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Arthroscopic Reduction and Fixation of an Anterior Cruciate Ligament Avulsion Fracture From the Tibial Eminence Using Bioabsorbable Pins - Technical Note - (생흡수성 핀을 이용한 소아 경골 과간부 견열 골절의 관절경적 정복 및 고정 방법 - 수술 술기 -)

  • Lee, Su-Chan;Yang, Il-Soon;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.183-187
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    • 2009
  • Purpose: We describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fracture using bioabsorbable pins in skeletally immature patients. Operative Technique: Diagnostic knee arthroscopy is performed using anterolateral and anteromedial portals. Fracture debris and blood clot are debrided to expose the injured site well. The fragment is reduced with the probe and fixed temporarily with a 1.1-mm diameter K-wire that is inserted percutaneously from the anterosuperior aspect of the knee joint. The drill guide is introduced into the joint and the fragment is secured by bioabsorbable, poly-p-dioxanone 1.3-mm pins inserted from different angles. The pins are 40 mm in length. The knee is placed in a long leg cast in extension for 4 weeks to assure that full extension is obtained. Conclusion: Arthroscopic fixation of an tibial intercondylar eminence avulsion fracture using bioabsorbable pins is not a technically demanding, suitable method that ensures fracture healing and restores the stability of the joint.

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Effects of Respiratory Rehabilitation Training Using a Harmonica for Patients With Spinal Cord Injuries (하모니카를 활용한 호흡재활 훈련이 척수손상환자의 호흡기능에 미치는 영향)

  • Kim, Hyuk Gun;Kim, Min Seo;Lim, Han Mil;Joeng, So;Shin, Uk Ju
    • Journal of Music and Human Behavior
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    • v.15 no.2
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    • pp.23-39
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    • 2018
  • The purpose of this research was to investigate the effects of respiratory rehabilitation using a wind instrument for patients suffering from spinal cord injuries. From January 15, 2018 to April 15, 2018, we conducted ten 1-hour sessions of a harmonica program with eight patients with spinal cord injuries with average age of 37 years who could not perform abdominal breathing by themselves. We measured and compared patients' breathing capacity before and after the 10 sessions. Designed particularly for patients with spinal cord injuries resulting in a limited range of neck movement, the study used a 10-hole diatonic harmonica whose length was relatively short. For those patients who had difficulty using their hands, a harmonica holder was provided. Participants were trained to play simple tunes. They were guided to use abdominal breathing to make sounds, with emphasis on those parts requiring long and strong breathing. The results showed that for all eight patients both their breathing volume and their inspiratory volume increased following participation in the harmonica program. Also, the program had psychological benefits (e.g., more life satisfaction and less sadness) and additional physical benefits (e.g., less dizziness due to low blood pressure and better phlegm spitting). This study offers a unique way to help patients with spinal cord injuries to improve their breathing capacity, which may also be associated with a greater quality of life.

A Study on Medical Information Platform Based on Big Data Processing and Edge Computing for Supporting Automatic Authentication in Emergency Situations (응급상황에서 자동인증지원을 위한 빅데이터 처리 및 에지컴퓨팅 기반의 의료정보플랫폼 연구)

  • Ham, Gyu-Sung;Kang, Mingoo;Joo, Su-Chong
    • Journal of Internet Computing and Services
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    • v.23 no.3
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    • pp.87-95
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    • 2022
  • Recently, with the development of smart technology, in medical information platform, patient's biometric data is measured in real time and accumulated into database, and it is possible to determine the patient's emergency situations. Medical staff can easily access patient information after simple authentication using a mobile terminal. However, in accessing medical information using the mobile terminal, it is necessary to study authentication in consideration of the patient situations and mobile terminal. In this paper, we studied on medical information platforms based on big data processing and edge computing for supporting automatic authentication in emergency situations. The automatic authentication system that we had studied is an authentication system that simultaneously performs user authentication and mobile terminal authentication in emergency situations, and grants upper-level access rights to certified medical staff and mobile terminal. Big data processing and analysis techniques were applied to the proposed platform in order to determine emergency situations in consideration of patient conditions such as high blood pressure and diabetes. To quickly determine the patient's emergency situations, edge computing was placed in front of the medical information server so that the edge computing determine patient's situations instead of the medical information server. The medical information server derived emergency situation decision values using the input patient's information and accumulated biometric data, and transmit them to the edge computing to determine patient-customized emergency situation. In conclusion, the proposed medical information platform considers the patient's conditions and determine quick emergency situations through big data processing and edge computing, and enables rapid authentication in emergency situations through automatic authentication, and protects patient's information by granting access rights according to the patient situations and the role of the medical staff.

The responsibility of C-terminal domain in the thermolabile haemolysin activity of Vibrio parahaemolyticus and inhibition treatments by Phellinus sp. extracts

  • Tran Thi Huyen;Ha Phuong Trang;Nguyen Thi-Ngan;Bui Dinh-Thanh;Le Pham Tan Quoc;Trinh Ngoc Nam
    • Fisheries and Aquatic Sciences
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    • v.26 no.3
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    • pp.204-215
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    • 2023
  • The thermolabile haemolysin (tlh) of Vibrio parahaemolyticus (Vptlh) from V. parahaemolyticus is a multiple-function enzyme, initially describes as a haemolytic factor activated by lecithin and phospholipase A2 enzymatic activity (Shinoda, 1991; Vazquez-Morado, 2021; Yanagase et al., 1970). Until now, the tlh structure has hypothesized including N-terminal and C-terminal domain, but what domain of the Vptlh structure does the haemolytic activity has not been refined yet. In this study, a 450-bp VpTLH nucleotide sequence of the entire Vptlh gene encoded the C-terminal domain cloned firstly to examine its responsibility in the activity of the Vptlh. The C-terminal domain fused with a 6-His-tag named the His-tag-VpC-terminal domain was expressed successfully in soluble form in the BL21 (DE3) PlysS cell. Remarkably, both expression and purification results confirmed a high agreement in the molecular weight of the His-tag-VpC-terminal domain was 47 kDa. This work showed the His-tag-VpC-terminal domain lysed the erythrocyte membranes in the blood agar and the phosphate buffered saline (0.9%) media without adding the lecithin substrate of the phospholipase enzyme. Haemolysis occurred at all tested diluted concentrations of His-tag-VpC-terminal domain (p < 0.05), providing evidence for the independent haemolytic activity of the His-tag-VpC-terminal domain. The content of 100 ㎍ of the His-tag-VpC-terminal domain brought the highest haemolytic activity of 80% compared to that in the three remaining contents. Significantly, the His-tag-VpC-terminal domain demonstrated not to involve the phospholipase activity in Luria-Bertani agar supplemented with 1% (vol/vol) egg yolk emulsion. All results proved the vital responsibility of the His-tag-VpC-terminal domain in causing the haemolytic activity without the required activation by the phospholipase enzyme. Raw extracts of Phellinus igniarus and Phellinus pipi at 10-1 mg/mL inhibited the haemolytic activity of the His-tag-VpC-terminal domain from 67.7% to 87.42%, respectively. Hence applying the His-tag-VpC-terminal domain as a simple biological material to evaluate quickly potential derivatives against the Vptlh in vivo conditions will accessible and more advantageous than using the whole of the Vptlh.

Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.24-33
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    • 2002
  • Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

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Analysis of Amperometric Response to Cholesterol according to Enzyme-Immobilization Methods (효소고정화 방법에 따른 콜레스테롤 검출용 바이오센서의 전류 감응도 분석)

  • Ji, Jung-Youn;Kim, Mee-Ra
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.5
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    • pp.731-738
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    • 2011
  • Cholesterol is the precursor of various steroid hormones, bile acid, and vitamin D with functions related to regulation of membrane permeability and fluidity. However, the presence of excess blood cholesterol may lead to arteriosclerosis and hypertension. Moreover, dietary cholesterol may affect blood cholesterol levels. Generally, cholesterol determination is performed by spectrophotometric or chromatographic methods, but these methods are very time consuming and costly, and require complicated pretreatment. Thus, the development of a rapid and simple analysis method for measuring cholesterol concentration in food is needed. Multi-walled carbon nanotube (MWCNT) was functionalized to MWCNT-$NH_2$ via MWCNT-COOH to have high sensitivity to $H_2O_2$. The fabricated MWCNT-$NH_2$ was attached to a glassy carbon electrode (GCE), after which Prussian blue (PB) was coated onto MWCNT-$NH_2$/GCE. MWCNT-$NH_2$/PB/GCE was used as a working electrode. An Ag/AgCl electrode and Pt wire were used as a reference electrode and counter electrode, respectively. The sensitivity of the modified working electrode was determined based on the amount of current according to the concentration of $H_2O_2$. The response increased with an increase of $H_2O_2$ concentration in the range of 0.5~500 ${\mu}M$ ($r^2$=0.96) with a detection limit of 0.1 ${\mu}M$. Cholesterol oxidase was immobilized to aminopropyl glass beads, CNBr-activated sepharose, Na-alginate, and toyopearl beads. The immobilized enzyme reactors with aminopropyl glass beads and CNBr-activated sepharose showed linearity in the range of 1~100 ${\mu}M$ cholesterol. Na-alginate and toyopearl beads showed linearity in the range of 5~50 and 1~50 ${\mu}M$ cholesterol, respectively. The detection limit of all immobilized enzyme reactors was 1 ${\mu}M$. These enzyme reactors showed high sensitivity; especially, the enzyme reactors with CNBr-activated sepharose and Na-alginate indicated high coupling efficiency and sensitivity. Therefore, both of the enzyme reactors are more suitable for a cholesterol biosensor system.

Cranial Irradiation in the Management of Childhood Leukemic Hyperleukocytosis (극심한 백혈구 증가증을 보이는 소아 백혈병 환자에서 전두개 방사선치료)

  • Hong, Se-Mie;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.142-145
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    • 2001
  • Purpose : Acute leukemia with hyperleukocytosis (more than $10^5/mm^3$) is at high risk of early sudden death, usually from intracerebral hemorrhage. Emergency cranial irradiation is a relatively simple approach to solve this the problem. We summarized our experience of cranial irradiation in 24 leukemic children who presented with hyperleukocytosis. Methods and Materials : Between 1990 and 1998, 40 children with acute leukemia presenting with hyperleukocytosis were referred for emergency cranial irradiation. Among these patients, 24 children were evaluable. There were 16 boys and eight girls, their ages ranged from 2 to 13 years (median 9.5 years). The initial leukocyte counts ranged $109,910/mm^3\;to\;501,000/mm^3$. Peripheral blood smear was peformed in all patients and noted the morphology of the blast. Introduction of emergency cranial irradiation was determined by the leukocyte counts (more than 100,000/mm) and the existence of the blast in peripheral blood smear. All patients were treated with intravenous hydration with alkaline fluid and oral allopurinol. Cranial irradiation started on the day of diagnosis. With 2 Gy in one fraction in 4 patients, 4 Gy in two fractions in 20 patients. Results : The WBC count had fallen in 19 patients (83%) and no intracerebral hemorrhage occurred after irradiation. There were five cases of early deaths. Four patients died of metabolic complications, and one patient with intracerebral hemorrhage. He died 5 hours after cranial irradiation. No patient had any immediate side effect from cranial irradiation. Conclusion : Our data suggest, that emergency cranial irradiation can be safely chosen and effective in childhood leukemic patients presenting with high leukocyte counts.

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Effect of Diet Regimen of Sasang Constitution on Health Status (사상체질별 식이 섭생이 건강에 미치는 영향 -한방건강증진센터 시범운영을 위한 기초연구-)

  • Kim, Kwuy-Bun;Cho, Kyoul-Ja;Lee, Hyang-Yeon;Shin, Hye-Sook;Kim, Kwang-Joo;Moon, Heui-Ja;Kim, Yoon-Hee;Kang, Hyun-Sook;Park, Shin-Ae;Ji, Eun-Sun
    • Journal of East-West Nursing Research
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    • v.7 no.1
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    • pp.18-31
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    • 2002
  • This study, as a basic research to manage a Chinese Medicine Health Promotion Center by way of showing an example, is a before and after experiment research for simple group to verify a difference with cholesterol, health status and perception of health in order to confirm a effectiveness of diet and regimen according to the 4th status of physical constitution. Research object was chosen of 42 persons who operate a physical constitutional dietary regimen among them after selecting professors and clinical nurses (55 persons) majoring in the science of nursing who participated in Chinese Medicine-oriented Nurse Training Course from Aug. of 2001 to Feb. of 2002 all over the country. Diagnostic tools for physical constitution was used of the questionary that is currently consisted of physical constitution grouping test in Eastern & Western Diagnose Center of K Medical Center, and rating of health status was used of the tool that standardized CMI(Cornell Medical Index) to be available for Korean, and perception measurement for health status was used of a visual analogue scale for the health status that each one perceive personally, and physiological status was measured of cholesterol in blood. Analysis for the collected data was carried out by percentage, $X^2$ test, paired t-test according to research object by using SPSS, and the results of this study are as follows. 1) There was no difference with cholesterol before or after the experiment for objects. As a result of estimation about difference with health status by areas before or after the experiment, there are more improved result in eyes, ears, digestive organs, bones and sinews organs, frequency of a disorder, habit, adaptation status, angry, healthy status than before the experiment. As a whole, after the experiment the health was more improved than before the experiment. As the result to inspect a difference of health perception between before and after experiment, after the experiment the health perception level was improved than before, however there was no meaningful differences. 2) As the result to inspect a difference of cholesterol between before and after experiment according to object's physical constitution, in the case of So-yang-in(a person with the minimum male: according to the male and female principles(the sun and the moon)) among the 4th status of physical constitution there was only meaningful difference statistically, however, after the experiment their cholesterol's value was increased. As the result to inspect the difference of health status between before and after the experiment according to physical constitution, all of Ta-um-in(a person with maximum the female), So-yang-in(with the minimum male), So-um-in(with the minimum female) had a meaningful difference before and after the experiment, which means that in all case by physical constitutional groups, after the experiment their health status was more improved than before the experiment. As the result to inspect a difference of health perception between before and after according to physical constitutions, in the case of Tae-um-in and So-um-in, average score after the experiment was risen than before the experiment so that it means that the level of health perception was improved, however, there was no meaning statistically. According to the above results, if continuous diet and regimen by each physical constitutions could be implemented, it is certain that the health could be maintained and promoted. And, what we are healthy is for oneself to feel it subjectively. However, I think that cholesterol score in blood that we can view objectively could be changed distinctly if we can implement a strict diet and regimen. Accordingly, it is necessary for a method and period of experiment to be more strict and longer. According to the above results, I would like to suggest as follows. 1) In order to understand health status by Korean's physical constitutions and to generalize it, these research will be repeated against much more objects that could be selected by proper grouping method to consider a representative. 2) It is necessary for a research to inspect health status by physical constitution by developing a health status measurement tool that has higher confidence and propriety based on physical constitutional theory.

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The Effects of Endothelin Receptor Antagonist on Hemodynamic and Respiratory Mechanics in Experimental Acute Pulmonary Thromboembolism (실험적 급성 폐색전증에서 Endothelin 수용체 길항제가 혈류 및 호흡 역학에 미치는 영향)

  • Lee, Ji-Hyun;Jeon, Yong-Gam;Choe, Kang-Hyeon;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.210-222
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    • 2000
  • Background: Endothelin(ET) is the most potent vasoconstrictor and bronchoconstrictor. The plasma ET-1 level is elevated in patients with acute pulmonary thromboembolism(APTE). This finding suggest that ET-1 may be an important mediator in the cardiopulmonary derangement of APTE. But whether ET-1 is a pathogenic mediator or a simple marker of APTE is not known. The role of ET-1 in the pathogenesis of cardiopulmonary dysfunction in APTE(delete) was investigated through an evaluation of the effects of $ET_A$-receptor antagonist on APTE. The increase in local levels of preproET-1 mRNA and ET-1 peptide in the embolized lung was also demonstrated. Methods: In a canine autologous blood clot pulmonary embolism model, $ET_A$-receptor antagonist(10 mg/kg intravenously, n=6) was administered one hour after the onset of the embolism. Hemodynamic measurements, blood gas tensions and plasma levels of ET-1 immunoreactivity in this treatment group were compared with those in the control group(n=5). After the experiment., preproET-1 mRNA expression(using Northern blot analysis) and the distribution of ET-1(by immunohistochemical analysis) in the lung tissues were examined. Results: The increases in pulmonary arterial pressure and pulmonary vascular resistance of the treatment group were less than those of the control group. Decrease in cardiac output was also less in the treatment group. Complications such as systemic arterial hypotension and hypoxemia did not occur with the administration of $ET_A$-receptor antagonist The plasma level of ET-1 like(ED: what does 'like' mean?) immunoreactivity was increased after embolization in both groups but was significantly higher in the treatment group. The preproET-1 mRNA and ET-1 peptide expressions were increased in the embolized lung. Conclusion: ET-1 synthesis increases with embolization in the lung and may plays play an important role in the pathophysiology of cardiopulmonary derangement of APTE. Furthermore, $ET_A$-receptor antagonist attenuates cardiopulmonary alterations seen in APTE, suggesting a potential benefit of this therapy.

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Mammalian Cloning by Nuclear transfer, Stem Cell, and Enzyme Telomerase (핵치환에 의한 cloning, stem cell, 그리고 효소 telomerase)

  • 한창열
    • Korean Journal of Plant Tissue Culture
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    • v.27 no.6
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    • pp.423-428
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    • 2000
  • In 1997 when cloned sheep Dolly and soon after Polly were born, it had become head-line news because in the former the nucleus that gave rise to the lamb came from cells of six-year-old adult sheep and in the latter case a foreign gene was inserted into the donor nucleus to make the cloned sheep produce human protein, factor IX, in e milk. In the last few years, once the realm of science fiction, cloned mammals especially in livestock have become almost commonplace. What the press accounts often fail to convey, however, is that behind every success lie hundreds of failures. Many of the nuclear-transferred egg cells fail to undergo normal cell divisions. Even when an embryo does successfully implant in the womb, pregnancy often ends in miscarriage. A significant fraction of the animals that are born die shortly after birth and some of those that survived have serious developmental abnormalities. Efficiency remains at less than one % out of some hundred attempts to clone an animal. These facts show that something is fundamentally wrong and enormous hurdles must be overcome before cloning becomes practical. Cloning researchers now tent to put aside their effort to create live animals in order to probe the fundamental questions on cell biology including stem cells, the questions of whether the hereditary material in the nucleus of each cell remains intact throughout development, and how transferred nucleus is reprogrammed exactly like the zygotic nucleus. Stem cells are defined as those cells which can divide to produce a daughter cell like themselves (self-renewal) as well as a daughter cell that will give rise to specific differentiated cells (cell-differentiation). Multicellular organisms are formed from a single totipotent stem cell commonly called fertilized egg or zygote. As this cell and its progeny undergo cell divisions the potency of the stem cells in each tissue and organ become gradually restricted in the order of totipotent, pluripotent, and multipotent. The differentiation potential of multipotent stem cells in each tissue has been thought to be limited to cell lineages present in the organ from which they were derived. Recent studies, however, revealed that multipotent stem cells derived from adult tissues have much wider differentiation potential than was previously thought. These cells can differentiate into developmentally unrelated cell types, such as nerve stem cell into blood cells or muscle stem cell into brain cells. Neural stem cells isolated from the adult forebrain were recently shown to be capable of repopulating the hematopoietic system and produce blood cells in irradiated condition. In plants although the term$\boxDr$ stem cell$\boxUl$is not used, some cells in the second layer of tunica at the apical meristem of shoot, some nucellar cells surrounding the embryo sac, and initial cells of adventive buds are considered to be equivalent to the totipotent stem cells of mammals. The telomere ends of linear eukaryotic chromosomes cannot be replicated because the RNA primer at the end of a completed lagging strand cannot be replaced with DNA, causing 5' end gap. A chromosome would be shortened by the length of RNA primer with every cycle of DNA replication and cell division. Essential genes located near the ends of chromosomes would inevitably be deleted by end-shortening, thereby killing the descendants of the original cells. Telomeric DNA has an unusual sequence consisting of up to 1,000 or more tandem repeat of a simple sequence. For example, chromosome of mammal including human has the repeating telomeric sequence of TTAGGG and that of higher plant is TTTAGGG. This non-genic tandem repeat prevents the death of cell despite the continued shortening of chromosome length. In contrast with the somatic cells germ line cells have the mechanism to fill-up the 5' end gap of telomere, thus maintaining the original length of chromosome. Cem line cells exhibit active enzyme telomerase which functions to maintain the stable length of telomere. Some of the cloned animals are reported prematurely getting old. It has to be ascertained whether the multipotent stem cells in the tissues of adult mammals have the original telomeres or shortened telomeres.

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