellitus in C57BL/KSJ Db/db Obese Mouse via Regulation of Hepatic Lipogenesis and Glucose Metabolism (삼채 추출물의 인슐린 저항성 개선 효과 및 기전 탐색)

  • Kim, Ji-Soo;Heo, Jin-Sun;Choi, Jong-Won;Kim, Gun-Do;Sohn, Kie-Ho
    • Journal of Life Science
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    • v.25 no.10
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    • pp.1081-1090
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    • 2015
  • Diabetes has been one of major health risks in industrialized countries. Allium hookeri is a wild herb distributed in India and Myanmar. The root of the plant has been used as food and medicine in Southeast Asia. We investigated Allium hookeri extract improves type 2 diabetes mellitus in C57BL/KSJ db/db obese mouse. C57BL/KSJ db/db obese mouse arise out of Type 2 diabetes and we treated Allium hookeri methanol extract 400 mg/kg (AH 400), 800 mg/kg (AH 800), positive control group (thiazolidinedine;TZDs) were administered orally for 8weeks. AH treated group normalized lipid enzyme system (triglyceride, total cholesterol, HDL-cholesterol and LDL-cholesterol) and serum glucose, HbA1c and plasma insulin level. AH treated group recovered β-cell damage by hyperglycemia and fatty liver disease. AH treated group significantly up regulated expression of Peroxisome proliferator-activated receptor gamma (PPAR-γ), pyruvate dehydrogenase kinase4 (PDK4), Sterol regulatory element-binding protein 1c (SREBP 1) and fork head box O1 (FOX 01) proteins in C57BL/KSJ db/db obese mouse liver. And we found that AH treated group decreased hepatic malondialdehyde formation in C57BL/KSJ db/db obese mouse liver. These results indicate that Allium hookeri methanol extract might be a potential anti-diabetic agent and could be useful in the treatment of type 2 diabetes mellitus.

Anti-hyperlipidemic and anti-obesity effects of Sparassis latifolia fruiting bodies in high-fat and cholesterol-diet-induced hyperlipidemic rats (고지방과 고콜레스테롤 식이 급여에 의해 고지혈증이 유도된 흰쥐에서 꽃송이버섯 자실체의 항고지혈증과 항비만 효과)

  • Im, Kyung-Hoan;Baek, Seung-A;Choi, Jaehyuk;Lee, Tae-Soo
    • Journal of Mushroom
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    • v.19 no.1
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    • pp.23-32
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    • 2021
  • This study investigated the anti-hyperlipidemic and anti-obesity effects of Sparassis latifolia (S. latifolia) fruiting body powder in rats fed with a high fat and cholesterol diet (HFD). Rats were fed a normal control diet (ND), an HFD, an HFD supplemented with 5% fruiting body powder of S. latifolia (HFD+SL), or an HFD supplemented with 0.03% simvastatin (HFD+SS), for 6 weeks. The HFD group demonstrated considerable increase in body weight gain, the food efficiency ratio (FER), and plasma cholesterol and triglyceride levels, compared to the ND group. In contrast, the HFD+SL and HFD+SS groups showed significantly reduced body weight gain, food intake, and plasma cholesterol and triglyceride levels compared to the HFD group. In particular, the HFD+SL and HFD+SS diets significantly suppressed the occurrence of non-alcoholic fat deposits in the liver. Taken together, these results suggest that dietary supplementation of the fruiting body powder of S. latifolia in an HFD could lower the risks of hyperlipidemia, atherogenesis, and obesity and may be used as a functional food to manage cardiovascular disease and fecal lipid and cholesterol levels.

Analysis of Factors for Cartilage Regeneration in Patients Who Underwent High Tibial Osteotomy Combined with Microfracture (근위 경골 절골술과 미세 골절술을 함께 시행 받은 환자 군에서 연골 재생에 영향을 미치는 요인에 대한 분석)

  • Lee, Young Min;Song, Eun-Kyoo;Oh, Ho-Seok;Kim, Yu-Seok;Seon, Jong-Keun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.404-412
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    • 2021
  • Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm2) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.

The efficacy of continuous positive airway pressure (CPAP) for patient with left breast cancer (좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가)

  • Jung, Il Hun;Ha, Jin Sook;Chang, Won Suk;Jeon, Mi Jin;Kim, Sei Joon;Jung, Jin Wook;Park, Byul Nim;Shin, Dong Bong;Lee, Ik Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.2
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    • pp.43-49
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    • 2019
  • Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

Effect of Cryopreservation by Slow and Rapid Freezing on the Sperm Motility Index, Viability and Morphology of Post-thaw Human Spermatozoa (인간 정자의 완만.급속 동결보존 방법이 융해 후 정자 운동성 지수와 생존율 및 정자 형태에 미치는 영향)

  • 김은국;김정욱;김형우
    • Journal of Embryo Transfer
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    • v.18 no.1
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    • pp.43-50
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    • 2003
  • The objective of this study was to investigate the effect of cryopreservation by slow and rapid freezing on the sperm motility index, viability and morphology of post-thaw human spermatozoa. After rapid freezing and thawing, sperm motility index was significantly higher (MOT:47.40$\pm$20.06%, VCL : 38.12$\pm$15.58 $\mu$m/s, VSL : 28.19$\pm$14.10 $\mu$m/s, VAP:33.64$\pm$15.15 $\mu$m/s, and HYP 2.77$\pm$2.71%) than slow freezing and thawing(MOT : 43.39$\pm$ 18.79%, VCL .33.91 $\pm$ 13.50 Um/s, VSL . 19.98$\pm$0.88 $\mu$m/s, VAP : 24.60$\pm$11.72 $\mu$m/s, and HYP . 1.33$\pm$1.57% ; P<0.05). But sperm Linearity(LIN) was significantly lower(28.83 $\pm$ 10.35) comparing to the slow freezing method(34.64 $\pm$ 11.36 ; P<0.05). On the other hand, significant difference were not observed MAD, WOB, DNC and DNM by slow and rapid frozen-thawed methods. After rapid freezing and thawing, sperm viability was lower(60 $\pm$ 2.2%) than slow freezing method(62 $\pm$2.1%) and sperm morphology was higher(46$\pm$7.7%) than that(44: 8.3). But there was no significantly These results indicate that rapid freezing method was positive effect of sperm cryopreservation in human.

The Effect of Korean Soysauce and Soypaste Making on Soybean Protein Quality Part II. Chemical Changes During Meju-brine Ripening (재래식 간장 및 된장 제조가 대두 단백질의 영양가에 미치는 영향 제2보 메주장의 숙성중에 일어나는 성분 변화)

  • Lee, Cherl-Ho
    • Korean Journal of Food Science and Technology
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    • v.8 no.1
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    • pp.19-32
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    • 1976
  • The laboratory Mejus as well as home-made Meju and improved Meju received from Korea were ripened in the brine for up to 8 months and the changes is the chemical composition during the process were determined and the differences between the types of Meju were compared. On the basis of the amino acid pattern, the changes in the protein quality of soybean during the process was evaluated. No significant changes in the general chemical composition of Meju were noticed during the ripening for 8 months. However, the nitrogen solubility of Meju increased for $13{\sim}29%$ to $66{\sim}78%$ during 8 month ripening of the Meju-brine mixture. The concentration of free amino-N to the total-N increased from $4{\sim}7%$ in Meju to $29{\sim}35%$ in the 8month ripened mixture. The concentration of amino-N to the total-N increased from $1{\sim}4%$ in Meju to $5{\sim}14%$ in the 8month ripened mixture and the changes varied with the type of Meju used. Remarkable changes in the amino acid pattern of soybean were occured during the ripening process. The concentration of methionine decreased to the half of original Meju during the first month of ripening. Arginine and histidine were destroyed rapidly by the ripening longer than 1 month. A considerable amount of ornithine was synthesized during the ripening. The amino acid pattern of Meju did change drastically during the ripening longer than 3 months and the changes varied with the type of Meju. The retention of the nutrients in soybean during 8 month ripening of the laboratory 3 month Meju in the brine was 49% for carbohydrates, 107% for crude fat, 93% for crude protein and 74% for the total amino acid. Histidine, arginine and methionine and 74% for the total amino acid. Histidine, arginine and methionine were the most damaged during the process, retaining only 25%, 27% and 49% of the contents in raw soybean, respectively, whereas lysine retained 79%. By the separation of the 8 month ripened mixture, approximately 60% of crude protein, all of crude fat and 80% of carbohydrates in the mixture were retained in soypaste. Soypaste contained higher concentrations of amino acids per 16gN compared to soysauce, except for lysine. The most limiting amino acid of the protein was the S-containing amino acids in all cases studied, whereas the second limiting amino acid varied from valine in soybean to threonine in most of Mejus and the brine mixtures, lysine in most of soypastes and tryptophan in some of soysauces. According to the protein quality evaluation made by the reference of the FAO provisional pattern of amino acid, the chemical score of raw soybean was 82, which was reduced to 77 by cooking and further reduced to $71{\sim}74$ by Meju fermentation. At the eighth month of ripening the chemical score of the Meju-brine mixtures were reduced to $51{\sim}66. After the separation, the chemical score of soypaste ranged from 60 to 71, whereas that of soysauce varied from 45 to 57. Generally, the products made from improved Meju recorded the highest score, whereas those made from homemade Meju showed the poorest protein quality. The essential amino acid index(EAAI) of the samples was similar to the chemical score, but it appeared to fit the overall changes in the amino acid pattern during the process better than the chemical score.

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