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Psychological Meaning of Creation Myths: Focused on Darkness/Massa Confusa, Separation of World Parent and Creation of Land/Island (무의식의 창조성 관점으로 고찰한 창조신화: 흑암/혼돈, 천지개벽/분리, 섬/육지 창조 중심)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.38 no.2
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    • pp.269-304
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    • 2023
  • The purpose of this paper is to present the psychological meaning of the creation myths by utilizing related myths, analysand's dreams, active imagination, and artwork to reveal the creative function of the unconscious. The creation myth is the phenomenon of projection when a new order is demanded in the chaotic phase of personal and human history. Depending on the attitude of the ego, it can be a sign of a reconstruction/alteration of consciousness or an invasion. Related literature such as Jung, von Franz, Neumann, Harding, and Edinger, domestic papers, and case reports are introduced to identify the background for this research. The psychological meaning of 'darkness' in creation myths is regarded as unconscious that is too dark to see. The Eskimo creation myth and an analysand's dreams of being blind and wandering in darkness are discussed in relation to nigredo in Alchemy. The psychological meaning of 'massa confusa' regards Uroboros, pleroma, early childhood experience, and a psychological womb in which everything is contained in one. With related myths and unconscious materials, a discussion is followed on how this realm can be a precursor of creation but also be trapped in an abyss. The psychological meaning of 'separation of world parent' is related to splitting one into two when unconscious contexts were touched before it became consciousness. Related myths, 'the world created between heaven and earth,' 'celestial being descending to the earth,' and 'the legend of relocation of a mountain,' as well as clinical material, are examined. Then this paper discusses the clinical implications of the separation of heaven and earth occurring on its own, that the creator's emotional aspects, such as loneliness and anxiety, are involved, and that delayed separation leads to the death of creatura and sudden separation leads to the death of the chaos. Then, the meaning of 'separation of world parent' is discussed in relation with separatio, the alchemical process of acquiring light/consciousness from darkness/unconsciousness. The psychological meaning of the creation of 'land/island' refers to the emergence of consciousness, the contents of the unconscious material into the realm of the ego. Related myths, such as the 'body of the monster/dragon becoming land' and analysand's dreams, are introduced, referring to the embodiment of Mercurius. This is followed by discussing related myths in creating the land to coagulatio in alchemy and utilizing creative work such as active imagination, art, music, and dance that can coagulate or concretize unconscious material in clinical approaches. Finally, myths of resurfaced land after the Flood or the complete destruction of the world in relation to the reconstruction of ego are discussed with related clinical material to show the importance of the analyst/therapist/supervisor's mental stability and capacity.

Depositional Environment and Formation Ages of Eurimji Lake Sediments in Jaechon City, Korea (제천 의림지 호저퇴적물 퇴적환경과 형성시기 고찰)

  • 김주용;양동윤;이진영;김정호;이상헌
    • The Korean Journal of Quaternary Research
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    • v.14 no.1
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    • pp.7-31
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    • 2000
  • Quaternary Geological and geophysical investigation was performed at the Eurimji reservoir of Jaechon City in order to interprete depositional environment and genesis of lake sediments. For this purpose, echo sounding, bottom sampling and columnar sampling by drilling on board and GPR survey were employed for a proper field investigation. Laboratory tests cover grain size population analysis, pollen analysis and $^{14}C$ datings for the lake sediments. The some parts of lake bottom sediments anthropogenically tubated and filled several times to date, indicating several mounds on the bottom surface which is difficult to explain by bottom current. Majority of natural sediments were accumulated both as rolling and suspended loads during seasonal flooding regime, when flash flow and current flow are relatively strong not only at bridge area of the western part of Eurimji, connected to stream valley, but at the several conduit or sewage system surrounding the lake. Most of uniform suspend sediments are accumulated at the lake center and lower bank area. Some parts of bottom sediments indicate the existence of turbid flow and mudflow probably due to piezometric overflowing from the lake bottom, the existence of which are proved by CM patterns of the lake bottom sediments. The columnar samples of the lake sediments in ER-1 and ER-3-1 boreholes indicate good condition without any human tubation. The grain size character of borehole samples shows poorly sorted population, predominantly composed of fine sand and muds, varying skewness and kurtosis, which indicate multi-processed lake deposits, very similar to lake bottom sediments. Borehole columnar section, echo sounding and GPR survey profilings, as well as processed data, indicate that organic mud layers of Eurimji lake deposits are deeper and thicker towards lower bank area, especially west of profile line-9. In addition the columnar sediments indicate plant coverage of the Eurimji area were divided into two pollen zones. Arboreal pollen ( AP) is predominant in the lower pollen zone, whreas non-aboreal pollen(NAP) is rich in the upper pollen zone. Both of the pollen zones are related to the vegetation coverage frequently found in coniferous and deciduous broad-leaved trees(mixed forest) surrounded by mountains and hilly areas and prevailing by aquatic or aquatic margin under the wet temperate climate. The $^{14}C$ age of the dark gray organic muds, ER1-12 sample, is 950$\pm$40 years B.P. As the sediments are anthropogenetically undisturbed, it is assumed that the reliability of age is high. Three $^{14}C$ ages of the dark gray organic muds, including ER3-1-8, ER3-1-10, ER3-1-11 samples, are 600$\pm$30 years B.P., 650$\pm$30 years B.P., 800$\pm$40 years B.P. in the descending order of stratigraphic columnar section. Based on the interpretation of depositional environments and formation ages, it is proved that Eurimji reservoir were constructed at least 950$\pm$40 years B.P., the calibrated ages of which ranges from 827 years, B.P. to 866 years B.P. Ancient people utilize the natural environment of the stream valley to meet the need of water irrigation for agriculture in the local valley center and old alluvium fan area.

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Prophylactic and therapeutic studies on intestinal giant-cystic disease of the Israel carp caused by Thelophanellus kitauei II. Effects of physical and chemical factors on T. kitauei spores in vitro (향어의 장포자충(Thelohanellus kitauei)증의 예방 및 치료에 관한 기초적 연구 II. 물리화학적 요인이 장포자충 포자에 미치는 영향)

  • Lee, Jae-Gu;Kim, Jong-O;Park, Bae-Geun
    • Parasites, Hosts and Diseases
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    • v.28 no.4
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    • pp.241-252
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    • 1990
  • In a basic attempt to develop the prophylactic and therapeutic measures on intestinal giantcystic disease of the Israel carp, C), prinks carpio nudum, the effects of physical and chemical factors on viability or survival of the spores of Thelchcnellus kiteuei were checked in vitro by means of extrusion test on the polar filament. When the fresh spores suspended with 0.45% and 0.9% scdium chloride solution and distilled water were laid at $5^{\circ}C$ and $28^{\circ}C$ for short terms, the extrusion rates increased until the 3rd day, meanwhile when son;e of them were suspended with Tyrode's solution at $-70^{\circ}C$ the rates increased gradually until the 8th day. Viabilities of the spores suspended with 0.9% saline and added antibiotics to the suspension at $5^{\circ}C$ for long terms lasted for 997 days and 1, 256 days (presumed values) at maximum, respectively. The spores suspended with distilled water at $28^{\circ}C$ for long terms survived 152.4 days, but the spores suspended with Tyrode's solution at $-70^{\circ}C$ for long terms showed almost the same viable pattern as early freezing stages up to 780 days. The spores suspended with Tyrode's solution, frozen at $-70^{\circ}C$ and thawed at $5^{\circ}C$, showed the highest rate of extrusion of the polar filament. In the case of frozen spores, the extrusion rates during heating tend to become higher in accordance with the increase of frozen period, and the critical points of 180 day-frozen spores to be killed were generally 78.5 hr. at $60^{\circ}C$, 23.4 hr. at $70^{\circ}C$, 189.1 min. at $80^{\circ}C$ or 10.5 min. at $90^{\circ}C$. The longer the spores were frozen, the more time was needed for the death of spores after thawing; 20 days-17.4 days, 100 days-33.2 days, and 400 days-37.8 days. The longer the spores were frozen, the more time was needed for the death of spores at a conventional when they were dried air drying condition, 540 days-23.5 days, 160 days-21.0 days, and 20 days-14.4 days. On the other hand, the longer the spores were frozen, the more spores were dead rapidly when they were irradiated with 10W UV-ray; 100 days-26.0 hr, 300 days-21.9 hr, and 540 days-13.9 hr. The time needed for killing 200 days-frozen spores by various disinfectants at 1, 000 ppd was 5.2 min. by calcium oxide, 10.4 min. by potassium permanganate, 27.8 min. by malachite green and 14.3 hr. by formalin. Transient inhibitory effects of the extrusion of the polar filament were observed by various antiprotozoal and antifungal agents in the descending order of ketoconazole. metronidasole and dapsone. The above results presume that full drying, followed by spraying CaO and maintaining sunny condition for a few days on the concrete bottoms of knish farm may be an effective method for the prevention of intestinal giant.cystic disease.

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Development of Korean Version of Heparin-Coated Shunt (헤파린 표면처리된 국산화 혈관우회도관의 개발)

  • Sun, Kyung;Park, Ki-Dong;Baik, Kwang-Je;Lee, Hye-Won;Choi, Jong-Won;Kim, Seung-Chol;Kim, Taik-Jin;Lee, Seung-Yeol;Kim, Kwang-Taek;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.97-107
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    • 1999
  • Background: This study was designed to develop a Korean version of the heparin-coated vascular bypass shunt by using a physical dispersing technique. The safety and effectiveness of the thrombo-resistant shunt were tested in experimental animals. Material and Method: A bypass shunt model was constructed on the descending thoracic aorta of 21 adult mongrel dogs(17.5-25 kg). The animals were divided into groups of no-treatment(CONTROL group; n=3), no-treatment with systemic heparinization(HEPARIN group; n=6), Gott heparin shunt (GOTT group; n=6), or Korean heparin shunt(KIST group; n=6). Parameters observed were complete blood cell counts, coagulation profiles, kidney and liver function(BUN/Cr and AST/ ALT), and surface scanning electron microscope(SSEM) findings. Blood was sampled from the aortic blood distal to the shunt and was compared before the bypass and at 2 hours after the bypass. Result: There were no differences between the groups before the bypass. At bypass 2 hours, platelet level increased in the HEPARIN and GOTT groups(p<0.05), but there were no differences between the groups. Changes in other blood cell counts were insignificant between the groups. Activated clotting time, activated partial thromboplastin time, and thrombin time were prolonged in the HEPARIN group(p<0.05) and differences between the groups were significant(p<0.005). Prothrombin time increased in the GOTT group(p<0.05) without having any differences between the groups. Changes in fibrinogen level were insignificant between the groups. Antithrombin III levels were increased in the HEPARIN and KIST groups(p<0.05), and the inter-group differences were also significant(p<0.05). Protein C level decreased in the HEPARIN group(p<0.05) without having any differences between the groups. BUN levels increased in all groups, especially in the HEPARIN and KIST groups(p<0.05), but there were no differences between the groups. Changes of Cr, AST, and ALT levels were insignificant between the groups. SSEM findings revealed severe aggregation of platelets and other cellular elements in the CONTROL group, and the HEPARIN group showed more adherence of the cellular elements than the GOTT or KIST group. Conclusion: Above results show that the heparin-coated bypass shunts(either GOTT or KIST) can suppress thrombus formation on the surface without inducing bleeding tendencies, while systemic heparinization(HEPARIN) may not be able to block activation of the coagulation system on the surface in contact with foreign materials but increases the bleeding tendencies. We also conclude that the thrombo-resistant effects of the Korean version of heparin shunt(KIST) are similar to those of the commercialized heparin shunt(GOTT).

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The Factors Influencing the Systemic Action of Dimethoate (O.O-dimethyl-S-(N-methylcarbamoylmethyl) phosphorodithioate) to the Rice Seeds and Phytotoxic Effects (수도종자에의 Dimethoate 침투력 및 발아저해에 관여하는 요인에 관한 연구)

  • Choi Seung Yoon
    • Korean journal of applied entomology
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    • v.9 no.2
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    • pp.57-74
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    • 1970
  • These experiments were conducted to investigate the :actors influencing the systemic action of Dimethoate (O,O-dimethyl-S-(N-methylcarhamoylmethyl) photphorodithioate) to rice seeds and the phytotoxic effects on the seed germination. Dimethoate $(Roxion^{(R)})$ $40\%$ emulsion was used. The varieties tested were Jinheung. Nongkwang,Suwon #82, Norm #6, Paltal, Shirogane, Suseong, Pungkwang, Shin #2, Fujisaka #5, Kwanok, and Jaekeun. The permeated Dimethoate was extracted from the treated seeds by chloroform and quantities were determined by Spectrophotometer. The phytotoxicity was evaluated from the effects on the germination of the treated seeds which were kept in an incubator. The oxygen consumption was measured by Warburg Manometer at $30^{\circ}C$ for 60 minutes. Indices of KOH disintegration of seeds and chemical composition of the seeds were also determined. The results obtained were as followings; 1) The amount of permeated Dimethoate in the seeds showed remarkable differences with varieties. The amount of Dimethoate per 100 grains was greater as in the ascending order of Suseong, Kwanok, Nongkwang, Jinheung, Paltal, Fujisaka #5, Suwon #82, Norm #6, Shirogane, Shin #2, Pungkwang and Jaekeun. 2) It was observed that the total amount of Dimethoate in the seeds(mg./100 grains) were greater among the varieties with large grain than those with small grains, while reverse cases were true in the amount of Dimethoate in a gramme of seeds, probably because of the greater surface areas In a small grains for a gramme weight. 3) There was no significant correlation between the permeated amount of Dimethoate and amount of absorbed water by the seeds when the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours. 4) The permeability of Dimethoate to seeds significantly increased in the prolonged soaking periods, higher concentration, and higher temperature. 5) When the seeds were treated with $0.1\%$ Dimethoate for 24 and 48 hours at $15^{\circ},\;20^{\circ},\; 20^{\circ},\; and \;30^{\circ}C$, the permeated amount of Dimethoate were increased at higher temperature. It seems to be that the more active penetration of Dimethoate was involved at the higher temperature. 6) The phytotoxic effects of Dinethoate on the seed germination varied with the varieties. An descending order of varietal tolerance of seeds was as followings: Jinheung, Fujisaka #5, Suwon #82, Paltal, Nongkwang, Jaekeun, Shin #2, Kwanok, Shirogane, Pungkwang, Suseong, and Norm #6. 7) There was a positive correlation between the amount of Dimethoate permeated into the seeds (mg./gram. of seeds) and phytotoxicity of seeds. 8) The Phytotoxic effects of Dimethoate showed close correlation with the degree of KOH disintegration of seeds, average germination periods, and oxygen respiration of seeds. 9) It was observed that higher protein contents of the seeds decreased the phytotoxic effects of Dimethoate. 10) Relatively high negative correlation between the degree of KOH disintegration of seeds and crude protein content of the seeds was observed. 11) The average germination period was delayed for about 2 days when the seeds were treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$. 12) The oxygen consumption of the seeds treated with $0.2\%$ Dimethoate for 24 hours at $30^{\circ}C$ was greatly decreased when compared with that of the normal seeds. 13) The amount of oxygen consumption of the seeds (in 24 hours after 24 hours water soaking) was negatively correlated with the average germination periods of the seeds.

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Therapeutic Angiogenesis by Intramyocardial Injection of pCK-VEGF165 in Pigs (돼지에서 pCK-VEGF165의 심근내 주입에 의한 치료적 혈관조성)

  • Choi Jae-Sung;Han Woong;Kim Dong Sik;Park Jin Sik;Lee Jong Jin;Lee Dong Soo;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.323-334
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    • 2005
  • Background: Gene therapy is a new and promising option for the treatment of severe myocardial ischemia by therapeutic angiogenesis. The goal of this study was to elucidate the efficacy of therapeutic angiogenesis by using VEGF165 in large animals. Material and Method: Twenty-one pigs that underwent ligation of the distal left anterior descending coronary artery were randomly allocated to one of two treatments: intramyocardial injection of pCK-VEGF (VEGF) or intramyocardial injection of pCK-Null (Control). Injections were administered 30 days after ligation. Seven pigs died during the trial, but eight pigs from VEGF and six from Control survived. Echo-cardiography was performed on day 0 (preoperative) and on days 30 and 60 following coronary ligation. Gated myocardial single photon emission computed tomography imaging (SPECT) with $^{99m}Tc-labeled$ sestamibi was performed on days 30 and 60. Myocardial perfusion was assessed from the uptake of $^{99m}Tc-labeled$ sestamibi at rest. Global and regional myocardial function as well as post-infarction left ventricular remodeling were assessed from segmental wall thickening; left ventricular ejection fraction (EF); end systolic volume (ESV); and end diastolic volume (EDV) using gated SPECT and echocardiography. Myocardium of the ischemic border zone into which pCK plasmid vector had been injected was also sampled to assess micro-capillary density. Result: Micro-capillary density was significantly higher in the VEGF than in Control ($386\pm110/mm^{2}\;vs.\;291\pm127/mm^{2};\;p<0.001$). Segmental perfusion increased significantly from day 30 to day 60 after intramyocardial injection of plasmid vector in VEGF ($48.4\pm15.2\%\;vs.\;53.8\pm19.6\%;\;p<0.001$), while no significant change was observed in the Control ($45.1\pm17.0\%\;vs.\;43.4\pm17.7\%;\;p=0.186$). This resulted in a significant difference in the percentage changes between the two groups ($11.4\pm27.0\%\;increase\;vs.\;2.7\pm19.0\%\;decrease;\;p=0.003$). Segmental wall thickening increased significantly from day 30 to day 60 in both groups; the increments did not differ between groups. ESV measured using echocardiography increased significantly from day 0 to day 30 in VEGF ($22.9\pm9.9\;mL\;vs.\;32.3\pm9.1\;mL;\; p=0.006$) and in Control ($26.3\pm12.0\;mL\;vs.\;36.8\pm9.7\;mL;\;p=0.046$). EF decreased significantly in VEGF ($52.0\pm7.7\%\;vs.\;46.5\pm7.4\%;\;p=0.004$) and in Control ($48.2\pm9.2\%\;vs.\;41.6\pm10.0\%;\;p=0.028$). There was no significant change in EDV. The interval changes (days $30\~60$) of EF, ESV, and EDV did not differ significantly between groups both by gated SPECT and by echocardiography. Conclusion: Intramyocardial injection of pCK-VEGF165 induced therapeutic angiogenesis and improved myocardial perfusion. However, post-infarction remodeling and global myocardial function were not improved.

Off Pump Total Arterial Myocardial Revascularization (동맥 도관만을 이용하여 체외심폐순환 없이 시행한 관상동맥우회술)

  • Youn Young Nam;Lee Kyo Joon;Lee Gy Jong;Joo Hyun Chul;Lim Sang Hyun;Kim Seung Ho;Kwak Young Lan;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.349-356
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    • 2005
  • Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of $59.3\pm11.9$ years ($36\~83$). Mean ejection fraction was $55.4\pm14.0\%\;(15\~86).$ Angiography showed left main disease or triple-vessel disease in $81.9\%$ of the patients. Indications of using arterial conduits was stenosis $\ge50\%$ of left anterior descending artery, stenosis $\ge80\%$ of branches of left circumflex artery, and stenosis $\ge90\%$ of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were $2.86\pm0.78$. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients ($1.8\%$), renal failure in 4 patients ($1.2\%$), perioperative myocardial infarction in 3 patients ($0.9\%$), reoperation for bleeding in 3 patients ($0.9\%$). There was no postoperative stroke. Patency rate of arterial conduits was $99.3\%$ (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.

Minimally Invasive Coronary Artery Bypass Grafting (소침습적 관상동맥우회술)

  • Na, Chan-Young;Lee, Young-Tak;Park. Joong-Won;Chung, Do-Hyun;Jung, Ill-Sang;Jung, Yoon-Seup;Kim, Ok-Sung;Bang, Jung-Hyun;Lee, Sub;Chung, Chul-Hyun;KIM, Woong-Han;Park, Young-Kwan;Kim, Chong-Whan;Hong, Sung-Nok;Han, Jae-Jin;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.118-124
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    • 1998
  • Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.

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The Study on the Independent Predictive Factor of Restenosis after Percutaneous Coronary Intervention used Drug-Eluting Stent : Case on MDCT Calcium-Scoring Implementation Patient (약물용출 스텐트를 이용한 관상동맥중재술 후 재협착의 독립적 예측인자에 관한 연구 : MDCT calcium-scoring 시행 환자 대상으로)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo;Jang, Young-Ill
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.37-44
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    • 2010
  • We sought to confirm an independent factor about in-stent restenosis (ISR) in the patients who underwent drug-eluting stent (DES) and know a possibility as a predictor of measured coronary artery calcium score by MDCT. A total of 178 patients (159 men, $61.7{\pm}10.0$ years of age) with 190 coronary artery lesions were included in this study out of 1,131 patients who underwent percutaneous coronary intervention (PCI) with DES implantation for significant stenosis on MDCT at Chonnam National University Hospital between May 2006 and May 2009. All lesions were divided into two groups with the presence of ISR : group I (re ISR, N = 57) and group II (no ISR, N = 133). Compared to group II, group I was more likely to be older ($65.8{\pm}9.0$ vs. $60.2{\pm}9.9$ years, p = 0.0001), diabetic (21.8% vs. 52.6%, p = 0.0001), have old myocardial infarction (8.8% vs. 2.3%, p = 0.040), left main stem disease (5.3% vs. 0.8%, p = 0.047), and smaller stent size ($3.1{\pm}0.3\;mm$ vs. $3.3{\pm}0.4\;mm$, p = 0.004). Group II was more likely to be smokers (19.3% vs. 42.1%, p = 0.003), have dyslipidemia (8.8% vs. 23.3%, p = 0.019). Left ventricular ejection fraction, lesion complexity, and stent length were not different between the two groups. Total CAC score was $389.3{\pm}458.3$ in group I and $371.2{\pm}500.8$ in group II (p = 0.185). No statistical difference was observed between the groups in CAC score in the culprit vessel, left main stem, left anterior descending artery, left circumflex artery, and right coronary artery. On multivariate logistic regression analysis, left main stem disease (OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), male sex (OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), and the presence of diabetes (OR = 2.62, 95% CI = 1.071-6.450, p = 0.035) were independent predictors of ISR after DES implantation. In patients who underwent DES implantation for significant coronary stenosis on MDCT, ISR was associated with left main stem disease, male sex, and the presence of diabetes. However, CAC score by MDCT was not a predictor of ISR in this study population.

A Study of Changes of Pulmonary Artery Size after Bidirectional Cavopulmonary Shunt (양방향성 상대정맥-폐동맥 단락술 후의 폐동맥 크기 변화에 관한 연구)

  • 지현근;이정렬
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.495-503
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    • 1996
  • The bidirectional cavopulmonary shunt may be useful as an intermediate procedure before Fontal oper- ation in high-risk patients, because it provides adequate relief of cyanosis and relief of ventricular volume overload. But there are no established theory about the effects of bidirectional cavopulmonary shunt on pulmonary arterial development. The purpose of this article is a study of changes of pulmonary artery size after bidirectional cavopulmonary shunt. Ca diac catheterization and angiography procedures were done on 19 patients who underwent bidirectional cavopulmonary shunt from February 1992 to July 1994, their results were reviewed. Preoperative cardiac catheterization and angiography procedures were performed at a mean interval of ).8 $\pm$4.8($\pm$SEM) months before surgery and following catheterization at a mean postoperative interval of 19.6 $\pm$4.8 months. Pulmonary arterial sixte measurement were standardized for body surface area(Pulmon- arty artery index), and for diameter of descending thoracic aorta(McGoon ratio). Patient's age, body stir- face area, pulmonary angioplasty, preoperative McGoon ratio and follow-up intervals were considered as variables. Before bidirectional cavopulmonary shunt, patient's mean age, body surface area, arterial 02 saturation, diameter of right pulmonary artery, diameter of left pulmonary artery, pulmonary artery Index, McGoon ratio were 13.7$\pm$15.6 months, 0.40$\pm$0.12m2, 71.4$\pm$12.4m2, 7.1$\pm$1.7mm, 6.2$\pm$1 , 191.8$\pm$82.7mm21m2, 1.73 $\pm$0.49, respectively. After bidirectional cavopulmonary shunt, the values were changed to 39.9 $\pm$ 16.2 months, 0.58$\pm$0.07 m2, 83.0$\pm$3.8m2, 9.0$\pm$ 1.5 mm, 7.7$\pm$2.0, 197.3$\pm$57.1 mm2/m2, 1.76$\pm$0.32, respect- ively With patients'development (age, body surf'ace area), diameters of pulmonary arteries were increased, but pulmonary artery indices and McGoon ratios were not changed. And there were no effects of age, body surf'ace area, amount of increased 02 saturation, pulmonary angiography and follow-up duration on the increment of pulmonary ar- tery size. But when the McGoon ratio was as low as 1.2, there were significant increase in postoperative pulmonary artery sizes. There was a significant correlation between preoperative pulmonary artery index (PAI) and McGoon ratio (MGR) ; PAI : MGRxl18.0-12.4 In conclusion, bidirectional cavopulmonary shunt provides adequate increment of arterial 02 saturation and does not increase the pulmonary artery size. Further investi ation is mandatory to evaluate the effect of pulsatile bidirectional cavopulmonary shunt on pulmonary artery growth.

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