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Effects of Ulinastatin on Postoperative Blood Loss and Hemostasis in Atrioventricular Valve Surgery with Cardiopulmonary Bypass

  • Park, Jae Bum;Kim, Seong Hyop;Lee, Song Am;Chung, Jin Woo;Kim, Jun Seok;Chee, Hyun Keun
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.185-191
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    • 2013
  • Background: Cardiopulmonary bypass (CPB) induces variable systemic inflammatory reactions associated with major organ dysfunction via polymorphonuclear neutrophils (PMNs). Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces systemic inflammatory responses. The aim of this study is to evaluate the effect of ulinastatin on postoperative blood loss and laboratory changes in patients undergoing open heart surgery. Materials and Methods: Between January 2008 and February 2009, 110 patients who underwent atrioventricular valve surgery through right thoracotomy were divided into two groups. Patients received either 5,000 U/kg ulinastatin (ulinastatin group, n=41) or the equivalent volume of normal saline (control group, n=69) before aortic cross clamping. The primary end points were early coagulation profile changes, postoperative blood loss, transfusion requirements, and duration of intubation and intensive care unit stay. Results: There were no statistically significant differences between the two groups in early coagulation profile, other perioperative laboratory data, and postoperative blood loss with transfusion requirements. Conclusion: Administration of ulinastatin during operation did not improve the early coagulation profile, postoperative blood loss, or transfusion requirements of patients undergoing open heart surgery. In addition, no significant effect of ulinastatin was observed in major organs dysfunction, systemic inflammatory reactions, or other postoperative profiles.

Comparison of removal torques between laser-treated and SLA-treated implant surfaces in rabbit tibiae

  • Kang, Nam-Seok;Li, Lin-Jie;Cho, Sung-Am
    • The Journal of Advanced Prosthodontics
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    • v.6 no.4
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    • pp.302-308
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    • 2014
  • PURPOSE. The purpose of this study was to compare removal torques and surface topography between laser treated and sandblasted, large-grit, acid-etched (SLA) treated implants. MATERIALS AND METHODS. Laser-treated implants (experimental group) and SLA-treated implants (control group) 8 mm in length and 3.4 mm in diameter were inserted into both sides of the tibiae of 12 rabbits. Surface analysis was accomplished using a field emission scanning electron microscope (FE-SEM; Hitachi S-4800; Japan) under ${\times}25$, ${\times}150$ and ${\times}1,000$ magnification. Surface components were analyzed using energy dispersive spectroscopy (EDS). Rabbits were sacrificed after a 6-week healing period. The removal torque was measured using the MGT-12 digital torque meter (Mark-10 Co., Copiague, NY, USA). RESULTS. In the experimental group, the surface analysis showed uniform porous structures under ${\times}25$, ${\times}150$ and ${\times}1,000$ magnification. Pore sizes in the experimental group were 20-40 mm and consisted of numerous small pores, whereas pore sizes in the control group were 0.5-2.0 mm. EDS analysis showed no significant difference between the two groups. The mean removal torque in the laser-treated and the SLA-treated implant groups were 79.4 Ncm (SD = 20.4; range 34.6-104.3 Ncm) and 52.7 Ncm (SD = 17.2; range 18.7-73.8 Ncm), respectively. The removal torque in the laser-treated surface implant group was significantly higher than that in the control group (P=.004). CONCLUSION. In this study, removal torque values were significantly higher for laser-treated surface implants than for SLA-treated surface implants.

Tissue CA125 and HE4 Gene Expression Levels Offer Superior Accuracy in Discriminating Benign from Malignant Pelvic Masses

  • Fawzy, Amal;Mohamed, Mohamed R;Ali, Mohamed AM;El-Magied, Mohamed H Abd;Helal, Amany M
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.323-333
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    • 2016
  • Background: Ovarian cancer remains a major worldwide health care issue due to the lack of satisfactory diagnostic methods for early detection of the disease. Prior studies on the role of serum cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) in detecting ovarian cancer presented conflicting results. New tools to improve the accuracy of identifying malignancy are urgently needed. We here aimed to evaluate the diagnostic utility of tissue CA125 and HE4 gene expression in comparison to serum CA125 and HE4 in discriminating benign from malignant pelvic masses. Materials and Methods: One-hundred Egyptian women were enrolled in this study, including 60 epithelial ovarian cancer (EOC) patients and 20 benign ovarian tumor patients, as well as 20 apparently healthy women. Preoperative serum levels of CA125 and HE4 were measured by immunoassays. Tissue expression levels of genes encoding CA125 and HE4 were determined by quantitative real time polymerase chain reaction (qRT-PCR). The diagnostic performance of CA125 and HE4, measured either as mRNA or protein levels, was evaluated by receiver operating characteristic (ROC) curves. Results: The serum CA125+HE4 combination and serum HE4, with area under the curve (AUC) values of 0.935 and 0.932, respectively, performed significantly better than serum CA125 (AUC=0.592; P<0.001). Tissue CA125 and HE4 (AUC=1) performed significantly better than serum CA125 (P<0.001), serum HE4 (P=0.016) and the serum CA125+HE4 combination (P=0.018). Conclusions: Measurement of tissue CA125 and HE4 gene expression not only improves discriminatory performance, but also broadens the range of differential diagnostic possibilities in distinguishing EOC from benign ovarian tumors.

The Seizure Outcome and Extent of Hippocampal Resection in Anterior Temporal Lobectomy (전측두엽 절제술시 해마체 절제 범위와 경련 예후)

  • Lee, Wan Su;Lee, Jung Kyo;Lee, Sang Am;Kang, Jung Ku;Ko, Tae Seong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1650-1656
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    • 2000
  • Objective : Little consensus exists concerning which temporal lobe structures need to be resected or how much resection should be done during hippocampal resection. The purpose of this study is to identify whether the extent of hippocampal resection influences seizure after anterior temporal lobectomy. Materials and Methods : The extent of hippocampal resection was assessed in 96 patients who underwent temporal lobectomy for medically intractable complex partial seizures originating from a unilateral seizure focus in the anteromesial temporal lobe. Patients who had structural lesion were excluded from the study. Postoperative magnetic resonance imaging in the coronal and saggital planes were used to quantify the extent of the hippocampal and lateral cortical resection. The patients were divided into two groups. Patients who underwent hippocampal resection to the level of the cerebral peduncle were included in the partial resection group, and those who had resection to the level of the colliculus were assigned to total resection group. Seizure outcomes were defined according to the Engel classification and compared between the two groups. Neuropsychologic outcomes in the selected cases were reviewed. Results : The over-all seizure-free outcome(Engel classification 1) was accomplished in 75%(72/96) of the patients (mean duration of follow-up, 36.8 months). The total hippocampectomy group had a statistically superior seizure outcome than the partial hippocampectomy group(87.3% versus 58.5% seizure-free, p-value=0.001). Also, younger patients had a more favorable outcome. Other variables such as laterality, the extent of lateral cortical resection, age at onset and gender were not significant. The pre- and postoperative memory functions were evaluated in 24 patients. A worse postoperative memory outcome was associated with partial hippocampectomy. However this was not acceptable due to a former bias. Conclusion : The result of this study conforms that aggressive hippocampectomy resulted in a better seizure outcome.

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Improvement of Marine Environmental Impact Assessment for Golf Course Projects in Southern Coastal Area of Korea (남해연안 골프장조성에 따른 해양환경영향평가 개선방안)

  • Kim, Gui-Young;Lee, Dae-In;Yu, Jun;Eom, Ki-Hyuk;Jeon, Kyeong-Am
    • Journal of Environmental Impact Assessment
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    • v.19 no.5
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    • pp.453-464
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    • 2010
  • We evaluated the status and problems of golf course developments in the southern coast of Korea. It's adjacent waters supports nursery and fishing grounds for commercially-important fisheries species, and various sites are designated and protected as marine protection area(MPA), fisheries reserve, or clean area(blue belt) for producing shellfish. We proposed key assessment items for environmental impact assessment(EIA) and checklists in selecting golf course locations. For the protected areas, we suggest that it is essential to limit golf course establishment while setting a minimal distance from the coast to secure a buffer zone for mitigating the environmental impacts. To efficiently utilize existing regional coastal management plans, it is necessary to diagnose how a golf course development will potentially modify geomorphology and scenery, amplify pollutant loads from non-point sources, and disrupt the functions of coastal ecosystem. Especially, continued monitoring and assesssing input loads of hazardous materials originating from agricultural chemicals should be obligatory. Finally, measures for improving the QA/QC analysis were discussed to enhance reliability of environmental data with respect to golf courses and adjacent coastal waters.

A Study on the Development of Low Back Pain and the Risk Factors of Manufacturing Workers (일부 제조업 근로자들의 요통유병률과 요인에 관한 조사)

  • Park, Am
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.1 s.41
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    • pp.37-48
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    • 1993
  • This study was conducted to investigate the prevalence rate of low back pain during past one year and its risk factors. The data were collected from 1,384 manufacturing factory workers from March 1, 1992 to August 30, 1992. The results obtained were as follows: 1. The one year prevalence rate of low back pain by manufacturing company was 38.4% in textile manufacturing, 35.2% in concrete reenforcement, 31.0% in cigarette and 26.1% in metal part(P<0.01). 2. In textile manufacturing, age groups with high prevalence rate of low back pain were 30's(36.8%) and 40's(36.4%) (P<0.05), and the one year prevelence rates of low back pain by marital state were 34.9% in married workers and 28.5% in unmarried(P=0.0511). 3. The one year prevelence rates of low back pain by job part are 35.0% in labor workers and 26.1% in clerical(P<0.05), and by work hour per day it was 34.9% in 9 or more and 28.9% in 8 or less(P<0.05). 4. The highest group of low back pain by work posture was 43.5% in 'lifting and transfering materials', and it by fitness of chair was 56.0% in uncomfortable one, and by height of working board was 33.6% in low working one. 5. In logistic regression analysis, significant determinants with low back pain were marital state(p<0.05), work hour per day(P<0.05), height of working board(P<0.01), and work posture(P<0.01).

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Analysis of Pre and Post-Operative Speech In Combined Operation of Type I Thyroplasty and Arytenoid Adduction for Unilateral Vocal Cord Palsy (편측성대마비에 대한 제 1형 갑상성형술과 피열연골내전술의 동시수술시 술전 및 술후 음성언어분석비교)

  • 최홍식;정유삼;김성국;김영호;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.1
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    • pp.66-70
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    • 1998
  • Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

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Evaluation of Indoor ETS Exposure Levels in Pubs, PC Game Rooms, and Billiards Halls around a University Campus using PM2.5 Concentrations (대학 캠퍼스 주변 호프집, PC방, 당구장의 실내 PM2.5 농도를 통한 ETS 노출 수준 평가)

  • Lee, Jae Hwan;Park, Donguk;Ha, Kwonchul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.26 no.4
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    • pp.411-417
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    • 2016
  • Objectives: The aims of this study were to determine the indoor level of environmental tobacco smoke (ETS) and to assess the implementation rate of smoke-free laws at hospitality venues around a university campus by measuring particulate matter smaller than $2.5{\mu}m$ ($PM_{2.5}$) as an indicator of ETS. Materials and Methods: We measured indoor $PM_{2.5}$ concentrations at 20 PC game rooms, 20 pubs, and 20 billiards halls using Sidepak AM510, a direct reading portable real time monitor, from October to December 2015. Results: Smoking was observed in 65% of the PC game rooms, 10% of pubs, and 85% of billiards halls. The average $PM_{2.5}$ concentrations were $98.2{\mu}g/m^3$, $29.0{\mu}g/m^3$, and $134.2{\mu}g/m^3$ at PC game rooms, pubs, and billiards halls, respectively. $PM_{2.5}$ concentrations in PC game rooms and billiards halls were 2 to 2.7 times higher than the 24-hour exposure standard for outdoor $PM_{2.5}$ ($50{\mu}g/m^3$) by the Ministry of Environment. Conclusions: Although a smoking ban has been implemented for PC rooms and pubs, smoking is still taking place in many of these places. More stringent legal action is required for successfully protecting patrons and workers from secondhand smoke exposure. A ban on smoking in billiards halls should be introduced as quickly as possible.

Comparative Analysis of Thoracotomy and Sternotomy Approaches in Cardiac Reoperation

  • Kim, Dong-Chan;Chee, Hyun-Keun;Song, Meong-Gun;Shin, Je-Kyoun;Kim, Jun-Seok;Lee, Song-Am;Park, Jae-Bum
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.225-229
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    • 2012
  • Background: Reoperation of cardiac surgery via median sternotomy can be associated with significant complications. Thoracotomy is expected to reduce the risk of reoperation and to enhance the surgical outcomes. We retrospectively analyzed two operative approaches (thoracotomy vs. sternotomy) in cardiac reoperation. Materials and Methods: From September 2007 to December 2010, 35 patients who required reoperation of the mitral valvular disease following previous median sternotomy were included. Average age of patients was $45.8{\pm}15.4$ years (range, 14 to 76 years) and male-to-female was 23:12. Interval period between primary operation and reoperation was $135.8{\pm}105.6$ months (range, 3.3 to 384.9 months). Results: Comparative analysis was done dividing the patient group into two groups that are thoracotomy group (22 patients) and sternotomy group (13 patients). Thoracotomy group was significantly lower in operative time ($415.2{\pm}90.3$ vs. $497.5{\pm}148.0$, p<0.05), bleeding control time ($108.0{\pm}29.5$ vs. $146.4{\pm}66.8$, p<0.05) and chest tube drainage ($287.5{\pm}211.5mL$ vs. $557.3{\pm}365.5mL$, p<0.05) compared to sternotomy group. Conclusion: The thoracotomy approach is superior to sternotomy in some variables, and it is considered as a valid alternative to repeat median sternotomy in patients who underwent a previous median sternotomy.

Comparison of Breakfast and Nutritional Attitudes in Elementary School Students by Obesity Level in Chungnam Area (충남 일부지역 초등학생의 비만도에 따른 아침식사와 영양태도 비교)

  • Lee, Soen Yong;Lee, Je-Hyuk;Kim, Myung Hee
    • Journal of the Korean Society of Food Culture
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    • v.29 no.5
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    • pp.390-405
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    • 2014
  • The aim of this study was to investigate the actual conditions underlying frequency of eating breakfast and nutritional attitudes in elementary school students in Chungnam area. Students had the highest ratio for eating breakfast everyday and spent 10-20 minutes eating breakfast. Students went to bed at 10-11 PM and woke up at 7-7:30 AM in the morning on average. The biggest reason for skipping breakfast was insufficient time in the morning. Additionally, favorite breakfast menu of subjects was a Korean style meal. The number of elementary students that recognized necessity of nutritional education was highest among subjects. Favorite educational method of subjects was education by teachers. Additionally, number of female students that recognized effect of breakfast on health status was significantly higher than boy students. Ratio of eating breakfast everyday was dependent on BMI value. Most subjects preferred video learning materials as the main nutritional education method. Overweight subjects showed the highest ratio for eating with loss of willpower compared to other students when they skipped the breakfast. Female subjects ate a greater variety of foods compared to male students, and showed better nutritional attitudes towards a desirable dietary life than male subjects. To prevent undesirable food habits and improve intake of various nutrients, systematic nutrition education is required to regulate breakfast of elementary students.