• Title/Summary/Keyword: Defects

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Prediction of Improvement of Myocardial Wall Motion after Coronary Artery Bypass Surgery Using Rest T1-201/Dipyridamole Stress Gated Tc-99m-MIBI/24 Hour Delay T1-201 SPECT (휴식기 T1-201/디피리다몰 부하 게이트 Tc-99m-MIBI/24시간 지연 T1-201 SPECT를 이용한 관상동맥 우회로 수술 후 심근벽 운동 호전의 예측)

  • Lee, Dong-Soo;Lee, Won-Woo;Yeo, Jeong-Seok;Kim, Seok-Ki;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.497-508
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    • 1998
  • Purpose: Using rest T1-201/dipyridamole stress gated Tc-99m-MIBI/ 24 hour delay T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. Materials and Methods: In 39 patients (M;F= 34:5, age $58{\pm}8$), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0: normal to 3: defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. Results: After bypass surgery, ejection fraction increased from $37.8{\pm}9.0%$ to $45.5{\pm}12.3%$ in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Conclusion: Among independent predictors obtained by rest T1-201/ stress gated Tc-99m-MIBI/ delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.

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On the manufacturing of WPC (Wood Plastic Composites) with Heat-Catalyst Polymerization (I) - On the characteristics of composites made from monomer Methyl MethacryIate and several commercial woods in Korea (가열(加熱)·촉매중합법(觸媒重合法)에 의한 목재(木材)·고분자복합체(高分子複合體) 제조(製造)(I) - MMA에 의한 한국산(韓國産) 주요목재(主要木材)의 복합체특성(複合體特性))

  • Cho, Nam-Seok;Jo, Jae-Myeong;Ahn, Won-Yong
    • Journal of the Korean Wood Science and Technology
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    • v.2 no.3
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    • pp.3-16
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    • 1974
  • One of the disadvantages of. wood and wood products is their hydroscopicity or dimensional instability. This is responsible for the loss of green volume of lumber as seasoning degrade. Dimensional stabilization is needed to substantially reduce seasoning defects and degrades and for increasing the serviceability of wood products. Recently, considerable world-wide attention has been drawn to the so-called Wood-Plastic Composites by irradiation-and heat-catalyst-polymerization methods and many research and developmental works have been reported. Wood-Plastic Composites are the new products having the superior mechanical and physical properties and the combinated characteristics of wood and plastic. The purpose of this experiment was to obtain the basic data for the improvement of wooden materials by manufacturing WPC. The species examined were Mulpurae-Namoo (Fraxinus, rhynchophylla), Sea-Namoo (Carpinus laxiflora), Cheungcheung-Namoo (Cornus controversa), Gorosae-Namoo (Acermono), Karae-Namoo(Juglans mandshurica) and Sanbud-Namoo (Prunus sargentii), used as blocks of type A ($3{\times}3{\times}40cm$) and type B ($5{\times}5{\times}60cm$), and were conditioned to about 10~11% moisture content before impregnation in materials humidity control room. Methyl methacrylate (MMA) as monomer and benzoyl peroxide (BPO) as initiator are used. The monomer containing BPO was impregnated into wood pieces in the vacuum system. After impregnation, the treated samples were polymerized with heat-catalyst methods. The immersed weights of monomer in woods are directly proportionated to the impregnation times. Monomer impregnation properties of Cheungcheung-Namoo, Mulpurae-Namoo and Seo-Namoo are relatively good, but in Karae-Namoo, it is very difficult to impregnate the monomer MMA. Fig. 3 shows the linear relation between polymer retentions in wood and polymerization times; that is, the polymer loadings are increasing with polymerization times. Furthermore species, moisture content, specific gravity and anatomical or conductible structure of wood, bulking solvents and monomers etc have effects on both of impregnation of monomer and polymer retention. Physical properties of treated materials are shown in table 3. Increasing rates of specific gravity are ranged 3 to 24% and volume swelling 3 to 10%. ASE is 20 to 46%, AE 14 to 50% and RWA 18 to 40%. Especially, the ASE in relation to absorption of liquid water increases approximately with increase of polymer content, although the bulking effect of the polymerization of monomer may also be influential. WPCs from Mulpurae-Namoo and Cheungcheung-Namoo have high dimensional stability, while its of Karae-Namoo and Seo-Namoo are-very low. Table 4 shows the mechanical properties of WPCs from 6 species. With its specific gravity and polymer loading increase, all mechanical properties are on the increase. Increasing rate of bending strength is 10 to 40%, compression strength 25 to 70%, ;impact bending absorbed energy 4 to 74% and tensile strength 18 to 56%. Mulpurae-Namoo and Cheungcheung-Namoo with high polymer content have considerable high increasing rate of strengths. But incase of Karae-Namoo with inferior monomer impregnation it is very low. Polymer retention in cell wall is 0.32 to 0.70%. Most of the polymer is accumulated in cell lumen. Effective. of polymer retention is 58.59% for Mulpurae-Namoo, 26.27% for Seo-Namoo, 47.98% for Cheungcheung-Namoo, 25.64% for Korosae-Namoo, 9.96% for Karae-Namoo and 25.84% for Sanbud-Namoo.

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Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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Surgical and Long Term Results for Double Outlet Right Ventricle by the Type of Ventricular Septal Defect (심실중격결손의 형태에 따른 양대혈관 우심실기시증의 수술 및 장기 결과)

  • Yu Song Hyeon;Park Han Ki;Cho Bum Koo;Park Young Hwan
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.181-190
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    • 2005
  • The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

Hematologic Changes and Factors Related to Postoperative Hemorrhage Following Cardiopulmonary Bypass (체외순환에 따른 혈액학적 변화와 술후 출혈에 관계하는 인자에 관한 연구)

  • 김하늘루;황윤호;최석철;최국렬;김승우;조광현
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.952-963
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    • 1998
  • Background: Cardiopulmonary bypass(CPB)-induced hemostatic defects may result increased possibility of excessive hemorrhage and additional multiple transfusion reactions or reoperation. Particularly, fibrinolytic activation and decreased platelet count and function by CPB were proposed as a predictor of hemorrhage during postoperative periods in several reports. Materials and methods: Present study, which was conducted in 20 adult patients undergoing CPB, was prospectively designed to examine the hematologic changes, including fibrinolytic activation during and after CPB and to clarify the relationships between these changes and the magnitude of the postoperative nonsurgical blood loss. The serial blood samples for measurment of hematologic parameters were taken during operation and postoperative periods. Blood loss was respectively counted via thoracic catheter drainage at postoperative 3, 6, 12, 24, 48 hours and total period. Results: The results were obtained as follows:Platelet count rapidly declined following CPB(p<0.01), which its decreasing rate was an inverse proportion to total bypass time(TBT, r=0.55, p=0.01), And platelet count in postoperative 7th day was barely near to its control value. Fibrinogen degradating product(FDP) and D-dimer level significantly increased during CPB(p<0.0001, p<0.0001, respectively), and both of fibrinogen and plasminogen concentration correlatively decreased during CPB(r=0.57, p<0.01), implying activation of fibrinolytic system. Postoperative bleeding time (BT), postoperative activated partial thromboplastin time(aPTT) and postoperative prothrombin time (PT) were significantly prolonged as compare with each control value (p=0.05, p<0.0001, p<0.0001, respectively). Total blood loss was positively correlated with patient's age, aortic clamping time (ACT) and TBT, while there was negative correlation between platelet count and blood loss at pre-CPB, CPB-off and the 1st postoperative day, and in some periods. Postoperative aPTT and postoperative PTwere positively related to postoperative 6 hr and 48 hr blood loss(r=0.53, p=0.02; r=0.43, p=0.05) but not to total blood loss, whereas there was no relationship between postoperative BT and blood loss at any period. Conclusions: These observations suggest that CPB results various hematologic changes, including fibrinolytic activation and severe reduction in platelet count. Diverse factors such as age, platelet count, ACT, TBT and postoperative aPTT and PT may magnify the postoperative bleeding. This study will be a basic reference in understanding CPB-induced hemostatic injuries and in decreasing the postoperative hemorrhage

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A Study of Coloration of Topaz(I): Mineralogical and Chemical Study on the Topaz Selected from Some Localities of the World (토파즈의 人工着色 處理를 위한 硏究(I) : 世界 主要 産地別 토파즈의 鑛物學的 및 化學的 特性)

  • Han, Yi-Kyeong;Park, Maeng-Eon;Jang, Yong-Nam
    • Journal of the Mineralogical Society of Korea
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    • v.5 no.2
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    • pp.109-121
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    • 1992
  • For the purpose of mineralogical and chemical study on the topazes from various localities of world(Brzail, China, India, Nigeria and Sri Lanka), electron microprobe analysis(EPMA), neutron activation analysis(NAA), X-ray diffractometry, Raman spectroscopy, etch test, scanning electron microscopy, refractive index, specific gravity, fluid inclusion were performed. The chemical composition in topaz was discussed along with its physical and structural properties. Variations in the unit-cell dimension and physical properties of topaz were found to have a close relations in the unit-cell dimension and physical properties of topaz were found to have a close relationship with extent of substitution of $OH^-\;for\;F^-$. According to neutron activation analyses, the trace elements had no effects on the physical properties of topaz. Raman spectra showed that the peaks of topaz were different in intensity from one locality to another. Etching defects in topaz includes negative crystal defect o point-bottom pit(India, Nigeria) and net work defect of curl-bottom pit(Brazil, China). Fluid inclusions in topaz may be classiffied into liquid $CO_2$-bearing inclusion, gaseous inclusion, halite, sylvite-bearing inclusion and liquid inclusion. The results of this study can be useful to devising artificial coloring methods for topaz with different mineralogical compositions.

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Treatment of Benign Bone Lesions with Autologous Bone Marrow Stromal Cell Transplantation (자가 골수 기질 세포 이식을 이용한 장관골 양성 골 병변의 치료)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Kim, Yong-Sik;Bahk, Won-Jong;Chung, Yang-Guk;Kim, Hyoung-Jun;Ok, Ji-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.13-21
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    • 2004
  • Purpose: We analyzed the result of autologous bone marrow stromal cell transplantation with or without cancellous chip bone allograft for benign long bone lesions. Materials and methods: Since July 1996, eight benign bone lesions treated by curettage, cancellous chip bone allograft and bone marrow or marrow stromal cell transplantation were observed for resolution of clinical symptoms, new bone formation and consolidation. There were 6 males and 2 females. Average age was 24 (range 8 to 47) years old. Histologic diagnoses were 5 fibrous dysplasia, 2 simple bone cysts and one chondroblastoma and fibrous cortical defect each. Mean follow-up period was 16.3 (range 3 to 84) months. Results: In all four symptomatic patients, the pain was subsided in two weeks after surgery. New bone formation in the lesion was observed at 4 weeks, which incorporated into surrounding normal bone around 8 weeks. There were one pathologic fracture through the lesion at 3 weeks and one recurrence of simple bone cyst at 5 months postoperatively. Conclusion: Bone marrow or marrow stromal cell transplantation for bone defects from curettage of benign bone lesions, with or without cancellous chip bone allograft revealed rapid healing. Though it was the result of short-term follow up, it supports that bone marrow stromal cell transplantation will be very useful for the treatment of benign long bone cysts or other lesions. The complete curettage of inner cystic wall is important to prevent later recurrence, and the rigid internal fixation is also needed in selected high risk lesions of fracture.

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Characteristic of Aromatic Amino Acid Substitution at α96 of Hemoglobin

  • Choi, Jong-Whan;Lee, Jong-Hyuk;Lee, Kwang-Ho;Lee, Hyean-Woo;Sohn, Joon-Hyung;Yoon, Joon-Ho;Yeh, Byung-Il;Park, Seung-Kyu;Lee, Kyu-Jae;Kim, Hyun-Won
    • BMB Reports
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    • v.38 no.1
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    • pp.115-119
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    • 2005
  • Replacement of valine by tryptophan or tyrosine at position $\alpha$96 of the $\alpha$ chain ($\alpha$96Val), located in the ${\alpha}_1{\beta}_2$ subunit interface of hemoglobin leads to low oxygen affinity hemoglobin, and has been suggested to be due to the extra stability introduced by an aromatic amino acid at the $\alpha$96 position. The characteristic of aromatic amino acid substitution at the $\alpha$96 of hemoglobin has been further investigated by producing double mutant r Hb ($\alpha$42Tyr$\rightarrow$ Phe, $\alpha$96Val$\rightarrow$Trp). r Hb ($\alpha$42Tyr$\rightarrow$Phe) is known to exhibit almost no cooperativity in binding oxygen, and possesses high oxygen affinity due to the disruption of the hydrogen bond between $\alpha$42Tyr and $\beta$99Asp in the ${\alpha}_1{\beta}_2$ subunit interface of deoxy Hb A. The second mutation, $\alpha$96Val$\rightarrow$Trp, may compensate the functional defects of r Hb ($\alpha$42Tyr$\rightarrow$Phe), if the stability due to the introduction of trypophan at the $\alpha$96 position is strong enough to overcome the defect of r Hb ($\alpha$42Tyr$\rightarrow$Phe). Double mutant r Hb ($\alpha$42Tyr$\rightarrow$Phe, $\alpha$96Val$\rightarrow$Trp) exhibited almost no cooperativity in binding oxygen and possessed high oxygen affinity, similarly to that of r Hb ($\alpha$42Tyr$\rightarrow$Phe). $^1$H NMR spectroscopic data of r Hb ($\alpha$42Tyr$\rightarrow$Phe, $\alpha$96Val$\rightarrow$Trp) also showed a very unstable deoxy-quaternary structure. The present investigation has demonstrated that the presence of the crucible hydrogen bond between $\alpha$42Tyr and $\beta$99Asp is essential for the novel oxygen binding properties of deoxy Hb ($\alpha$96Val$\rightarrow$Trp).

Quantitative Analysis of Magnetization Transfer by Phase Sensitive Method in Knee Disorder (무릎 이상에 대한 자화전이 위상감각에 의한 정량분석법)

  • Yoon, Moon-Hyun;Sung, Mi-Sook;Yin, Chang-Sik;Lee, Heung-Kyu;Choe, Bo-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.98-107
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    • 2006
  • Magnetization Transfer (MT) imaging generates contrast dependent on the phenomenon of magnetization exchange between free water proton and restricted proton in macromolecules. In biological materials in knee, MT or cross-relaxation is commonly modeled using two spin pools identified by their different T2 relaxation times. Two models for cross-relaxation emphasize the role of proton chemical exchange between protons of water and exchangeable protons on macromolecules, as well as through dipole-dipole interaction between the water and macromolecule protons. The most essential tool in medical image manipulation is the ability to adjust the contrast and intensity. Thus, it is desirable to adjust the contrast and intensity of an image interactively in the real time. The proton density (PD) and T2-weighted SE MR images allow the depiction of knee structures and can demonstrate defects and gross morphologic changes. The PD- and T2-weighted images also show the cartilage internal pathology due to the more intermediate signal of the knee joint in these sequences. Suppression of fat extends the dynamic range of tissue contrast, removes chemical shift artifacts, and decreases motion-related ghost artifacts. Like fat saturation, phase sensitive methods are also based on the difference in precession frequencies of water and fat. In this study, phase sensitive methods look at the phase difference that is accumulated in time as a result of Larmor frequency differences rather than using this difference directly. Although how MT work was given with clinical evidence that leads to quantitative model for MT in tissues, the mathematical formalism used to describe the MT effect applies to explaining to evaluate knee disorder, such as anterior cruciate ligament (ACL) tear and meniscal tear. Calculation of the effect of the effect of the MT saturation is given in the magnetization transfer ratio (MTR) which is a quantitative measure of the relative decrease in signal intensity due to the MT pulse.

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The Effect and Side Effect of Dipyridamole in Myocardial SPECT (Dipyridamole 부하 심근 SPECT에서 Dipyridamole의 작용과 부작용)

  • Yang, Hyung-In;Lee, Dong-Soo;Yeo, Jeong-Suk;Bae, Sang-Kyun;Choi, Chang-Woon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.203-209
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    • 1993
  • Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamle, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension, 0.9% showed no change of blood pressure, 5.5% had increased blood pressure. 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patiens without perfusion defects on SPECT(y=7.1x+ 48.4 r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y= -11.6x+68.9 r=0.17 p<0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

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