• Title/Summary/Keyword: Closing Department

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Effect of Intraoperative Glucose Fluctuation and Postoperative IL-6, TNF-α, CRP Levels on the Short-term Prognosis of Patients with Intracranial Supratentorial Neoplasms

  • Liu, Tie-Cheng;Liu, Qi-Ran;Huang, Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10879-10882
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    • 2015
  • Objective: To investigate the effect of intraoperative glucose fluctuation and postoperative interlukin-6 (IL-6), tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), C-reactive protein (CRP) levels on the short-term prognosis of patients with intracranial supratentorial neoplasms. Materials and Methods: Eighty-six patients undergoing intracranial excision were selected in The Second Hospital of Jilin University. According to the condition of glucose fluctuation, the patients were divided into group A (glucose fluctuation <2.2 mmol/L, n=57) and group B (glucose fluctuation ${\geq}2.2mmol/L$, n=29). Glucose was assessed by drawing 2 mL blood from internal jugular vein in two groups in the following time points, namely fasting blood glucose 1 d before operation ($T_0$), 5 min after anesthesia induction ($T_1$), intraoperative peak glucose ($T_2$), intraoperative lowest glucose ($T_3$), 5 min after closing the skull ($T_4$), immediately after returning to intensive care unit (ICU) ($T_5$) and 2 h after returning to ICU ($T_6$). 1 d before operation and 1, 3 and 6 d after operation, serum IL-6 and TNF-${\alpha}$ levels were detected with enzyme-linked immunosorbent assay (ELISA), and CRP level with immunoturbidimetry. Additionally, postoperative adverse reactions were monitored. Results: There was no statistical significance between two groups regarding the operation time, anesthesia time, amount of intraoperative bleeding and blood transfusion (P>0.05). The glucose levels in both groups at $T_1{\sim}T_6$ went up conspicuously compared with that at $T_0$ (P<0.01), and those in group B at $T_2$, $T_4$, $T_5$ and $T_6$ were significantly higher than in group A (P<0.01). Serum IL-6, TNF-${\alpha}$ and CRP levels in both groups 1, 3 and 6 d after operation increased markedly compared with 1 d before operation (P<0.01), but the increased range in group A was notably lower than in group B (P<0.05 or P<0.01). Postoperative incidences of hypoglycemia, hyperglycemia and myocardial ischemia in group A were significantly lower than in group B (P<0.05), and respiratory support time obviously shorter than in group B (P<0.01). Conclusions: The glucose fluctuation of patients undergoing intracranial excision is related to postoperative IL-6, TNF-${\alpha}$ and CRP levels and those with small range of glucose fluctuation have better prognosis.

CLINICAL CONSIDERATION ON USING THE ELASTIC 'TIE BACKS' DURING SPACE CLOSURE ('Elastic tie back'을 이용한 발치공간 폐쇄에 관한 임상적 고려)

  • Cho, Ki-Soo;Chun, Youn-Sic
    • The korean journal of orthodontics
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    • v.23 no.2 s.41
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    • pp.217-227
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    • 1993
  • Preadjusted appliance, following the original concept of the Andrews Straight-Wire appliance, became increasingly common in the 1980s. In six phases of treatment, anchorage control, leveling and aligning, overbite control, overjet reduction, space closure, and finishing are very effective with using the preadjusted appliances. Space closure is the phase of treatment in which the difference between standard edgewise and preadjusted mechanics is most noticeable. Orthodontists have been able to reduce the use of closing loops and, because of the level slot lineup, enjoy the advantages of sliding mechanics. In 1990, Dr. John C. Bennett and Richard P. McLaughlin introduced the new space closure system, namely, elastic 'tiebacks'. They found an $.019'\times.025'$ working archwire most effective in an .022'-slot system. Hooks of .024' stainless steel or .028' brass wire are soldered to the upper and lower archwires. The force required for space closure is delivered by elastic 'tiebacks'. An elastic modulo stretched by 2-3mm(to twice its normal length) usually delivers 0.5-1.5mm of space closure per month. Group movement and sliding mechanics are combined for gentle, controlled space closure, so that about 0.5mm of incisor retraction and 0.5mm of mesial molar movement can be seen each month. The tiebacks are replaced every four to six weeks. By using the elastic 'tiebacks', the next two cases were treated during space closure. Even though we found some clinical problems of this mechanics, long treatment time, hard to control of vertical dimension and anchorage, the application method of this system is so simple that orthodontists can manage many patients during short chair time. But we must apply this mechanics after perfect understanding of the biomechanics in tooth movement.

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Medico-Legal Consideration of Hemopneumothorax - Closing Claim Study- (${\cdot}$기흉과 관련된 의료법학적 문제에 대한 고찰 -종결된 사건을 중심으로-)

  • Bae, Hyu-Na;Cheon, Young-Jin
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.117-126
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    • 2006
  • Background: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. Material and Method: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. Result: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. Conclusion: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.

Correlation between Sandbar Development and Environmental Factors in the Nakdong River Estuary (낙동강 부정형적 사주발달과 환경인자간의 상관성 비교 연구)

  • Lee, I.C.;Yoo, C.I.;Yoon, H.S.
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.10 no.1
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    • pp.13-20
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    • 2007
  • This study was performed to provide fundamental data for long-term geomorphic predictions of estuarine sandbars in the Nakdong River. We monitored the geomorphic changes of Jinudo (Jinu Island), which is located on the far-southern side of the first western sandbar. We evaluated the temporal and spatial dynamics of the sandbar and the relationship between erosion and deposit speed with environmental factors. We found that: 1) The south side of Jinudo showed very rapid water channel closing and shoal generation. This phenomenon was more obvious during autumn (September and October) than during spring, with greater water depth reduction and variation between sides. 2) The mean deposit speed for Jinudo was approximately 0.85 mm/day. The deposit speed was 1.32 and 1.26 mm/day for the east and south sides of Jinudo, respectively. The maximum deposit and erosion speeds were 27 mm/day and 26 mm/day in July and December, respectively, on the east side of the island. 3) Mean surface deposit size was 0.18-0.26 mm. The newly deposited sandbar had a rotatively larger deposit size than the original land. 4) Correlation analysis showed that, on the southern side of the island, deposit activity prevailed in the winter due to low precipitation and a northerly wind, while erosion was dominant in the summer due to high water flow and a southerly wind. In contrast, the correlation analysis for the eastern side of the island showed that deposition is dominant when water flow is high. These results indicate that geomorphic dynamics vary among island sides.

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Rheographic View of the Change in the Renal Blood Flow in Acute Hemorrhage (Rheogram으로 본 실혈시 신장혈액유통 변화)

  • Chang, Se-Gu;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.5 no.1
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    • pp.59-69
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    • 1971
  • Studies were undertaken on the changes in the renal blood flow by relating them with the alterations in the amplitudes in the rheogram of rabbits. The changing pattern of the electrical conductivity was recorded by means of the needle electrodes inserted into the kidney and the surrounding aluminium foil which was grounded. The Impedance Rheograph manufactured by the Narco Company was used. The small artifact which persisted after ligation of the renal vessels was subtracted from the value obtained in each pulsatile wave in the rheogram. The animals were nembutalized intravenously, 30 mg/kg. A plastic canule was inserted into the carotid artery and the arterial blood pressure was monitored continuously with the pressure transducer connected to the physiograph. Stepwise bleedings were performed on the animal. The first bleeding was between 13 to 18 ml in the amount, and it was folowed by consecutive hemorrhages, 5 or 10 ml each time. The total amount of bleeding was summed as much as 1.5-2% of the body weight. Two minutes fter each bleeding th arterial blood pressure, ECG and the rheogram were taken. That was the necessary time to obtain the stabilized picture of each parameter. After closing the bleeding process, the shed blood was retransfused into the animal and the response in the renal blood flow was observed as well as the arterial blood pressure. Particularly the presence or absence of the autoregulatory mechanism in the situation of the hemorrhage was also studied. The results obtained were as follows: 1. In 7 cases out of 22, that was about one third of the total number of experiments, the autoregulatory mechanism of the renal blood flow persisted even in acute hemorrhage, and the decreases in the renal blood flow were less than 10% of the control values even when the arterial blood pressure dropped to 66-87% of the original value obtained before the bleeding. 2. Because of the stepwise bleeding the exact blood pressure at which the renal blood flow reduced as much as one third of the control value could not be obtained. However, the results revealed that the approximate pressure, expressed as percentage of the control value, was 50-60% in 3 cases, 61-70% in 4 cases and 71-80% in 8 cases. In one case the decrease in the renal blood flow exceeded one third of the control value before the pressure dropped to 80% of the control. 3. In 19 cases the decreases in the renal blood flow exceeded one half of the control values by hemorrhage. Then the arterial blood pressure revealed less than 40% of the control value in 6-cases. In 2 cases the pressure was 51-60% of the control pressure. In 5 cases the range of bleed pressure was 61-70%, and in e remaining 6 cases the pressure ranged from 71 to 80% of e control value. 4. Out of 15 cases of retransfusion after definite decreases in the renal blood flow loller·ing the hemorrhage, 9 cases restored their renal blood flow. On the contrary 6 cases showed low values even when the shed blood was retransfused. 5. Theories concerning the mechanism of the autoregulation of the renal blood flow were reviewed for the purpose of explanation of the results obtained. However, there are much to be done before greater satisfaction

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Histological and Ultrastructural Differentiations of the Neuroepithelial Cells in the Mouse Embryo during Early Neurulation (마우스 초기 신경배형성과정에서 신경상피세포의 조직학적 및 미세구조적 분화)

  • Kim, Yul-A;Chung, Young-Wha
    • Applied Microscopy
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    • v.29 no.1
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    • pp.105-124
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    • 1999
  • Histological and ultrastructural differentiations of the neuroepithelial cells in the mouse embryo during neurulation were observed. The neural plates and grooves consisted of pseudostratified columnar epithelium in the embryonic day (ED) 8 embryo were developed. In the ED 9 embryo, the neural tube was developed in all body length of embryo except both the cephalic and caudal ends. Secondary neurulation was shown at the tail bud of the ED 10 embryo. In the ED 8 embryo, the primitive streak was shown in the posterior end of the embryonic disc. The neuroepithelium, notochord and mesenchyme were well differentiated in the cephalic and cervical portions. In the ED 9 and 10 embryos, the roof plates of neural tubes were constituted of the closing of the surface ectodermal cells in the hindbrain and the neuroepithelial cells in the spinal cord. The floor plate of neural tube were consisted of the low pseudostratified columnar epithelium. The spinal motor nerve fibers were initially differentiated in the ED 10 embryo. According to the electron density of the cell and the differentiation of tell organelles, the neuroepithelial cells in the ED 9 and 10 embryos were classified into three types: dark, intermediate and light types. All types in the ED 9 embryo were observed but the dark cell in the ED 10 embryo was not done. The free ribosomes and polysomes in all neuroepithelial cells were developed. The RER and lipid droplets in the dark cell and the Golgi complex in the intermediate and light cells were observed. Many microfilaments in the cytoplasmic processes of intermediate cell and the microfilaments and microtubules in the light cell processes were observed to be well differentiated.

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Synthesis and Characterization of Poly(ethylene glycol) Grafted Polysuccinimide (폴리(에틸렌 글리콜)이 결합된 Polysuccinimide의 합성과 특성)

  • Lim, Nak-Hyun;Lee, Ha-Young;Kim, Moon-Suk;Khang, Gil-Son;Lee, Hai-Bang;Cho, Sun-Hang
    • Polymer(Korea)
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    • v.29 no.1
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    • pp.36-40
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    • 2005
  • Poly(amino acid) derivatives have been widely investigated as a drug carrier in drug delivery system. Particularly,polysuccinimide (PSI) is one of the most promising drug carriers since it possesses suitable physicochemical characteristics for development of macromolecular prodrugs, due to biocompatibility and biodegradability. In this study, we deal with the synthesis of polyaspartamide having various functional groups such as methoxy-poly(ethylene glycol) (MPEG) via ring closing of PSI. PSI was synthesized by polyonensation polymerization of spartic acid. The variety of average molecular weight was confirmed with reacion time and catalyst content to observe the optimum condition of synthesis. MPEG, hydrophilic chain, was bonded to fabricate polymeric micell composed of hydrophilic and hydrophobic polymer. All materials were characterized by 1H-NMR, FT-IR and GPC. In addition, the formation of nanoparticle micelle as drug carrier were also examined. Micelle size was measured by ELS and AFM. The functionalized polysparamide formed nanoparticle micelle whose size ranged from 90 to 130 nm. In conclusion, we prepared polyaspartamide functionalized with PEG examined the possibility as drug carriers.

The Present Situation, Problems, Improving Plans about the Establishment and the Operation of a Medical Association - Mainly on the Violations of the Rules Regulating Medical Institute's Opening - (의료협동조합의 의료기관 개설·운영 현황과 문제점 및 개선방안 - 의료기관 개설기준 위반을 중심으로 -)

  • KIM, JOON RAE;BAEK, NAM BOK;LEE, YOON HAK
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.227-261
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    • 2015
  • Cooperative associations are established in order to enhance the rights and the interests of their members and serve the local communities, and actually do much for the local society. And among these, consumer cooperatives are spontaneously founded, particularly in the spirit of mutual help, in order to promote the common welfare of the members. Meanwhile, because the current medical law qualifys noncommercial corporation to open medical institution, consumer cooperative and noncommercial- corporation cooperative which are established under the Cooperative Act have the right to do. However, though cooperative association should be founded for common interests of the members who are weaker parties of society, it became rapidly to be abused as means of circumvention of law. Especially as National Health Insurance Corporation stepped up the investigation and the collection of unfair profits against the hospital owned by non-medical personnel who are unable to establish a medical institution, setting up medical institutions as a roundabout way to avoid the restricts dramatically increased in number. In this study, we are going to introduce the current dualised normative system regulating the establishment of a medical cooperative association, and find a way to improve the system and make up for the week points. And we will look though the present situation about medical cooperative association's opening, operating, and closing, and review the normative and systematic improving plans.

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Physiological and Growth Responses of M. thunbergii to Different Levels of Fertilization (시비처리에 따른 후박나무의 생리 및 생장 반응)

  • Jung-Won Sung;Yeong Geun Song;Haeun Koo;Hyeon Hwa Kim;Se Min Byun;Chae Rim Lee;Seok-Gon Park;Kyeong Cheol Lee
    • Korean Journal of Plant Resources
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    • v.36 no.2
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    • pp.172-180
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    • 2023
  • In the current study, four groups; control, 500, 1000, and 2000 mg/L, were treated to investigate the effects of physiological and growth characteristics on Machilus thunbergii under various fertilization levels. As a result of the physiological response to the fertilization treatment, the fertilized group demonstrated relatively higher levels of A, ITE, WUEi, Vcamx, PIabs, and SFIabs in comparison to the control. The best photosynthetic mechanism was most clearly seen at 1000 mg/L, which involved gas exchange through active stomatal opening and closing. For a productive photosynthetic mechanism. As seen in the growth response of M. thunbergii to fertilization treatment, the fertilized group has significantly higher height, DRC, leaf dry weight, stem dry weight, total dry weight, LWR, and SWR than the control group. A healthy seedling quality index was particularly evident at 1000 mg/L, and other growth indicators were also at a decent level. 500 mg /L also demonstrated growth characteristics that were comparable to those at 1000 mg/L. As a result, M. thunbergii featured the best physiological and growth characteristics in response to the fertilization treatment at 1000 mg/L, and 500 mg/L also showed a similar trend, which is considered to be a good option from an economical perspective.

A Study on the Value-Relevance of Intangible Expenditure: compare high-technology firms to low-technology firms (첨단산업과 비첨단산업의 무형자산성 지출의 가치관련성에 대한 비교연구)

  • Lee, Chae Ri
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.1
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    • pp.153-164
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    • 2014
  • This study is to investigate the effects of intangible assets such as research & development, education & training and advertisement on firm values of high-technology firms and low-technology firms listed in the KOSDAQ market, and to analyze the value-relativeness between the audit quality of companies and the expenditure of intangible assets. The substitute measurement of firm values is Tobin's Q model. The sample period for positive analysis is from 2003 to 2008, and the samples, excepting for financial business, are manufacturing companies of closing accounts corporate on December, based on companies of KOSDAQ that are listed in security. Finally, data from about 305 companies are used in this analysis. Followings are the results of the analysis. First, research & development, education & training of high-technology firms have an effect on firm values, and education & training of low-technology have an effect on firm values. Second, we find that audit quality(BIG4) increases the value relevance of R&D expenditures of high-technology firms and audit quality(BIG4) increases the value relevance of education & training expenditures of low-technology firms. This paper is meaningful in that it verified the value-relativeness of cost of intangible assets compared with high-technology firms to low-technology firms.

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