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A Study on Pulmonary Toxic Effect of High-Dose Cisplatin Administered by Isolated Lung Perfusion in Dogs (잡견에서 분리폐관류 방법으로 투여된 고농도 cisplatin의 페독성에 관한 연구)

  • 김관민;한정호;김주현
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.697-706
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    • 2000
  • Background: Isolated lung perfusion(ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. Material and Method: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme(ACE), tumor necrosis factor-$\alpha$(TNF-$\alpha$), and concentration of serum lactate dehydrogenase(LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. Result: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1$\pm$6.3, 44.6$\pm$9.3, 46.7$\pm$9.5, 50.8$\pm$9.1, 46.1$\pm$4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4$\pm$12.6, 39.0$\pm$8.6, 42.3$\pm$15.9, 50.0$\pm$2.6, 53.8$\pm$8.3 and 55.5$\pm$12.3, 47.0$\pm$6.3, 45.1$\pm$6.9, 74.8$\pm$19.5, 60.2$\pm$12.0 U/L, respectively. Serum TNF-$\alpha$ activities in each group before and after ILP were 5.0$\pm$1.5 / 7.7$\pm$2.2 / 6.6$\pm$2.5 / 4.3$\pm$1.3 / 5.2$\pm$1.1(control), 8.7$\pm$1.6 / 9.9$\pm$2.2 / 7.9$\pm$1.5 / 6.3$\pm$2.2 / 7.4$\pm$2.4 (cisplatin 2.5 mg/Kg), and 6.9$\pm$0.7 / 8.9$\pm$3.4 / 7.9$\pm$4.0 / 3.3$\pm$0.9 / 5.8$\pm$1.3 pg/ml(cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L(cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-$\alpha$, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. Conclusion: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.

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Surgical Outcome of Biventricular Repair for Double-outlet Right Ventricle: A 18-Year Experience (양대혈관우심실기시증에 대한 양심실 교정의 수술 성적: 18년 치험)

  • 이정렬;황호영;임홍국;김용진;노준량;배은정;노정일;윤용수;안규리
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.566-575
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    • 2003
  • We reviewed our 18-year surgical experience of biventricular repair for double-outlet right ventricle. Material and Method: One hundred twelve consecutive patients (80 males and 32 females) who underwent biventricular repair for double-outlet right ventricle between May 1986 and September 2002 were included. We assessed risk factors for early mortality and reoperation. Reoperation-free survival rate and actual survival rate were analysed. Result: Most common type of ventricular septal defect was subaortic (n=58, 52%) and non-committed type was second most common (n=32, 29%). Four different surgical methods were used: intraventricular baffle repair (n=71 , 63%): right ventricle to pulmonary ariery conduit interposition or REV with left ventricle to aorta baffle repair (n=24, 21 .4%): arierial switch operation with left ventricle to pulmonary artery baffle (n=14, 12.5%): Senning atrial switch operation with left ventricle to pulmonary artery baffle (n=3, 2.7%). Thirty four patients(30%) underwent palliative procedures before definite repair. Twenty three patients (21%) required reoperations. There were 12 (10.7%) early deaths and 4 late deaths. Age younger than 3 months at repair (p=0.003), cardiopulmonary bypass and aortic cross clamp time (p=0.015, p=0.067), type of operation (arterial switch operation) (p <0.001) and type of ventricular septal defect (subpulmonic type) (p=0.002) were revealed as risk factors for early death in univariate analysis, while age under 3 months was the only significant risk factor in multivariate analysis. Patients younger than 1 year of age (p=0.02), pulmonary artery angioplasty at definitive repair (p=0.024), type of ventricular septal defect (non-committed) (p=0.001), type of operation (right ventricle to pulmonary artery conduit interposition and REV operation) (p=0.028, p=0.017) were risk factors for reoperation in univariate analysis but there was no significant risk factor in multivariate analysis. Follow-up was available on 91 survivals with a mean duration of 110.8$\pm$56.4 (2~201) months. 5, 10 and 15 year survival rates were 86.5%, 85% and 85% and reoperation free survival were 85%, 71.5%, 70%. Conclusion: Age under 3 months at repair, subpulmonic ventricular septal defect and arterial switch operation were significant risk factors for early mortality. Patients with non-committed ventricular septal defect and who underwent conduit interposition or REV operation were risk factors for reoperation. With careful attention to chose best timing and surgical approach depending on morphologic characteristics, biventricular repair for double outlet right ventricle can be achieved with good long-term outcome.

Carbon and Nitrogen Stocks of Trees and Soils in a 'Niitaka' Pear Orchard ('신고'배 재배지 내 수체 및 토양의 탄소 및 질소 저장량)

  • Lee, Tae-Kyu;Choi, Jang-Jeon;Kim, Jong-Sung;Lee, Han-Chan;Ro, Hee-Myong
    • Horticultural Science & Technology
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    • v.31 no.6
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    • pp.828-832
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    • 2013
  • To report country-specific carbon and nitrogen stocks data in a pear orchard by Tier 3 approach of 2006 IPCC guidelines for national greenhouse gas inventories, an experimental pear orchard field of the Pear Research Station, National Institute of Horticultural & Herbal Science, Rural Development Administration, Naju, Korea ($35^{\circ}01^{\prime}27.70N$, $126^{\circ}44^{\prime}53.50^{\prime\prime}E$, 6 m altitude), where 15-year-old 'Niitaka' pear (Pyrus pyrifolia Nakai cv. Niitaka) trees were planted at a $5.0m{\times}3.0m$ spacing on a Tatura trellis system, was chosen to assess the total amount of carbon and nitrogen stocks stored in the trees and orchard soil profiles. At the sampling time (August 2012), three trees were uprooted, and separated into six fractions: trunk, main branches, lateral branches (including shoots), leaves, fruits, and roots. Soil samples were collected from 0 to 0.6 m depth at 0.1 m intervals at 0.5 m from the trunk. Dry mass per tree was 4.7 kg for trunk, 13.3 kg for main branches, 13.9 kg for lateral branches, 3.7 kg for leaves, 6.7 kg for fruits, and 14.1 kg for roots. Amounts of C and N per tree were respectively 2.3 and 0.02 kg for trunk, 6.4 and 0.07 kg for main branches, 6.4 and 0.09 kg for lateral branches, 6.5 and 0.07 kg for roots, 1.7 and 0.07 kg for leaves, and 3.2 and 0.03 kg for fruits. Carbon and nitrogen stocks stored between the soil surface and a depth of 60 cm were 138.29 and $13.31Mg{\cdot}ha^{-1}$, respectively, while those contained in pear trees were 17.66 and $0.23Mg{\cdot}ha^{-1}$ based on a tree density of 667 $trees{\cdot}ha^{-1}$. Overall, carbon and nitrogen stocks per hectare stored in a pear orchard were 155.95 and 13.54 Mg, respectively.

Using Trophic State Index (TSI) Values to Draw Inferences Regarding Phytoplankton Limiting Factors and Seston Composition from Routine Water Quality Monitoring Data (영양상태지수 (trophic state index)를 이용한 수체 내 식물플랑크톤 제한요인 및 seston조성의 유추)

  • Havens, Karl E
    • Korean Journal of Ecology and Environment
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    • v.33 no.3 s.91
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    • pp.187-196
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    • 2000
  • This paper describes a simple method that uses differences among Carlson's (1977) trophic state index (TSI) values based on total phosphorus (TP), chlorophyll a (CHL) and Secchi depth (SD) to draw inferences regarding the factors that are limiting to phytoplankton growth and the composition of lake seston. Examples are provided regarding seasonal and spatial patterns in a large subtropical lake (Lake Okeechobee, Florida, USA) and inter- and intra-lake variations from a multilake data set developed from published studies. Once an investigator has collected routine water quality data and established TSI values based on TP, CHL, and SD, a number of inferences can be made. Additional information can be provided where it also is possible to calculate a TSI based on total nitrogen (TN). Where TSI (CHL)<>TSI (SD), light attenuating particles are large (large filaments or colonies of algae), and the phytoplankton may be limited by zooplankton grazing. Other limiting conditions are inferred by different relationships between the TSI values. Results of this study indicate that the analysis is quite robust, and that it generally gives good agreement with conclusions based on more direct methods (e.g., nutrientaddition bioassays, zooplankton size data, zooplankton removal experiments). The TSI approach, when validated periodically with these more costly and time-intensive methods, provides an effective, low cost method for tracking long-term changes in pelagic structure and function with potential value in monitoring lake ecology and responses to management.

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Performance of Drip Irrigation System in Banana Cultuivation - Data Envelopment Analysis Approach

  • Kumar, K. Nirmal Ravi;Kumar, M. Suresh
    • Agribusiness and Information Management
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    • v.8 no.1
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    • pp.17-26
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    • 2016
  • India is largest producer of banana in the world producing 29.72 million tonnes from an area of 0.803 million ha with a productivity of 35.7 MT ha-1 and accounted for 15.48 and 27.01 per cent of the world's area and production respectively (www.nhb.gov.in). In India, Tamil Nadu leads other states both in terms of area and production followed by Maharashtra, Gujarat and Andhra Pradesh. In Rayalaseema region of Andhra Pradesh, Kurnool district had special reputation in the cultivation of banana in an area of 5765 hectares with an annual production of 2.01 lakh tonnes in the year 2012-13 and hence, it was purposively chosen for the study. On $23^{rd}$ November 2003, the Government of Andhra Pradesh has commenced a comprehensive project called 'Andhra Pradesh Micro Irrigation Project (APMIP)', first of its kind in the world so as to promote water use efficiency. APMIP is offering 100 per cent of subsidy in case of SC, ST and 90 per cent in case of other categories of farmers up to 5.0 acres of land. In case of acreage between 5-10 acres, 70 per cent subsidy and acreage above 10, 50 per cent of subsidy is given to the farmer beneficiaries. The sampling frame consists of Kurnool district, two mandals, four villages and 180 sample farmers comprising of 60 farmers each from Marginal (<1ha), Small (1-2ha) and Other (>2ha) categories. A well structured pre-tested schedule was employed to collect the requisite information pertaining to the performance of drip irrigation among the sample farmers and Data Envelopment Analysis (DEA) model was employed to analyze the performance of drip irrigation in banana farms. The performance of drip irrigation was assessed based on the parameters like: Land Development Works (LDW), Fertigation costs (FC), Volume of water supplied (VWS), Annual maintenance costs of drip irrigation (AMC), Economic Status of the farmer (ES), Crop Productivity (CP) etc. The first four parameters are considered as inputs and last two as outputs for DEA modelling purposes. The findings revealed that, the number of farms operating at CRS are more in number in other farms (46.66%) followed by marginal (45%) and small farms (28.33%). Similarly, regarding the number of farmers operating at VRS, the other farms are again more in number with 61.66 per cent followed by marginal (53.33%) and small farms (35%). With reference to scale efficiency, marginal farms dominate the scenario with 57 per cent followed by others (55%) and small farms (50%). At pooled level, 26.11 per cent of the farms are being operated at CRS with an average technical efficiency score of 0.6138 i.e., 47 out of 180 farms. Nearly 40 per cent of the farmers at pooled level are being operated at VRS with an average technical efficiency score of 0.7241. As regards to scale efficiency, nearly 52 per cent of the farmers (94 out of 180 farmers) at pooled level, either performed at the optimum scale or were close to the optimum scale (farms having scale efficiency values equal to or more than 0.90). Majority of the farms (39.44%) are operating at IRS and only 29 per cent of the farmers are operating at DRS. This signifies that, more resources should be provided to these farms operating at IRS and the same should be decreased towards the farms operating at DRS. Nearly 32 per cent of the farms are operating at CRS indicating efficient utilization of resources. Log linear regression model was used to analyze the major determinants of input use efficiency in banana farms. The input variables considered under DEA model were again considered as influential factors for the CRS obtained for the three categories of farmers. Volume of water supplied ($X_1$) and fertigation cost ($X_2$) are the major determinants of banana farms across all the farmer categories and even at pooled level. In view of their positive influence on the CRS, it is essential to strengthen modern irrigation infrastructure like drip irrigation and offer more fertilizer subsidies to the farmer to enhance the crop production on cost-effective basis in Kurnool district of Andhra Pradesh, India. This study further suggests that, the present era of Information Technology will help the irrigation management in the context of generating new techniques, extension, adoption and information. It will also guide the farmers in irrigation scheduling and quantifying the irrigation water requirements in accordance with the water availability in a particular season. So, it is high time for the Government of India to pay adequate attention towards the applications of 'Information and Communication Technology (ICT) and its applications in irrigation water management' for facilitating the deployment of Decision Supports Systems (DSSs) at various levels of planning and management of water resources in the country.

The Role of Axillary Artery Cannulation in Surgery for Type A Acute Aortic Dissection (급성 상행대동맥 박리증 수술에서 액와동맥 삽관술의 역할)

  • 유지훈;박계현;박표원;이영탁;김관민;성기익;양희철
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.343-347
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    • 2003
  • Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.

Diagnostic Accuracy of Rest T1-201/Stress Tc-99m-MIBI Myocardial SPECT in the Diagnosis of Coronary Artery Disease (휴식 T1-201/부하 Tc-99m MIBI 심근 SPECT의 관상동맥질환 진단 정확성)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Kang, Keon-Wook;Sohn, Dae-Won;Oh, Byung-Hee;Lee, Myung-Mook;Chung, June-Key;Park, Young-Bae;Lee, Myung-Chul;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.112-117
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    • 1996
  • Objective: Standard stress/rest Tc-99m MIBI and T1-201 myocardial perfusion study have some limitations such as stress/rest image overlap for Tc-99m-MIBI, low energy for T1-201 and long period of study time for two separate studies. Separate acquisition rest T1-201/stress Tc-99m MIBI dual isotope study is a potentially efficient myocardial perfusion imaging protocol that combines the high resolution of Tc-99m for stress perfusion assessment and T1-201 for viability assessment. This study assessed the usefulness and diagnostic accuracy for this new approach. Methods: We tried to evaluate sensitivity and specificity of dual isotope separate acquisition protocol in 67 patients. Immediately after resting T1-201 SPECT data was acquired, dipyridamole stress Tc-99m MIBI myocardial perfusion study was performed. Visual analysis was carried out qualitatively with 0 to 3 scoring system for 17 segments of left ventricle in the reconstructed horizontal long axis and short axis slices. Results: Total study was completed within 3 hours. In angiographic correlation, dual isotope SPECT demonstrated high sensitivity(85%) and in a small group of patients, high specificity was also observed (100%). Conclusion: Combined thallium-201/stress Tc-99m MIBI SPECT displayed similiar diagnostic accuracy to protocol using stress/rest Tc-99m MIBI SPECT. This protocol was completed in shorter period than the previous protocols and therefore enhance laboratory throughput and patients convenience.

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Spiritual Needs of Hospice Patients (호스피스 환자의 영적 요구)

  • Han, Young-Mi
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.39-48
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    • 2000
  • Purpose : The purpose of the study is to disclose the spiritual needs of hospice patients. Method : The questionaire survey was carried out on 49 hospice patients and 40 caregivers who were in the 9 hospice institutions from lune to August in 1999. Results : In the patients, mean scores of the spiritual needs were significantly higher in the group with stomach cancer, college education, christians, $8{\sim}14$ days of hospice care and the group thinking that religion was important, and in the caregivers in the group of religions besides christianity and lives under $3{\sim}5$ years of medical treatment. In the total average of the spiritual needs, the patients's average was significantly lower than the caregiver's. Among the different categories, the patient's needs were highest in the area of meaning of life and the hope, the caregiver's needs in the love and the concern. However, both groups were low in the religion area. In the items of the love and the concern, the patient was highly responding to the 'wanting someone to give warm concern in conversation' and the caregiver was highly responding to the 'giving a warm response to questions on the sad and hard time'. And also, the patient was lowly responding to the 'wanting more concerns to him than other patients', and the caregiver was low responding to the 'patients wanting warm response in conversation'. In the categories of religious area both group were highly responding to the 'wanting to be helped to relax out of all'. And they gave lowest response to the 'wanting to introduce a book to know God'. In the area of meaning of life and hope, the both groups gave highest response to the 'wanting to be guided to have the hope' and lowest to the 'wanting to have opportunity to reconcile the person with bad relationship'. Conclusion : Summing up the above results, personal in-depth conversation is necessary to understand more deeply the spiritual needs of hospice patient. Moreover the hospice team needs to have more systematic approach to find out the spiritual needs of hospice patients.

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A Study on Nutrition Status by Diet of Female College Students of Masan City - 1. Focus on Diet Survey - (여대생의 체중감량이 영양상태에 미치는 영향 - 제1보. 다이어트 실태조사를 중심으로 -)

  • 김종현
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.185-191
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    • 1998
  • This study was performed to investigate the nutrition status by weight loss(diet) of 287 female college students, focus on questionnaire about diet survey. The subjects mainly had irregularly one or two meal per a day so food behavior was not good. Over half of subjects had a tendency to overestimate body shape of self. The desired weight(46.95$\pm$0.39kg) was significant lower than real weight(50.32$\pm$0.9)(p=0.0114). The time when diet is first tried was mainly after high school(94.51%). Mean weight loss was 1~4kg but most of subjects didn't maintain the lost weight. The diet approach method tried was sequently the fasting 1 meal or the more in a day(23.61%), exercise(21.92%), restricting calories(15.85%) etc. The source of diet was orderly newspaper or magazine(30.86%), friends or relatives or family(28.86%) etc. The group who recognized the self body shape was normal or a little fat had higher self notion of health than other groups.

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Wind Stability of Commercially Important Tree Species and Silvicultural Implications, Daegwallyeong Korea (대관령 지역 경제림에 대한 내풍 안정성 분석 및 임업적 적용)

  • Moktan, Mani Ram;Kwon, Jino;Lim, Joo-Hoon;Shin, Moon-Hyun;Park, Chan-Woo;Bae, Sang-Won
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.17 no.1
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    • pp.58-68
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    • 2015
  • This study compares the wind stability of Larix kaempferi (Lamb.) Carr., Pinus koraiensis Sie. & Zucc. and Abies holophylla Maxim. to understand and inform wind risk management of these plantation trees at Daegwallyeong, Korea. Temporary square plots of $20m{\times}20m$ ($400m^2$) were laid out, and DBH (Diameter at Breast Height) and height for trees greater than 10 cm in DBH were measured by species. A total of 15 plots with 5 plots each in L. kaempferi, P. koraiensis and A. holophylla stands were sampled at random. Among the species, A. holophylla and P. koraiensis have comparatively lower h/d (Height/DBH) ratios than L. kaempferi. These results indicate that the former two species are more wind firm than the latter species. About 9% of the L. kaempferi trees have higher h/d ratios than the critical threshold limit 80. These trees are vulnerable to wind damage and should be removed in the next thinning regime. The analysis of variance detected a significant difference (p < 0.05) in the h/d ratios and Gini coefficient indicating species differences and DBH size variation, respectively. Gini coefficient was 16.4% in A. holophylla, 15.9% in P. koraiensis and 14% in L. kaempferi stands indicating limited DBH size variation. Lower h/d ratios are attributed to thinning in these stands and tree morphological differences. To increase wind firmness, low thinning should concentrate to remove trees with the h/d ratio above 80 coinciding at the time of stand distinction phase. Forest managers and practitioners should measure and maintain h/d ratios of trees below the critical threshold limit of 80 through stand density management. Variable density thinning approach should be tested to increase tree DBH sizes of the even-aged stands.