Son Ho Sung;Fang Yong Hu;Hwang Znuke;Min Byoung Ju;Cho Jong Ho;Park Sung Min;Lee Sung Ho;Kim Kwang Taik;Sun Kyung
Journal of Chest Surgery
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v.38
no.2
s.247
/
pp.101-109
/
2005
Background: In sudden cardiac arrest, the effective maintenance of coronary artery blood flow is of paramount importance for myocardial preservation as well as cardiac recovery and patient survival. The purpose of this study was to directly compare the effects of pulsatile and non-pulsatile circulation to coronary artery flow and myocardial preservation in cardiac arrest condition. Material and Method: A cardiopulmonary bypass circuit was constructed in a ventricular fibrillation model using fourteen Yorkshire swine weighing $25\~35$ kg each. The animals were randomly assigned to group I (n=7, non-pulsatile centrifugal pump) or group II (n=7, pulsatile T-PLS pump). Extra-corporeal circulation was maintained for two hours at a pump flow of 2 L/min. The left anterior descending coronary artery flow was measured with an ultrasonic coronary artery flow measurement system at baseline (before bypass) and at every 20 minutes after bypass. Serologic parameters were collected simultaneously at baseline, 1 hour, and 2 hours after bypass in the coronary sinus venous blood. The Mann-Whitney U test of STATISTICA 6.0 was used to determine intergroup significances using a p value of < 0.05. Result: The resistance index of the coronary artery was lower in group II and the difference was significant at 40 min, 80 min, 100 min and 120 min (p < 0.05). The mean velocity of the coronary artery was higher in group II throughout the study, and the difference was significant from 20 min after starting the pump (p < 0.05). The coronary artery blood flow was higher in group II throughout the study, and the difference was significant from 40 min to 120 min (p < 0.05) except at 80 min. Serologic parameters showed no differences between the groups at 1 hour and 2 hours after bypass in the coronary sinus blood. Conclusion: In cardiac arrest condition, pulsatile extracorporeal circulation provides more blood flow, higher flow velocity and less resistance to coronary artery than non-pulsatile circulation.
From September 1992 to May 1996, 38 patients ranging in age from 23 to 78, were operated for aortic dissection at Asan medical center There were 21 men and 17 women. The underlying aortic pathology were acute aortic dissection in 23, chronic aortic dissection in 15. Eight patients had Martian syndrome. In 34 cases of DeBakey type I, II patients, femoral artery and vein and/or right atrial auricle were used as cannulation site. With deep hypothermic c rculatory arrest (esophageal temperature 12 $\pm$ 2.5$^{\circ}C$) and retrograde cerebral perfusion of cold oxygenated blood through SVC, we replaced the ascending aorta and the part of arch if necessary. The mean duration of the total circulatory arrest time was 25 $\pm$ 1.7 mintstuts. In 4 cases of DeBakey type III patients, we replaced descending thoracic aorta or thoracoabdomlnal aorta without shunt or bypass under normothermia with an average 30: 1.5 minutesaortic cross clamp time. One death(2.6%) occurred on the twenty-second postoperative day owing to asphyxia related to ulcer bleeding. Postoperative complications were myocardial infarction with transient left peroneal palsy in 1 case, transient lower extremity weakness in 1 case and prolonged ventilatory support in 1 case. Two patients required reoperation due to retrograde extended dissection and aortic insufuciency. There was no late death with an average 25 months follow-up period.
Kim Dong-Jin;Min Sun-Kyung;Kim Woong-Han;Lee Jeong-Sang;Kim Yong-Jin;Lee Jeong-Ryul
Journal of Chest Surgery
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v.39
no.4
s.261
/
pp.275-280
/
2006
Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.
Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.
Tobacco plants grown in pots by sand culture for 70 days after transplanting were used to evaluate the sensing distance and measurement efficiency of ground-based remote sensors. The leaf distribution of tobacco plant and sensing distance from the sensors to the target leaves were controlled by two removal methods of leaves, top-down and bottom-up removal. In the case of top-down removal, the canopy reflectance was measured by the sensor located at a fixed position having an optimum distance from the detector to the uppermost leaf of tobacco every time that the higher leaves were one at a time. The measurement of bottom-up removal, a the other hand, was conducted in the same manner as that of the top-down removal except that the lower leaves were removed one by one. Canopy reflectance measurements were made with hand held spectral sensors including the active sensors such as $GreenSeeker^{TM}$ red and green, $Crop\;Circle\;ACS-210^{TM}$ red and amber, the passive sensors of $Crop\:Circle^{TM}$, and spectroradiometer $SD2000^{TM}$. The reflectance indices by all sensors were generally affected by the upper canopy condition rather than lower canopy condition of tobacco regardless of sensor type, passive or active. The reflectance measurement by $GreenSeeker^{TM}$ was affected sensitively at measurement distance longer than 120 cm, the upper limit of effective sensing distance, beyond which measurement errors are appreciable. In case of the passive sensors that has no upper limit of effective distance and $Crop\;Circle^{TM}(ACS210)$ that has the upper limit of effective sensing distance specified with 213 cm, longer than that of estimated distance, the measurement efficiency affected by the sensing distance showed no difference. This result suggests that it is necessary to use the sensor specified optimum distance. The result revealed that active sensors are more superior than their passive counterparts in establishing between the relative ratio of reflectance index and the dry weight of tobacco treated by top-down removal, and in the evaluation of biomass. $The\;Crop\;Circle\;ACS-210^{TM}$ red was proved to have the highest efficiency of measurement, followed by $Crop\;Circle^{TM}(ACS210)$ amber and $GreenSeeker^{TM}$ red, $Crop\;Circle^{TM}$ passive, $GreenSeeker^{TM}$ green, and spectroradiometer, in descending order.
Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.
Seismic reflection profiles and exploratory drilling well samples from the southern marginal-continental shelf basin of Korea delineate that the Tertiary sedimentary sequences can be grouped into five sequences (Sequence A, Sequence B, Sequence C, Sequence D and Sequence E, in descending order). Paleontologic data, K-Ar age datings, correlation with tuff layers and sequence stratigraphic analysis reveal that the sequences A, B, C, D and E can be considered as the deposits of Holocene $\~$ Pleistocene, Pliocene, Late Miocene, Early $\~$ Middle Miocene and Oligocene, respectively. The sequence stratigraphic and structural analyses suggest that the southern part of the Cheju Basin had experienced severe folding and faulting. NE-SW trending strike-slip movement is responsible for the deformation. The sinistral movement of strike-slip fault ceased before the deposition of Sequence B. Age dating and rare-earth elements analysis of volvanic rocks reveal+ that the Sequence D was deposited during the Early $\~$ Middle Miocene and the Sequence I was deposited earlier than the deposition of the Green Tuff Formation. Sedimentary petrological studies indicate that sediments of the Sequence I came from the continental block provenance. After the deposition of the Sequence E, uplift of the source area resulted in increase of sediment supply, subsidence and volcanic activities. The Sequence D show these factors and the sediments of the Sequence D are considered to be transported from the recycled orogenic belt.
Human Papilloma viruses (HPVs) are etiological agents for cervical cancer and are classified into low- and high-risk categories. The aim of this study was to determine the frequency of the HPV genotype in the HPV screening test of Korean women using PCR-direct sequencing. Consensus primers of L1 legion were used for the amplification of HPV DNA and the PCR products (450 bps) obtained were analyzed by automatic sequencing. Sequences were compared with those in GenBank by using the BLAST program. Cervical swab samples of 3,978 women (20-73 years) were tested and the average age was 37.6 years. In this study, 1,174 samples were HPV positive out of 3,978 cervical swab samples screened (29.5%) and 136 samples (11.6%) showed a double infection. A total of 1,310 HPV genotypes were analyzed. The HPV positive rate was the lowest in the 20 years group (69.5%) and most of the samples of the > 60 years group were found HPV positive. Among thirty seven different HPV types identified by sequencing, 21 were HPV high risk types and 16 HPV low risk types were 69.8% (914/1,310) and 26.0% (340/1,310), respectively. In HPV high-risk types, 16 (13.21%), was the most frequently found. HPV 53 (9.62%) and 58 (9.24%) were also frequently found. This group was followed by HPV types 70 (5.50%), 33 (4.73%), 66 (4.20%), 18 (4.05%), 52 (4.05%), 31 (3.97%) and 56 (3.51%) in descending order of frequency. Among HPV low-risk types, 62 (4.20%), 6 (3.59%), 81 (3.59%), 84 (3.51%), and 11 (2.6%) were frequently found. In conclusion, PCR-direct sequencing could be used for quick and reliable typing of known and novel HPVs from clinical specimens. This data could be useful for epidemiological study of HPV and it also allows type-specific follow-up of women who have been treated for cervical intraepithelial neoplasia.
Development, survival, and reproduction of brown planthopper (BPH) Nilaparvata lugens $St{\aa}l$ (Hemiptera: Delphacidae), were studied in laboratory at $25{\pm}2^{\circ}C$, $65{\pm}5%$ RH and a 16L : 8D hours photoperiodism on five rice cultivars of: Dongjin 1ho, Chungchungbyeo, Jangseongbyeo, Chinnongbyeo and Jungmo 1045. BPH nymphs successfully survived on all rice cultivars, although survival rate was lowest on Jangseongbyeo (36.0%). Developmental time of immature stages ranged from $11.7{\pm}0.59d$ on Jungmo 1045 to $12.8{\pm}0.59d$ on Chinnongbyeo. Reproductive period and female longevity were longest on Dongjin 1ho, Chinnongbyeo and Jungmo 1045 while highest fecundity of N. lugens being observed on these three rice cultivars. Highest and lowest net reproductive rates were calculated on rice cultivars, Jungmo 1045 and Jangseongbyeo, respectively. Mean generation time was the longest on rice cultivar Dongjin 1ho. Respective descending order of intrinsic rates of population increase were on Jungmo 1045, Chinnongbyeo, Dongjin 1ho, Chungchungbyeo and Jangseongbyeo. These population parameters showed that N. lugens can successfully survive and reproduce on Chinnongbyeo and Jungmo 1045.
Hwang, Sung Il;Lee, Hak Jong;Kim, Kil Joong;Chung, Jin-haeng;Jung, Hyun Sook;Jeon, Jong June
Ultrasonography
/
v.32
no.2
/
pp.132-142
/
2013
Purpose: The purpose of this study is to investigate the correlations of various kinetic parameters derived from the time intensity curve in a xenograft mouse model injected with a prostate cancer model (PC-3 and LNCaP) using an ultrasound contrast agent with histopathologic parameters. Materials and Methods: Twenty nude mice were injected with human prostate cancer cells (15 PC-3 and five LNCaP) on their hind limbs. A bolus of $500{\mu}L$ ($1{\times}10^8$ microbubbles) of second-generation US contrast agent (SonoVue) was injected into the retroorbital vein. The region of interest was drawn over the entire tumor. The time intensity curve was acquired and then fitted to a gamma variate function. The maximal intensity (A), time to peak (Tp), maximal wash-in rate (washin), washout rate (washout), area under the curve up to 50 sec ($AUC_{50}$), area under the ascending slope ($AUC_{in}$), and area under the descending slope ($AUC_{out}$) were derived from the parameters of the gamma variate fit. Immunohistochemical staining for VEGF and CD31 was performed. Tumor volume, the area percentage of VEGF stained in a field, and the count of CD31 (microvessel density, MVD) positive vessels showed correlation with the parameters from the time intensity curve. Results: No significant differences were observed between the kinetic and histopathological parameters from each group. MVD showed positive correlation with A (r=0.625, p=0.003), washin (r=0.462, p=0.040), $AUC_{50}$ (r=0.604, p=0.005), and $AUC_{out}$ (r=0.587, p=0.007). Positive correlations were also observed between tumor volume and $AUC_{50}$ (r=0.481, p=0.032), washin (r=0.662, p=0.001), and $AUC_{out}$ (r=0.547, p=0.012). Washout showed negative correlations with MVD (r=-0.454, p=0.044) and tumor volume (r=-0.464, p=0.039). The area percentage of VEGF did not show any correlation with calculated data from the curve. Conclusion: MVD showed correlations with several of the kinetic parameters. CEUS has the potential for prediction of tumor vascularity in a prostate cancer animal model.
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