• 대한의용생체공학회:의공학회지
• /
• 제43권6호
• /
• pp.434-440
• /
• 2022

Liver transplantation is a critical used treatment method for patients with end-stage liver disease. The number of cases of living donor liver transplantation is increasing due to the imbalance in needs and supplies for brain-dead organ donation. As a result, the importance of the accuracy of the donor's suitability evaluation is also increasing rapidly. To measure the donor's liver volume accurately is the most important, that is absolutely necessary for the recipient's postoperative progress and the donor's safety. Therefore, we propose liver segmentation in abdominal CT images from pre-operation, POD 7, and POD 63 with a two-dimensional U-Net. In addition, we introduce an algorithm to measure the volume of the segmented liver and measure the hepatectomy rate and regeneration rate of pre-operation, POD 7, and POD 63. The performance for the learning model shows the best results in the images from pre-operation. Each dataset from pre-operation, POD 7, and POD 63 has the DSC of 94.55 ± 9.24%, 88.40 ± 18.01%, and 90.64 ± 14.35%. The mean of the measured liver volumes by trained model are 1423.44 ± 270.17 ml in pre-operation, 842.99 ± 190.95 ml in POD 7, and 1048.32 ± 201.02 ml in POD 63. The donor's hepatectomy rate is an average of 39.68 ± 13.06%, and the regeneration rate in POD 63 is an average of 14.78 ± 14.07%.

• 여성건강간호학회지
• /
• 제28권2호
• /
• pp.134-144
• /
• 2022

Purpose: A descriptive correlational survey was conducted to examine nurses' attitudes and stress related to perinatal bereavement care (PBC) and their relationships, with the ultimate goal of improving nurses' capabilities related to PBC. Methods: Korean nurses (N=136) who had experienced perinatal death at least once were recruited from seven hospitals. Data were analyzed using descriptive statistics. The Korean version of Nurses' Attitudes towards Perinatal Bereavement Support was assessed in terms of three subdomains (attitudes to PBC, importance of policies related to PBC, and importance of training related to PBC), and nurses' stress was measured. Results: The participants gave high scores for the attitude-related items of "giving sufficient time to bereaved parents to mourn for their dead baby" (4.54 points) and "nurses should treat bereaved parents with respect and dignity" (4.51 points), and they perceived a high level of importance for the policy-related items of "every staff member in the hospital should understand the policies relevant for PBC" and "when nurses feel emotional exhaustion, they should seek support" (4.58 points). Nurses' attitude toward PBC was associated with the perceived importance of policies (r=.40, p<.001), the perceived importance of PBC-related training (r=.61, p<.001), and stress related to PBC (r=.29, p<.001). Nurses' perceived importance of PBC-related training was associated with stress related to PBC (r=.38, p<.001). Conclusion: Establishing hospital policies related to PBC and providing PBC training for nurses could positively affect nurses' attitudes toward PBC. A stress management program for nurses could reduce the stress caused by PBC.

• Archives of Plastic Surgery
• /
• 제49권2호
• /
• pp.174-183
• /
• 2022

Management of traumatic skull base fractures and associated complications pose a unique reconstructive challenge. The goals of skull base reconstruction include structural support for the brain and orbit, separation of the central nervous system from the aerodigestive tract, volume to decrease dead space, and restoration of the three-dimensional appearance of the face and cranium with bone and soft tissues. An open bicoronal approach is the most commonly used technique for craniofacial disassembly of the bifrontal region, with evacuation of intracranial hemorrhage and dural repair performed prior to reconstruction. Depending on the defect size and underlying patient and operative factors, reconstruction may involve bony reconstruction using autografts, allografts, or prosthetics in addition to soft tissue reconstruction using vascularized local or distant tissues. The vast majority of traumatic anterior cranial fossa (ACF) injuries resulting in smaller defects of the cranial base itself can be successfully reconstructed using local pedicled pericranial or galeal flaps. Compared with historical nonvascularized ACF reconstructive options, vascularized reconstruction using pericranial and/or galeal flaps has decreased the rate of cerebrospinal fluid (CSF) leak from 25 to 6.5%. We review the existing literature on this uncommon entity and present our case series of n = 6 patients undergoing traumatic reconstruction of the ACF at an urban Level 1 trauma center from 2016 to 2018. There were no postoperative CSF leaks, mucoceles, episodes of meningitis, or deaths during the study follow-up period. In conclusion, use of pericranial, galeal, and free flaps, as indicated, can provide reliable and durable reconstruction of a wide variety of injuries.

• 대한한방내과학회지
• /
• 제28권1호
• /
• pp.47-67
• /
• 2007

Objectives : This study was aimed to investigated the warning signs and its relationship with the other characteristics in acute stroke patients. Methods : 225 acute stroke patients were recruited at the Department of Cardiovascular and Neurologic Diseases (Stroke Center) of Kyung Hee University Oriental Hospital from October 2005 to September 2006. We evaluated their stroke type with brain MRI, their warning signs, and general characteristics such as age, sex, past history, risk factors, etc. Results : 225 subjects were included in the final analysis. In the subjects' general characteristics, the most common etiology of stroke was small vessel occlusion. In the assessment of the subjects' warning signs, the frequency of tension felt at the cervical area was highest followed by blepharospasm, sensory dysfunction (one side of numbness, tingling sensation, dead sensation), one side paralysis or weakness, etc. After analyzing etiology, cerebral hemorrhage had more facial spasm sign and hypertension than cerebral infarction. On the other hand, cerebral infarction had more diabetes and sensory dysfunction (one side of numbness, tingling sensation, dead sensation) than cerebral hemorrhage. Among stroke locations, subjects with their brain lesion in the cortex had more warning sings of motor dysfunction such as one side paralysis, or weakness. Multiple lesions showed a close relationship with smoking habit and were more common in males than in females. The under 65 years old group were more commonly associated with alcohol consumption, accidental mental stress and blepharospam than the over 65 years old group. In the group of under 65 years old, males more commonly had lesions in occipital lobe, alcohol consumption and smoking habit than females. Otherwise, females more commonly had vision dysfunction and blepharospasm than males. In the group of over 65 years old, males more commonly had cortex lesion than females. On the other hand, Females more commonly had accidental mental stress than males. Conclusions : We observed various warning signs and their distribution in acute stroke patients. The subjects' brainlesions and their etiology seemed to affect the features of the warning signs. Hypertension, diabetes and hyperlipidemia were also related to etiology of stroke and some habitual problems such as smoking and drinking seemed to reduce the age of stroke ictus. Although a concrete conclusion can hardly be drawn from this study, it reminds physicians of the importance of warning signs which appear among their patients.

• Journal of Trauma and Injury
• /
• 제18권2호
• /
• pp.101-106
• /
• 2005

Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was $36.5{\pm}19.4$ years old. 110 were male and 35 were female. Mean height of fall was $11.1{\pm}8.5m$. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is $8.9{\pm}5.8m$ for 94 survivors and $15.2{\pm}11.0m$ for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between 'below 13.5m group' and 'above 13.5m group', but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient's death.

• Journal of Chest Surgery
• /
• 제31권10호
• /
• pp.1004-1008
• /
• 1998

본 논문은 동맥관개존증으로 인한 Eisenmenger 증후군 환자에서 시행된 심장-폐이식 수술에 대한 증례 보고이다. 동맥관 개존증으로 인한 Eisenmenger 증후군인 32세의 여자 수혜자는 1996년 6월 이후 심부전으로 심한 호흡곤란을 겪고 있었으며, 1997년 7월초에 빈맥, 호흡곤란, 하지부종을 주소로 응급실을 통하여 입원한 후 호흡곤란, 저산소증, 상심실성 빈맥, 전해질 이상 등으로 치료받으면서 퇴원하지 못하고 심장-폐 이식 대상자로 등록되었다. 수술전에 시행한 심초음파검사에서 우-좌단락의 동맥관개존증, 우심실 및 우심방의 심한 확장, 100 mmHg의 우심실 수축기압 소견을 보였다. 폐동맥압이 체동맥압보다 높게 역전되어 있었고 심한 이산화탄소 정체 및 저산소증의 소견을 보여서 중환자실에서 인공호흡기로 호흡기능을 보조받고 있었다. 공여자는 교통사고로 두부손상을 입고 뇌사판정을 받은 1 8세 남자였다. 공여자 및 수헤자의 혈액형은 모두 AB(+)형이었다. 1997년 10월 26일 심장-폐이식을 시행하였다. 심장 -폐분절은 공여자가 있던 타병원에서 구득하여 냉장보존 상태로 본원으로 이송하였다. 이식된 심장 및 폐의 총 허혈 시간은 각각 249분 및 270분이었다. 면역억제요법은 cyclosporine, azathioprine을 수술전부터 투여하였으며 steroid 는 기관 문합부위의 치유와 감염예방을 위하여 수술후 3주 이후부터 사용하였다. 환자는 수술후 31일째에 특별한 합 병증없이 퇴원하였으며 심장-폐이식후 4개월이 지난 현재, 심폐기능의 이상소견과 거부반응의 증거없이 NYHA funct ional class I의 상태로 지내고 있으며 면역억제제와 예방적 항생제, 소량의 이뇨제 및 항고혈압제를 복용하고 있다.

• Toxicological Research
• /
• 제15권1호
• /
• pp.79-87
• /
• 1999

To know the stress response and antioxidative effect of sulfur containing compounds, we observed the expression of the stress protein (heat shock protein; inducible protein) from mouse tissues and evaluated the protective effects to hydroxyl radical in mouse brain cell culture. Cysteine, methionine or sodium sulfide was fed by oral administration of 1 ml/per 6hr/three times with 1 mM, 2mM or 3mM to mouse, respectively. After that, the stress proteins were extracted from mouse tissues and analyzed the features of expression. The stress proteins by sulfur containing compounds were showed different aspects in the kinds and concentrations of their compounds, and in the tissues of mouse. In the liver, the stress proteins were appeared at different time on the concentration of sulfur containing compounds and had less than 20 KDa as small molecules. In general, the molecular weights of stress protein in liver, the stress proteins were appeared at different time on the concentration of sulfur containing compounds and had less than 20 KDa as small molecules. In general, the molecular weights of stress protein in the spleen were evaluated from 32KDa to 50KDA, and the induced times were relatively late at high concentration of cysteine, early at low concentration of methionine or sodium sulfide. The stress proteins in mouse muscle were detected mostly between 24hr after treatment of sulfur containing compounds. Their molecular weights were 15~24KDa. In the antioxidative effects of sulfur containing compounds to hydroxyl radical, cell viabilities were measured by 63.2% at 10 $\mu\textrm{M}$, 65.5% at 50 $\mu\textrm{M}$, 68.6% at 100 $\mu\textrm{M}$, 78.3% at 150 $\mu\textrm{M}$, or 83.0% at 200 $\mu\textrm{M}$ of cysteine, respectively. At addition of methionine, the cell viabilities were assessed as 58.1% at 10 $\mu\textrm{M}$, 62.8% at 50 $\mu\textrm{M}$, 75.7% at 100 $\mu\textrm{M}$, 78.6% at 150 $\mu\textrm{M}$, and 79.2% at 200 $\mu\textrm{M}$ after 4hrs exposure with 20mU/ml glucose oxidase (GO) system, while the numbers of live cells to hydroxyl radicals in treatment of sodium sulfide were showed 48.6% at 10 $\mu\textrm{M}$, 54.8% at 100 $\mu\textrm{M}$, 51.8% at 150 $\mu\textrm{M}$, and 51.6% at 200 $\mu\textrm{M}$ in the neuronal cells. In the inhibitory effects on the proliferation of tumor cells, percentages of dead cells of the CT-26 or HeLa cell were generally less than 30% even 48hr after addition of sulfur containing compounds. Conclusively, the results of these experiments indicate that stress protein by sulfur containing compounds can be used as physiological indicator for animal nutrition and for environment, and also that cysteine and methionine can play critical roles as an antioxidant.

• Toxicological Research
• /
• 제23권4호
• /
• pp.405-413
• /
• 2007

This study was to investigate single and repeated-dose toxicities of Tensolin-$F^{(R)}$, an anti-wrinkle agent, in Sprague-Dawley (SD) rats or ICR mice. In single-dose oral toxicity study, the test materials were administered once by gavage to male and female SD rats at dose levels of 0 and 2,000 mg/kg. No dead animals and abnormal necropsy findings were found in control and Tensolin-$F^{(R)}$ treated group. Therefore, the approximate lethal dose of Tensolin-$F^{(R)}$ was considered to be higher than 2,000 mg/kg in rats. In the 4-week repeated oral toxicity study, the test material was administered once daily by gavage to male and female ICR mice at dose levels of 0, 25, 50 and 100 mg/kg/day for 4-weeks. In the results, no abnormality was observed in mortality, clinical findings, body weight changes, food and water consumptions, opthalmoscopic findings, necropsy findings, histopathological findings. In hematological analysis, there was a trend of increase in reticulocyte at male 25 mg/kg, although such changes were in normal ranges. On the other hand, there was a trend of decrease in hemoglobin at female 50, 100 mg/kg, such changes were in normal ranges. In addition, serum biochemical parameters including sodium, BUN and chloride increased at 25, 50 and 100 mg/kg. Relative organ weights of right testis, brain, lung and left epididymis were increased in 100 mg/kg groups of male rats in contrast to not change in female groups. However, these changes of relative organ weights, hematological and serum biochemical parameters were not accompanied with related signs such as histopathological changes or clinical findings. In conclusion, 4-week repeated oral dose of Tensolin-$F^{(R)}$ to ICR mice did not cause apparent toxicological change at the dose of 25, 50, 100 mg/kg body weight. Consequently the no-observed-adverse-effect level (NOAEL) for Tensolin-$F^{(R)}$ in ICR mice following gavage for at least 4-week is higher than 100 mg/kg/day.

• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.71-76
• /
• 2009

Purpose: The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group. Methods: All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29,2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study. Results: Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11${\pm}$11units, BeforeTT 16${\pm}$15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251${\pm}$223 minutes, BeforeTT 486${\pm}$460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11${\pm}$12 days, Before TT 15${\pm}$30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43${\pm}$37 days, BeforeTT 68${\pm}$70 days, p=0.032), but this difference was not statistically significant. Conclusion: Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS<9) are good indices for activating the trauma team.

• 동의생리병리학회지
• /
• 제24권6호
• /
• pp.1034-1041
• /
• 2010

The oriental medicine Jangwonhwan, which is a boiled extract of 12 medicinal herbs/mushroom, has been prescribed for patients with cognitive dysfunction and it is originally from the Korean medical text, DonguiBogam(amnesia chapter). Recently, a modified recipe of Jangwonhwan (LMK02-Jangwonhwan) consisting of seven medicinal plants/mushroom, was shown to reduce ${\beta}$-amyloid deposition in the brain of Tg-APPswe/PS1dE9 mouse model of Alzheimer disease. The toxicity of LMK02 was investigated in SD rats by oral repeated adminstration for 4 weeks and we tried to determine test does for 13 weeks repeated study. Quality control of tablet form of LMK02 was established by estimating indicative components, Ginsenoside Rg3 of Red Ginseng and Decursin of Angelicagigas Nakai. The toxicity of LMK02 was investigated in 6 weeks old specific pathogen free (SPF) Sprageu-Dawley rats by oral administration. Each test group were consist of 5 male and 5 female and they received doses of 500, 1,000 and 2,000 mg/kg/day of test substance for 4 weeks. The clinical signs, death rate, body weight, food consumption, ophthalmic examination, urinalysis, hematological and serum biochemistry, organ weight and pathological changes were examined and compared with those of control group. Urinalysis : We observed increase of PRO(p<0.01), SG(p<0.01) in female rats of 1,000 mg/kg/day and 2,000 mg/kg/day(p<0.01). Also, we observed increase of pH and KET in female rats of 1,000 mg/kg/day(p<0.05) and of 2,000 mg/kg/day(p<0.01). WBC in female rats in 1,000 mg/kg/day and 2,000 mg/kg/day were on increase. Hematological test : We observed increase of MCV in male rats of 250 mg/kg/day. (p<0.05) Serum biochemistry test : We found increase of CHO in female rats of 2,000 mg/kg/day(p<0.05). During the experimental period, there were no animals dead or moribund. There were no treatment related changes of general symptom, food and water consumption, organ weight and autopsy According to the results of 4-week repeated dose range finding study, the highest dose was established as 1000 mg/kg for 13-week repeated dose toxicity study and we determined to put 2 more groups by common ratio two.