• Journal of Chest Surgery
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• 제21권3호
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• pp.425-446
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• 1988

After 24 hours of preservation under 15 mmHg perfusion pressure the recovery rates of isolated canine hearts were determined. Preservation was performed in a cold room maintained at 4*C with 4 different types of perfusates bubbled with a mixture of 95% 0y and 5% CO~ using a modified perfusion unit designed in our institute. The perfusates used were as follows; Group 1: Krebs-Henseleit solution, Group 2: Krebs solution added by albumin and PGE1. Group 3: Modified Wicomb*s solution, Group 4: Modified Collin*s solution. The extent of myocardial recovery was evaluated using a modified isolated carmine perfusion model by measuring heart rate, systolic arterial pressure, left atrial pressure[LAP] and cardiac output. In addition to the above hemodynamic parameters, biochemical and enzymatic assays from perfusates and electron microscopic changes of the myocardium were also studied. The results were as follows; 1] The heart recovery rates were 41.6%, 53.4% and 108.9% in groups 1, 2 and 3, respectively, and group 3 elicited the best result[p< 0.001]. The heart beat was never recovered in group 4. 2] Recovered systolic arterial pressures[mmHg] were 63.3% in group 1, 94.9% in group 2 and 94.3% in group 3. 3] LAPs[mmHg] were 20 in group 1, 13.5 in group 2 and 11.2 in group 3, which suggested that the best myocardial preservation was elicited in group 3[p< 0.05]. 4] Cardiac output, the sum of aortic stroke volume and coronary leakage, were 69.1% in group 2, and 90.7% in group 3, but these were not statistically significant[p=0.24]. No aortic stroke output was measured in group 1 and 4. 5] The degree of myocardial edema increase was 17.5` in group 1, 24.6% in group 2, 20.9% in group 3 and 55.3% in group 4. But there were no statistical differences in each group[p= 0.08]. 6] CPK-MB[U/L] levels were increased 750% and 332%[p< 0.05], glucose levels[mg/dl] 60.5% and 78.2% and SGOT[U/L] levels 523% and 333%, in groups 2 and 3, respectively. Biochemical and enzymatic assays could not be performed in group 1 and group 4, because of poor recovery of heart beat. 7] Electron microscopic findings in the myocardium of most groups revealed slight to moderate muscle cell and mitochondrial edema. But all these findings were within the limits of reversible change. From these above results, it is suggested that modified Wicomb*s solution seems to be the most useful physiologic salt solution for preservation of the heart. We propose that after further study and improvement, our portable continuous hypothermic perfusion system will contribute to the development of a better preservation method for donor hearts for human heart transplantation.

• Journal of Chest Surgery
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• 제32권8호
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• pp.693-701
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• 1999

최근 혈관 질환의 진단을 위한 비침습적 영상이 발달하면서, 기존의 도자술은 중재적 치료에 국한되는 실 정이다. 그러나 관상동맥이나 우회로는 작은 직경, 심박동 움직임 등으로 도자술이 아직도 진단에 필수적이 며, 비침 응\ulcorner영상 진단의 마지막 도전 영역이다. 전자선 단층 촬영기는 높은 시간 해상능으로 심장 영상을 얻을 수 있다. 전자선 단층 촬영을 이용하여 모관상 동맥 협착이나 관상동맥 우회로 이식술 후 개존성의 평 가가 시도되고 있으며, 이중 관상동맥 우회로술 평가의 정확도는 매우 높아서 임상 적용이 가능하다. 저자와 다른 연구자의 경험에 의하면 복재 정맥은 넓은 직경, 비교적 짧고 직선적인 경로, 심박동에 덜 영 향 받음으로써 EBT조영술의 정확도가 높았다. 전향적 민감도와 특이도가 각각 92%, 97%를 보였다. 그러나 위양성과 위음성을 보인 두 예는 후향적으로 분석 할 때 경험 부족에 의한 초기의 판독 오류로 사료되어 복 재 정맥의 경우 후향적으로는 100%의 정확도를 보였다. 반면 내유동맥 이식혈관은 작은 내경과 주변의 수술 클립에 의한 인공산물로 개존성을 확인하기가 대체로 어려웠고, 역동적 검사를 병행하여 우회로내 혈류를 확인하는 것이 필요하다. 내유동맥의 경우 상대적으로 정확도가 낮아 민감도, 특이도가 각각 100%, 80%를 보였으며, 위양성을 보인 2예는 후향적으로도 개존을 확인할 수 없었다. 전자선 단층 촬영 혈관 조영술은 관상 동맥 우 막\ulcorner이식술 후의 우회 혈관 개존성의 평가, 특히 복재 정맥 우회로의 경우 매우 정확도가 높은 비침습적 검사로써, 임상 적용이 기대된다. 앞으로 촬영 기기와 영상 재구성 software의 발달로 정확도를 더욱 높일 수 있는 잠재성이 있다.

• Journal of Chest Surgery
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• 제29권4호
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• pp.444-448
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• 1996

작은 인공판막주위 누출에 의한 용혈성 빈혈은 인공판막 치환술후올수 있는 합병증중의 하나이다. 경도의 용혈은 대개 기계 판막으로 대동맥 판막 치환술을 시행했을 때 생기 지만, 드물게는 승모판막 치환 술 후에 생 기도 더욱 드물게 조직판막 치환술 후에도 생 긴다 조직판막 치환술후에 용혈성 빈혈은 거의 생기지 않는다. lonescu-Shiley 심낭판막 치환술을 받은 환자에서 용혈성 빈혈은 승모판막에서는 없었고, 대동맥판막 에서 주로 발생하였다고 보고되 어 왔다. 41세 여자환자가 갑자기 진한적색뇨가생겨 본원에 입원하였다. 이 환자는 10년전 승모판막 폐쇄부전증으로 승모판막 치환술(lonescu-Shiley판막 27mm)을 받았던 병 력 이 있다. 심초음파검사상 판막을 통한 경도의 승모판막 폐쇄부전과 함께 판막의 비후가 관찰되었으나 판막주 위를 통해 세어나오는 판막주위 누출의 소견은 관찰할 수 없었다. 말초혈액도말검사상정적혈구성 정색소성 빈혈을 보였다. 혈액 및 요 검사에서 심한 용혈소견이 보였다. 51. Jude Medical 양엽 판막(size 27mm)으로 승모판막 치환술을 시행하였다. 수술시 lonescu-Shiley 판막에 판엽의 석 회화와 뒤틀림 ( istortion)이 있었고, 술자위 치 에서 1시 방향에 직경 5mm의 작은 판막주위 누출이 발견되었으며 이것이 용혈성 빈혈의 원인으로 생각되었다. 승모판 막 재치환술후 용혈소견은 완전히 사라졌다. 저자들은 작은 인공판막주위 누출에 의한 심한 용혈성 빈혈이 발생한 1예를 경험하였기에 문헌고찰 과 함께 보고하는 바이다.

• 한국발생생물학회지:발생과생식
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• 제9권2호
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• pp.105-114
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• 2005

배아 줄기세포는 세포 치료 목적을 위한 재료로써 매우 큰 잠재력을 가지고 있으며, 이러한 잠재력의 실현을 위해서 세포의 운명에 결정적인 역할을 하는 요소들을 확인하고 특정 세포의 대량 생산을 위한 방법을 개발하여야 한다. 조혈과정은 폭넓게 연구되어 왔으며, 배아 줄기세포로부터 조혈세포의 분화는 lineage commitment에 관한 연구에 좋은 모델이 된다. 본 연구에서는, 두 종류의 마우스 배아 줄기세포주 TC-1과 B6-1를 이용하여 그 특성과 조혈세포 분화능을 비교하여 보았다. 두 세포주는 작은 차이는 있으나 줄기세포로서의 특성을 공통적으로 가지고 있었다. 그러나 methylcellulose 배양 system을 사용하여 embryonic body 형성능을 확인한 결과 TC-1이 B6-1에 비해 월등함을 확인하였다. 조혈세포 분화의 추적을 위해 blast colony의 형성, progenitor assay, RT-PCR을 통한 조혈세포 분화 관련 marker의 발현 분석을 수행한 결과, TC-1은 정상적으로 조혈세포를 생성해 내지만, B6-1은 제대로 분화되지 못함을 확인할 수 있었다. 이러한 결과들은 in vitro에서 배아 줄기세포로부터 조혈세포로 분화를 유도할 때, 보다 적합한 세포주의 탐색이 요구됨을 제시하며 이는 향후 인간 배아 줄기세포주에서도 마찬가지로 적용될 수 있음을 암시한다고 사료된다.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Journal of Nutrition and Health
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• 제46권1호
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• pp.15-25
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• 2013

The purpose of this study is to investigate the proportion and associated risk factors of hypertriglyceridemia in rural Vietnamese women. Research data were collected as part of the Korean Genome and Epidemiology Study (KoGES). A cross-sectional study of 957 Vietnamese women in their 20 to 30s was conducted in rural areas of Bavi, Vietnam. Subjects were classified as hypertriglyceridemic (serum TG ${\geq}$ 150 mg/dL). Demographic, socio-economic details, anthro-pometric measurements, and blood profiles were recorded. The proportion of hypertriglyceridemic subjects was 22.0%, and the mean age of hypertriglyceridemics subjects was older than that of normo-triglyceridemic subjects (p < 0.05). In hypertriglyceridemic subjects, height, HDL-cholesterol, and LDL-cholesterol were significantly lower, compared to subjects with normo-triglyceridemia, while weight, body mass index, waist hip ratio, body fat %, blood pressure, fasting blood sugar, total cholesterol, and atherogenic index were higher, compared to those with normo-triglyceridemia. Intake of cereal and cereal products, total plant food, and cereal/potato fiber in subjects with hypertriglyceridemia was significantly higher, compared to normo-triglyceridemic subjects. Hypertriglyceridemic subjects had a significantly lower intake of animal calcium and retinol than normo-triglyceridemic subjects. Significant positive relationships were observed between the prevalence of hypertriglyceridemia and consumption of total plant food [OR (95% CI) for the highest tertile, compared to the lowest: 1.764 (1.131-2.750); p for trend = 0.008] and crude fiber [OR (95% CI) for the highest tertile compared to the lowest: 1.651 (1.092-2.497); p for trend = 0.027]. In addition, a significant inverse relationship was observed between the prevalence of hypertriglyceridemia and cholesterol intake [OR (95% CI) for the highest tertile, compared to the lowest: 0.601 (0.400-0.901); p for trend = 0.012]. These findings may provide basic data for use by policymakers and dieticians in future development of nutrition and health programs to encourage healthier eating habits, and to prevent hypertriglyceridemia advancing cardiovascular disease in rural Vietnamese women.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1076-1081
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• 2005

목 적 : 인슐린 저항성은 소아 및 청소년 비만증에서 내당능 장애, 당뇨병증, 심혈관계질환을 일으키는 중요한 위험요인 중 하나로 알려져 있다. 따라서 이 연구의 목적은 비만증 청소년이 소아에 비해 인슐린저항성이 증가하는가 그리고 성별에 따른 차이점을 규명하며 인슐린저항성에 영향을 미치는 요인들을 분석하고자 한다. 방 법 : 5-16세의 학생 9,837명을 신체검사하여 92명의 비만증 소아와 187명의 비만증 청소년을 선별하였고, 이들을 대상으로 당부하검사, 공복상태의 혈당, 인슐린농도, 총콜레스테롤, LDL-콜레스테롤, HDL-콜레스테롤, 중성지방의 농도, leptin, hs-CRP 및 adiponectin 농도를 측정하였다. 결 과 : 당부하검사를 통한 비만증 소아 및 청소년에서 성별에 따른 인슐린의 농도는 여자에서 인슐린의 농도가 높았다(P<0.05). 비만증 소아에서 4명(4.3%), 비만증 청소년에서 25명(13.3%)에서 내당능 장애로 나타났으며, 당뇨병으로 진단된 경우는 1례도 없었다. 인슐린 저항성은 여자, leptin, adiponectin, 중성지방의 농도와 밀접한 상관관계가 있었다(P<0.05). 결 론 : 비만증에서 인슐린 저항성은 소아보다 청소년에서 컸으며, 남자보다 여자에서 컸다. 또한 leptin 및 중성지방의 농도가 높을수록, adiponectin의 농도가 낮을수록 인슐린 저항성이 컸다. 소아 및 청소년 비만증에서 인슐린 저항성에 미치는 요인들에 관하여 좀 더 많은 연구가 필요하다.

• 대한간호
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• 제35권2호
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• pp.52-70
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• 1996

This historical research was conducted to analyze and categorize the titles which were presented in the journal, The Korean Nurse, from August 1962 to October 1995. Titles which were published with the purpose of educating graduate nurses and to update 0 their nursing knowledge to improve professional practice were included. There were 348 articles published from the beginning of publication in August, 1962 to October, 1995. All of the journals were reviewed except nine missing journals which were not available in any library. According to the characteristics of the articles in the periodical, the articles were divided into three periods. In each of the three peroids there were five categories: Subject, Clinical Practice, Fundamentals of Nursing Science, Nursing Administration, Others. These categories were adopted from Kim's(1994) division system which was developed to analyze nurse's insurance education program. The special feature peroid was from August, 1962 to December, 1974. In this period the articles were presented in an unorganized manner in the area of special feature or main issue. The largest area was the subject category(44%). The second largest area wes the fundamental of nursing science category(31%). From May, 1975 to December, 1977, the articles with the educational purposes were published in a designated area called continuing education. This period was labelled as the continuing education period. Among the published articles in this period, 45% focused on the subject category and 45% on the fundamentals of nursing science category. In this period the articles were focusing on nurses 'work in specific areas such as industry, nurses' aid schools, and nursing administration, articles on physical assessment first started to appear. The written continuing education period was from January 1978 to October, 1995. All the educational articles published in this area were analyzed and categorized into five areas as for the other periods. 48% of the articles focused on the subject category. In the mid-eighties, the term nurse specialist first.appeared and ten years later in 1990, the titles were subdivided into more specific titles, such as, home nursing, industrial nursing, emergency nursing, 23% were in the fundamental nursing science category and they dealt with nursing process, nursing theories, theory development. For the content analysis, three articles, one from each period, dealing with cardiovscular diseases were selected for comparsion. First, the special feature period, the title of the article was on diet therapy for cardiovascular disease patients, but instead the content was about rest, hygiene, medication, observation. They recommended rings to prevent bed sores, which is now considered as a cause for bed sores. In the continuing education period, the content was more focused on rehabilitation rather than general nursing .care. It became more specific, systematic, and organized compared with the special feature period. In the written continuing education period, the focus was on rehabilitation, not broadly, but very specifically on exercise. The further research on the content analysis is recommended along with a comparison of the trends in the Journal of Nurses Academic Society.

• Nutritional Sciences
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• 제7권2호
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• pp.65-69
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• 2004

A study was carried out to determine the effect of a very low-carbohydrate diet on weight gain, body composition, and serum levels of cholesterol, triacylglycerol, glucose, ketone bodies and insulin. Twenty rats (mean initial weight, 212 g) were divided into two groups and each group was assigned a conventional high-carbohydrate diet (control) or a very low-carbohydrate diet containing 59.8% ground pork rind snack and fed the diet for four weeks. Average daily body weight gain was not different between the two groups during the first two weeks, but was significantly lower in rats fed the very low-carbohydrate diet than in those in the control group during third (p<0.05) and fourth weeks (p<0.01). Feedintake as well as energy intake was lower in rats fed the very low-carbohydrate diet than in those in the control group. The very low-carbohydrate diet reduced (p<0.01) serum triacylglycerol (34$\pm$83 vs 82$\pm$8 mg/l00 mL) and insulin (3.90$\pm$0.53 vs 7.60$\pm$0.61 $\mu$IU/mL) levels, while increasing (p<0.01) ketone body level (368$\pm$25 vs 236$\pm$24 $\mu$mol/L), compared with the control. Serum glucose and total cholesterol levels were not different (p>0.05) between the two dietary treatments. Proximate analysis of carcasses showed that the very low-carbohydrate diet decreased (p<0.01) body fat (26.1$\pm$1.04 vs 30.5$\pm$0.86%), while increasing (p<0.01) body protein (63.1$\pm$0.94 vs 59.4$\pm$0.70%) contents. Results indicate that short-term feeding of a very low-carbohydrate diet is beneficial for alleviating risk factors known to involve cardiovascular diseases or artherosclerosis. However, more studies with model animals as well as humans are recommended to examine the long-term health benefits of low-carbohydrate diets.

• Journal of Chest Surgery
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• 제20권2호
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• pp.289-299
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• 1987

A total of 1,239 patients had cardiac valve replacement using 1,514 substitute valves at Seoul National University Hospital from 1968 to 1986. Of the total substitute vales, 84.9% were the glutaraldehyde-treated xenograft valves. Six hundred ninety-four patients who had 820 bioprosthetic tissue valves were studied for their clinical characteristics. They were a total and consecutive cases to the end of the study. Four hundred sixty-four patients had the lonescu-Shiley pericardial valves: MVR 291, AVR 66 and MVR+AVR 107; 163 had the Hancock porcine valves; 46 had the Angell-Shiley porcine valves; and 21 had the Carpentier-Edwards porcine valves. Five hundred forty patients underwent single valve replacement: MVR 460, AVR 76 and TVR 4; 154 had multiple valve replacement: MVR+AVR 141, MVR+TVR 12 and one triple valve replacement. Additional surgery was necessary in 22.3% of the cases. Operative mortality rate within 30 days of surgery was 6.77% for the total patients: 5.2% and 4.2% with MVR, 13.6% and 12.5% with AVR, and 7.5% and 7.4% with MVR+AVR using the lonescu and the Hancock valves respectively. A linealized annual late mortality rate was 2.56%/patient-year. Six hundred forty-three operative survivors were followed up for a total of 1482.7 patient-years [a mean 27.7 months], and the follow-up rate was 67.7%. The Idealized complication rates were: 2.02% emboli/patient-year, 0.94% bleeding/patient-year, 1.21% endocarditis/patient-year, and 3.84% overall valve failure/patient-year. A linealized rate of primary tissue failure was 0.87%/patient-year. Actuarial survival rates including the operative mortality were: 87.8*2.6%, 82.3*4.9% and 82.2*4.7% with MVR, AVR and MVR+AVR using the lonescu valves at 4 years after surgery respectively; and they were 88.0*4.1% with MVR at 8 years, 82.3*4.9% with AVR at 4 years and 84.9*7.0% with MVR+AVR at 6 years after surgery using the Hancock valves respectively. Probabilities of freedom from thromboembolism were 89.8*6.3% with MVR using the lonescu valves at postoperative 5 years and 89.2*3.8% with MVR using the Hancock valves at postoperative 7 years, and 93.3*3.9% with AVR using the lonescu valves at postoperative 5 years. None had embolic complication after AVR using the Hancock valves. Probabilities of freedom from valve failure [according to the Stanford criteria] were 81.0*7.1% with MVR using the lonescu valves at postoperative 4 years and 57.4*12.5% with MVR using the Hancock valves at postoperative 9 years. These clinical results prove the excellent antithrombogenicity of the glutaraldehyde-treated xenograft substitute valves and confirm the previously speculated rate of tissue failure. At the present situation, it may be concluded that there is a room for the further development of more durable bioprosthetic valves.