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Arterial Switch Operation in Patients with Intramural Coronary Artery: Early and Mid-term Results

  • Kim, Hyung-Tae;Sung, Si-Chan;Kim, Si-Ho;Chang, Yun-Hee;Ahn, Hyo-Yeong;Lee, Hyoung-Doo
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.115-122
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    • 2011
  • Background: The intramural coronary artery has been known as a risk factor for early death after an arterial switch operation (ASO). We reviewed the morphological characteristics and evaluated the early and mid-term results of ASO for patients with an intramural coronary artery. Materials and Methods: From March 1994 to September 15th 2010, 158 patients underwent ASO at Dong-A and Pusan National University Hospitals for repair of transposition of the great arteries and double outlet right ventricle. Among these patients, 14 patients (8.9%) had an intramural coronary artery. Mean age at operation was $13.4{\pm}10.2$ days (4 to 39 days) and mean body weight was $3.48{\pm}0.33$ kg (2.88 to 3.88 kg). All patients except one were male. Eight patients had TGA/IVS and 4 patients had an aortic arch anomaly. Two patients (14.3%) had side-by-side great artery relation, of whom one had an intramural right coronary artery and the other had an intramural left anterior descending coronary artery. Twelve patients had anterior-posterior relation, all of whom had an intramural left coronary artery (LCA). The aortocoronary flap technique was used in coronary transfer in 8 patients, of whom one patient required a switch to the individual coronary button technique 2 days after operation because of myocardial ischemia. An individual coronary button implantation technique was adopted in 6, of whom 2 patients required left subclavian artery free graft to LCA during the same operation due to LCA injury during coronary button mobilization and LCA torsion. Results: There was 1 operative death (7.1%), which occurred in the first patient in our series. This patient underwent an aortocoronary flap procedure for coronary transfer combining aortic arch repair. Overall operative mortality for 144 patients without an intramural coronary artery was 13.2% (19/144). There was no statistical difference in operative mortality between the patients with and without an intramural coronary artery (p>0.1). There was no late death. The mean follow-up duration was $52.1{\pm}43.0$ months (0.5 to 132 months). One patient who had a subclavian artery free graft required LCA stenting 6.5 years after surgery for LCA anastomotic site stenosis. No other surviving patient needed any intervention for coronary problems. All patients had normal ventricular function at latest echocardiography and were in NYHA class 1. Conclusion: The arterial switch operation in Transposition of Great Arteries or Double Outlet Right Ventricle patients with intramural coronary can be performed with low mortality; however, there is a high incidence of intraoperative or postoperative coronary problems, which can be managed with conversion to the individual coronary button technique and a bypass procedure using a left subclavian free graft. Both aortocoronary flap and individual coronary button implantation techniques for coronary transfer have excellent mid-term results.

Effects of Roughage Feeding Type during the Growing and Early-Fattening Periods on Growth Performance, Feed Efficiency and Carcass Characteristics in Holstein Steers (육성 및 비육전기의 조사료 급여형태가 홀스타인 거세우의 성장 발육, 사료이용성 및 도체특성에 미치는 영향)

  • Kang, S.W.;Ki, K.S.;Oh, Y.K.;Kim, K.H.;Choi, C.W.
    • Journal of Animal Science and Technology
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    • v.47 no.5
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    • pp.769-782
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    • 2005
  • Twenty four Holstein steers fed commercial concentrates with rice straw(T1), mixed grass hay(T2), or wet brewer’s grains based TMR ad libitum(T3) were used to investigate the effects of roughage feeding type during the growing and early-fattening periods on growth performance, feed efficiency and carcass characteristics. Growth performance and feed efficiency were investigated during the feeding trial conducted from 6 to 23 mo of age, and carcass characteristics were investigated after slaughter. Body weight at slaughter and daily gains were 751 to 802 kg(mean 782 kg) and 1.064 to 1.159 kg/d(mean 1.122 kg/d), respectively, showing that those for T2 were highest followed by T3. Compared with T1, the daily gain for T2 was improved by 8.9%. The TDN intakes per kg gain were 6.87, 7.17 and 7.15 kg for T1, T3 and T2, respectively, indicating that feed efficiency for T2 was improved(approx. 5%) compared with T1. The feeding treatments did not change dressing percentage(mean 60.8%), back fat thickness(6.68 mm) and rib-eye area(84.0$cm^2$). Neither meat quality characteristics nor physicochemical properties were significantly different among the treatments. However, economic analysis accounting for 882.8, 991.7 and 943.8 thousand won per head for T1, T2 and T3, respectively, indicated that T2 and T3 increased(7-12%) total net income compared with T1. Therefore, it may be concluded that high quality meat of Holstein steers can be produced if they are fattened until 23 mo of age and that feeding mixed grass hay as roughage or TMR containing mainly wet brewer's grains during the growing and early-fattening periods can improve growth performance compared with feeding rice straw.

Effect of Supplementation of Complex Probiotics on Performances, Physio-chemical Properties of Meat and Intestinal Microflora in Broiler (복합생균제의 급여가 육계의 생산성, 육의 이화학적 특성 및 장내 미생물에 미치는 영향)

  • Yu, D.J.;Na, J.C.;Kim, T.H.;Kim, S.H.;Lee, S.J.
    • Journal of Animal Science and Technology
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    • v.46 no.4
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    • pp.593-602
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    • 2004
  • A feeding trial was carried out to investigate the effect of supplemental complex probiotics on performances, physio-chemica1 properties of meat and inetestinal microflora in broiler chicks. Four hundred eighty broiler chickens, one days old with mixed sexes were fed one of four diets containing 0, 0.1, 0.2 and 0.4% complex probiotics for 7 weeks. There were four replicates with thirty chicks per pen. Diet contained ME 3,100, 3,l00kcal/kg, and CP 22.0, 20.0% for starting and finishing period, respectively. Body Weight gain of chicks fed the complex probiotics tended to increase from the frist week and all complex probiotics higher than control from the 4th week. Chickens fed the diets containing 0.2% probiotics had higher(P<0.05) than those fed the other levels from the 4th week to 5th week. Feed conversion also improved significantly(P<0.05) in the supplemental 0.2% probiotics from the 4th week to 5th week. In physio-chemica1 properties of meat, carcass rate increased significantly(P<0.05) in the supplemental 0.4% probiotics compared to that of control at 7 weeks overall means and abdominal fat pad rate increased significantly(P< 0.05) in the supplemental 0.2% probiotics compared to that of control. Cooking loss decreased significantly(P<0.05) in the supplemental all probiotics. But shear force increased significantly(P<0.05) in the supplemental 0.4% probiotics. The number of ileum and cecum Lactobacillus spp. tended to increase in the supplemental complex probiotics at 7 week of age, but was not significantly different. As the result, supplemental complex probiotics increased performance and physio-chemica1 properties of meat and the number of intestinal Lactobacillus of broiler chicks.

Effects of Supplementing Herbs on Growth Performances, Blood Composition and Diarrhea in Hanwoo Calves (한방제재 첨가급여가 한우송아지의 성장, 혈액성상 및 설사에 미치는 영향)

  • Kim, Byung-Ki;Choi, Chang-Bon;Lee, Sang-Oug;Baek, Kyung-Hoon;Jung, Dae-Jin;Hwang, Eun-Gyeong
    • Journal of Animal Science and Technology
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    • v.53 no.5
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    • pp.451-459
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    • 2011
  • The current study was conducted to determine the effects of herbal supplement on growth performances and diarrhea in Hanwoo calves. Total 24 Hanwoo calves (3 treatments: 8 calves per treatment) were randomly assigned to either Control (no treatment), Treatment 1 (0.3% herb supplement), or Treatment 2 (0.5% herb supplement) diets for 150 days. Total body weight gain and total feed intake per head in Treatment 1 was 142.8 kg and 545.9 kg, respectively, and it was higher (p<0.05) compared to other groups. The blood total cholesterol range was 86.43~97.00 mg/dl, triglycerides 13.26~13.86 mg/dl, GOT 76.97~79.60 mg/dl, GPT 19.54~20.97 mg/dl, WBC 8.75~9.95 k/${\mu}{\ell}$, RBC 10.14~11.91 M/${\mu}{\ell}$, and hemoglobin 10.74~11.20 g/$d{\ell}$, respectively, with no significant (p>0.05) differences among treatments. The blood immunoglobulin G levels were 5.74~6.05 mg/ml which tended to decrease as experimental period extended. Total number of pathogens in feces showed peaks at 1~2 months after the initiation of experiment, and tended to decrease thereafter. Total number of Eimeria spp., E. coli and BVDV in feces showed no significant differences but control group showed higher counts than both treatment groups. During overall period, the incidence of pathogenic diarrhea in calves of 2 treatment groups was much lower than control group calves (C: 24, vs T1: 9, T2: 13 heads), however, it was not significant (p>0.05). In conclusion, supplementation of herbs in Hanwoo calf diets might be beneficial to improve growth performances and prevent diarrhea.

Effects of Rearing Densities on Behavior Characteristics in Korean Native Broilers (사육밀도가 토종육계의 행동특성에 미치는 영향)

  • Ha, Jae-Jung;Rhee, Yong-Joon;Kim, Byong-Chon;Ohh, Sang-Jip;Song, Young-Han
    • Journal of Animal Science and Technology
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    • v.53 no.5
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    • pp.481-487
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    • 2011
  • Rearing density is a major factor in welfare production and health of broiler chicks. An experiment was conducted to investigate the effect of rearing density on the behavioral characteristics of Korean native chicks. In the study, 20, 30, and 40 chicks per pen (3.17 $m^2$) were used in each treatment and randomly allotted to 6.3 bird/$m^2$, 9.5 bird/$m^2$, and 12.6 bird/$m^2$ density, respectively. The broilers' behavior was recorded for 12 hours continuously during 1 to 8 weeks of age. The time budgets (standing, sitting, and walking) and frequencies of certain behaviors (drinking, feeding, preening, scratching, dust bathing, flapping, aggressive pecking, and pecking) in the broilers were checked during the day. The behavioral characteristics in the early period (1 to 4 weeks) were compared to the later period (5 to 8 weeks) to know the changes in each behavior as the chicks matured. It was observed that 40 chicks per pen showed significant decrease in feed intake and body weight. Corticosterone hormone was higher in the order of 12.6 bird/$m^2$ > 9.5 bird/$m^2$ > 6.3 bird/$m^2$ (p<0.05). The behaviors of standing and sitting were the highest in groups of 30 and 40 respectively. The walking behavior was gradually decreased as rearing density increased. The frequencies of the other behaviors also decreased in a high density treatment; especially for feeding, drinking, preening, and pecking. These tendencies widened the gaps of behaviors as time passed. It was concluded that a group of 20 chicks (6.3 bird/$m^2$) was the proper rearing density among these three treatments. Broilers in the lower rearing density showed more activity than that with higher density and therefore this environment may lead to better welfare condition.

Effects of Crude Protein Levels on Nitrogen Balance in Adult Jindo Dog (사료내 조단백질 수준이 진도성견의 질소균형에 미치는 영향)

  • Kang, Tae-Il;Maeng, Won-Jai;Kim, Myeong-Hwa;Lee, Sang-Rak
    • Journal of Animal Science and Technology
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    • v.51 no.2
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    • pp.155-162
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    • 2009
  • This study was conducted to determine the protein requirement level in adult Jindo dog (Korea Jindo Dog) through nitrogen balance experiments. 12 female dogs aged 36~38 weeks old (for early stage) or aged 45~49 weeks old (for late stage) were fed one of 3 diets containing 17, 19 and 21% of crude protein. Body weight of dogs were measured during the 12 days of feeding trial, and feces and urine were collected last 3 days of the trial period. In early stage of Jindo dog, average daily gain of dogs fed experimental diets containing 17, 19 and 21% of crude protein were -38.33, -16.25 and -12.71g/d, respectively. There was a significant differences between 17 and 21% of crude protein treatments (p<0.05) and calculated retained nitrogen were -0.29, -0.04 and -0.03g/kg$BW^{.75}$/d, respectively. In late stage of Jindo dog, average daily gain of dogs fed experimental diets containing 17, 19 and 21% of crude protein were -34.05, -28.71 and -28.28g/d, and calculated retained nitrogen were -0.33, -0.06 and 0.09g/kg$BW^{.75}$/d, respectively, and were significantly higher (p<0.05) in dogs fed 21% of crude protein diet than those of other dogs. In early stage and late stage of adult Jindo dog, a calculated linear regression equation for nitrogen intake (x) and nitrogen retention (y) were y = 0.7484x-1.18 ($R^2$ = 0.9923) and y = 0.88231x-1.0894 ($R^2$ = 0.9982) and the requirement of crude protein were estimated as 9.85g/kg$BW^{.75}$/d and 7.72g/kg$BW^{.75}$/d from above equation.

Supraclavicular Brachial Plexus block with Arm-Hyperabduction (상지(上肢) 외전위(外轉位)에서 시행(施行)한 쇄골상(鎖骨上) 상완신경총차단(上腕神經叢遮斷))

  • Lim, Keoun;Lim, Hwa-Taek;Kim, Dong-Keoun;Park, Wook;Kim, Sung-Yell;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.214-222
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    • 1988
  • With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

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Bioequivalence of Carvelol Tablet to Dilatrend Tablet (Carvedilol 25 mg) (딜라트렌 정(카르베딜롤 25 mg)에 대한 카베롤 정의 생물학적 동등성)

  • Cho, Hea-Young;Lee, Moon-Seok;Park, Soon-Cheol;Lim, Dong-Koo;Moon, Jai-Dong;Lee, Yong-Bok
    • Journal of Pharmaceutical Investigation
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    • v.31 no.4
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    • pp.289-295
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    • 2001
  • Carvedilol is an antihypertensive and antianginal compound that combines nonselective beta-adrenoceptor blocking and vasodilation properties and is devoid of intrinsic sympathomimetic activity. The purpose of the present study was to evaluate the bioequivalence of two carvedilol tablets, $Dilatrend^{TM}$ (Chong Kun Dang Pharmaceutical Co., Ltd.) and $Carvelol^{TM}$ (Dae Won Pharmaceutical Co., Ltd.), according to the prior and revised guidelines of Korea Food and Drug Administration (KFDA). The carvedilol release from the two carvedilol tablets in vitro was tested using KP VII Apparatus II method with various different kinds of dissolution media (pH 1.2, 4.0, 6.8 buffer solution, water and blend of PSB80 into water). Eighteen normal male volunteers, $24.22{\pm}1.86$ years in age and $64.81{\pm}4.56\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 25 mg of carvedilol was orally administered, blood was taken at predetermined time intervals and the concentrations of carvedilol in serum were determined using HPLC method with fluorescence detector. The dissolution profiles of two carvedilol tablets were very similar at all dissolution media. Besides, the pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using non-transformed and logarithmically transformed $AUC_t$ and $C_{max}$. The results showed that the differences in $AUC_t$, $C_{max}$ and $T_{max}$ between two tablets based on the $Dilatrend^{TM}$ were 2.23%, -2.00% and 0.00%, respectively. Minimum detectable differences $({\Delta})$ at ${\alpha}=0.05$ and $1-{\beta}=0.8$ were less than 20% (e.g., 13.55% and 17.61% for $AUC_t$ and $C_{max}$, respectively). The powers $(l-{\beta})$ at ${\alpha}=0.05$, ${\Delta}=0.2$ for $AUC_t$ and $C_{max}$ were 98.08% and 88.81%, respectively. The 90% confidence intervals were within ${\pm}20%$ (e.g., $-5.69{\sim}10.16$ and $-12.30{\sim}8.30$ for $AUC_t$ and $C_{max}$, respectively). There were no sequence effect between two tablets in logarithmically transformed $AUC_t$ and $C_{max}$. The 90% confidence intervals using logarithmically transformed were within the acceptance range of log(0.8) to log(1.25) (e.g., $0.95{\sim}1.11$ and $0.89{\sim}1.09$ for $AUC_t$ and $C_{max}$, respectively). Two parameters met the criteria of prior and revised KFDA guideline for bioequivalence, indicating that $Carvelol^{TM}$ tablet is bioequivalent to $Dilatrend^{TM}$ tablet.

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Effect of Warm Curtain Installation on Growth Performance, Blood Hormone Levels and Immunity of Weaning Pigs (보온막 설치가 이유자돈의 생산성 및 혈중 호르몬과 면역성분의 농도에 미치는 영향)

  • Kim, Y.H.;Lee, S.D.;Kim, D.H.;Jeong, H.J.;Kim, D.W.;Cho, K.H.;Sa, S.J.;Hur, T.Y.;Kim, S.H.;Kim, I.C.
    • Journal of Animal Environmental Science
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    • v.17 no.2
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    • pp.115-122
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    • 2011
  • This study was conducted to investigate the changes in growth performance, blood hormone levels and immunity of weaning pigs by the installation of warm curtain for keeping warmth in pigpen. A total of sixty-four piglets was weaned at 21 d of age with an average body weight of 5.8 kg. Each thirty-two piglets were allocated into the pens with (TRT) or without warm curtain (CONT). Daily gain and feed intake were increased by 17% and 9% in TRT from 2nd week to 4th week compared with CONT, respectively. The occurrence of diarrhea was decreased by 62% in TRT from initial to 2nd week compared with CONT. There were no significant differences in blood hormone levels and immunity of weaning pigs between treatments. In conclusion, the installation of warm curtain, which supported high temperature in pigpen, was considered to be effective in improving growth performance and reducing diarrhea occurrence of weaning pigs.

Study on the Internal Availability of Forest by-product Silage in Spotted deer (Cervus nippon) (꽃사슴에 있어서 육림부산물 발효사료의 체내이용성에 관한 연구)

  • 문상호;김명화;이상무;전병태
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.22 no.3
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    • pp.169-176
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    • 2002
  • To determine availability as a feed source of deer of by-products that produced at reforestation areas and comprised shrubs and wild grasses, mixed forest by-product silage(FBS), arrowroot silage(ARS), bristletooth oak tree silage(BOS), white oak tree silage(WOS) were prepared to compare dry matter intake, digestibility and nitrogen balance in digestion balance trials with spotted deer. Dry matter intake was highest in WOS and lowest in ARS but there was no significant difference(P>0.05). Digestible dry matter intake was higher in FBS and ARS that had higher dry matter digestibility than in WOS and BOS that had lower dry matter digestibility(P>0.05). Dry matter digestibility was highest fur ARS and lowest for BOS(P<0.05). Digestibility of crude protein was similar to that of dry matter. That of crude fiber was higher for FBS and ARS than for BOS and WOS(P>0.05). Daily gain of body weight was slightly greater for WOS than fer other treatments(P>0.05). Nitrogen intake was highest for ARS and lowest for BOS(P<0.05), and fecal nitrogen was opposite to nitrogen intake(P<0.05). Nitrogen excretion with urine was highest for ARS that had higher nitrogen intake and lowest for BOS and there was a significant difference(P<0.05). Retained nitrogen was highest for FBS and lowest for. BOS (P>0.05). Although there was no significant difference(P>0.05): the ration of nitrogen intake to retained nitrogen was highest in FBS for 43.9% and lowest in BOS for 24.7%. Consequently because by-products that produced at reforestation areas had high intake and internal availability, it was evaluated to valuable feed source for deer.