Background: Follow-up studies have shown that although outcomes have improved substantially over time, results of the Fontan operation and its modifications remain suboptimal. In this study, we reviewed our experience with the extracardiac conduit Fontan operation, with a focus early and midterm change of internal diameter of PTFE conduit. Material and Method: Between April 1997 and July 2000 were reviewed. Twelve patients (M:6, F:6, mean age 42.04 $\pm$ 12.43months, mean body weight 13.80$\pm$ 1.94kg) underwent extracardiac conduit Fontan operation with expanded PTFE graft. Mean cardiopulmonary bypass time was 109.7$\pm$26.99minute and mean operation time was 455$\pm$89.51minute. Intraoperative fenestration was performed in 10 patients. The aortic cross clamping was not performed in all patients. Result: There was no early deaths and no postoperative dysrhythmia. Postoperative protein losing enteropathy and prolonged pleural effusion occurred in 1(8.3%) and 4 patients(33.3%). Conduit patency was evaluated by magnetic resonance imaging studies. A 9.84$\pm$3.84% mean reduction in conduit internal diameter and there was no statistical correlation between the change of internal diameter of conduit and the postoperative duration after partial correlation analysis(r=0.019, p=0.955). Conclusion: These results demonstrate that the extracardiac conduit Fontan operation provies good early and midterm results and may reduce the prevalence of late arrhythmia. And there is no correlation between the change of internal diameter of conduit and the postoperative duration after extracardiac conduit Fontan operation with the expanded PTFE graft conduit.
Jo, Yeong-Hyun;Kim, Yun;Ryu, Cheong-Ro;Lee, Kyeong-Sig;Lee, In-Tae;Yoon, Han-Sam;Jun, Sue-Kyung
Journal of the Korean Society of Marine Environment & Safety
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제16권2호
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pp.175-183
/
2010
To understand the variation of macro benthos community according to the installation of structure and topographic placement in the shellfish farm on tidal flat, the practical example of the tidal shellfish growing area at Namsung-ri Goheung was observed. The results of the research for the field observation were summarized as follows. (1) The ground gradient of the shellfish farm was very flat below about $1^{\circ}$. The shellfish farm ground took the shape of $\sqcup$ from the shoreline to the place of 150 m seawards, and the shape of $\sqcap$ from there to the low tide line. During ebb tide, the $\sqcup$ shape ground stored the sea water, and the $\sqcap$ shape ground was supposed to act as the effect factor to leak slowly or to prevent the outflow. (2) The oyster shell bag or the type of riprap wall as the boundary in the shellfish farm was classified into five types. The air exposure time and flooding time were 181 and 434 minutes, respectively. (3) In the numerical experiment, the deep-sea water wave coming in the study area had 0.5 m of maximum wave height to show the very stable conditions and the wave direction pattern of S-direction was dominant at Naro great ridge, and SE, SSW and S-direction were distributed strongly around the shellfish farm. (4) By the grain size analysis, the sediment around tidal flat consisted of gravel 0.00~5.81(average 1.70)%, sand 14.15~18.39(average 13.23)%, silt 27.59~47.15(average 30.84)% and clay 35.79~55.73(average 36.19)%, and the sediment type was divided into (g)M(lightly gravelly mud), sM(sandy mud) and gM(gravelly mud) by Folk's diagram. (5) The macro benthos community survey conducted in this site in January, 2010 showed that 1 species of Mollusca, 8 species of Polychaeta and 2 species of Crustacea appeared, and 11 species occupying over 1% of total abundance were dominant.
Kim, Sung Geun;Kim, Young Kyun;Heo, Youn Jung;Song, Kyo Young;Kim, Jin Jo;Jin, Hyung Min;Kim, Wook;Park, Cho Hyun;Park, Seung Man;Lim, Keun Woo;Kim, Seung Nam;Jeon, Hae Myung
Journal of Gastric Cancer
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제7권1호
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pp.16-22
/
2007
Purpose: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastricemptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. Materials and Methods: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an $^{99m}Tc$-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. Results: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). Conclusion: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.
Journal of the korean academy of Pediatric Dentistry
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제37권1호
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pp.35-43
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2010
We have developed a sodium fluoride containing gelatin and methyl cellulose gel. Cariostatic abilities of those gel were investigated and compared with APF gel and fluoride varnish($Cavityshield^{TM}$). We prepared the bovine tooth samples and divided into two surface, control side and experimental side in same specimen for exclusion of difference between specimens. The experiment was consisted of 4 groups : (I) APF gel : (II) $Cavityshield^{TM}$ : (III) Gelatin F gel : (IV) Methyl cellulose F gel Decalcification were produced by placing each specimen into artificial acidic solution(pH 4.0) for 72 hours. Surface microhardness were measured and depth of demineralization lesion were measured by polarizing light microscope. The results were as follows: 1. The difference of VHN between control and experimental side is smallest in group I (p<0.05). 2. The largest difference was shown in group II (p<0.05). 3. There were no significant difference between group III and IV in microhardness test (p>0.05). 4. The difference of lesion depth is smallest in group I (p<0.05). 5. There were no significant difference between group II, III and IV in lesion depth (p>0.05). The result of the present study indicate that the fluoride containing gelatin and methyl cellulose gel is more effective than APF gel and is similar to fluoride varnish application for prevention of demineralization.
This study investigated antioxidant activity and the lipid content of serum for the possible outcome of improving the activity of Ishige okamurae extracts in ovariectomized rats. The antioxidant effects of an Ishige okamurae water extract and an Ishige okamurae ethanol extract were measured by evaluating DPPH free radical scavenging activity and SOD-like activity. Fifty, seven-week old female Sprague Dawley rats were randomly assigned to five groups as follows: sham-operated rats (SHAM), ovariectomized rats (OVX-CON), ovariectomized rats that were treated with 17-beta-estradiol (200 ${\mu}g/kg/day$), and ovariectomized rats that were treated with Ishige okamurae extracts (50 mg/kg/day and 200 mg/kg/day, respectively). The diets were fed to the rats for seven weeks after ovariectomy. The antioxidant activities of the water and ethanol extracts of Ishige okamurae increased in a dose-dependent manner, and the ethanol extract was found to be higher than the water extract. Therefore, we examined the effect of an Ishige okamurae ethanol extract on total serum cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol levels, and anti-platelet aggregation. The total-cholesterol and triglyceride content of the serum increased in the OVX-CON group compared to the SHAM group, but supplementation with the Ishige okamurae ethanol extract caused these factors to decrease. Notably, the serum LDL-cholesterol concentration in the supplemented 200 mg/kg/day Ishige okamurae ethanol extract group was significantly more reduced than it was in the OVX-CON group. In addition, the platelet aggregation ability was lower in the groups treated with Ishige okamurae than it was in the OVX-CON group. According to these results, the effects of Ishige okamurae extract on serum lipid content in ovariectomized rats were illuminated.
Purpose : 'Programming' describes the process that stimulus at a critical period of development has lifelong effects. The fact that low birth weight links to the risk of elevated blood pressures in adult life is well known. This study aims to examine whether this link is evident in the newborn by investigating the relationship of the intrauterine growth indices and neonatal blood pressure(BP). Methods : We studied 127 neonates who were born at Ewha Womans' Hospital and their mothers enrolled our cohort study during pregnancy. Data on the mothers and details of the birth records were tracked and collected from medical charts. Neonatal BP was measured within 24 hours after birth. Results : Neonatal SBP was positively correlated to intrauterine growth indices; birth weight(BW)(r=0.4), head circumference(HC)(r=0.4), and birth height(r=0.3). However, an inverse relationship existed, between HC/BW ratio and neonatal SBP(r=-0.4). After adjusting for the baby's sex, maternal BP, and gestational age, neonatal SBP still associated with intrauterine growth indices. SBP was 7 mmHg higher in the highest BW group(${\geq}90percentiles$) compared to the lowest group(<10 percentiles). On the other hand, SBP was 17 mmHg lower in the highest HC/BW group(${\geq}90percentiles$) compared in the lowest group(<10 percentiles). Conclusion : This study could not find the evidence that intrauterine growth retardation affect on elevated neonatal BP. It suggests that the initiating events of BP programming may occur during postnatal growth period. To identify the critical starting period that intrauterine growth retardation leads to elevated BP, a study tracking BP changes from birth to childhood is required.
Purpose : It is not clear that the development of glomerular injury and aggravation by tumor necrosis factor alpha($TNF-{\alpha}$) is related to intrarenal or serum concentration of $TNF-{\alpha}$. So, we studied the relationship between the concentration of $TNF-{\alpha}$ and aggravation of glomerular damage in the Henoch-$Sch{\ddot{o}}nlein$ nephritis(HSN) and idiopathic nephrotic syndrome(INS). Methods : We collected the sera and urines of 21 patients with Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) and 22 patients with INS visited Chungbuk National University hospital from March 1998 to March 2001. The concentration of $TNF-{\alpha}$ in the sera and urines were measured by sandwich ELISA. Results : Serum $TNF-{\alpha}$ levels in the HSP patients with renal involvement were significantly higher than those without renal involvement(P=0.009). But urine $TNF-{\alpha}$ levels have no correlation with renal involvement(P=0.088). In the HSN patients, proteinuria have a significant correlation with serum $TNF-{\alpha}$ levels(P=0.004) but less correlation with urine $TNF-{\alpha}$ levels(P=0.053). Otherwise, proteinuria have no correlation with serum $TNF-{\alpha}$ levels(P=0.763) but have a significant correlation with urine $TNF-{\alpha}$ levels(P=0.007) in INS. Conclusion : These result suggest that the serum concentration of $TNF-{\alpha}$ would be important to glomerular involvement in HSP. And, it is interesting that proteinuria shows a significant relation with serum $TNF-{\alpha}$ levels in the HSN, but with urine $TNF-{\alpha}$ levels in the INS. This means the major production of $TNF-{\alpha}$ may be originated by extrarenal inflammation in the HSN and by intrarenal tubulo-interstitial damage due to proteinuria in the INS.
Park, Min Jee;Jeon, In-sang;Tchah, Hann;Choi, Kang Ho;Jung, Mi-Jin;Choi, Deok Young
Clinical and Experimental Pediatrics
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제52권10호
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pp.1161-1166
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2009
Purpose : Kawasaki disease—the most common cause of acquired heart disease in children—incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. Methods : Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. Results : Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2-3-fold, respectively. Conclusion : The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.
Song, Wung Joo;Lee, Sunho;Jeon, Young Mi;Kim, Sook Za;Jang, Mea Young
Journal of The Korean Society of Inherited Metabolic disease
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제18권2호
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pp.35-42
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2018
Purpose: To follow up Korean patients with metabolic and endocrine disorders ascertained by Korea Genetics Research Center, and assess the long-term effectiveness of extended newborn screening program in Korea. Methods: From January 2000 to December 2017, tandem mass spectrometry and fluoroimmunoassay were employed in extended newborn screening (NBS). The NBS program obtained dried blood spots from 283,626 babies, 48 hours after birth, and screened for galactosemia, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and 50 preventable inborn errors of amino acid, fatty acid, and organic acid metabolism. Results: 28 cases of amino acid disorders, 75 cases of organic acid disorders, 27 cases of fatty acid disorders, 51 cases of urea cycle disorders, 127 cases of CH, 14 cases of CAH, and 15 cases of galactosemia were ascertained through NBS and subsequent confirmatory laboratory tests. Patients with amino acid metabolic disorders, galactosemia, CH, or CAH were more likely to have a better long-term outcome if detected early. Early management of MSUD led to much better outcome in over 90%. Despite early intervention, 32% of other organic acidemia cases still resulted in developmental delay and neurological problems. Fatty acid disorders showed varied results; those with EMA and MCAD had a good outcome, but those with VLCAD had serious neurological problems and considerably higher mortality. 75% with UCD experienced serious neurological complications and higher mortality. Conclusion: The nation-wide NBS program must be accompanied by comprehensive long-term management and physician and family education of inborn errors of metabolism for a better outcome.
Jo, Yongjun;Lee, So-young;Park, Hae-il;Kim, YeongSic;Lee, Jehoon;Kim, Yonggoo;Han, Kyungja
Laboratory Medicine Online
/
제2권1호
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pp.10-14
/
2012
Background: Measurement of HbA1c levels is widely used to diagnose diabetes mellitus and to evaluate and monitor plasma-glucose concentrations over 6-8 weeks. In this study, we evaluated the diagnostic performance of the newly developed latex immunoturbidimetric method by using Autolab HbA1c. Methods: We analyzed and compared the diagnostic performance of Autolab HbA1c with that of Toshiba 200FR between April 2009 and July 2009. According to guidelines (EP5-A2, EP6-P, EP9-A2) of the clinical and laboratory standards institute (CLSI), we compared linearity, precision and correlation of Autolab HbA1c with those of G7 (Tosoh Corp., Kyoto, Japan) by using high-performance liquid chromatography (HPLC) method. Results: Data obtained using Autolab HbA1c showed good linearity in mixtures of samples with low (3.1%) and high (15.1%) levels of HbA1c (r2=0.9997). In the analysis of within-run precision of the samples with HbA1c levels of 5.1% and 12.1%, the SDs were 0.04 and 0.06 and covariances of these samples were 0.8% and 0.5%, respectively. In the Deming regression model, the regression equation was as follows: Autolab HbA1c=1.0859×Tosoh HPLC-0.6957. Conclusions: In this study, Autolab HbA1c method showed better performance characteristics than Tosoh G7 did. In reference review, there was no interference of variant hemoglobin. The data acquisition time of Autolab HbA1c was lower than that of Tosoh G7. The advantages of Autolab HbA1c are that it can be used as an autoanlyzer in routine chemical analysis, it does not require pre-analytical treatment, and the samples are automatically treated with distilled water for hemolysis.
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