• Journal of Chest Surgery
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• 제31권5호
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• pp.509-512
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• 1998

후측개흉술은 흉근을 절단하는 단점은 있으나 훌륭한 수술시야를 제공하므로 표준개흉술로 이용되고 있다. 이에 반하여 근육보존수직개흉술은 흉근이 보존되며 팔을 내리면 액와부 수술 상흔이 감추어지는 미용상의 장점이 있다. 그러나 수직개흉술은 흉부의 정측면에 절개선이 이루어지므로 측와위에서 수직으로 수술시야를 내려다보게 되어 흉강내의 구조물, 특히 폐문부나 첨부 및 하부의 길이가 멀어져 수술조작이 불편하다. 본 인하대병원 흉부외과에서는 수술조작에 관련된 차이를 알아보고자 후측개흉술(15례)과 수직개흉술(14례)을 이용해 폐쐐기절제술 이상의 수술을 실시한 29례에서 수술과 관련된 임상지표들을 비교관찰한 결과, 수술시간, 수술 1일과 2일의 흉관 배액량, 흉관 거치기간, 수혈 수와 수혈량, 수술 중 실혈량, 수술 후 합병증 등에서 양군간에 차이가 없었다. 이상의 결과를 볼 때 근육보존수직개흉술도 후측개흉술과 마찬가지로 폐절제술시 안전하게 사용될 수 있다고 본다.

• Molecules and Cells
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• 제40권2호
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

• 한국축산시설환경학회지
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• 제18권sup호
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• pp.55-64
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• 2012

축산물 생산은 집약적 사육환경으로 인한 각종 병원균이 내재한 가운데 이루어지고 있어 항생제 및 각종 사료첨가제등의 사용이 날로 증가해왔다. 한편, 축산물의 안전성에 대한 인식이 높아짐에 따라 농축산물 생산에 있어서 안전성 확보에 대한 연구가 절실히 요구되고 있다. 따라서 본 연구에서 특수발효 미생물을 이용하여 복합미량원소(Se, Ge, Zn, S)를 강화시킨 점토광물질 발효 산물이 돈육의 생산성 및 품질에 미치는 영향을 조사하였다. 공시동물은 Large White와 Yorkshire 교잡종 80두를 대조구와 실험구로 임의 배치해 실험하였다. 실험 결과, 점토광물질 발효산물을 사료 내 0.3% 첨가 급여했을 때 사료섭취량 및 증체량, 사료효율, 도체의 pH, 육색의 명도와 대퇴부의 밝기 등은 일반사료를 급여한 군과 비슷하였으나, 지육율은 2.7%, 도체육의 적색도는 12%, 보수력은 10% 개선되고 가열감량은 6% 감소하였다. 또한 면역기능조절효과를 조사하기 위해 비육돈의 혈액을 채취하여 혈액 내 말초혈액단핵세포의 증식 및 cytokine 분비 능을 조사한 결과, PBMC는 증식정도가 유의하게 증가하였고, LPS와 Con A를 처리하였을 때 대조구에 비해 더욱 뚜렷이 증가하는 것으로 나타났다. cytokine의 분비량도 TNF-${\alpha}$의 경우 약간 증가하는 경향을 보였다. 따라서 양이온 치환능력이 높고 원적외선 수치가 높은 점토광물 발효산물을 급여함으로써 면역능력이 강화되어 항생제를 사용하지 않고도 안전성 높은 고품질 친환경 돈육을 생산할 수 있는 가능성이 시사되었다.

• 한국어병학회지
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• 제26권3호
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• pp.193-206
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• 2013

피조개, Scapharca broughtonii는 돌조개 과에 속하는 이매패류로 한국과 일본에서 매우 중요한 수산식품이며, 주로 국내 남해안 지역에서 양식되고 있다. 그러나 피조개 생산량은 여름철 대량폐사로 인하여 지난 10년 동안 급격하게 감소하였다. 대량폐사로 인한 경제적인 손실을 해결하기 위하여 피조개의 생리에 영향을 미치는 다양한 환경 인자에 대한 연구가 집중적으로 수행되어 왔으나 미생물학적인 연구는 미진한 실정이다. 본 연구에서는 피조개의 주요 혈액 성분인 헤모글로빈이 미생물의 병원성인자에 의하여 피해를 받아 발생하는 용혈현상과 피조개의 폐사와의 연관성을 규명하기 위하여 피조개 양식장의 용혈활성 미생물을 중심으로 분석하였다. 여름철 고수온기인 6월부터 9월까지 강진만과 진해만 피조개 양식장의 해저퇴적물과 피조개 체내에서 분리한 약 4,200여점의 배양가능 용혈성 미생물의 다양성 및 지역 특이적인 미생물을 분석하였다. 6월에 25속 118종, 7월에 24 속 89종, 8월에 30속 109종, 그리고 39속 141종의 미생물을 분리하였으며, 16S rDNA 정보를 통하여 지역별 미생물 다양성을 분석한 결과 폐사빈발 지역에서만 특이적으로 존재하는 140종의 미생물을 분리하였다. 이러한 지역 특이적 미생물 균총 연구는 피조개 대량폐사 원인 규명의 기초자료로 활용될 수 있을 것으로 사료되며 나아가 다양한 패류의 폐사연구에도 기여할 것으로 기대된다.

• 한국식품과학회지
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• 제32권5호
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• pp.1206-1212
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• 2000

가미육미지황탕이 BB rat에서 유발되는 당뇨병을 개선시킬 수 있는가를 알아보았다. BB rat은 태아시기부터 생후 120일까지 가미육미지황탕을 공급받았으며 생후 21일된 BB rat 60마리(수놈 30마리, 암놈 30마리)를 무처치군인 BBDP군과 가미육미지황탕을 투여한 군인 BBDP-GY군으로 임의로 배치하여 생후 120일까지 사육하였다. BBDP-GY군의 쥐들에게는 가미육미지황탕을 16mL/㎏ B.W./day 분량으로 물에 섞어 주었다. 가미육미지황탕의 항당뇨 효과는 다뇨, 다음, 고혈당 및 체중감소와 같은 임상적인 요소들에 의하여 조사되었다. 그 결과 가미육미지황탕은 당뇨병의 발병시기를 지연시켰을 뿐만 아니라 당뇨병의 발병율도 현저하게 감소시켰다. 그러나 일단 발병이 되고 나서는 당뇨병의 진전을 지연시키거나 치유하는 효과가 없는 것으로 나타났다. 당뇨의 발병과 동시에 체중의 현저한 감소 및 물 소모량, 배뇨량 그리고 혈당에 있어 현저한 증가가 나타났고 당뇨의 발병이 있기 전에는 체중에 있어서 발병 2-4일전에 체중의 증가가 거의 없거나 또는 약간 있을 뿐 다른 항목들에서는 발병을 알리는 어떤 변화도 나타나지 않았다.

• 한국산학기술학회논문지
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• 제15권5호
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• pp.2914-2922
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• 2014

진행성위암의 위험요인을 파악하고 조기검진의 효과를 평가하고자 2007년 6월부터 2011년 12월까지 대전 소재 1개 대학교병원에서 위암으로 최초 진단과 수술을 받은 조기위암 171명과 진행성위암 환자 342명, 총 580명을 대상으로 설문조사와 의무기록 조사를 실시하였다. 두 군간에 카이제곱 검정과 로지스틱 회귀분석으로 교차비를 계산한 결과 진행성위암은 조기위암에 비하여 70세 이상에서(OR 2.393; 95%CI 1.329-4.310), 과거 흡연자(OR 1.612; 95%CI 0.970-2.680), 혈액형 A형(OR 1.784; 95%CI 1.035-3.075) 및 H. pylori균 감염(OR 1.699; 95%CI 0.905-3.191)에서 상대적으로 높았다. 또한 체중감소(OR 2.752; 95%CI 1.333-5.684)와 소화불량(OR 1.574; 95%CI 1.069-2.319)이 중요한 증상과 징후였다. 조기진단의 효과는 파악할 수 없었지만 조기진단이 성공적인 치료의 기회를 높이고 생존율을 향상시킨다는 것을 감안할 때 집단을 대상으로 조기검진을 고취시키는 교육과 선별검사가 요구된다.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.116-120
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• 2011

Purpose: Scalp avulsion is a life-threatening injury that may cause trauma to the forehead, eyebrows, and periauricular tissue. It is difficult to treat scalp avulsion as it may lead to severe bleeding. Therefore, emergency scalp replantation surgery is necessary, and we must consider the function, aesthetics, and psychology of the patients. A case of scalp avulsion leading to massive bleeding was encountered by these authors, which led to a failure to achieve the proper operation conditions in an adequate time period. Methods: A 49-year-old female was hospitalized due to having had her head caught in a rotatory machine, causing complete scalp avulsion which included the dorsum of the nose, both eyebrows, and ears. Emergent microsurgical replantation was performed, where a superficial temporal artery and a vein were anastomosed, but the patient's vital signs were too unstable for further operation due to excessive blood loss. Three days after the microanastomosis, venous congestion developed at the replanted scalp, and a medicinal leech was used. Leech therapy resolved the venous congestion. A demarcation then developed between the vitalized scalp tissue and the necrotized area. Debridement was performed 2 times on the necrotized scalp area. Finally, split-thickness skin graft with a dermal acellular matrix ($Matriderm^{(R)}$) was performed on the defective areas, which included the left temporal area, the occipital area, and both eyebrows. Results: The forehead, vertex, right temporal area, and half of the occipital area were successfully replanted, and the hair at the replanted scalp was preserved. As stated above, two-thirds of the scalp survived; the patient could cover the skin graft area with her hair, and could wear a wig. Conclusion: Complete scalp avulsion needs emergent replantation with microsurgical revascularization, but it often leads to serious vital conditions. We report a case with acceptable results, although the microanastomosed vessel was minimal due to the patient's unstable vital signs.

• Journal of Animal Science and Technology
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• 제63권5호
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• pp.1076-1085
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• 2021

The study was conducted to evaluate the effects of spray-dried plasma (SDP) supplementation during late gestation and lactation on productive performance and immune responses of sows and their litters. Twelve sows (227.78 ± 2.16 kg average body weight; 2.0 average parity) were randomly allotted to two dietary treatments: a basal diet (CON) and the basal diet supplemented with 1% SDP. Sows were fed experimental diets from d 30 before farrowing to weaning of their piglets. Blood samples were collected from sows on d 1, 3, and 7 of lactation and from two randomly selected nursing pigs per litter on d 3 and 7 after birth, and d 1, 3, and 7 after weaning. Productive performance and immune responses of sows and their piglets were measured. There was a trend of less body weight loss in sows supplemented with SDP (p < 0.10) during the lactation period and a trend of greater (p < 0.10) average daily gain in SDP piglets compared to those in the CON group. Sows in the SDP group tended to have lower (p < 0.10) serum concentrations of tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1), and cortisol on d 3 and lower serum concentration of TNF-α on d 7 compared with sows in CON group. In comparison with CON piglets, piglets from SDP sows tended to have lower (p < 0.10) serum concentrations of TNF-α, TGF-β1, and cortisol on d 7 after birth, lower (p < 0.10) serum TNF-α and C-reactive protein on d 3 and 7 after weaning, and greater (p < 0.10) average daily gain after weaning. Moreover, weaned pigs from sows fed SDP had significantly lower (p < 0.05) serum concentrations of cortisol and TGF-β1 on d 3 and 7 postweaning, respectively, than CON piglets. In conclusion, SDP supplementation in sow diets from late gestation to weaning improved the productive performance of sows and their offspring; the beneficial effects of SDP may be mediated in part through modulation of immune responses of both sows and piglets.

• Archives of Plastic Surgery
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• 제46권4호
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• pp.336-343
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• 2019

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

• Journal of Minimally Invasive Surgery
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• 제21권4호
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• pp.168-176
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• 2018

Purpose: Robotic-associated minimally invasive surgery is a novel method for overcoming some limitations of laparoscopic surgery. This study aimed to evaluate the outcomes (postoperative pain, cosmesis, surgeon's workload) of single-incision robotic cholecystectomy (SIRC) vs. single-incision laparoscopic cholecystectomy (SILC) vs. conventional three-port laparoscopic cholecystectomy (3PLC). Methods: 134 patients who underwent laparoscopic or robotic cholecystectomy at a single center during 2016~2017 were enrolled. Prospectively collected data included demographics, operative outcomes, questionnaire regarding pain and cosmesis, and NASA-Task Load Index (NASA-TLX) scores for surgeon's workload. Results: 55 patients underwent SIRC, 29 SILC, and 50 3PLC during the same period. 3PLC patient group was older than the others (SIRC vs. SILC vs. 3PLC: 48.1 vs. 42.2 vs. 54.1 years, p<0.001). Operative time was shortest with 3PLC (44.1 vs. 38.8 vs. 25.4 min, p<0.001). Estimated blood loss, postoperative complications, and postoperative stay were similar among the groups. Pain control was lowest in the 3PLC group (98.2% vs. 100% vs. 84.0%, p=0.004), however, at 2 weeks postoperatively there were no differences among the groups (p=0.374). Cosmesis scores were also worst after 3PLC (17.5 vs. 18.4 vs. 13.3, p<0.001). NASA-TLX score was highest in the SILC group (21.9 vs. 44.3 vs. 25.2, p<0.001). Conclusion: Although SIRC and SILC take longer than 3PLC, they produce superior cosmetic outcomes. Compared with SILC, SIRC is more ergonomic, lowering the surgeon's workload. Despite of higher cost, SIRC could be an alternative for treating gallbladder disease in selected patients.