• Title/Summary/Keyword: 임상적 결과

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Application of a Single-pulsatile Extracorporeal Life Support System for Extracorporeal Membrane Oxygenation -An experimental study - (단일 박동형 생명구조장치의 인공폐 적용 -실험연구-)

  • Kim, Tae-Sik;Sun, Kyung;Lee, Kyu-Baek;Park, Sung-Young;Hwang, Jae-Joon;Son, Ho-Sung;Kim, Kwang-Taik;Kim. Hyoung-Mook
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.201-209
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    • 2004
  • Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47$\pm$ 10 and 41 $\pm$ 9 mmHg) than the nonpulsatile group 1 (17 $\pm$ 7 mmHg, p<0.001). The intra-circuit pressure at membrane oxygenator were 222 $\pm$ 8 mmHg in group 1, 739 $\pm$ 35 mmHg in group 2, and 470 $\pm$ 17 mmHg in group 3 (p<0.001). At 2 hour bypass, arterial oxygen partial pressures were significantly higher in the pulsatile group 2 & 3 than in the non-pulsatile group 1 (77 $\pm$ 41 mmHg in group 1, 96 $\pm$ 48 mmHg in group 2, and 97 $\pm$ 25 mmHg in group 3: p<0.05). The levels of plasma free hemoglobin which was an indicator of blood cell trauma were lowest in group 1, highest in group 2, and significantly decreased in group 3 (55.7 $\pm$ 43.3, 162.8 $\pm$ 113.6, 82.5 $\pm$ 25.1 mg%, respectively; p<0.05). Other laboratory findings for blood profile were not different. The above results imply that the pulsatile blood pump is beneficial in oxygenation while deleterious in the aspects to high pressure generation in the circuits and blood cell trauma. However, when a pressure-relieving compliance chamber is applied between the pulsatile pump and a membrane oxygenator, it can significantly reduce the high circuit pressure and result in low blood cell trauma.

Suggestion of Learning Objectives in Social Dental Hygiene: Oral Health Administration Area (사회치위생학의 학습목표 제안: 구강보건행정 영역)

  • Park, Su-Kyung;Lee, Ga-Yeong;Jang, Young-Eun;Yoo, Sang-Hee;Kim, Yeun-Ju;Lee, Sue-Hyang;Kim, Han-Nah;Jo, Hye-Won;Kim, Myoung-Hee;Kim, Hee-Kyoung;Ryu, Da-Young;Kim, Min-Ji;Shin, Sun-Jung;Kim, Nam-Hee;Yoon, Mi-Sook
    • Journal of dental hygiene science
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    • v.18 no.2
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    • pp.85-96
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    • 2018
  • The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into 'dental hygiene job relevance', 'dental hygiene competency relevance', 'timeliness', and 'value discrimination of educational goal setting' to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.

Hypoglycemic and Antioxidative Effects of Fermented Chaga Mushroom (Inonotus obliquus) on Streptozotocin-induced Diabetic Rats (Streptozotocin 유발 당뇨쥐에서 발효 차가버섯의 항당뇨 및 항산화 효과)

  • Cha Jae-Young;Jun Bang-Sil;Lee Chi-Hyeoung;Yooi Ki-Soo;Moon Jae-Chul;Cho Young-Su
    • Journal of Life Science
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    • v.15 no.5 s.72
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    • pp.809-818
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    • 2005
  • The effects of fermented chaga mushroom (Inonotus obliquus) on the concentrations of serum glucose, insulin, lipids and lipid peroxidation in streptozotocin (STZ)-induced diabetic rats were investigated. Rats were fed a semisynthetic diet supplemented with 50 g/kg chaga mushroom powder (the CM group) and fermented chaga mushroom powder (the FCM group), and no supplemented (the control group) for 3 weeks. The polysaccharide concentrations were CM by $42.9\%$ and FCM by $ 39.1\%$, and the total polyphenol concentrations were CM by $ 0.80\%$ and FCM by $0.91\%$. Feed intakes and water consumption, serum glucose, insulin, triglyceride, and blood urea nitrogen concentrations were significantly lower in the FCM group than in both the CM and control groups. The activities of AST and ALT were also significantly lower in the FCM group than in the control group. No significant differences were detected with regard to the serum cholesterol and creatinine concentrations among the experimental groups. Lipid peroxidations in hepatic homogenate, microsomal and mitochondrial subcellular and pancreas were significantly lowered by the administration of FCM in the STZ-diabetic rats. Hepatic glutathione concentrations, which is closely associated with antioxidant system, was significantly higher in the FCM group than in the control group, indicating a marked effect of FCM administration on the endogenous antioxidant system. However, CM treatment showed a moderate antioxidative activity in the STZ-diabetic rats. Our results indicate that fermented chaga mushroom exert hypoglycemic and antioxidative effects in type 1 diabetes mellitus.

Reviews of Radiation Protection and Shielding for Computed Tomography in Foreign Countries (외국의 컴퓨터 단층촬영 장치의 방어시설 문헌 조사)

  • Jahng, Geon-Ho;Yang, Dal-Mo;Sung, Dong-Wook;Lee, Kwang-Yong;Kim, Hyeog-Ju
    • Progress in Medical Physics
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    • v.19 no.4
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    • pp.276-284
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    • 2008
  • A computed tomography (CT) is a powerful system for the effectively fast and accurate diagnosis. The CT system, therefore, has used substantially and developed for improving the performance over the past decade, resulting in growing concerns over the radiation dose from the CT. Advanced CT techniques, such as a multidetector row CT scanner and dual energy or dual source CT, have led to new clinical applications that could result in further increases of radiation does for both patients and workers. The objective of this study was to review the international guidelines of the shielding requirements for a CT facility required for a new installation or when modifying an existing one. We used Google Search Engine to search the following keywords: computed tomography, CT regulation or shield or protection, dual energy or dual source CT, multidetector CT, CT radiation protection, and regulatory or legislation or regulation CT. In addition, we searched some special websites, that were provided for sources of radiation protection, shielding, and regulation, RSNA, AAPM, FDA, NIH, RCR, ICRP, IRPA, ICRP, IAEA, WHO (See in Table 1 for full explanations of the abbreviations). We finally summarized results of the investigated materials for each country. The shielding requirement of the CT room design was very well documented in the countries of Canada, United States of America, and United Kingdom. The wall thickness of the CT room could be obtained by the iso-exposure contour or the point source method. Most of documents provided by international organizations were explained in importance of radiation reduction in patients and workers. However, there were no directly-related documents of shielding and patient exposure dose for the dual energy CT system. Based international guidelines, the guideline of the CT room shielding and radiation reduction in patients and workers should be specified for all kinds of CT systems, included in the dual energy CT. We proposed some possible strategies in this paper.

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Evaluation of Difference between Skin Motion and Tumor Motion for Respiration Gated Radiotherapy (호흡조절방사선치료를 위한 피부움직임과 종양움직임 차이 평가)

  • Kwon, Kyung-Tae;Lim, Sang-Wook;Park, Sung-Ho;Kwon, Soo-Il;Shin, Sung-Soo;Lee, Sang-Wook;Ahn, Seung-Do;Kim, Jong-Hoon;Choi, Eun-Kyung
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.14-20
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    • 2008
  • Accounting for tumor motion in treatment planning and delivery is one of the most recent and significant challenges facing radiotherapy. The purpose of this study was to investigate the correlation and clarified the relationship between the motion of an external marker using the Real-Time Position Management (RPM) System and an internal organ motion signal obtained fluoroscope. We enrolled 10 patients with locally advanced lung cancer and liver cancer, retrospectively. The external marker was a plastic box, which is part of the RPM used to track the patient's respiration. We investigated the quantitatively correlation between the motions of an external marker with RPM and internal motion with fluoroscope. The internal fiducial motion is predominant in the caraniocaudal direction, with a range of $1.3{\sim}3.5cm$ with fluoroscopic unit. The external fiducial motion is predominant in the caraniocaudal direction, with a range of $0.43{\sim}2.19cm$ with RPM gating. The two measurements ratio is from 1.31 to 5.56. When the regularization guided standard deviation is from 0.08 to 0.87, mean 0.204 cm, except only for patients #3 separated by a mean 0.13 cm, maximum of 0.23 cm. This result is a good correlation between internal tumor motion imaged by fluoroscopic unit and external marker motion with RPM during expiration within 0.23 cm. We have demonstrated that gating may be best performed but special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct phase difference alone would not guarantee that the entire tumor volume is within the treatment field.

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A FEM comparison study about the force, displacement and initial stress distribution on the maxillary first molars by the application of Asymmetric Head-Gears with the different traction forces (Asymmetric Head-Gear의 견인력의 차이에 따른 상악 제 1 대구치에 나타나는 힘과 변위 및 초기 응력분포에 관한 유한요소법적 비교 연구)

  • Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.31 no.3 s.86
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    • pp.311-323
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    • 2001
  • One of the various mechanics used to treat unilateral Class II malocclusion is head gear with asymmetric face bow. We made the finite element models of unilateral Class II maxillary dental arch and power arm asymmetric face bow. We designed this experiment to observe stress distribution of periodontal ligament, reaction force, and displacement and to understand force system, so to predict the therapeutic effect. On the basis of computerized tomograph of maxillary dental arch of 25 years old male with normal occlusion without extraction and orthodontic treatment history, we made finite element models of maxillary dental arch and periodontal ligament. Then we modified that model to unilateral maxillary Class II malocclusion model of which maxillary left molar displaced mesially. Also, We made finite element model of asymmetric face bow of which right outer bow shorter than left by 25mm(RMO, Penta-FormTM/Medium size, 0.045 inch iner bow, 0.072 inch outer bow). After that, retraction force of 250g, 300b, 350g were applied to maxillary first molar. We concluded as follow. 1. The Net force that both maxillary first molars were received increased as the retraction force increased. Mesially positioned tooth received more force than normally positioned tooth. But, both tooth were received distal force, so distal movement occured. 2. Both tooth received buccal lateral force. In analysis of force element, as the retraction force were increased, force of X-axis at mesially positioned tooth decreased, and force of X-axis at normally positioned tooth increased. so lateral force component moved to the side received less force from more force. 3. There were rotation, tipping with distal movement in maxillary first molar. As retraction force were increased, rotation and tipping also increased. More tipping and rotation occured at the side received more force, that is, mesially positioned tooth. Though it Is small change, displacement of same pattern occur in normally positioned tooth

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A STUDY ON PROFILE CHANGE OF SKELETAL CLASS III MALOCCLUSION PATIENTS AFTER WEARING PROTRACTION HEAD GEAR (골격성 제III급 부정교합 환자에서 상악골 전방견인장치 사용후 측모 변화에 대한 연구)

  • Lim, Joong-Ki;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.25 no.4
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    • pp.375-401
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    • 1995
  • Cause of skeletal Class III malocclusion in growing patients can be classified into maxillary deficiency, mandibular overgrowth, and combination of the two. Use of Protraction Head Gear(P.H.G.) has been recommended for treatment of growing Class III malocclusion patients, for it results in forward & downward movement of maxilla and backward & downward rotation of mandible. Numerous animal experiments were performed and clinical study data have been reported ; nevertheless, studies on soft tissue profile change and comparison of treatment effects among the patients who had undergone treatment are considered to be somewhat insufficient. The author selected 93 patients, who had been diagnosed as skeletal Class III malocclusion with maxillary deficiency and then treated with P.H.G. ; the sample group was divided according to sex, treatment beginning age, palatal suture opening(intraoral appliance), and facial growth pattern. For each group, changing patterns of hard and soft tissue profile observed, and comparision with 20 normal group(Angle's Class I) patients of statistical significance in amount of growth and treatment of hard and soft tissue was done. The following results were obtained. 1. Skeletal, dental, and soft tissue measurements indicated that more growth changes was induced in the sample group that used P.H.G. compared to the growth amount of normal group. 2. No statistical significance was observed in the amounts of maxillary forward movement and mandibular backward & downward rotation depending on treatment beginning age in both sex group. 3. R.P.E. showed more significant maxillary forward movement and less protrusion of upper incisor than La-Li. 4. There was no statistical significance in the amount of maxillary forward movement depending on facial growth pattern. On the other hand, measurements indicating mandibular downward & backward rotation indicated greater change in counterclockwise growth pattern group than the clockwise. 5. Changes in upper and lower lip thicknesses showed a close relationship with positional changes in underlying bone tissue and upper and lower teeth, and upper lip height and nasolabial angle increased and mentolabial angle decreased.

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Physiological Properties of Jeju Traditional Doenjang (제주 재래식된장의 생리적 특성)

  • Hwang, Joon-Ho;Oh, You-Sung;Lim, Ja-Hun;Park, Ji-Eun;Kim, Mi-Bo;Yoon, Hoon-Seok;Lim, Sang-Bin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.12
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    • pp.1656-1663
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    • 2009
  • The antioxidant activities of water extracts from wild vegetables such as Ligularia fischeri (GC), Capsicum annuum L. (GCY), Aster scaber (CNM), Petasites japonicus S. et Z. Max (MYD), Ipomoea batatas L. (Lam) (GGM) were evaluated and compared with water extracts from freeze dried block. The antioxidant properties of water extracts from wild vegetables and their freeze dried block were evaluated using different antioxidant tests; 2.2-diphenyl-1-picryl-hydrazyl (DPPH) radical scavenging, hydroxyl radical scavenging and nitrite scavenging activities. The water extracts from wild vegetables were found to have a higher total phenolic content than water extracts from freeze dried block. Total phenolic contents of water extracts from GC, GCY, CNM, MYD, and GGM were $471.66{\pm}3.52\;{\mu}g/mg,\;141.33{\pm}2.51\;{\mu}g/mg,\;177.33{\pm}2.88\;{\mu}g/mg,\;238.66{\pm}9.50\;{\mu}g/mg\;and\;122.67{\pm}3.51\;{\mu}g/mg$, respectively. At the concentrations of 1000 ppm, water extracts from GC, GCY, CNM, and GGM showed higher activities than water extracts from their freeze dried block on DPPH radical scavenger activity. The activity of water extracts from CNM, GC, GCY, MYD, and GGM were 90.9%, 89.9%, 76.6%, 71.1%, and 57.4%, respectively. When 10000 ppm of GC, GCY, CNM, MYD, and GGM water extracts tested for hydroxyl radical scavenging activity, activities were increased by 38.8%, 33.4%, 35.9%, 34.3%, and 33.8%, respectively and a similar effect was found with water extracts from GCY, CNM, and GGM freeze dried block at 10000 ppm concentration. However, the water extracts from GC and MYD was slightly more effective than freeze dried block extracts. The water extracts from wild vegetables and their freeze dried block had effective DPPH radical scavenger activity and hydroxyl radical scavenging activity at all tested concentrations. Nitrite scavenging activity of GC water extract significantly increased in a dose-dependent manner and the extract had higher nitrite scavenging activity than extracts freeze dried block extracts. We found that freeze dried block maintained antioxidant activities of the wild vegetables.

Estimation of Glomerular Filtration Rate(GFR) Using $^{99m}Tc$-DTPA Renal Scan and the Parameters for Renal Function ($^{99m}Tc$-DTPA를 이용한 신장스캔에서 사구체 여과율의 측정방법과 영상분석에서 구한 지표들에 의한 신장기능의 평가)

  • Cho, Ihn-Ho;Yoon, Hyun-Dae;Won, Kyu-Chang;Lee, Chan-Woo;Lee, Hyoung-Woo;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.101-108
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    • 1994
  • Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of $^{99m}Tc$-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using $^{99m}Tc$-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GFR calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of $^{99m}Tc$-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GFR. In conclusion, the determination of GFR according to the Gates' formula shows good and reproducible of GFR with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

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Understanding Spatial Variations of Water Quality Using Agricultural Nutrient Indices in Chonnam Province (전남 지역 농업분야 양분 지표를 이용한 수질 공간 변이 해석)

  • Jeon, Byeong-Jun;Lim, Sang-Sun;Lee, Kwang-Seung;Lee, Se-In;Ham, Jong-Hyun;Yoo, Sun-Ho;Yoon, Kwang-Sik;Choi, Woo-Jung
    • Korean Journal of Environmental Agriculture
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    • v.33 no.1
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    • pp.44-51
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    • 2014
  • BACKGROUND: Water quality of rural areas are susceptible to agricultural nutrient input and supply such as chemical fertilizer and livestock manure. This study was conducted to evaluate the usefulness of nutrient (N and P) indices in understanding spatial variations of water quality across Chonnam province which is a typical agricultural region in Korea. METHODS AND RESULTS: The nutrient indices including chemical fertilizer supply, livestock manure production, and nutrient balance were correlated with water quality data (T-N, T-P, BOD, and COD) for the twenty-two districts of the province. Concentration of T-N were positively correlated with chemical fertilizer supply, livestock manure N production, and nutrient balance (P<0.05 or P<0.01). Meanwhile, T-P concentration was not correlated with these nutrient indices; however, there was a tendency that T-P concentration increases with livestock manure P production (P=0.06) and with nutrient balance (P=0.09). These results suggest that T-N concentration is susceptible to both chemical fertilizer and livestock manure; whereas T-P is likely to be affected by livestock manure rather than chemical fertilizer. The concentrations of BOD and COD were also positively (P<0.05 or P<0.01) correlated with livestock manure production. CONCLUSION: This study shows the usefulness of nutrient indices in understanding spatial variations of water quality and suggests that livestock manure rather than chemical fertilizer can be a more critical water pollution source and thus highlights the need for more attention to livestock manure treatments for rural water quality management.