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LINAC-based Stereotactic Radiosurgery for Meningiomas (수막종에 대한 선형가속기형 정위방사선수술)

  • Shin Seong Soo;Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Huh Seung Jae;Yeo Inhwan J;Shin Hyung Jin;Park Kwan;Kim BoKyoung;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.87-94
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    • 2001
  • Purpose : To evaluate the role of LINAC-based stereotactic radiosurgery (SRS) in the management of meningiomas, we reviewed clinical response, image response, neurological deficits for patients treated at our institution. Methods and materials : Between February 1995 and December 1999, twenty-six patients were treated with SRS. Seven patients had undergone prior resection. Nineteen patients received SRS as the initial treatment. There were 7 male and 19 female patients. The median age was 51 years (range, $14\~67\;years$). At least one clinical symptom presented at the time of SRS in 17 patients and cranial neuropathy was seen in 7 patients. The median tumor volume was $4.7\;cm^3\;(range,\;0.7\~16.5\;m^3)$. The mean marginal dose was 15 Gy (range, $10\~20\;Gy$), delivered to the $80\%$ isodose surface (range, $46\~90\%$). The median clinical and imaging follow-up periods were 27 months (range, 1-71 months) and 25 months (range, $1\~52\;months$), respectively. Results : Of 14 patients who had clinical follow-up of one year or longer, thirteen patients $(93\%)$ were improved clinically at follow-up examination. Clinical symptom worsened in one patient at 4 months after SRS as a result of intratumoral edema, who underwent surgical resection at 7 months. OF 14 patients who had radiologic follow-up of one year or longer, tumor volume decreased in 7 patients $(50\%)$ at a median of 11 months (range, $6\~25\;months$), remained stable in 6 patients $(43\%)$, and increased in one patient $(7\%)$, who underwent surgical resection at 44 months. New radiation-induced neurological deficits developed in six patients $(23\%)$. Five patients $(19\%)$ had transient neurological deficits, completely resolved by conservative treatment including steroid therapy. Radiation-induced brain necrosis developed in one patient $(3.8\%)$ at 9 months after SRS who followed by surgical resection of tumor and necrotic tissue. Conclusions : LINAC-based SRS proves to be an effective and safe management strategy for small to moderate sized meningiomas, inoperable, residual, and recurrent, but long-term follow-up will be necessary to fully evaluate its efficacy. To reduce the radiation-induced neurological deficit for large size meningioma and/or in the proximity of critical and neural structure, more delicate treatment planning and optimal decision of radiation dose will be necessary.

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Health Assessment of the Nakdong River Basin Aquatic Ecosystems Utilizing GIS and Spatial Statistics (GIS 및 공간통계를 활용한 낙동강 유역 수생태계의 건강성 평가)

  • JO, Myung-Hee;SIM, Jun-Seok;LEE, Jae-An;JANG, Sung-Hyun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.18 no.2
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    • pp.174-189
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    • 2015
  • The objective of this study was to reconstruct spatial information using the results of the investigation and evaluation of the health of the living organisms, habitat, and water quality at the investigation points for the aquatic ecosystem health of the Nakdong River basin, to support the rational decision making of the aquatic ecosystem preservation and restoration policies of the Nakdong River basin using spatial analysis techniques, and to present efficient management methods. To analyze the aquatic ecosystem health of the Nakdong River basin, punctiform data were constructed based on the position information of each point with the aquatic ecosystem health investigation and evaluation results of 250 investigation sections. To apply the spatial analysis technique, the data need to be reconstructed into areal data. For this purpose, spatial influence and trends were analyzed using the Kriging interpolation(ArcGIS 10.1, Geostatistical Analysis), and were reconstructed into areal data. To analyze the spatial distribution characteristics of the Nakdong River basin health based on these analytical results, hotspot(Getis-Ord Gi, $G^*_i$), LISA(Local Indicator of Spatial Association), and standard deviational ellipse analyses were used. The hotspot analysis results showed that the hotspot basins of the biotic indices(TDI, BMI, FAI) were the Andong Dam upstream, Wangpicheon, and the Imha Dam basin, and that the health grades of their biotic indices were good. The coldspot basins were Nakdong River Namhae, the Nakdong River mouth, and the Suyeong River basin. The LISA analysis results showed that the exceptional areas were Gahwacheon, the Hapcheon Dam, and the Yeong River upstream basin. These areas had high bio-health indices, but their surrounding basins were low and required management for aquatic ecosystem health. The hotspot basins of the physicochemical factor(BOD) were the Nakdong River downstream basin, Suyeong River, Hoeya River, and the Nakdong River Namhae basin, whereas the coldspot basins were the upstream basins of the Nakdong River tributaries, including Andong Dam, Imha Dam, and Yeong River. The hotspots of the habitat and riverside environment factor(HRI) were different from the hotspots and coldspots of each factor in the LISA analysis results. In general, the habitat and riverside environment of the Nakdong River mainstream and tributaries, including the Nakdong river upstream, Andong Dam, Imha Dam, and the Hapcheon Dam basin, had good health. The coldspot basins of the habitat and riverside environment also showed low health indices of the biotic indices and physicochemical factors, thus requiring management of the habitat and riverside environment. As a result of the time-series analysis with a standard deviation ellipsoid, the areas with good aquatic ecosystem health of the organisms, habitat, and riverside environment showed a tendency to move northward, and the BOD results showed different directions and concentrations by the year of investigation. These aquatic ecosystem health analysis results can provide not only the health management information for each investigation spot but also information for managing the aquatic ecosystem in the catchment unit for the working research staff as well as for the water environment researchers in the future, based on spatial information.

The Status of North Korean Airspace after Reunification (북한 공역의 통일 후 지위)

  • Kwon, Chang-Young
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.287-325
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    • 2017
  • Considering the development of aerospace, military science and technology since the 20th century, the sky is very important for the nation's existence and prosperity. The proverb "Whosoever commands the space commands the world itself!" emphasizes the need for the command of the air. This essay is the first study on the status of airspace after reunification. First, the territorial airspace is over the territory and territorial sea, and its horizontal extent is determined by the territorial boundary lines. Acceptance of the present order is most reasonable, rather than attempting to reconfigure through historical truths about border issues, and it could be supported by neighboring countries in the reunification period. For peace in Northeast Asia, the reunified Korea needs to respect the existing border agreement between North Korea and China or Russia. However, the North Korean straight baselines established in the East Sea and the Yellow Sea should be discarded because they are not available under United Nations Convention on the Law of the Sea. It is desirable for the reunified Korea to redefine the straight baselines that comply with international law and determine the territorial waters up to and including the 12-nautical mile outside it. Second, the Flight Information Region (hereinafter "FIR") is a region defined by the International Civil Aviation Organization (hereinafter "ICAO") in order to provide information necessary for the safe and efficient flight of aircraft and the search and rescue of aircraft. At present, Korea is divided into Incheon FIR which is under the jurisdiction of South Korea and Pyongyang FIR which is under the jurisdiction of North Korea. If North Korea can not temporarily exercise control of Pyongyang FIR due to a sudden change of circumstances, it is desirable for South Korea to exercise control of Pyongyang FIR, and if it is unavoidable, ICAO should temporarily exercise it. In reunified Korea, it is desirable to abolish Pyongyang FIR and integrate it into Incheon FIR with the approval of ICAO, considering systematic management and control of FIR, establishment of route, and efficiency of management. Third, the Air Defense Identification Zone (hereinafter "ADIZ") is a zone that requires easy identification, positioning, and control of aircraft for national security purposes, and is set up unilaterally by the country concerned. The US unilaterally established the Korea Air Defense Identification Area (KADIZ) by the Declaration of Commitment on March 22, 1951. The Ministry of Defense proclaimed a new KADIZ which extended to the area including IEODO on December 13, 2013. At present, North Korea's military warning zone is set only at maritime boundaries such as the East Sea and the Yellow Sea. But in view of its lack of function as ADIZ in relations with China and Russia, the reunified Korea has no obligation to succeed it. Since the depth of the Korean peninsula is short, it is necessary to set ADIZ boundary on the outskirts of the territorial airspace to achieve the original purpose of ADIZ. Therefore, KADIZ of the reunified Korea should be newly established by the boundary line that coincides with the Incheon FIR of the reunified Korea. However, if there is no buffer zone overlapping with or adjacent to the ADIZs of neighboring countries, military tensions may rise. Therefore, through bilateral negotiations for peace in Northeast Asia, a buffer zone is established between adjacent ADIZs.

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The Respiratory and Hemodynamic Effect of Prone Position in Patients with ARDS (급성호흡부전증후군에서 Prone Position의 호흡 및 혈류역학적 효과)

  • Lim, Chae-Man;Koh, Youn-Suck;Jung, Bok-Hyun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1105-1113
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    • 1997
  • Background : Prone position improves oxygenation in some patients with ARDS. According to some authors, prone position can also improve the deteriorated hemodynamics induced by PEEP. But these respiratory and hemodynamic effects of prone position has not yet been fully established. Methods : Twentythree consequtive patients with ARDS(M : F= 11 : 12, $62.1{\pm}20.8yrs$) were the subjects for this study. ABGA, static compliance of the respiratory system, mean arterial pressure and pulse rate were obtained in supine position and at 5min, 0.5h and 2h of prone position. Positive respiratory response was defined as 20mmHg or more increase in $PaO_2/FIO_2$ within 2h of prone position. Early of late respiratory responses were defined if the positive response was observed within of after 3 day of ARDS onset, respectively. Positive hemodynamic response was defined as 10mmHg or more increase in mean arterial pressure at 5min of prone position. Results : Fifteen patients (65%) showed positive respiratory response. In the respiratory responders, $PaO_2$ was $69.8{\pm}17.6mmHg$ in supine position, $83.2{\pm}22.6mmHg$ in prone position 0.5h, $96.8{\pm}22.7mmHg$ in prone position 2h(p<0.001), and $PaO_2/FIO_2$ was $108{\pm}41mmHg$, $137{\pm}57mmHg$, $158{\pm}50mmHg$, respectively(p=0.001). Age, sex, cause of ARDS, supine $PaO_2$ and $PaO_2/FIO_2$ were not different between the respiratory responders and the nonresponders. The respiratory responders, however, showed higher mean arterial pressure than the nonresponders($91.1{\pm}13.1mmHg$ vs. $76.0{\pm}18.7mmHg$, p=0.035), and tendency of higher survival rate(9/15 vs. 2/8, p=0.074). Static compliance of the respiratory system was decreased in prone position 0.5h($28.4{\pm}7.9ml/cm$ $H_2O$ vs. $23.8{\pm}7.6ml/cm$ $H_2O$, p=0.007). The overall rate of early response(n=23) and late response(n=11) were similar(14/23 vs. 7/11, p>0.05). But patient without early response showed late response only in 25%(1/4), while patient with early response showed late response in 85.7%(6/7)(p=0.072). Five patients(22%) showed positive hemodynamic response, two of them being respiratory nonresponders. There were no differences in the baseline mean arterial pressure or the level of PEEP applied in supine between the hemodynamic responders and the hemodynamic nonresponders. Conclusions : Prone position either improved oxygenation or increased arterial pressure in significant proportion of patients with ARDS. And the respiratory response to prone position was thought to be determined in the early stage of ARDS.

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Establishment of Analytical Method for Dichlorprop Residues, a Plant Growth Regulator in Agricultural Commodities Using GC/ECD (GC/ECD를 이용한 농산물 중 생장조정제 dichlorprop 잔류 분석법 확립)

  • Lee, Sang-Mok;Kim, Jae-Young;Kim, Tae-Hoon;Lee, Han-Jin;Chang, Moon-Ik;Kim, Hee-Jeong;Cho, Yoon-Jae;Choi, Si-Won;Kim, Myung-Ae;Kim, MeeKyung;Rhee, Gyu-Seek;Lee, Sang-Jae
    • Korean Journal of Environmental Agriculture
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    • v.32 no.3
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    • pp.214-223
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    • 2013
  • BACKGROUND: This study focused on the development of an analytical method about dichlorprop (DCPP; 2-(2,4-dichlorophenoxy)propionic acid) which is a plant growth regulator, a synthetic auxin for agricultural commodities. DCPP prevents falling of fruits during their growth periods. However, the overdose of DCPP caused the unwanted maturing time and reduce the safe storage period. If we take fruits with exceeding maximum residue limits, it could be harmful. Therefore, this study presented the analytical method of DCPP in agricultural commodities for the nation-wide pesticide residues monitoring program of the Ministry of Food and Drug Safety. METHODS AND RESULTS: We adopted the analytical method for DCPP in agricultural commodities by gas chromatograph in cooperated with Electron Capture Detector(ECD). Sample extraction and purification by ion-associated partition method were applied, then quantitation was done by GC/ECD with DB-17, a moderate polarity column under the temperature-rising condition with nitrogen as a carrier gas and split-less mode. Standard calibration curve presented linearity with the correlation coefficient ($r^2$) > 0.9998, analysed from 0.1 to 2.0 mg/L concentration. Limit of quantitation in agricultural commodities represents 0.05 mg/kg, and average recoveries ranged from 78.8 to 102.2%. The repeatability of measurements expressed as coefficient of variation (CV %) was less than 9.5% in 0.05, 0.10, and 0.50 mg/kg. CONCLUSION(S): Our newly improved analytical method for DCPP residues in agricultural commodities was applicable to the nation-wide pesticide residues monitoring program with the acceptable level of sensitivity, repeatability and reproducibility.

Effect of OPU (Ovum Pick-Up) Duration on the Rate of Collected Ova and In Vitro Produced Blastocyst Formation (OPU(Ovum Pick-Up) 채란기간이 난자 및 수정란 생산에 미치는 영향)

  • Jin, Jong-In;Kwon, Tae-Hyeon;Choi, Byeong-Hyun;Kim, Sung-Soo;Jo, Hyun-Tae;Kong, Il-Keun
    • Journal of Embryo Transfer
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    • v.25 no.1
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    • pp.15-20
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    • 2010
  • This study was performed to identify the optimal timing for oocyte donor replacement during OPU procedure. OPU was carried out to collect oocytes from every donor at an interval of $3{\sim}4$ days (2 times a week). The collected oocytes were matured in vitro in TCM-199 supplemented with 10% FBS, 10 mg/ml of FSH and 1 mg/ml of estradiol for 24 h. After 24 h of exposure to sperm, the presumptive zygotes were cultured in CR1aa medium supplemented with 4 mg/ml of BSA for 3 days before being changed to CR1aa medium with 10% of FBS for another $3{\sim}4$ days. The mean numbers of retrieved oocytes were remained constantly up to 3 months ($6.0{\pm}0.5$, $6.2{\pm}0.7$, $5.2{\pm}0.6$), but significantly decreased at over 4 to 6 months ($3.7{\pm}0.5$, $2.8{\pm}0.4$, $1.2{\pm}0.2$) (p<0.05). The blastocyst development potential was also very similar rate from 1 to 3 months (37.2%, 40.4% and 44.6%), but significantly decreased from 4 to 6 months (24.8%, 29.3% and 28.6%, respectively) (p<0.05). The production of OPU derived embryos in periods of 1 to 3 months ($2.2{\pm}0.3$, $2.5{\pm}0.3$ and $2.3{\pm}0.4$) were significantly higher than those in 4 to 6 months ($0.9{\pm}0.2$, $0.8{\pm}0.2$ and $0.3{\pm}0.2$, respectively) (p<0.05). In conclusion, the efficient periods for the production of OPU derived embryos was until 4 months, twice per week to produce over 64 transferable embryos and then replace new donor after 3 months use. The best replacement time is 3 months and could be maximized production of OPU derived embryos.

Effect of Early Pregnant Heifer as Donor on the Ovum Pick-Up Derived Oocyte Aspiration and Embryo Production (초기 임신우의 공란우 활용이 초음파 유도 난자 채취 및 수정란 생산에 미치는 영향)

  • Jin, Jong-In;Kwon, Tae-Hyeon;Choi, Byeong-Hyun;Kim, Sung-Soo;Jo, Hyun-Tea;Bang, Jae-Il;Kim, Sam-Chul;Cho, Kyu-Woan;Lee, Jung-Gyu;Kong, Il-Keun
    • Journal of Embryo Transfer
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    • v.26 no.1
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    • pp.19-25
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    • 2011
  • This study was carried out to evaluate the effect of early pregnant cow as donor for Ovum Pick-Up (OPU) derived oocyte aspiration and embryo production in Holstein heifers. Four non-pregnant and 2 pregnant Holstein heifers were used as donor and then carried out total 17 OPU session for 10 weeks (2 times per week). Recovered cumulus-oocyte-complexes (COCs) were classified into 4 grade by oocyte cytoplasm and cumulus cells and matured in vitro in TCM-199 supplemented with 10% FBS, 10 mg/ml FSH and 1 mg/ml estradiol in 5% $CO_2$ and over 99% humidity for 24 h. After 24 h co-incubation with post-thaw sperm, the presumed zygotes were cultured in CR1aa medium with 4 mg/ml BSA for 3 days and then changed CR1aa medium with 10% of FBS for another 3~4 days. The Mean number of aspirated follicles and collected oocytes in the early stage pregnant and non-pregnant heifers were $13.0{\pm}4.3$ and $10.6{\pm}3.9$, $5.4{\pm}3.4$ and $7.7{\pm}3.6$ per session, respectively. Rate of collected oocyte from aspirated follicles were 59.2% and 50.5%, respectively. The average number of good quality oocytes (Grade I and II) in the early stage pregnant and non-pregnant heifers was $3.7{\pm}2.7$ and $4.9{\pm}2.6$ (Mean${\pm}$SD). Cleavage and blastocyst developmental rates in Grade I and II were 22.2% and 25.5%, and then $1.7{\pm}0.9$ and $1.4{\pm}1.1$ blastocyst per session, respectively. In conclusion, OPU technology can be used in early stage pregnant and non-pregnant heifers without any problem and so applied OPU derived embryo production to maximize the ability of genetically valuable females.

Varietal and Locational Variation of Grain Quality Components of Rice Produced in Hilly and High Altitude Areas in Korea (중산간지와 고냉지산 쌀 형태 및 이화학적특성의 품종 및 산지간 변이)

  • Choi, Hae-Chune;Chi, Jeong-Hyun;Lee, Chong-Seob;Kim, Young-Bae;Cho, Soo-Yeon
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.39 no.1
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    • pp.27-37
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    • 1994
  • To catch the relative importance of varietal and environmental variation in various grain quality components associated with palatability of cooked rice, grain appearance, milling recovery, several physicochemical properties of milled rice and texture or eating quality of cooked rice for rice materials of five japonica cultivars, produced at four locations of the mid-mountainous and alpine area of Korea in 1989, were evaluated and analyzed the obtained data. Highly significant varietal and locational variations were detected in 1000-grain weight, amylose content, K/Mg ratio, gelatinization temperature, peak viscosity, breakdown and setback viscosities as compared with variety x location interaction variation. Also, marked locational variations were recongnized in milling recovery from rough to brwon rice, alkali digestibility and protein content, and significant varietal variation was caught in stickiness /hardness ratio of cooked rice. The variety x location interaction variation was especially large in quality components of grain appearance and ripening, palatability of cooked rice and consistency viscosity. One thousand kernel weight was heaviest in Jinbuolbyeo and Odaebyeo, and the unfilled grain ratio was lowest in Jinbuolbyeo. Odaebyeo showed slightly' lower ratio of intact and clear milled rice because of more chalky rice kernels compared with other cultivars. Amylose content of Jinbuolbyeo and Sobaegbyeo was about 1% lower than that of others and K/Mg ratio of Odaebyeo was the lowest one among rice materials. Odaebyeo, Sobaegbyeo and Jinbuolbyeo revealed significantly low gelatinization temperature and setback viscosity while high peak and breakdown viscosities. Cholwon rice showed the greatest kernel weight, good grain filling but lowest ratio of intact and clear milled rice while Jinbu rices exhibited the highest milling recovery from rough to brown rice and ratio of sound milled rice. Amylose content of milled rice in Jinbu rices was about 2-3% lower than those in other locations. Protein content of polished rice was about 1% lower in rice materials of middle zone than those of southern part of Korea. K/Mg ratio of milled rice was highest in Jinbu rice and potassium content was slightly higher in the rice materials of middle region than in those of southern region. Alkali digestion value and gelatinization temperature of polished rice was markedly high in Jinbu rices as compared with other locations. Breakdown viscosity was hightest in Chlown rices and next higher with the order of Hwaso>Unbong>Jinbu rices, and setback viscosity was the quite contrary tendency with breakdown. The stickiness /hardness ratio of cooked rice was relatively higher value in Cholwon rices than in the others and the palatability of cooked rice was a little better in Unbong and Cholwon rices than in Jinbu and Hwaso rices, although variety x location interaction variation was large. The rice materials can be classified largely into two groups of Jinbu and the others by the distribution on the plane of 1st and 2nd principal components (about 60% of total informations) contracted from twelve grain quality properties closely associated with eating quality of cooked rice. Also, Jinbu and the other rices were divided into two and three rice groups respectively. Varietal variation of overall rice quality was smallest in Hwaso. The most superior rice group in overall quality evaluation included Odaebyeo produced at Cholwon, Unbong and Hwaso, and Sobaegbyeo grown at Unbong

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Cardioprotective Effect of Calcium Preconditioning and Its Relation to Protein Kinase C in Isolated Perfused Rabbit Heart (적출관류 토끼 심장에서 칼슘 전처치에 의한 심근보호 효과와 Protein Kinase C와의 관계)

  • 김용한;손동섭;조대윤;양기민;김호덕
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.603-612
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    • 1999
  • Background : It has been documented that brief repetitive periods of ischemia and reperfusion (ischemic preconditioning, IP) enhances the recovery of post-ischemic contractile function and reduces infarct size after a longer period of ischemia. Many mechanisms have been proposed to explain this process. Recent studies have suggested that transient increase in the intracellular calcium may have triggered the activation of protein kinase C(PKC); however, there are still many controversies. Accordingly, the author performed the present study to test the hypothesis that preconditioning with high concentration of calcium before sustained subsequent ischemia(calcium preconditioning) mimics IP by PKC activation. Material and Method : The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) Method: The isolated hearts from the New Zealand White rabbits(1.5∼2.0 kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 45-minute global ischemia followed by a 120-minute reperfusion with IP(IP group, n=13) or without IP(ischemic control, n=10). IP was induced by single episode of 5-minute global ischemia and 10-minute reperfusion. In the Ca2+ preconditioned group, perfusate containing 10(n=10) or 20 mM(n=11) CaCl2 was perfused for 10 minutes after 5-minute ischemia followed by a 45-minute global ischemia and a 120-minute reperfusion. Baseline PKC was measured after 50-minute perfusion without any treatment(n=5). Left ventricular function including developed pressure(LVDP), dP/dt, heart rate, left ventricular end-diastolic pressure(LVEDP) and coronary flow(CF) was measured. Myo car ial cytosolic and membrane PKC activities were measured by 32P-${\gamma}$-ATP incorporation into PKC-specific pepetide. The infarct size was determined using the TTC (tetrazolium salt) staining and planimetry. Data were analyzed using one-way analysis of variance(ANOVA) variance(ANOVA) and Tukey's post-hoc test. Result: IP increased the functional recovery including LVDP, dP/dt and CF(p<0.05) and lowered the ascending range of LVEDP(p<0.05); it also reduced the infarct size from 38% to 20%(p<0.05). In both of the Ca2+ preconditioned group, functional recovery was not significantly different in comparison with the ischemic control, however, the infarct size was reduced to 19∼23%(p<0.05). In comparison with the baseline(7.31 0.31 nmol/g tissue), the activities of the cytosolic PKC tended to decrease in both the IP and Ca2+ preconditioned groups, particularly in the 10 mM Ca2+ preconditioned group(4.19 0.39 nmol/g tissue, p<0.01); the activity of membrane PKC was significantly increased in both IP and 10 mM Ca2+ preconditioned group (p<0.05; 1.84 0.21, 4.00 0.14, and 4.02 0.70 nmol/g tissue in the baseline, IP, and 10 mM Ca2+ preconditioned group, respectively). However, the activity of both PKC fractions were not significantly different between the baseline and the ischemic control. Conclusion: These results indicate that in isolated Langendorff-perfused rabbit heart model, calcium preconditioning with high concentration of calcium does not improve post-ischemic functional recovery. However, it does have an effect of limiting(reducing) the infart size by ischemic preconditioning, and this cardioprotective effect, at least in part, may have resulted from the activation of PKC by calcium which acts as a messenger(or trigger) to activate membrane PKC.

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Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease (좌심실 판막질환 수술 후 동반된 삼첨판패쇄부전증의 경과에 영향을 미치는 요인)

  • Jin, Ung;Kim, Hwan-Wook;Lee, Jong-Ho;Kweon, Jong-Bum;Jo, Min-Seop;Yoon, Jeong-Seob;Moon, Seok-Whan;Sim, Sung-Bo;Park, Kuhn;Kim, Chi-Kyung;Cho, Keon-Hyun;Wang, Young-Pil;Lee, Sun-He;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.150-156
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    • 2003
  • Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.