• Title/Summary/Keyword: 장기적 관계

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Tetralogy of Fallot Associated with Pulmonary Atresia and Major Aortopulmonary Collateral Arteries -Comparison between the different surgical approaches- (폐동맥폐쇄와 주대동맥폐동맥혈관부행지를 동반한 활로씨사징증 -다양한 외과적 치료접근의 비교-)

  • 이정렬;양지혁;김용진;노준량
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.471-479
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    • 1999
  • Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

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The Measurement of Blood Loss and Its Effect on Red Cell Survival Studies with $^{51}Cr$ (실혈(失血)이 적혈구수명(赤血球壽命) 측정(測定)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Lee, Mun-Ho;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.1
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    • pp.27-36
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    • 1970
  • 적혈구(赤血球) 수명의 측정에는 $^{51}Cr$-표지적혈구법(標識赤血球法)이 임상적(臨床的)으로 이용(利用)되고 있으며 이는 이론상(理論上) steady state 즉(卽) 측정기간(測定期間)동안 순환(循環) $^{51}Cr$량(量)-적혈구량(赤血球量)이 일정(一定)할 때에 한(限)하여 유효(有效)하며 unsteady state 때는 true red cell survival을 알기 위하여서는 측정치에 영향을 주는 요인(要因)에 대하여 각각(各各) 교정(校正)해 줄 필요(必要)가 있다. 이 요인(要因)중에 특히 실혈(失血)로 인(因)한 영향에 관(關)하여는 계통적인 연구(硏究)가 적다. 이에 저자(著者)들은 $^{51}Cr$표지적혈구법(標識赤血球法)을 이용(利用)하여 실혈(失血)이 적혈구(赤血球) 수명측정(測定)에 미치는 영향을 인체(人體)에서 실험 관찰하여 몇가지 성적을 얻었다. 연구대상(硏究對象)은 총(總) 56명(名)의 청장년(靑壯年)으로 급성실혈군(急性失血群)과 만성실혈군(慢性失血群)으로 구분(區分)하여 급성실혈군(急性失血群)은 위장출혈등(胃腸出血等)이 없는 2대(代)의 의대생(醫大生)으로 $^{51}Cr$표지적혈구법(標識赤血球法)을 사용하여 적혈구(赤血球) 수명을 측정하는 동안($10{\sim}14$ 일간(日間)) 1일당(日當) 10ml(6명(名)), 25ml(4명(名)), 50ml(4명(名)), 75ml(4명(名)), 100ml(6명(名))를 각각(各各) 사혈(瀉血)한 군(群)과 10일간(日間) 1,000ml를 사혈한 군(群) 즉 200ml씩 5회(回)(4명(名)), 500ml씩 2회(回)(4명(名))로 세분(細分)하였으며 만성실혈군(慢性失血群)은 직업적인 공혈자(供血者)로 반복사혈로 생긴 9명(名)의 빈혈자와 십이지장충증(十二指腸蟲症)에 감염(感染)되어 구충(驅蟲)한 중등도(中等度)의 철결핍성 빈혈환자 7명(名)으로 나누어 관찰하였다. 측정(測定) 방법(方法)으로는 Gray 및 Sterling법(法)을 개설한 방법(方法)으로 $^{51}Cr$표지적혈구(標識赤血球)의 계측시료(計測試料)로서 전혈(全血) 및 적혈구(赤血球)를 사용(使用)하였다. 실험(實驗)성적은 1. 1일당(日當) 실혈량(失血量)이 증가(增加)할수록 적혈구(赤血球)수명($T\frac{1}{2}$)은 짧아짐을 알 수 있었다. 즉(卽) 1일당(日當) $20{\sim}50ml$ 사혈군에서는 $T\frac{1}{2}$이 현저히 짧아지는 rapid phase을 나타내고 1일당(日當) 50ml이상(以上) 사혈군에서는 짧아지는 정도(程度)가 완만한 slow phase을 나타낸다(Fig. 6). 2. 1일량(日量) 10ml 및 25ml식(式) 사혈한 군(群)의 적혈구수명(赤血球壽命)을 측정(測定)하는데 있어 적혈구(赤血球)를 사용하였을 때에는 $T\frac{1}{2}$측 정치에 유의한 차(差)가 없었으며 이 범위 내에서는 Hct., Hb. 및 혈청철치(血淸鐵値)도 역시 유의한 차(差)가 없었다. 3. 1일량(日量) 50ml 및 75ml, 100ml씩 사혈한 군(群)에서는 적혈구(赤血球)만을 사용(使用)하였을 때와 전혈(全血)을 시료(試料)로 하였을 때 사이에 $T\frac{1}{2}$의 측정치에 유의한 차(差)가 있었으며 이 때는 Hct., Hb. 및 혈청철치(血淸鐵値)에도 변화(變化)가 있었다. 즉(卽), 전혈(全血)을 사용한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치가 적혈구(赤血球)만를 사용(使用)한 적혈구(赤血球) 수명($T\frac{1}{2}$)의 측정치 보다 짧았다. 4. 일정(一定)기간(10 일(日)) 사혈의 총량(1000ml)이 같을 매는 200ml를 5회(回) 사혈한 군(群)이나 500ml를 2회(回) 사혈한 군(群) 사이에 적혈구(赤血球) 수명($T\frac{1}{2}$)에 유의(有義)한 차(差)를 볼 수 없었다. 5. 직업적 공혈자의 반복사혈로 인(因)한 만성(慢性) 빈혈환자 9명(名)에서의 $^{51}Cr$적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 평균(平均) 19.2일(日)로 짧아져 있으나 적혈구수명측정전후(赤血球壽命測定前後)에 충분(充分)한 철제(鐵劑)를 투여(投與)하여 Hct., Hb. 및 혈청철치(血淸鐵値)를 증가(增加)시켰으며 이때 볼 수 있었든 Hct치(値)를 규준(規準)하여 교정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 거의 정상(正常)범위 안에 있어(27.6일(日)) 이러한 인자(因子)를 고려하지 않으면 잘못 이해할 수가 있다. 6. 구충자충(鉤蟲仔蟲)을 구충한 7명(名)의 중등도(中等度) 철(鐵)결핍성 빈혈환자에서의 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치는 25일(日)$\sim$31일(日)로 평균(平均) 28일(日)이었으며, 이때 장 출혈량은 1일(日) $1.0{\sim}3.5ml$이었다. 단시일내의 급성실혈시에는 이와같은 소량의 실혈(失血)도 적혈구(赤血球)수명($T\frac{1}{2}$) 측정치에 영향을 보여 줌을 알 수 있었다. 따라서 이러한 정도의 실혈은 실험오차에 기인하는 것인지 아니면 장기 출혈에서는 이러한 소량의 실혈이 적혈구(赤血球)수명($T\frac{1}{2}$) 측정에 영향을 미치지 않는 것인지는 아직 확실히 말할 수 없다. 8. $^{51}Cr$-표지적혈구(標識赤血球)로 측정한 적혈구(赤血球)수명($T\frac{1}{2}$)은 측정시의 실혈량(失血量)에 큰 영향을 받음을 알 수 있으며 저자(著者)들은 $^{51}Cr$표지적혈구(標識赤血球)를 이용(利用)한 적혈구(赤血球) 수명 측정때 검사기간중 실혈량이 적혈구수명치(赤血球壽命値)에 미치는 관계를 상술(上述)한 실험치(實驗値)를 기초(基礎)로 하여 다음과 같을 교정식(校正式)을 고찰(考察)해 보았다. $^{51}Cr\;T\frac{1}{2}=17.0e^{-0.0495}+18.4e^{-0.000924x}$ 단(但) X : 1일(日) 실혈량(失血量)(단위(單位) ml)

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Indication of Dissection of the 14v Lymph Node in Advanced Distal Gastric Cancer (원위부 진행성 위암에서의 상장간막정맥(14v) 림프절 절제술의 적응증)

  • Lim, Jung-Taek;Jung, Oh;Kim, Ji-Hoon;Oh, Sung-Tae;Kim, Byung-Sik;Park, Kun-Choon;Yook, Jeong-Hwan
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.154-160
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    • 2006
  • Purpose: According to the 2nd English Edition of the Japanese Gastric Cancer Association (JGCA) in 1998, in case of distal gastric cancer, the 14v (superior mesenteric vein) lymph node (LN) is included in the N2 group. However, in Korea, a modified radical gastrectomy is performed, and a 14v LN dissection is not done as a routine procedure. Thus, we investigated the rate of metastatic 14v LNs, evaluated the necessity of dissection of the 14v LN, and searched for indications of 14v LN dissection. Materials and Methods: From April 2004 to August 2005, we enrolled the patients who were diagnosed as having advanced gastric cancer in the distal third portion of the stomach. We peformed a distal gastrectomy with D2 lymph node dissection as defined in the 2nd English edition of the JGCA classification. We calculated the positive rate of metastatic LNs of each station and analyzed the relationship between the positive rates of No.6 LNs and 14v LNs. We also compared the positive 14v LN group with the negative 14v LN group. Results: The total number of patients was 50, the mean age was 56 (range $30{\sim}80$) years, and sex ratio (Male/Female) was 1.63 : 1. In 47 (94%) cases, distal a gastrectomy with gastroduodenostomy was done, and in the remaining 3 (6%) cases, a distal gastrectomy with gastrojejunostomy was done. The most frequently metastatic LNs were nos. 3 and 6 (54%). The metastatic rate of the f4v LN was 10%, which was similar to that of LN no. 9. In the comparison of the 14v positive group with the 14v negative group, there were significant differences in the numbers of metastatic LNs (mean 25.4 vs 4.91, P<0.001) and the numbers of metastatic no. 6 LNs, (mean 6.8 vs 1.42, P<0.001), and if no. 6 LNs were metastatic, the possibility of metastasis to the 14v LN was 19.2%. In the 14v positive group, all cases were more than stage 3 by the UICC 6th edition. Conclusion: In cases of advanced cancer with metastasis to the no. 6 IN, there was a good chance of metastasis to the 14v LN. Thus, in the operative field, if the tumor is advanced to more than stage 3 by the UICC classification and the no. 6 LN is metastatic, a 14v LN dissection is necessary. However, the usefulness of a 14v LN dissection should be evaluated prospectively through an analysis of tumor recurrence and long-term survival.

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Reversal of Multidrug Resistance with KR-30035: Evaluated with Biodistribution of Tc-99m MIBI in Nude Mice Bearing Human Tumor Xenografts (이종이식된 인체종양에서 KR-30035가 Tc-99m MIBI체내 분포에 미치는 영향으로 평가한 다약제내성 역전가능성)

  • Kim, Jung-Kyun;Lee, Byung-Ho;Choi, Sang-Woon;Yoo, Sung-Eun;Lee, Sang-Woo;Chun, Kyung-Ah;Ahn, Byeong-Cheol;Park, Jae-Young;Suh, Jang-Soo;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.168-184
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    • 2001
  • Purpose: KR-30035 (KR), a new MDR reversing agent, has been found to produce a similar degree of increased Tc-99m MIBI uptake in cultured tumor cells over-expressing mdr1 mRNA compared to verapamil (VP), with less cardiovascular effects. We assessed the MDR-reversing ability of KR in vivo, and effects of various doses of KR on MIBI uptake un nude mice hearing P-glycoprotein (P-gp) positive (+) and P-gp negative (-) human tumor xenografts. Methods: P-gp (+) HCT15/CL02 colorectal and P-gp (-) A549 non-small cell cancer cells were inoculated in each flank of 120 nude mice (20 mice ${\times}$ 6 groups). Group 1 (Gr1) mice received 10mg/kg KR i.p. 3 times $({\times}3)$; Gr2, 10mg/kg VP i.p. ${\times}3$; Gr3, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.p. ${\times}1$; Gr4, 10mg/kg KR i.p. ${\times}2$ + 50mg/kg i.p. ${\times}1$; Gr5, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.v. ${\times}1$, GrC, controls. The mice were then injected with Tc-99m MIBI and sacrificed after 10 min, 30 min, 90 min and 240 min. Tumor uptake of MIBI (TU) in each group was compared. Results: TU in P-gp (+) and (-) tumors were both higher in Gr1 than Gr2. Washout rate between the 10 min and 4 hours was lower in Gr5 of P-gp (+) cell(0.93) than the control. Percentage increases in TU were higher in P-gp (+) than P-gp (-) tumors with all KR doses. Pgp (+) TU were highest at 10 mon (173% of GrC) and persisted up to 240 min (144%) in Gr3. Larger doses of KR resulted in a lesser degree of increase in P-gp (+) TU at 10 min (130% in Gr4 and 117% un Gr5) and 30 min (178%, 129%), but TU increased by time up to 240 min (177%, 196%). Heart and lung uptakes were markedly increased in Gr4 and Gr5 at 10 and 30 min, likely due to cardiovascular effects. No mice died. Conclusion: These data further suggest that KR that has significantly lower cardiovascular toxicity than verapamil can be used as an active inhibitor of MDR. Even a relatively low dose of KR significantly increased Tc-99m MIBI uptake in P-gp (+) tumors in vivo.

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Usefulness of Troponin-I, Lactate, C-reactive protein as a Prognostic Markers in Critically Ill Non-cardiac Patients (비 순환기계 중환자의 예후 인자로서의 Troponin-I, Lactate, C-reactive protein의 유용성)

  • Cho, Yu Ji;Ham, Hyeon Seok;Kim, Hwi Jong;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.562-569
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    • 2005
  • Background : The severity scoring system is useful for predicting the outcome of critically ill patients. However, the system is quite complicated and cost-ineffective. Simple serologic markers have been proposed to predict the outcome, which include troponin-I, lactate and C-reactive protein(CRP). The aim of this study was to evaluate the prognostic values of troponin-I, lactate and CRP in critically ill non-cardiac patients. Methods : From September 2003 to June 2004, 139 patients(Age: $63.3{\pm}14.7$, M:F = 88:51), who were admitted to the MICU with non-cardiac critical illness at Gyeongsang National University Hospital, were enrolled in this study. This study evaluated the severity of the illness and the multi-organ failure score (Acute Physiologic and Chronic Health EvaluationII, Simplified Acute Physiologic ScoreII and Sequential Organ Failure Assessment) and measured the troponin-I, lactate and CRP within 24 hours after admission in the MICU. Each value in the survivors and non-survivors was compared at the 10th and 30th day after ICU admission. The mortality rate was compared at 10th and 30th day in normal and abnormal group. In addition, the correlations between each value and the severity score were assessed. Results : There were significantly higher troponin-I and CRP levels, not lactate, in the non-survivors than in the survivors at 10th day($1.018{\pm}2.58ng/ml$, $98.48{\pm}69.24mg/L$ vs. $4.208{\pm}10.23ng/ml$, $137.69{\pm}70.18mg/L$) (p<0.05). There were significantly higher troponin-I, lactate and CRP levels in the non-survivors than in the survivors on the 30th day ($0.99{\pm}2.66ng/ml$, $8.02{\pm}9.54ng/dl$, $96.87{\pm}68.83mg/L$ vs. $3.36{\pm}8.74ng/ml$, $15.42{\pm}20.57ng/dl$, $131.28{\pm}71.23mg/L$) (p<0.05). The mortality rate was significantly higher in the abnormal group of troponin-I, lactate and CRP than in the normal group of troponin-I, lactate and CRP at 10th day(28.1%, 31.6%, 18.9% vs. 11.0%, 15.8 %, 0%) and 30th day(38.6%, 47.4%, 25.8% vs. 15.9%, 21.7%, 14.3%) (p<0.05). Troponin-I and lactate were significantly correlated with the SAPS II score($r^2=0.254$, 0.365, p<0.05). Conclusion : Measuring the troponin-I, lactate and CRP levels upon admission may be useful for predicting the outcome of critically ill non-cardiac patients.

Comparison of Resistance to Fowl Typhoid among Crossbreed (산란계 합성종의 가금티푸스 저항성 비교 연구)

  • 김기석;이영주;강민수;한성욱;오봉국
    • Korean Journal of Poultry Science
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    • v.29 no.1
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    • pp.59-75
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    • 2002
  • The present study was conducted to compare the disease resistance to fowl typhoid among White Leghorn (WL) known as possessing greater genetic resistance to Salmonella, Rhode Island Red (RIR) susceptible to the disease and their mating crossbreed, WL ${\times}$RIR. Also, it was carried out to compare fowl typhoid-resistance among Hyline white${\times}$Hyline brown(HwHb), Hw${\times}$lsa brown(Hwlb), Isa white${\times}$lb(Iwlb), Iw${\times}$ Hb(IwHb) and Ib ${\times}$ Iw(IbIw) in order to select crossbreed chickens which have disease resistance to fowl typhoid and simultaneously produce the brown eggs which our domestic consummers prefer There was no death of WL chickens challenged with Sal. gallinarum at each 2, 5 and 8 wk of age, while average 86.2 to 64.1% of RIR chickens tested died at the same challenge age during the test period of 2 weeks. Their maiting crossbreed, WL ${\times}$ RIR were intermediate between the two breeds. weight gains of tested chickens were significantly higher in WL and WL ${\times}$RIR without difference between them than RIR. In recovery rate of tested strain of Sal. gallinarum from braun, heart, fiver, spleen and cecum of chickens challenged, WL ${\times}$RIR fell between the other two breeds, with somewhat higher rate then WL but much lower then RIR. In the disease resistance determination test using HwHb, Hwlb, Iwlb, IwHb and IbIw$.$ crossbreed chickens experimentally infected with Sal. gallinarum, it was recognized that all of crossbreeds tested developed marked resistance to fowl typhoid, based on the results judged by the measurement parameters of mortality, weight gain, recovery rate of challenged strain of bacteria, and positive rate of agglutination antibody, and HwHb had a tittle higher disease resistance then ethers.

Distribution of Mast cells and Nerves in the Developing Postnatal Submandibular and Sublingual Glands of Rats (생후 발생중인 흰쥐의 턱밑샘 및 혀밑샘에서의 비만세포와 신경의 분포양상)

  • Kim, Jae-Gon;An, Soo-Hyeon;Lee, Young-Su;Baik, Byeong-Ju;Cho, Eui-Sic
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.2
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    • pp.350-364
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    • 1999
  • The distribution of mast cells and nerves were investigated in the submandibular and sublingual glands of postnatal rats, using morphometric, histochemical and immunohistochemical techniques. Mast cells were observed in the submandibular and sublingual glands of postnatal development. Number of mast cells gradually increased in both glands following development. At birth, mast cells were relatively fewer in submandibular gland than those in sublingual gland, and they were mainly distributed in parenchymal tissues. At $2{\sim}4$ weeks, most of the mast cells were observed in the connective tissues, surrounding neurovascular elements, but some mast cells were closely related with the acini of submandibular gland. PGP 9.5 immunoreactive nerve fibers were found in the submandibular and sublingual glands of all developmental age. The nerve fibers were showed in varicose shape, and mainly located in adjacent area of ducts and vascular components of both glands. The number of nerve fibers were increased rapidly until 8 weeks, but they were not increased any more until 24 weeks. Therefore, it is suggested that mast cells and nerve fibers related with each other, and that their interactions may play roles not only in maturation of secretory units but also growth and differentiation of the tubular structures of the rat submandibular and sublingual glands during postnatal development.

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Traumatic Injuries of the Diaphragm (외상성 횡격막 손상)

  • 김덕실;허동명
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.433-439
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    • 1996
  • From January 1980 to July 1995, 32 patients with blunt diaphragmatic trauma and 12 wish penetrating diaphragmatic trauma were treated at Kyungpook University Hospital. The mean age of patients with blunt trauma was 37.6 years, and with penetrating trauma 29.2 years. The mean age was older in patients with blunt trauma by 8.4 years (p< 0.05). When simple chest X-ray diagnosis was performed, 24cases (75%) of the diaphragmatic injuries were found in blunt trauma and 4 case(33%) in penetrating trauma. When opei.ations were done due to injuries of thoracic or abdominal organ, 7 diaphragmatic injuries (58%) were found in penetrating trauma. Herniation occurred in 24 patients (75%) in blunt trauma and 5 patients (42%) in penetrating truma. The size of injured diaphragms in 29 cases in which hernia was discovered was 10.9 $\pm$ 4.3cm. On the other hand, the size in 15 cases in which hernia did not occur was 3.5 $\pm$ 2.9cm. There was a remarkable difference in their size depending on the presence or absence of hernia (p< 0.051. That is, a close relation between the sire of injured diaphragms and hernia was shown. All diaphragmatic injuries were repaired primarily. In blunt trauma approach of repair were as follows : 20 (63%) thoracic, 9 abdominal, 2 thoracoabdominal, and 1 thoracic and in penetrating trauma 6 (50%) abdominal, 4 thoracic, and 2 thoracic and abdominal. The complication rate was 19% in blunt trauma and 25% in penetrating trauma. Two patients with blunt trauma died with a mortality rate of 6.3% . All patients with penetrating trauma recovered. This study suggests that diaphragmatic injury should be suspected in all patients w th blunt as well as penetrating injury of the chest and abdomen. The size of injured diaphragms was larger in blunt trauma than in penetrating trauma. For herniation, it appeared to be more common in blunt trauma. The morbidity and mortality were related primary to the severity of associated injuries.

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GAMETOGENESIS AND REPRODUCTIVE CYCLE OF THE TOPSHELL, TURBO CORNUTUS SOLANDER (소라, Turbo cornutus의 생식세포형성과정 및 생식주기에 관한 조직학적 연구)

  • LEE Ju Ha
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.13 no.4
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    • pp.125-134
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    • 1980
  • The dovelopment of the gonads, gametogenesis and the reproductive cycle of the topshell, Turbo cornutus Solander, which is one of valuable food animals fom Korean waters were studied by photomicroscophy. The materials were monthly collected from Bangeojin, Jeongjari and Dangweol, all these places being located in the south-eastern part of Korea, for one year from March 1979 to February 1980. Topshell is dioecious and oviparous. Gonad is situated on the surface of liver, which lies posteriorly. The surface of ovary and testis is covered with a fibrous membrane, membrane of connective and muscular fibers and then an outermost layer of simple-columnar epithelial cells which are composed of cuboidal and columnar mucous gland cells. Primordial germ cells develop on the germinal epithelium of ovarian and testicular lobuli which are originated from the fibrous membrane and extend toward hepatic gland. Undifferentiated mesenchymal tissue and pigment granular cells are abundantly distributed between the growing oocytes and spermatocytes in the early development stages. With the further development of the ovary and testis these tissue and cells gradually disappear. Then the undifferentiated mesenchymal tissue and pigment granular cells are considered to be related to the growing of the oocytes and spermatocytes. Early multiplicating oogonium is ca. $10\mu$ in diameter and nucleushaving a central nucleolus is ra. $8\mu$. As the oocytea grow to ca. $50-60\mu$ by the increase of cytoplasm, the oocytes become look like bunches of grapes which are attached to ovarian lobuli. Mature eggs are ca. $180-210\mu$ in diameter and it is surrounded by a gelatinous membrane of ca. $10\mu$ in thickness. After spawning, undischarged ripe eggs and spermatozoa remain in the ovary and testis respectively for some time. Then they finally degenerate, and proliferation of new oogonia and spermatogonia occur along the germinal epithelia of newly developed ovarian and testicular lobuli. Reprocuctive cycle of Turbo cornutus could be classified into five successive stages: multiplicative, growing, maturer spent and recovery stages. Spawning occurs from August to November with Peak spawning from early September to late October.

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COMPARISON OF MICROLEAKAGE IN SEALANT REPAIRED WITH DIFFERENT SURFACE TREATMENT (파손된 치면열구전색제의 수리 방법에 따른 미세누출 비교)

  • Kang, Myung-Bong;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.204-214
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    • 2007
  • The aim of this study was to investigate whether differences in surface treatment prior to repair influenced the seal of a resin fissure sealant placed on the occlusal surfaces of permanent molar teeth. One hundred and twenty extracted human molars were selected and a light curing sealant was placed on their occlusal surface following cleaning by prophylaxis and acid etching. The teeth were deliberately damaged, and then stored in artificial saliva for four weeks. Sixty teeth with the desired morphology of sealant failure were randomly divided into four groups where one group was treated with only etching agent, another by only air-abrasion, another by applying an etching agent followed by a bonding agent, and the last by air-abrasion followed by a bonding agent each. After sealant application, the samples were thermocycled and the degree of microleakage was determined. The results were as follows : 1. In the sealant/sealant interface group 2(0.22), 4(0.23) using air-abrasion showed a significantly lower microleakage score than group 1(0.38), 3(0.35) using an etching agent(p<0.05). There were no statistically significant differences(p>0.05) between groups 1, 2 and groups 3, 4. 2. In the sealant/tooth interface, group 3(0.20), 4(0.20) which used a bonding agent showed a significantly lower microleakage score than group 1(0.35), 2(0.40) (p<0.05). There were no statistically significant differences(p>0.05) between groups 1, 3 and groups 2, 4. 3. In SEM examination, while sealant surfaces treated with etching did not result in highly rough surfaces, those treated with air-abrasion did show rough surfaces.

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