• Title/Summary/Keyword: 향후변화분석

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Analysis of Neurological Complications on Antegrade Versus Retrograde Cerebral Perfusion in the Surgical Treatment of Aortic Dissection (대동맥 박리에서 전방성 뇌 관류와 역행성 뇌 관류의 신경학적 분석)

  • Park Il;Kim Kyu Tae;Lee Jong Tae;Chang Bong Hyun;Lee Eung Bae;Cho Joon Yong
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.489-495
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    • 2005
  • In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

Lung Injury Indices Depending on Tumor Necrosis Factor-$\alpha$ Level and Novel 35 kDa Protein Synthesis in Lipopolysaccharide-Treated Rat (내독소처치 흰쥐에서 Tumor Necrosis Factor-$\alpha$치 상승에 따른 폐손상 악화 및 35 kDa 단백질 합성)

  • Choi, Young-Mee;Kim, Young-Kyoon;Kwon, Soon-Seog;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1236-1251
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    • 1998
  • Background : TNF-$\alpha$ appears to be a central mediator of the host response to sepsis. While TNF-$\alpha$ is mainly considered a proinflammatory cytokine, it can also act as a direct cytotoxic cytokine. However, there are not so many studies about the relationship bet ween TNF-$\alpha$ level and lung injury severity in ALI, particularly regarding the case of ALI caused by direct lung injury such as diffuse pulmonary infection. Recently, a natural defense mechanism, known as the stress response or the heat shock response, has been reported in cellular or tissue injury reaction. There are a number of reports examining the protective role of pre-induced heat stress proteins on subsequent LPS-induced TNF-$\alpha$ release from monocyte or macrophage and also on subsequent LPS-induced ALI in animals. However it is not well established whether the stress protein synthesis such as HSP can be induced from rat alveolar macrophages by in vitro or in vivo LPS stimulation. Methods : We measured the level of TNF-$\alpha$, the percentage of inflammatory cells in bronchoalveolar lavage fluid, protein synthesis in alveolar macrophages isolated from rats at 1, 2, 3, 4, 6, 12, and 24 hours after intratracheal LPS instillation. We performed histologic examination and also obtained histologic lung injury index score in lungs from other rats at 1, 2, 3, 4, 6, 12, 24 h after intratracheal LPS instillation. Isolated non-stimulated macrophages were incubated for 2 h with different concentration of LPS (0, 1, 10, 100 ng/ml, 1, or 10 ${\mu}g/ml$). Other non-stimulated macrophages were exposed at $43^{\circ}C$ for 15 min, then returned to at $37^{\circ}C$ in 5% CO2-95% for 1 hour, and then incubated for 2 h with LPS (0, 1, 10, 100ng/ml, 1, or 10 ${\mu}g/ml$). Results : TNF-$\alpha$ levels began to increase significantly at 1 h, reached a peak at 3 h (P<0.0001), began to decrease at 6 h, and returned to control level at 12 h after LPS instillation. The percentage of inflammatory cells (neutrophils and alveolar macrophages) began to change significantly at 2 h, reached a peak at 6 h, began to recover but still showed significant change at 12 h, and showed insignificant change at 24 h after LPS instillation compared with the normal control. After LPS instillation, the score of histologic lung injury index reached a maximum value at 6 h and remained steady for 24 hours. 35 kDa protein band was newly synthesized in alveolar macrophage from 1 hour on for 24 hours after LPS instillation. Inducible heat stress protein 72 was not found in any alveolar macrophages obtained from rats after LPS instillation. TNF-$\alpha$ levels in supernatants of LPS-stimulated macro phages were significantly higher than those of non-stimulated macrophages(p<0.05). Following LPS stimulation, TNF-$\alpha$ levels in supernatants were significantly lower after heat treatment than in those without heat treatment (p<0.05). The inducible heat stress protein 72 was not found at any concentrations of LPS stimulation. Whereas the 35 kDa protein band was exclusively found at dose of LPS of 10 ${\mu}g/ml$. Conclusion : TNF-$\alpha$ has a direct or indirect close relationship with lung injury severity in acute lung injury or acute respiratory distress syndrome. In vivo and in vitro LPS stimulation dose not induce heat stress protein 72 in alveolar macrophages. It is likely that 35 kDa protein, synthesized by alveolar macrophage after LPS instillation, does not have a defense role in acute lung injury.

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Long Term Follow Up of Interferon-alpha Treatment in Children with Chronic Hepatitis B (만성 B형간염 환아에 대한 Interferon-alpha 치료결과의 장기 추적관찰)

  • Baek, Seoung-Yon;Eom, Ji-Hyun;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.140-151
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    • 2003
  • Purpose: We tried to evaluate the long term efficacy and positive predictive factors of interferon-alpha treatment in children with chronic hepatitis B. Methods: The study population included 113 children who received interferon therapy between May 1982 and July 2002 (20 years) for chronic hepatitis B in Department of Pediatrics, Yonsei University College of Medicine. Male to female ratio was 2.3 : 1 and the mean age at diagnosis was $11.1{\pm}4.1$ years old. Response to treatment was defined as normalization of alanine aminotransferase (ALT), disappearance of HBeAg and HBV-DNA Eighty two children responded while 32 did not. Interferon-alpha was given intramuscularly for 6 months at a dosage of $3{\times}10^6$ unit, 3 times weekly. In relapsed cases, lamivudine or interferon retreatment was done. Results: Seroconversion rate was 77.0% in terms of HBeAg, 74.3% in terms of HBV-DNA, and 80.5% in terms of ALT normalization after treatment. Seroconversion rate of both HBeAg and HBV-DNA was 72.6%. Analyzed by life table method, the effect of the treatment had been maintained over 10 years after cessation of therapy. Pre-treatment ALT level was the only significant positive predictive factor of response. Eleven cases (13.4%) relapsed, and 2 out of 3 showed response when treated with lamivudine and 1 out of 3 with interferon retreatment. Conclusion: Interferon-alpha showed significant efficacy in the treatment of chronic hepatitis B in our study. Further studies about the effect of interferon therapy on complications of hepatitis such as hepatocarcinoma, cirrhosis are warranted.

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Clinical and Electrophysiological Study on Guillain-Barr$\acute{e}$ Syndrome (Guillain-Barr$\acute{e}$ 증후군의 임상적 및 전기생리학적 연구)

  • Yun, Sung-Hwan;Hah, Jung-Sang;Joo, Sung-Gyun;Cho, Yong-Kook;Kim, Jung-Hyun;Chung, Ji-Yeun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.52-61
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    • 2005
  • Background: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. Materials and Methods: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. Results: The male to female ratio was 1.8:1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7 % of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3 %). Intravenous immunoglobulin therapy was performed in 29 cases (64.4 %). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. Conclusion: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

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Induction of G1 Arrest by Methanol Extract of Lycopus lucidus in Human Lung Adenocarcinoma A549 Cells (택란 메탄올 추출물에 의한 인체 폐암 세포주 A549의 G1 arrest 유발)

  • Park, Hyun-Jin;Jin, Soojung;Oh, You Na;Yun, Seung-Geun;Lee, Ji-Young;Kwon, Hyun Ju;Kim, Byung Woo
    • Journal of Life Science
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    • v.23 no.9
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    • pp.1109-1117
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    • 2013
  • Induction of G1 Arrest by Methanol Extract of Lycopus lucidus in Human Lung Adenocarcinoma A549 Cells Lycopus lucidus, a herbaceous perennial, is used as a traditional remedy in East Asia, including China and Korea. It has been reported that L. lucidus has anti-allergic effects, inhibitory effects on cholesterol acyltransferase in high glucose-induced vascular inflammation, and anti-proliferative effects in human breast cancer cells. However, the molecular mechanisms of the anti-cancer effects of L. lucidus have not yet been fully determined. In this study, we evaluated the anti-cancer effect and the mechanism of action of L. lucidus in human lung adenocarcinoma A549 cells using methanol extracts of L. lucidus (MELL). MELL treatment showed cytotoxic activity in a dose-dependent manner and induced G1 arrest in A549 cells. The induction of G1 arrest by MELL was associated with the up-regulation of phospho-CHK2 and the down-regulation of Cdc25A phosphatase. In addition, MELL treatment induced decreased expression of G1/S transition-related proteins, including CDK2, CDK4, CDK6, cyclin D1 and cyclin E. MELL also regulated the mRNA expression of CDK2 and cyclin E. On the other hand, the expression of p53 and the cyclin-dependent kinase inhibitor p21 was not induced by MELL. Collectively, these results suggest that MELL may exert an anti-cancer effect by cell cycle arrest at G1 phase through the ATM/CHK2/Cdc25A/CDK2 pathway in A549 cells.

THE EFFECT OF A MENTAL HEALTH PROMOTION PROGRAM AT A MENTAL HEALTH MODEL MIDDLE SCHOOL (정신건강시범 중학교에서 수행된 정신건강 증진 프로그램의 효과)

  • Kwak, Young-Sook;Ko, Hey-Joung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.251-260
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    • 2005
  • Objectives : This study was performed to evaluate the effects of a mental health program within a mental health model middle school. Methods : Subjects of the study consisted of 748 students from the second grade and third grade students at the middle school chosen for a school mental health program by the Ministry of Education in Jeju. The subjects participated in 12 consecutive sessions of group discussion developed to prevent mental health problems. The authors investigated the effects of the program by evaluating the students with Young's Internet Addiction Scale (IAS), Conners & Wells' Adolescent Self Report Scale(CASS) and Minnesota Multiphasic Personality Inventory (MMPI) before the initial session and after the final session. The data was analyzed by t-test in SPSS PC+ 10.0. The range of significance was p<.05. Results : In MMPI, the percentage of students above clinical range reduced from $12.9\%\;to\;11.0\%$. It reduced in the second grade students, but increased in the third grade students. The scores of paranoia and mania subscales showed a statistically significant reduction. In IAS, the percentage of students above the range of Internee overuse reduced from $16.0\%\;to\;6.8\%$. The percentage of students who showed risk of attention problems in CASS reduced from $22.7\%\;to\;18.3\%$. Also, both IAS and CASS scores showed a statistically significant reduction. The clinical significance of the reduction of IAS scores was within moderate range. Conclusion : The mental health program reduced the percentage of students' risk of mental health problems, internet addiction and attention problems and it was clinically effective on preventing Internet addiction. These results support the effects of a school mental health program to promote students' mental health. The authors suggest to expand this program to other schools, to reconfirm the effect of the program by using proper & specified instruments and to evaluate long-term effect of the program.

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The Impacts of Entrepreneurial Proclivity and Merchandising Strategy on Conventional Market and Its Policy Implications (한국 재래시장상인의 창업가정신과 상품화 전략이 시장이미지와 경영성과에 미치는 영향과 재래시장 정책에 대한 시사점)

  • Suh, Geun-Ha;Yoon, Sung-Wook;Suh, Chang-Soo
    • Journal of Distribution Science
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    • v.7 no.3
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    • pp.71-100
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    • 2009
  • The main purpose of this study is to define relevant factors that influence successful start-ups and management innovations of traditional markets from the point of market structures and relations. To do this, we devide an entrepreneurship of merchant into two factors, risk taking and managerial experience and choose product planning and its implementation to see merchandising of traditional markets. In this study we identify that several factors we chose are contributing to generating management performances through market promotional parameters. Also we confirm that image factors of traditional markets is consist of awareness and value of markets, and that these factors shows some sequential and continual patterns in the course of generating performances. In additions, it is identified that four independent factors have positive effects to star-up success; risk taking 0.29(t 2.61), managerial experience 0.04(t 1.79), merchandising implementation 0.374(t 2.61), market value 0.47(t 5.25), market awareness 0.22(t 2.30). This study can help merchants of traditional markets to make and change their market strategies, restructure their businesses and survive in the field. This also provide some ideas and guidances to relevant government agencies in formulating traditional market policies.

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Sociopsychological Factors related to Prediction of Treatment Outcome of the Temporomandibular Disorders (측두하악장애 치료결과의 예측에서 사회심리학적 요인의 영향)

  • Yeo, In-Sik;Han, Kyung-Soo;Kim, Yun-Hee
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.433-446
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    • 2005
  • The purpose of this study was to investigate the sociopsychological factors which might influence the course of the temporomandibular disorders and to develop models for prediction of treatment outcome related to pain, dysfunction and sound. For this study, 268 patients with temporomandibular disorders were selected from the patients presented to department of Oral Medicine, Wonkwang university dental hospital. Chief complaints of these subjects were largely grouped into three categories such as pain, dysfunction and sound, and 10 cm visual analogue scale(VAS) was used to record the state of the three complaints every visit and Treatment Index(VAS TI) was calculated from VAS. All the forty-two items obtained from clinical examination or questionnaire were statistically processed with $SPSS^{(R)}$ windows. The results of this study were as follows: 1. The items showed a difference between male and female subjects were maximum mouth opening, palpation score, jaw jerk during mandibular movement, and sleep disturbance. Among questionnaires such as SRRS, HAD scale and PSQI, the HAD scales showed the most highly significant correlation with the each scale item of the SCL-90R. 2. Among the groups classified by VAS TI, the group with the lowest VAS TI showed the highest VAS score in the start of treatment but showed the lowest score in the end of treatment, without respect to the type of chief complaint. From these results, it is assumed that the active treatment duration for the subjects with lower VAS score in the first visit would be longer than the subjects with higher score with the somewhat poor treatment outcome. 3. With regard to all the three complaints, the items showing significant effect in the model for prediction of treatment outcome were from questionnaire, except one item, maximum mouth opening, which suggest that the sociopsychological factors would be strongly related to development and progress of the symptoms.

The Change of Cell-cycle Related Proteins and Tumor Suppressive Effect in Non-small Cell Lung Cancer Cell Line after Transfection of p16(MTS1) Gene (폐암세포에 p16 (MTS1) 유전자 주입후 암생성능의 변화 및 세포주기관련 단백질의 변동에 관한 연구)

  • Kim, Young-Whan;Kim, Jae-Yeol;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.796-805
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    • 1997
  • Background : It is clear that deregulation of cell cycle progression is a hallmark of neoplastic transformation and genes involved in the $G_1$/S transition of the cell cycle are especially frequent targets for mutations in human cancers, including lung cancer. p16 gene product, one of the G1 cell-cycle related proteins, that is recently identified plays an important role in the negative regulation of the the kinase activity of the cyclin dependent kinase (cdk) enzymes. Therefore p16 gene is known to be an important tumor suppressor gene and is also called MTS1 (multiple tumor suppressor 1). No more oncogenes have been reported to be frequently related to multiple different malignancies than the alterations of p16 gene. Especially when it comes to non-small cell lung cancer, there was no expression of p16 in more than 70% of cell lines examined. And also it is speculated that p16 gene could exert a key role in the development of non-small cell lung cancer. This study was designed to evaluate whether p16 gene could be used as a candidate for gene therapy of non-small cell lung cancer. Methods : After the extraction of total RNA from normal fibroblast cell line and subsequent reverse transcriptase reaction and polymerase chain reaction, the amplified p16 cDNA was subcloned into eukaryotic expression plasmid vector, pRC-CMV. The constructed pRC-CMV-p16 was transfected into the NCI-H441 NSCLC cell line using lipofectin. The changes of G1 cell-cycle related proteins were investigated with Western blot analysis and immunoprecipitation after extraction of proteins from cell lysates and tumor suppressive effect was observed by clonogenic assay. Results : (1) p16(-) NCI-H441 cell line transfected with pRC-CMV-p16 showed the formation of p16 : cdk 4 complex and decreased phosphorylated Rb protein, while control cell line did not. (2) Clonogenic assay demonstrated that the number of colony formation was markedly decreased in p16(-) NCI-H441 cell line transfected with pRC-CMV-p16 than the control cell line. Conclusion : It is confirmed that the expression of p16 protein in p16 absent NSCLC cell line with the gene transfection leads to p16 : cdk4 complex formation, subsequent decrease of phosphorylated pRb protein and ultimately tumor suppressive effects. And also it provides the foundation for the application of p16 gene as a important candidate for the gene therapy of NSCLC.

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The Bacterial Colonization of Burn Wound and the Changes of Antibiotic Susceptibility in Childhood Burn (January, 1999~December, 2002) (소아 화상의 화상부위 세균 집락화와 항균제 감수성 변화(1999년 1월~2002년 12월))

  • Kim, Jin-Man;Lee, So-Yeon;Kim, Young-Ho;Shin, Eon-Woo;Oh, Phil-Soo;Kim, Kwang-Nam;Lee, Kyu-Man;Oh, Suk-Joon
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.157-165
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    • 2005
  • Purpose : Children occupy a large proportion of burn victims. So we want to aid to pediatric burn care through the understanding of the bacterial distribution in burn wounds and antibiotic susceptibility against isolated microorganisms from burn wounds. Methods : We analysed the medical records of 213 pediatric burn patients(0~15 years), 406 samples that grew bacteria in burn wound sites. Results : Of the total 213 patients, male were 59.6% and female were 40.4%. Scalding burn was the most common(78.4%), flame burn was the second(16.4%). Pathogens were isolated in 406 samples. The most common was Pseudomonas aeruginosa(58.1%). Next were Enterococcus species, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus species, Acinetobacter species. P. aeruginosa was resistant to trimethoprim-sulfamethoxazole in 100%, cephalothin in 98.1%, ampicillin-sulbactam in 96.2%, ampicillin in 95.3%, ceftriaxone in 95.2%, tobramycin in 93.7%, cefoperazone in 68.9%, ceftazidime in 67.7%. Enterococcus species were resistant to tetracycline in 63.9%, streptomycin in 45.5%, gentamicin in 36.1%, penicillin G in 13.7%. S. aureus was resistant to gentamicin in 89.7%, tetracycline in 86.2%, ciprofloxacin in 86.2%, penicillin G in 84.3%, oxacillin in 78.4%, erythromycin in 76.5%. Acinetobacter species were resistant to ampicillin-sulbactam in 100%, gentamicin in 85.7%, ampicillin in 83.3%, piperacillin in 61.5%. Conclusion : P. aeruginosa was highly resistant to drugs like cefoperazone in 68.9%, ceftazidime 67.7%. S. aureus was highly resistant to penicillin G in 84.3%, oxacillin in 25.9 %, but none to vancomycin in 0%, teicoplanin in 2.2%. According to the study, Acinetobacter species turned out to be multi-resistant strains, so careful attention must be paid to the choice of antibiotics.

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