• KSBB Journal
• /
• v.22 no.5
• /
• pp.297-304
• /
• 2007

For large and rapid screening of high-yielding mutants of lovastatin produced by filamentous fungal cells of Aspergillus terreus, one of the most important stage is to test as large amounts of mutated strains as possible. For this purpose, we intended to develop a miniaturized cultivation method using $7m{\ell}$ culture tube instead of traditional $250m{\ell}$ flask (working volume $50m{\ell}$). For obtaining large amounts of conidiospores to be used as inoculums for miniaturized cultures, 4 components i.e., glucose, sucrose, yeast extract and $KH_2PO_4$ were intensively investigated, which had been observed to show positive effect on enhancement of spore production through Plackett-Burman design experimet. When optimum concentrations of these components that were determined through application of response surface method (RSM) based on central composite design (CCD) were used, maximum spore numbers amounting to $1.9\times10^{10}$ spores/plate were obtained, resulting in approximately 190 fold increase as compared to the commonly used PDA sporulation medium. Using the miniaturized cultures, intensive strain development programs were carried out for screening of lovastatin high-yielding as well as highly reproducible mutants. It was observed that, for maximum production of lovastatin, the producers should be activated through 'PaB' adaptation process during the early solid culture stage. In addition, they should be proliferated in condensed filamentous forms in miniaturized growth cultures, so that optimum amounts of highly active cells could be transferred to the production culture-tube as reproducible inoculums. Under these highly controlled fermentation conditions, compact-pelleted morphology of optimum size (less than 1 mm in diameter) was successfully induced in the miniaturized production cultures, which proved essential for maximal utilization of the producers' physiology leading to significantly enhanced production of lovastatin. As a result of continuous screening in the miniaturized cultures, lovastatin production levels of the 81% of the daughter cells derived from the high-yielding producers turned out to be in the range of 80%$\sim$120% of the lovastatin production level of the parallel flask cultures. These results demonstrate that the miniaturized cultivation method developed in this study is efficient high throughput system for large and rapid screening of highly stable and productive strains.

• KSBB Journal
• /
• v.22 no.5
• /
• pp.288-296
• /
• 2007

Monascus pilosus (KCCM 60160) in submerged culture was optimized based on culture medium and fermentation conditions. Monacolin-K (Iovastatin), one of the cholesterol lowing-agent which was produced by Monascus pilosus may maintain a healthy lipid level by inhibiting the biosynthesis of cholesterol. Plackett-Burman design and response surface method were employed to study the culture medium for the desirable monacolin-K production. As a result of experimental designs, optimized production medium components and concentrations (g/L) were determined on soluble starch 96, malt extract 44.5, beef extract 30.23, yeast extract 15, $(NH_4)_2SO_4$ 4.03, $Na_2HPO_4{\cdot}12H_2O$ 0.5, L-Histidine 3.0, $KHSO_4$ 1.0, respectively. Monacolin-K production was improved about 3 times in comparison with shake flask fermentation of the basic production medium. The effect of agitation speed (300, 350, 400 and 450 rpm) on the monacolin-K production were also observed in a batch fermenter. Maximum monacolin-K production with the basic production medium was 68 mg/L when agitation speed was 500 rpm. And it was found that all spherical pellets (average diameter of $1.0{\sim}1.5mm$) were dominant during fermentation. Based on the results, the maximum production of 185 mg/L of monacolin-K with the optimized production medium was obtained at pH (controlled) 6.5, agitation rate 400 rpm, aeration rate 1 vvm, and inoculum size 3%.

• The korean journal of orthodontics
• /
• v.28 no.2 s.67
• /
• pp.297-310
• /
• 1998

The purpose of this study was to investigate the initial tissue change, to repair on the teeth & surrounding tissue under the intrusive orthodontic forces by use of elastic chain, through the microscopic findings. For this study, three young adult mongrel dogs were used, and were divied into three group : the control group was deliveried only casting crown and the experimental group 1 was equipped with energy chain during 1 week and experimental 2 group was deliveried using energy chain during 1 week and 3 weeks observation. All experimental groups and control groups were sacrificed to make the samples for microscopic findings on premolar teeth. All samples were examed and compared the histologic changes through the microscopic with H-E stain. The obtained results were as follows. 1. In hematoxylin-eosin stain of the control group, the periodontal ligament was constant width from apical third to cervical third of the root, and the periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle and apical third of the root. 2. In Masson Trichrome stain of the control group, osteoblast and osteoclast appeared in cervical third of root, and bone resorption and new bone formation was observed in middle and apical third of the root. 3. In experimental 1, osteoclasts were increased highly, and hyperemia of blood vessels and new bone formation and bone resorption by reversal line in apical third of the root were seen. PDL width was increased apprarently from crest to apex of the root and more in apical third. 4. In experimental 2, osteoclasts and hyperemia of blood vessels were more increased than control material in apical third of the root. PDL width was increased more than control group in root apex, and was seen less than experimental 1. PDL arrangement was similar to experimental 1 and was mixed only in root apex. Therefore, in premolar intrusion of the young adult dog, there were increased osteoclast, hyperemia and dilation of blood vessel, resorption of alveolar bone and cementum and different arrangement of PDL in initial tissue change. There was not observed complete repair after remove intrusive force.

• Journal of agricultural medicine and community health
• /
• v.27 no.2
• /
• pp.127-136
• /
• 2002

This study was taken to provide data for the approaches of day care service for the elderly in community health practitioner's post through the study on the utilization rate, characteristics and health promotion that the elderly used the day care services. Data collection used three records that case management in take sheet, dementia check list and ADL record during the one year, from June 21, 2001 to June 30, 2002. During the one year, the elderly used day care services were 119 persons that 26.9% of the total elderly population, 1.5 time per used the elderly, and female elderly(88.9%) more used than male elderly. 39.5%of the elderly user have chronic diseases that was arthritis and hypertension and etc. 41.2% of the elderly users have dementia state that score was $17.39{\pm}7.17$(handicapped elderly), $18.43{\pm}7.36$(healthy elderly), but statistically not significant PADL score was $2.18{\pm}0.55$(handicapped elderly), $2.78{\pm}0.30$(healthy elderly), IADL score was $1.78{\pm}0.51$(handicapped elderly), $2.47{\pm}0.60$(healthy elderly) that were statistically significant. One year later, PADL and IADL of the elderly users were improved that statistically significant(p=0.01). The elderly users were wanted rehabilitation service(22.2%), talking service(20.6%), bath service(12.7%), food service(9.5%) of day care services in CHP's post. We are recommended that day care service for the elderly in CHP's post was very useful and contributed to promote ADL functions.

• Journal of Aquaculture
• /
• v.11 no.1
• /
• pp.11-17
• /
• 1998

Variations of hepatocyte in the larval liver of grouper, Epinephelus akaara wre examined to understand the effect of starvation during the first feeding period, 3 to 5 days after hatching. Total length of the fed larvae increased from the 5th day after hatching, although no significant difference between the fed and starved larvae was found untill the 4th day after hatching. Survival rate of the starved larvae decreased from the 4th day after hatching, and almost all of the larvae died by the 5th day after hatching. Nuclear size of hepatocyte in the starved larvae starterd to decrease from the 4th day after hatching. The sizes by 4th and 5th days after hatching in the starved larvae were 1.4 to 1.9 times smaller than those in the fed ones. Hepatocytes in the starved larvae showed irregular morphology in which the nuclei were irregularly shrunk and highly compacted from the 4th day, while hepatocyte nuclei in the fed ones maintained their uniform features during the whole experimental period. These results implied that the initial larval food should be supplied at least within the 4th day after hatching. Also, it suggested that the size of hepatocyte nucleus might be and indicator of starvation for wild and cultured grouper larvae.

• Journal of Gastric Cancer
• /
• v.5 no.2
• /
• pp.95-100
• /
• 2005

Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

• Tuberculosis and Respiratory Diseases
• /
• v.52 no.6
• /
• pp.608-615
• /
• 2002

Background : ADA is an enzyme found in most cells, and is involved in purine metabolism, but its chief role concerns the proliferation and differentiation of lymphocytes, especially T-lymphocytes. For that reason ADA has been looked on as a marker of cell-mediate immunity, which is the key mechanism of the tuberculous pleural effusion. Thus, the pleural fluid ADA activity is increased in the tuberculous pleural effusion. Age associated immune decline is characterized by decreases in both B and T-lymphocyte function and the former may be largely a result of the latter. Therefore, the pleural fluid ADA activity would be lower in old rather than in young, patients with tuberculous pleural effusion. We studied the relationship between age, and pleural fluid ADA activity, in patients with tuberculous pleural effusion. Materials and Methods : In the 46 patients with tuberculous pleural effusion enroll in this study, the pleural fluid ADA activities were measured by means of an automated kinetic method. Results : The mean age of the patients was $53.0{\pm}22.0$ years, with a male to female ratio of 30:16. The patients were divided into two groups, young patients, regarded as < 65 and old regarded as ${\geq}65$ years with 28 and 18 patients, respectively. The pleural fluid ADA activity in both groups show significant differences : $99.4{\pm}22.6$ IU/L(young patients) Vs. $75.8{\pm}30.9$ IU/L(old patients)(p<0.05), but a negative correlation with age (r=-0.311, p<0.05). Conclusion : Although pleural fluid ADA activity was not adequately increased, tuberculous pleural effusion, in older patients, would have to be considered clinically suspicious tuberculous pleural effusion.

• Progress in Medical Physics
• /
• v.25 no.1
• /
• pp.53-63
• /
• 2014

The objective of this study is to investigate the difference of ITV lengths and ITVs between 4DCT and Slow-CT images according to respiratory patterns using a respiratory motion phantom. The respiratory periods 1~4 s and target motion 1~3 cm were applied on each respiratory pattern. 4DCT and Slow-CT images were acquired for 3 times. 4DCT and Slow-CT ITVs were measured with contouring the target in the Eclipse RTP system. The measured ITV lenghts and ITVs in 4DCT and Slow-CT images were compared to the known values. For the ITV lengths and ITVs in the 4DCT, the difference of them were reduced as the respiratory period is longer and target motion is shorter. For the Slow-CT, there was same tendency with change in 4DCT ITV lengths and ITVs about target motion. However, the difference of ITV lengths and ITVs for the respiratory periods were the lowest in respiratory period 1 second and different slightly within respiratory period 2-4 seconds. According to the respiratory patterns, pattern A had the highest reproducibility. Pattern B, C and D were showed the difference similar to each other. However, for pattern E, the reproducibility was the lowest compared with other four patterns. The difference of ITV lengths and ITVs between Slow-CT and 4DCT was increased by increasing the respiratory periods and target motion for all respiratory patterns. When the difference of Slow-CT ITV lengths and ITVs were compared with that of 4DCT ITV lengths and ITVs, Slow-CT ITV lengths and ITVs were approximately 22 % smaller than 4DCT, and the representations of target were different in each pattern. In case of pattern A, B and C, length difference was 3 mm at S (superior) and I (inferior) direction, and the length difference of pattern D was 1.45 cm at only "I" direction whereas the length difference of pattern E was 5 mm longer in "S" direction than "I" direction. Therefore, the margin in SI directions should be determined by considering the respiratory patterns when the margin of Slow-CT is compensated for 4DCT ITV lengths. Afterward, we think that the result of this study will be useful to analyze the ITV lengths and ITVs from the CT images on the basis of the patient respiratory signals.

• Clinical and Experimental Pediatrics
• /
• v.49 no.8
• /
• pp.851-856
• /
• 2006

Purpose : The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants. Methods : Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase of premature infants with total parenteral nutrition induced cholestasis were measured for comparison and analysis of their correlation. Results : Changes of serum bile acid analysis after birth showed no significant difference between boys and girls, between premature infants and term infants without cholestasis. Serum bile acid levels are constant after two weeks after birth in neonates without cholestasis. In premature infants with total parenteral nutrition induced cholestasis, the increase of serum direct bilirubin over 2 mg/dL was $34.9{\pm}18.3$ days after birth, and the increase of serum bile acid was $28.1{\pm}18.3$ days. Its increase was about 1 week faster than serum direct bilirubin, however, there was no statistical significance(P=0.114). Comparing analysis of serum bile acid, ${\gamma}$-glutamic acid transferase, and alkaline phosphatase, serum bile acid showed the highest correlation to serum direct bilirubin(r=0.487, P=0.000). Conclusion : Serum bile acid is an important parameter of total parenteral nutrition induced cholestasis in premature infants and will be useful for early diagnosis and treatment.

• The Korean Society of Law and Medicine
• /
• v.18 no.2
• /
• pp.163-194
• /
• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.