• Title/Summary/Keyword: 제4군

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Aoric Valve Lesion in Type I Ventricular Septal Defect (제1형 심실중격결손에서 대동맥판막 병변)

  • 김관창;임홍국;김웅한;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.492-498
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    • 2004
  • Background: In this study, we investigated the risk factors for the development or progression of aortic regurgitation(AR) in patients with type I ventricular septal defect (VSD) to determine the optimal surgical timing and strategy. Material and Method: Three-hundred and ten patients with type I VSD with or without AR were included. The mean of age was 73.7$\pm$114.7 (1-737) months. One hundred and eighty six patients (60%) had no AR, 83 (27%) had mild AR, 25 (8%) had moderate AR and 16 (5%) had severe AR. Aortic valve was repaired in 5 patients and replaced in 11 patients with closure of VSD in the first operation. Four patients required redo aortic valve repair and 11 patients required redo aortic valve replacement. Age at operation, association with aortic valve prolapse, Qp/Qs, systolic pulmonary arterial pressure, VSD size and systolic pulmonary artery to aortic pressure ratio(s[PAP/AP]) were included as risk factors analysis for the development of AR. The long-term result of aortic valve repair and aortic valve replacement were compared. Result: Older age at operation, association with aortic valve prolapse, high Qp/Qs, and s[PAP/AP] were identified as risk factors for the development of AR (p<0.05, Table 2). The older the patient at the time of operation, the higher the severity of preoperative AR and the incidence of postoperative AR (p<0.05, Table 1, Fig. 1). For the older patients at operation, aortic valve repair had higher occurrence of AR compared to those who had aortic valve replacement (p<0.05, Fig. 2). Conclusion: From the result of this study, we can concluded that early primary repair is recommended to decrease the progression of AR. Aortic valve repair is not always a satisfactory option to correct the aortic valve pathology, which may suggest that aortic valve replacement should be considered when indicated.

Mitral Valve Reconstruction in Mitral Insufficiency : Intermediate-Term Results (승모판 폐쇄부전증에서 승모판 재건술의 중기평가)

  • 김석기;김경화;김공수;조중구;신동근
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.705-711
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    • 2002
  • The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

Oral Health and Occupational Status among Korean Adults (우리나라 성인의 직업 수준에 따른 구강건강불평등 현황)

  • Shin, Bo-Mi;Bae, Soo-Myoung;Yoo, Sang-Hee;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.225-234
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    • 2016
  • The purpose of this study was to determine the oral health condition and behavioral status of Korean adults according to occupational status. The subjects were 7,676 adults, aged between 19 and 64 years, who completed both oral examination and questionnaire survey, among those who indicated that they were currently participating in economic activities, according to the data from the Fourth Korea National Health and Nutrition Examination Survey. Occupational class and employment status were selected as measures of occupational status. Complex-samples logistic regression models were used to assess the associations among oral health, behavioral, and occupational statuses. We found a significant occupational class-related difference in the oral health and behavioral statuses of both the men and women. In particular, the prevalence odds ratios of untreated dental caries in manual workers were 1.19 and 1.67 times higher than in non-manual workers, for men and women, respectively. As for oral health condition and behavioral status according to employment status, the health risk in temporary employment workers was higher than that in permanent employment workers. As for the prevalence odds ratios of the risk of dental caries, the highest values were observed for tooth brushing fewer than 3 times per day, not undergoing oral examinations, and chewing difficulty complaints. The risk of dental caries for agricultural, forestry, and fishing workers for both men and women was found to be the highest among other workers. Thus, strategies to promote workplace oral health in the microscopic and macroscopic perspectives should be developed to constantly monitor oral health problems, and to identify vulnerable social groups within occupational groups and the related factors that mediate oral health differences.

Effect of Grape Seed Water Extract on Lipid Metabolism and Erythrocyte Antioxidant Defense System in High-Fat Diet-Induced Obese C57BL/6 Mice (포도씨열수추출물이 고지방식이로 유도한 비만마우스의 지질대사와 적혈구 항산화 방어계에 미치는 영향)

  • Cho, Young-Sook;Jang, Eun-Mi;Jang, Sun-Mi;Chun, Mi-Sun;Shon, Mi-Yae;Kim, Myung-Joo;Lee, Mi-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.12
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    • pp.1537-1543
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    • 2007
  • This study was investigate the effect of grape seed water extract (GSW) on lipid profiles, lipid metabolism and erythrocyte antioxidant defense system in high-fat diet-induced obese mice. Three groups of male C57BL/6 mice were fed different diets for 6 weeks: normal diet (Normal), high-fat diet (HF control; 37% calorie from fat) and high-fat diet supplemented with GSW (HF-GSW; 1% wt/wt). Supplementation of GSW did not affect the body weight, food intake, daily energy intake, white adipose tissue weights and plasma leptin level in high-fat fed mice. Plasma and hepatic cholesterol and triglyceride contents were significantly higher in the HF control group than in the Normal group; however, GSW supplement significantly lowered plasma triglyceride and hepatic cholesterol concentrations compared to the HF control group. GSW supplement significantly increased fecal excretion of triglyceride in high-fat fed mice. Hepatic carnitine palmitoyl transferase activity was significantly higher in the HF-GSW group than in the HF control group, while fatty acid ${\beta}$-oxidation tended to be lowered by GSW supplement. Erythrocyte superoxide dismutase activity was also significantly higher in the HF-GSW group than in the HF control group and glutathione peroxidase activity tended to be lowered in HF-GSW group. The GSW supplement significantly lowered erythrocyte lipid peroxidation level compared to the HF control group. Accordingly, these results suggest that GSW can be considered as a lipid-lowering agent and as being effective for enhancing erythrocyte antioxidant defense system in high-fat diet-induced obese mice.

The Effect of Pleurodesis with Doxycycline in the Rabbit (토끼에서 Doxycycline을 이용한 흉막유착 효과)

  • Won, Kyoung-Sook;Park, Keon-Uk;Jeon, Won-Ho;Baik, Jae-Jung;Jeong, Yeon-Tae;Suh, Jung-Il;Son, Jin-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.531-536
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    • 1994
  • Background: The intrapleural instillation of tetracycline for pleural sclerosis had been most commonly used in patients with symptomatic malignant pleural effusion or recurrent pneumothorax for a long time. Unfortunately, at a time of expanding use of this agent, the production of injectable tetracycline hydrochloride used for pleurodesis was discontinued by its sole manufacturer in mid-1991 because the manufacturer was unable to meet US Food and Drug Administration purity standards. So we performed a preliminary study of doxycycline, as a alternative pleural sclerosant on rabbit pleura and compared its efficacy with that of tetracycline. Method: Eighteen New Zealand white rabbits weighing 2 to 3kg(mean 2.6kg) were devided into three groups. In each groups, one tetracycline(20 mg/ml/kg) and two doxycycline solutions(7 mg/ml/kg and 20 mg/ml/kg) instillated into the right pleural space through an 18-gauge angiocath with care to prevent pneumothorax. All rabbits were sacrificed after 28 days. Results: 1) In the group of tetracycline 20 mg/ml/kg(six rabbits), five rabbits showed partial pleural symphysis with several fibrous bands, and one rabbit died on 22th day. 2) In the group of doxycycline 7 mg/ml/kg(six rabbits), three rabbits showed partial pleural symphysis and the other three rabbits showed complete pleural symphysis without necrosis of underlying parenchymal lung tissue. 3) In the group of doxycycline 20 mg/ml/kg(six rabbits), two rabbits showed complete pleural symphysis without lung necrosis, another two rabbits showed complete pleural symphysis with lung necrosis, and the other two rabbits died on 4th and 13th day, respectively. Conclusion: We concluded that doxycycline is a highly effective sclerosing agent having stronger pleurodesis effect with that of tetracycline by dose base and its optimal dosage was considered as 7 mg/ml/kg with minimal complications.

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Expression of Osteopontin and Transforming Growth Factor- ${\beta}$ in Childhood Minimal Change Nephrotic Syndrome After Cyclosporine Treatment (미세변화 신증후군 환아에서 사이클로스포린 치료 후 Osteopontin과 Transforming Growth Factor-${\beta}$의 발현)

  • Lim Beom-Jin;Kim Pyung-Kil;Hong Soon-Won;Jeong Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.142-154
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    • 2002
  • Purpose : One of the most important adverse effects of long-term cyclosporine therapy is nephrotoxicity, the morphologic changes of which include interstitial fibrosis and arteriolar hyalinization. Recently, several authors have shown that osteopontin plays an important role in the development of interstitial fibrosis by acting as a macrophage chemoattractant and stimulating the production of $TGF-{\beta}$ in experimental cyclosporine nephrotoxicity. However, the relationship between osteopontin and $TGF-{\beta}$ in humans has not been clearly documented so far. We studied the expression of osteopontin and $TGF-{\beta}$ in children with minimal change nephrotic syndrome treated with cyclosporine to demonstrate whether there is a relationship between cyclosporine toxicity and osteopontin expression as previously shown in animal models. Materials and methods : Nineteen children (15 males and 4 females) were the subject of this study. Renal biopsies had been performed before and after the cyclosporine therapy (mean duration: 15.9 months). In 5 patients, additional biopsies were performed after completing the cyclosporine treatment (mean; 26 months). The expressions of osteopontin and $TGF-{\beta}$ were evaluated by immunohistochemistry in the glomeruli and tubulointerstitium. Results : Osteopontin expression was significantly increased in the glomerular mesangium and tubules after cyclosporine treatment. But there was no statistically significant increase of $TGF-{\beta}$ in the interstitium. There was no significant increase in tubular osteopontin and interstitial $TGF-{\beta}$ expression in those cases developing interstitial fibrosis after cyclosporine treatment compared with cases those not developing interstitial fibrosis. No significant changes in osteopontin or $TGF-{\beta}$ expression were observed in subsequent 5 biopsy samples after discontinuation of cyclosporine compared with the first follow up biopsies. Conclusion : These results suggest that osteopontin is a nonspecific marker of renal injury rather than a mediator of interstitial fibrosis in cyclosporine nephrotoxicity of human.

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Perspectives on the Landscape Ecological Function of Dangsan Forests and Rural Community Forests as a Stream Landscape (하천경관으로서 당산숲.마을숲의 경관생태학적 기능 고찰)

  • Choi, Jai-Ung;Kim, Dong-Yeob
    • Journal of Environmental Policy
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    • v.4 no.2
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    • pp.31-55
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    • 2005
  • Dangsan forests and Rural Community Forests(RCF) have been historical assets for the rural communities of more than 40,000 in Korea and they have provided an identity through the cultural heritage. The Dangsan forests and the RCF are parts of a unique cultural landscape in the rural areas as components of stream landscape. In many cases, the Dangsan forests and the RCF are located close to stream corridors. The objective of this study was to understand the function of the Dangsan forests and the RCF on stream water quality and to evaluate its ecological landscape values. Through the consideration of international concensus and domestic government policy for close-to-nature stream, we could find out that Dangsan forests and RCF's have close relationship with the close-to-nature streams. The water quality of the streams close to the Dangsan forests and the RCF are maintained with local culture. It is also compared to the streams located where Dangsan forests and the RCF are absent. Eight study sites were selected. Water samples were collected at three different locations at each study site. Water samples were analyzed for temperature, pH, total P, total N, dissolved oxygen, EC, BOD, COD and SS. Aquatic invertebrates were observed as water quality indicator species. The results showed that the number of aquatic invertebrate species, GPI, DO, EC, BOD, and SS were significantly improved in stream water due to the presence of the Dangsan forests and the RCF. The role of Dangsan forests and the RCF was evident in the conservation of stream landscape and rural culture as well as in maintaining stream water quality. The management schemes of the streams with Dangsan forests and the RCF's are also suggested.

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A Review of Staphylococcus aureus Infections in Children with an Emphasis on Community-associated Methicillin-resistant S. aureus Infections (소아 황색포도알균 감염증의 임상 양상에 대한 고찰: 지역사회 관련 메티실린 내성 황색포도알균 감염을 중심으로)

  • Choe, Young June;Lee, So Yeon;Sung, Ji Yeon;Yang, Mi Ae;Lee, Joon Ho;Oh, Chi Eun;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.150-161
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    • 2009
  • Purpose : Staphylococcus aureus causes a variety of infections, ranging from benign skin infections to fatal invasive infections. Recently, methicillin-resistant S. aureus (MRSA) infections have emerged in patients who do not have established risk factors. This study was conducted to characterize S. aureus infections in children with an emphasis on communityassociated MRSA infections at a tertiary care pediatric facility during a 3-year period. Methods : Four hundred twenty-nine cases of S. aureus infections diagnosed at the Seoul National University Children's Hospital between January 2004 and December 2006 were retrospectively reviewed. The cases were classified as hospitalonset (HO) or community-onset (CO), healthcare-associated (HA), or community-associated (CA) infections. Results : Among the 206 cases <1 year of age, 72%, 7%, and 21% were HO-HA, CO-HA, and CA infections, respectively, as compared to 48%, 28%, and 24% among the 223 cases >1 year of age. The proportion of CO-HA infections among HA infections (8.6% vs. 37.1%, P<0.001) and the proportion of HA infections among the CO infections (24.5% vs. 54.3%, P <0.001) were greater in older children than in infants. Overall, 57% of the isolates were methicillin-resistant. Twenty-nine (30%) of 96 CA strains were MRSA, and the most common site of CA-MRSA infection was the skin and soft tissues (26 cases). Conclusion : The methicillin resistance rate of S. aureus from CA infections was high and CA-MRSA was most often associated with skin and soft tissue infections.

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Sargassum sp. Attenuates Oxidative Stress and Suppresses Lipid Accumulation in vitro (모자반추출물의 항산화활성 및 지방세포 생성억제 효과)

  • Kim, Jung-Ae;Karadeniz, Fatih;Ahn, Byul-Nim;Kwon, Myeong Sook;Mun, Ok-Ju;Kim, Mihyang;Lee, Sang-Hyeon;Yu, Ki Hwan;Kim, Yuck Yong;Kong, Chang-Suk
    • Journal of Life Science
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    • v.24 no.3
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    • pp.274-283
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    • 2014
  • Oxidative stress causes tissue damage and facilitates the progression of metabolic diseases, including diabetes, cardiovascular heart diseases, and obesity. Lipid accumulation and obesity-related complications have been observed in the presence of extensive oxidative stress. As part of an ongoing study to develop therapeutic supplements, Sargassum sp. were tested for their ability to scavenge free radicals and intracellular reactive oxygen species (ROS), as well as to suppress lipid accumulation. Three species, S. hemiphyllum, S. thunbergii, and Sargassum horneri, were shown to scavenge free radicals in a di(phenyl)-(2,4,6-trinitrophenyl)iminoazanium (DPPH) assay. In addition, Sargassum sp. was shown to scavenge intracellular ROS and to decrease nitric oxide (NO) production in $H_2O_2$ and lipopolysaccharide (LPS)-induced in RAW264.7 mouse macrophages, respectively. Taken together, the results suggest that Sargassum sp. possess huge potential to relieve oxidative stress and related complications, as well as lipid-induced oxidation. They indicate that S. hemiphyllum, S. thunbergii, and S. horneri are potent functional supplements that can produce beneficial health effects through antioxidant and antiobesity activities, with S. hemiphyllum being the most potent among the Sargassum sp. tested. A potential mechanism for the effect of Sargassum sp. on the suppression of lipid accumulation in differentiating 3T3-L1 mouse preadipocytes through deactivation of the peroxisome proliferator-activated receptor ${\gamma}$ (PPAR ${\gamma}$) is presented.

Prognostic Significance of Cyclin D1 Overexpression in Non-Small Cell Lung Cancer (Cyclin D1의 발현이 비소세포폐암의 예후에 미치는 영향)

  • Yang, Seok-Chul;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.776-784
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    • 1998
  • Background: The cyclin D1 gene is one of the most frequently amplified chromosomal regions(11q13) in human carcinomas. In laryngeal and head and neck carcinomas, its overexpression has been shown to be associated with advanced local invasion and presence of lymph node metastases. Cyclin D1 may therefore playa key role in cell growth regulation and tumorigenesis. Lung cancer is a worldwide problem and in many contries it is the most lethal malignancy. As relapse is frequent after resection of early stage non-small cell lung cancer, there is an urgent need to define prognostic factors. Purpose: This study was undertaken to evaluate the prognostic value of the cyclin D1, that is one the G1 cyclins which control cell cycle progression by allowing G1 to S phase transition, on the patients in radically resected non-small cell lung cancer. Method: Total 81 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from January 1, 1983 to July 31, 1995 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for cyclin D1. Results : The histologic classification of the tumor was based on WHO criteria, and the specimens included 45 squamous cell carcinomas, 25 adenocarcinomas and 11 large cell carcinomas. Cyclin D1 overexpression was noted in 26 cases of 81 cases tested (30.9%). Cyclin D1 expression was not significantly associated with cell types of the tumor, pathological staging and the size of the tumor. But cyclin D1 overexpression was significantly correlated with positive lymph node metastasis(p=0.035). The mean survival duration was $22.76{\pm}3.50$ months in cyclin D1 positive group and $45.38{\pm}5.64$ months in eyclin D1 negative group. There was a nearly significant difference in overall survival between cyclin D1 positive and negative groups(p=0.0515) in radically resected non-small cell lung cancer. Conclusion: Based on this study, cyelin D1 overexpression appears an important poor prognostic indicator in non-small cell lung cancer and may have diagnostic and prognostic importance in the treatment of resectable non-small cell lung cancer.

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