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The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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Change Acceptable In-Depth Searching in LOD Cloud for Efficient Knowledge Expansion (효과적인 지식확장을 위한 LOD 클라우드에서의 변화수용적 심층검색)

  • Kim, Kwangmin;Sohn, Yonglak
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.171-193
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    • 2018
  • LOD(Linked Open Data) cloud is a practical implementation of semantic web. We suggested a new method that provides identity links conveniently in LOD cloud. It also allows changes in LOD to be reflected to searching results without any omissions. LOD provides detail descriptions of entities to public in RDF triple form. RDF triple is composed of subject, predicates, and objects and presents detail description for an entity. Links in LOD cloud, named identity links, are realized by asserting entities of different RDF triples to be identical. Currently, the identity link is provided with creating a link triple explicitly in which associates its subject and object with source and target entities. Link triples are appended to LOD. With identity links, a knowledge achieves from an LOD can be expanded with different knowledge from different LODs. The goal of LOD cloud is providing opportunity of knowledge expansion to users. Appending link triples to LOD, however, has serious difficulties in discovering identity links between entities one by one notwithstanding the enormous scale of LOD. Newly added entities cannot be reflected to searching results until identity links heading for them are serialized and published to LOD cloud. Instead of creating enormous identity links, we propose LOD to prepare its own link policy. The link policy specifies a set of target LODs to link and constraints necessary to discover identity links to entities on target LODs. On searching, it becomes possible to access newly added entities and reflect them to searching results without any omissions by referencing the link policies. Link policy specifies a set of predicate pairs for discovering identity between associated entities in source and target LODs. For the link policy specification, we have suggested a set of vocabularies that conform to RDFS and OWL. Identity between entities is evaluated in accordance with a similarity of the source and the target entities' objects which have been associated with the predicates' pair in the link policy. We implemented a system "Change Acceptable In-Depth Searching System(CAIDS)". With CAIDS, user's searching request starts from depth_0 LOD, i.e. surface searching. Referencing the link policies of LODs, CAIDS proceeds in-depth searching, next LODs of next depths. To supplement identity links derived from the link policies, CAIDS uses explicit link triples as well. Following the identity links, CAIDS's in-depth searching progresses. Content of an entity obtained from depth_0 LOD expands with the contents of entities of other LODs which have been discovered to be identical to depth_0 LOD entity. Expanding content of depth_0 LOD entity without user's cognition of such other LODs is the implementation of knowledge expansion. It is the goal of LOD cloud. The more identity links in LOD cloud, the wider content expansions in LOD cloud. We have suggested a new way to create identity links abundantly and supply them to LOD cloud. Experiments on CAIDS performed against DBpedia LODs of Korea, France, Italy, Spain, and Portugal. They present that CAIDS provides appropriate expansion ratio and inclusion ratio as long as degree of similarity between source and target objects is 0.8 ~ 0.9. Expansion ratio, for each depth, depicts the ratio of the entities discovered at the depth to the entities of depth_0 LOD. For each depth, inclusion ratio illustrates the ratio of the entities discovered only with explicit links to the entities discovered only with link policies. In cases of similarity degrees with under 0.8, expansion becomes excessive and thus contents become distorted. Similarity degree of 0.8 ~ 0.9 provides appropriate amount of RDF triples searched as well. Experiments have evaluated confidence degree of contents which have been expanded in accordance with in-depth searching. Confidence degree of content is directly coupled with identity ratio of an entity, which means the degree of identity to the entity of depth_0 LOD. Identity ratio of an entity is obtained by multiplying source LOD's confidence and source entity's identity ratio. By tracing the identity links in advance, LOD's confidence is evaluated in accordance with the amount of identity links incoming to the entities in the LOD. While evaluating the identity ratio, concept of identity agreement, which means that multiple identity links head to a common entity, has been considered. With the identity agreement concept, experimental results present that identity ratio decreases as depth deepens, but rebounds as the depth deepens more. For each entity, as the number of identity links increases, identity ratio rebounds early and reaches at 1 finally. We found out that more than 8 identity links for each entity would lead users to give their confidence to the contents expanded. Link policy based in-depth searching method, we proposed, is expected to contribute to abundant identity links provisions to LOD cloud.

Customer Behavior Prediction of Binary Classification Model Using Unstructured Information and Convolution Neural Network: The Case of Online Storefront (비정형 정보와 CNN 기법을 활용한 이진 분류 모델의 고객 행태 예측: 전자상거래 사례를 중심으로)

  • Kim, Seungsoo;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.221-241
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    • 2018
  • Deep learning is getting attention recently. The deep learning technique which had been applied in competitions of the International Conference on Image Recognition Technology(ILSVR) and AlphaGo is Convolution Neural Network(CNN). CNN is characterized in that the input image is divided into small sections to recognize the partial features and combine them to recognize as a whole. Deep learning technologies are expected to bring a lot of changes in our lives, but until now, its applications have been limited to image recognition and natural language processing. The use of deep learning techniques for business problems is still an early research stage. If their performance is proved, they can be applied to traditional business problems such as future marketing response prediction, fraud transaction detection, bankruptcy prediction, and so on. So, it is a very meaningful experiment to diagnose the possibility of solving business problems using deep learning technologies based on the case of online shopping companies which have big data, are relatively easy to identify customer behavior and has high utilization values. Especially, in online shopping companies, the competition environment is rapidly changing and becoming more intense. Therefore, analysis of customer behavior for maximizing profit is becoming more and more important for online shopping companies. In this study, we propose 'CNN model of Heterogeneous Information Integration' using CNN as a way to improve the predictive power of customer behavior in online shopping enterprises. In order to propose a model that optimizes the performance, which is a model that learns from the convolution neural network of the multi-layer perceptron structure by combining structured and unstructured information, this model uses 'heterogeneous information integration', 'unstructured information vector conversion', 'multi-layer perceptron design', and evaluate the performance of each architecture, and confirm the proposed model based on the results. In addition, the target variables for predicting customer behavior are defined as six binary classification problems: re-purchaser, churn, frequent shopper, frequent refund shopper, high amount shopper, high discount shopper. In order to verify the usefulness of the proposed model, we conducted experiments using actual data of domestic specific online shopping company. This experiment uses actual transactions, customers, and VOC data of specific online shopping company in Korea. Data extraction criteria are defined for 47,947 customers who registered at least one VOC in January 2011 (1 month). The customer profiles of these customers, as well as a total of 19 months of trading data from September 2010 to March 2012, and VOCs posted for a month are used. The experiment of this study is divided into two stages. In the first step, we evaluate three architectures that affect the performance of the proposed model and select optimal parameters. We evaluate the performance with the proposed model. Experimental results show that the proposed model, which combines both structured and unstructured information, is superior compared to NBC(Naïve Bayes classification), SVM(Support vector machine), and ANN(Artificial neural network). Therefore, it is significant that the use of unstructured information contributes to predict customer behavior, and that CNN can be applied to solve business problems as well as image recognition and natural language processing problems. It can be confirmed through experiments that CNN is more effective in understanding and interpreting the meaning of context in text VOC data. And it is significant that the empirical research based on the actual data of the e-commerce company can extract very meaningful information from the VOC data written in the text format directly by the customer in the prediction of the customer behavior. Finally, through various experiments, it is possible to say that the proposed model provides useful information for the future research related to the parameter selection and its performance.

Studies on effect and Safety of various Aqua-acupunctures from Scutellariae Radix (다양(多樣)한 황금약침제제(黃芩藥鍼製劑)의 안전성(安定性) 및 효능(效能)에 관한 연구(硏究))

  • Kim, Ho-Kyoung;Ma, Jin-Yeul;Cheon, Won-Kyung;Yun, Su-Young;Kang, Eun-Jung;Joo, Hye-Jeong;Ko, Byoung-Seob
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.183-197
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    • 1997
  • In order to detect the safety and effect of various aqua-acupunctures from Scutellariae Radix, the modifications of boiling, filtration and dilution were employed for the manufacture of aqua-acupunctures. We injected 0.2cc of aqua-acupunctures into Joksamri (足三里) of rat, repeatedly. We compared subacute toxicity of them with saline group, distilled water(D.W.) group, acupuncture group and control group. The results were summarized as follows: 1. The groups were all healthy and alive, and there was no special abnormality in physical condition and autopsy. And there were not any toxic symptoms in repeating application of aqua-acupunctures to the rat, including changes of body weight, organ weight, haematological examination and serum biochemical test. 2. There was slight change of body weight in acupuncture group : We could see significance after 3 days(p<0.05) and after 7 days(p<0.001) in body weight loss. After 9 days, all tested groups were suppressed in body weight increment. 3. Result of organ weight : In Palkang aqua-acupuncture(D-2 group), saline group and acupuncture group there were some statistical significance. Especially, acupuncture group revealed significant result in liver and spleen than aqua-acupunctures. From this result, we could suggest that the efficacy of acupuncture was preceded herbal medicine. 4. In serum biochemical test, we examined glucose(GLU), triglyceride(TG) and cholesterol(CHOL). In comparison with control group, the diluted 10 times of Hwanggum aqua-aqupuncture$({\times}10\;group)$ was recognized significant decrease of glucose, but the diluted 100 times of Hwanggum aqua-acupuncture$({\times}100\;group)$, D-2 group, saline group were confirmed significant increment. There was not any meaningful change of CHOL in all of tested group, excepting the acupuncture group was exhibited statistically significant decrease(p<0.05). In TG level all tested group except complex injection of standard compound(CPA group) and HG, there were significant value iii statistically. The diluted solution was more significant decrease than Hwanggum aqua-acupuncture(HG). The mutual relationship of components of aqua-acupunture tended to decrease level of TG, regardless of its concentration. In acupunture guoup, we gained some interesting result In meaningful decrease in 7G. 5. Haematological examination showed significant increment of granulocytes(GR) in all tested groups except Hwanggum aqua-acupuncture. And the diluted solutions of HG expressed very high increment of them(p<0.001). The GR and Mean Corpuscular Volume(MCV) of acupuncture group showed statistical significance.

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Effect of Experimental Muscle Fatigue on Muscle Pain and Occlusal Pattern (실험적으로 유발되는 근피로가 근통증 및 교합양상에 미치는 영향)

  • Kim, Jae-Chang;Lim, Hyun-Dae;Kang, Jin-Kyu;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.33 no.3
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    • pp.279-294
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    • 2008
  • This study aimed to make an analysis of the occlusion in the state of muscle fatigue produced by excessive mouth opening and clenching during the dental treatment to control the dental pain and to evaluate the sensory nerve in the muscle pain state. Most of the reasons why patients visit the dental office result in pain-either conceivably the dental origin pain or the non-dental origin pain. The dental offices have many therapeutic actions to produce the masticatory muscle fatigue for the treatment. Dental treatment with long minutes of mouth opening can cause some headaches, masticatory muscle pain and mouth opening difficulties. Patients with mastication problems who visits a dental office to alleviate pain run against another unexpected pain with other aspects. This study uses T-scan II system(Tekscan Co., USA) for the evaluation on the occlusal pattern in the experimental muscle fatigue after clenching, opening the mouth excessively and chewing gum. The occlusal contact pattern is analyzed by the contact timing, namely first, intercuspal, maximum and end point of contact. This inspection was performed at frequencies of 2000Hz, 250 Hz and 5 Hz before and after each experimental muscle pain was produced to 24 subjects who had normal occlusion without the orthodontic treatment or a wide range of the prosthesis by using $neurometer^{\circledR}$ CPT/C(Neurotron, Inc. Baltimore, Maryland, USA). The measuring sites were mandibular nerve experimental muscle fatigue respectively. This study could obtain the following results after the assessment of occlusion and sensory nerve of the experimental muscle fatigue. 1. There were the fastest expression after the excessive mouth opening in muscle fatigue and after tooth clenching in muscle pain. In the visual analog scale that records the subjective level, there was the highest scale after the clenching in the muscle fatigue in jumping off the point of pain. 2. Tooth contact time, contact force, relative contact force on the point of the first contact had no difference, and there were decreases in the contact force after the excessive mouth opening on intercuspal position point, after the excessive mouth opening and the gum chewing on the point of the maximum, and in the contact time after all the experimental muscle fatigue state on the point of the end contact. 3. There was no statistic significance in the current perception threshold before and after the experimental muscle fatigue. 4. There was no significant difference in the contact number, the maximal contact number on the point of the first contact, and the contact number after the mouth opening and gum chewing on the point of the intercuspal position and the contact number after the experimental muscle fatigue on the maximum point, and showed significant decreases. In conclusion, it was found that the occlusal pattern can cause the changes on the case of the clinical muscle weakness by intra-external oral events. It was important that the sedulous attention to details is required during dental treatment in case of excessive mouth opening, mastication and clenching.

Effect of $H_2O_2$ on Alveolar Epithelial Barrier Properties (폐상피세포 장벽에 대한 $H_2O_2$의 영향)

  • Suh, Duk-Joon;Cho, Se-Heon;Kang, Chang-Woon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.236-249
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    • 1993
  • Background: Among the injurious agents to which the lung airspaces are constantly exposed are reactive species of oxygen. It has been widely believed that reactive oxygen species may be implicated in the etiology of lung injuries. In order to elucidated how this oxidant causes lung cell injury, we investigated the effects of exogenous $H_2O_2$ on alveolar epithelial barrier characteristics. Methods: Rat type II alveolar epithelial cells were plated onto tissue culture-treated polycarbonate membrane filters. The resulting confluent monolayers on days 3 and 4 were mounted in a modified Ussing chamber and bathed on both sides with HEPES-buffered Ringer solution. The changes in short-circuit current (Isc) and monolayer resistance (R) in response to the exogenous hydroperoxide were measured. To determine the degree of cellular catalase participation in protection against $H_2O_2$ injury to the barrier, experiments were repeated in the presence of 20 mM aminotriazole (ATAZ, an inhibitor of catalase) in the same bathing fluid as the hydroperoxide. Results: These monolayers have a high transepithelial resistance (>2000 ohm-$cm^2$) and actively transport $Na^+$ from apical fluid. $H_2O_2$(0-100 mM) was then delivered to either apical or basolateral fluid. Resulting indicated that $H_2O_2$ decreased Isc and R gradually in dose-dependent manner. The effective concentration of apical $H_2O_2$ at which Isc (or R) was decreased by 50% at one hour ($ED_{50}$) was about 4 mM. However, basolateral $H_2O_2$ exposure led to $ED_{50}$ for Isc (and R) of about 0.04 mM. Inhibition of cellular catalase yielded $ED_{50}$ for Isc (and R) of about 0.4 mM when $H_2O_2$ was given apically, while $ED_{50}$ for basolateral exposure to $H_2O_2$ did not change in the presence of ATAZ. The rate of $H_2O_2$ consumption in apical and basolateral bathing fluids was the same, while cellualr catalase activity rose gradually with time in culture. Conclusion: Our data suggest that basolateral $H_2O_2$ may affect directly membrane component (e.g., $Na^+,\;K^+$-ATPase) located on the basolateral cell surface. Apical $H_2O_2$, on the other hand, may be largely degraded by catalase as it passes through the cells before reaching these membrane components. We conclude that alveolar epithelial barrier integrity as measured by Isc and R are compromised by $H_2O_2$ being relatively sensitive to basolateral (and insensitive to apical) $H_2O_2$.

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The Changes of Pulmonary Function and Systemic Blood Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 혈압 및 폐기능의 변화에 관한 연구)

  • Moon, Hwa-Sik;Lee, Sook-Young;Choi, Young-Mee;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.206-217
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    • 1995
  • Background: In patients with obstructive sleep apnea syndrome(OSAS), there are several factors increasing upper airway resistance and there is a predisposition to compromised respiratory function during waking and sleep related to constitutional factors including a tendency to obesity. Several recent studies have suggested a possible relationship between sleep apnea(SA) and systemic hypertension. But the possible pathophysiologic link between SA and hypertension is still unclear. In this study, we have examined the relationship among age, body mass index(BMI), pulmonary function parameters and polysomnographic data in patients with OSAS. And also we tried to know the difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Methods: Patients underwent a full night of polysomnography and measured pulmonary function during waking. OSAS was diagnosed if patients had more than 5 apneas per hour(apnea index, AI). A careful history of previously known or present hypertension was obtained from each patient, and patients with systolic blood pressure $\geq$ 160mmHg and/or diastolic blood pressure $\geq$ 95mmHg were classified as hypertensives. Results: The noctural nadir of arterial oxygen saturation($SaO_2$ nadir) was negatively related to AI and respiratory disturbance index(RDI), and the degree of noctural oxygen desaturation(DOD) was positively related to AI and RDI. BMI contributed to AI, RDI, $SaO_2$ nadir and DOD values. And also BMI contributed to $FEV_1,\;FEV_1/FVC$ and DLco values. There was a correlation between airway resistance(Raw) and AI, and there was a inverse correlation between DLco and DOD. But there was no difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Conclusion: The obesity contributed to the compromised respiratory function and the severity of OSAS. AI and RDI were important factors in the severity of hypoxia during sleep. The measurement of pulmonary function parameters including Raw and DLco may be helpful in the prediction and assessment of OSAS patients. But we could not find clear difference between hypertensive and normotensive OSAS patients.

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The Effect of Surfactant on Neutrophil Apoptosis in Lipopolysaccharide Induced Acute Lung Injury in Rat (기관내 내독소 투여로 유도한 백서의 급성 폐손상 모델에서 surfactant가 호중구의 아포토시스에 미치는 영향)

  • Yoo, Ji-Hoon;Lee, Byoung-Jun;Jeong, Do-Young;Lee, Sang-Hoon;Shin, Jong-Wook;Kim, Jae-Yeol;Park, In-Won;Choi, Byoung-Whui
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.409-419
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    • 2002
  • Background : The therapeutic effects of surfactant on acute lung injury derive not only from its recruiting action on collapsed alveoli but also from its anti-inflammatory effects. Pro-apoptotic action on alveolar neutrophils represents one of the important anti-inflammatory mechanisms of surfactant. In the present study, we evaluated the effects of sufactant on the apoptosis of human peripheral and rat alveolar neutrophils. Methods : In the (Ed- the article is not definitely needed but it helps to separate the two prepositions 'in') in vitro study, human neutrophils were collected from healthy volunteers. An equal number of neutrophils ($1{\times}10^6$) (Ed-confirm) was treated with LPS (10, 100, 1000ng/ml), surfactant (10, 100, $1000{\mu}g/ml$), or a combination of LPS (1000ng/ml) and surfactant (10, 100, $1000{\mu}g/ml$). After incubation for 24 hours, the apoptosis of neutrophils was evaluated by Annexin V method. In the in vivo study, induction of acute lung injury in SD rats by intra-tracheal instillation of LPS (5mg/kg) was followed by intra-tracheal administration of either surfactant (30mg/kg) or normal saline (5ml/kg). Tenty-four hours after LPS instillation, alveolar neutrophils were collected and the apoptotic rate was evaluated by Annexin V method. In addition, changes of the respiratory mechanics of rats (respiratory rate, tidal volume, and airway resistance) were evaluated with one chamber body plethysmography before, and 23 hours after, LPS instillation. Results : in the in vitro study, LPS treatment decreased the apoptosis of human peripheral blood neutrophils (control: $47.4{\pm}5.0%$, LPS 10ng/ml; $30.6{\pm}10.8%$, LPS 100ng/ml; $27.5{\pm}9.5%$, LPS 1000ng/ml; $24.4{\pm}7.7%$). The combination of low to moderate doses of surfactant with LPS promoted apoptosis (LPS 1000ng/ml + Surf $10{\mu}g/ml$; $36.6{\pm}11.3%$, LPS 1000ng/ml +Surf $100{\mu}g/ml$; $41.3{\pm}11.2%$). The high dose of surfactant ($1000{\mu}g/ml$) decreased apoptosis ($24.4{\pm}7.7%$) and augmented the anti-apoptotic effect of LPS (LPS 1000ng/ml + Surf $1000P{\mu}g/ml$; $19.8{\pm}5.4%$). In the in vivo study, the apoptotic rate of alveolar neutrophils of surfactant-treated rats was higher than that of normal saline-treated rats ($6.03{\pm}3.36%$ vs. $2.95{\pm}0.58%$). The airway resistance (represented by Penh) of surfactant-treated rats was lower than that of normal saline-treated rats at 23 hours after LPS injury ($2.64{\pm}0.69$ vs. $4.51{\pm}2.24$, p<0.05). Conclusion : Surfactant promotes the apoptosis of human peripheral blood and rat alveolar neutrophils. Pro-apoptotic action on neutrophils represents one of the important anti-inflammatory mechanisms of surfactant.

A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.133-151
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    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

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The Evaluations of Phoria and AC/A Ratio by Watching 3D TV at Near (3D TV 근거리 시청에 따른 사위도와 조절성폭주비 평가)

  • Son, Jeong-Sik;Kim, Dong-Su;Kim, Jung-Ho;Kim, Jae-Do;Hamacher, Alaric;Yu, Dong-Sik
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.3
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    • pp.319-324
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    • 2015
  • Purpose: This study was designed to evaluate the changes of phoria and calculated AC/A ratio, and their recovery time points by watching 3D television (3D TV). Methods: 50 subjects (male 30, female 20) of 20s to 40s ages who can watch 3D, were measured phoria using a Howell phoria card at 3 m for distance and 40 cm for near. The phoria was evaluated before watching 3D TV and every 10 minutes from starting of watching 3D TV for 30 minutes, and every 5 minutes after finishing of watching 3D TV for 30 minutes again. Results: For the distance phoria during and after watching 3D TV, it was increased to more exophoria $-0.98{\pm}1.37{\Delta}$ (prism diopters) after 10 minutes from starting of 3D TV watching (p=0.063) and increased to more exophoria $-1.00{\pm}1.28{\Delta}$ after 30 minutes (p=0.024), and started to decrease after finishing of watching 3D TV and recovered to the level of before 3D TV watching ($-0.78{\pm}1.11{\Delta}$) after 20 minutes (p=0.32) with comparing to phoria of before watching 3D TV ($-0.80{\pm}1.12{\Delta}$). For the near phoria, it was also increased to more exophoria $-5.71{\pm}4.45{\Delta}$ after 10 minutes from starting of watching 3D TV (p=0.000) and $-6.58{\pm}4.36{\Delta}$ after 30 minutes (p=0.000), and started to decrease after finishing of watching 3D TV and recovered to the level of before watching 3D TV after 20 minutes ($-4.34{\pm}3.67{\Delta}$) (p=0.32) with comparing to the phoria of before watching 3D TV ($-4.36{\pm}3.66{\Delta}$). AC/A ratio was decreased from $4.92{\pm}1.17{\Delta}/D$ for before 3D TV watching to $4.11{\pm}1.50{\Delta}/D$ for after 30 minutes from starting of watching 3D TV (p=0.000), and increased after the end of watching 3D TV and recovered to the level of before 3D TV watching ($4.93{\pm}1.18{\Delta}/D$) after 25 minutes (p=0.598). Conclusions: During watching 3D TV at near, it showed a tendency of convergence insufficiency by decrease of calculated AC/A ratio as result that exophoria at near was higher increased than exophoria at distance. However, the increased exophoria at both near and distance was recovered to the level of base line after 25 minutes from the end of watching 3D TV. Through this study, it seems to need rational proposals of advice for watching 3D TV.