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Cardiac Injury due to Thoracic Trauma (흉부외상에 의한 심장손상)

  • Kim, Han-Yong;Kim, Myoung-Young;Park, Jae-Hong;Chei, Chang-Seck;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.831-836
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    • 2007
  • Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.

Mammalian Cloning by Nuclear transfer, Stem Cell, and Enzyme Telomerase (핵치환에 의한 cloning, stem cell, 그리고 효소 telomerase)

  • 한창열
    • Korean Journal of Plant Tissue Culture
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    • v.27 no.6
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    • pp.423-428
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    • 2000
  • In 1997 when cloned sheep Dolly and soon after Polly were born, it had become head-line news because in the former the nucleus that gave rise to the lamb came from cells of six-year-old adult sheep and in the latter case a foreign gene was inserted into the donor nucleus to make the cloned sheep produce human protein, factor IX, in e milk. In the last few years, once the realm of science fiction, cloned mammals especially in livestock have become almost commonplace. What the press accounts often fail to convey, however, is that behind every success lie hundreds of failures. Many of the nuclear-transferred egg cells fail to undergo normal cell divisions. Even when an embryo does successfully implant in the womb, pregnancy often ends in miscarriage. A significant fraction of the animals that are born die shortly after birth and some of those that survived have serious developmental abnormalities. Efficiency remains at less than one % out of some hundred attempts to clone an animal. These facts show that something is fundamentally wrong and enormous hurdles must be overcome before cloning becomes practical. Cloning researchers now tent to put aside their effort to create live animals in order to probe the fundamental questions on cell biology including stem cells, the questions of whether the hereditary material in the nucleus of each cell remains intact throughout development, and how transferred nucleus is reprogrammed exactly like the zygotic nucleus. Stem cells are defined as those cells which can divide to produce a daughter cell like themselves (self-renewal) as well as a daughter cell that will give rise to specific differentiated cells (cell-differentiation). Multicellular organisms are formed from a single totipotent stem cell commonly called fertilized egg or zygote. As this cell and its progeny undergo cell divisions the potency of the stem cells in each tissue and organ become gradually restricted in the order of totipotent, pluripotent, and multipotent. The differentiation potential of multipotent stem cells in each tissue has been thought to be limited to cell lineages present in the organ from which they were derived. Recent studies, however, revealed that multipotent stem cells derived from adult tissues have much wider differentiation potential than was previously thought. These cells can differentiate into developmentally unrelated cell types, such as nerve stem cell into blood cells or muscle stem cell into brain cells. Neural stem cells isolated from the adult forebrain were recently shown to be capable of repopulating the hematopoietic system and produce blood cells in irradiated condition. In plants although the term$\boxDr$ stem cell$\boxUl$is not used, some cells in the second layer of tunica at the apical meristem of shoot, some nucellar cells surrounding the embryo sac, and initial cells of adventive buds are considered to be equivalent to the totipotent stem cells of mammals. The telomere ends of linear eukaryotic chromosomes cannot be replicated because the RNA primer at the end of a completed lagging strand cannot be replaced with DNA, causing 5' end gap. A chromosome would be shortened by the length of RNA primer with every cycle of DNA replication and cell division. Essential genes located near the ends of chromosomes would inevitably be deleted by end-shortening, thereby killing the descendants of the original cells. Telomeric DNA has an unusual sequence consisting of up to 1,000 or more tandem repeat of a simple sequence. For example, chromosome of mammal including human has the repeating telomeric sequence of TTAGGG and that of higher plant is TTTAGGG. This non-genic tandem repeat prevents the death of cell despite the continued shortening of chromosome length. In contrast with the somatic cells germ line cells have the mechanism to fill-up the 5' end gap of telomere, thus maintaining the original length of chromosome. Cem line cells exhibit active enzyme telomerase which functions to maintain the stable length of telomere. Some of the cloned animals are reported prematurely getting old. It has to be ascertained whether the multipotent stem cells in the tissues of adult mammals have the original telomeres or shortened telomeres.

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The Making and Use of the Bifid Ornamental Hairpin Stone Mold Excavated at Neungsan-ri, Buyeo (부여 능산리 출토 가랑비녀 용범(鎔范)의 제작과 사용 양상)

  • LEE, Soleon;KIM, Jiyoung;SEO, Hyunju
    • Korean Journal of Heritage: History & Science
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    • v.54 no.2
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    • pp.4-21
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    • 2021
  • A stone mold from the Sabi period of Baekje was excavated at the western tombs in Neungsan-ri, Buyeo where there was a recent excavation survey (2016). It was believed and reported that such stone molds were used for copper needles during the early Iron Age; however, a close re-examination of the form revealed that they were used for bifid ornamental hairpins. Given its casting form, the stone mold of Neungsan-ri is estimated to have been used to make bifid ornamental hairpins in a ∩ shape, narrowing down toward the tip. It is considered an artifact of the Goryeo dynasty. The stone used to make the bifid ornamental hairpin mold of Neungsan-ri was chlorite-schist, the principal minerals of which include chlorite, amphibole, and talc. Similar rocks are in nearby Buyeo (Oesan-myeon), Cheongyang, Gongju, and Yesan. They are mainly found between Jiseon-ri, Oesan-myeon, Buyeo, Sucheol-ri, Yesane-up, and Yesan. Nearly 70 bifid ornamental hairpins from the Goryeo dynasty were excavated at Neungsan-ri, Buyeo and the surrounding areas. Among them, the bronze ones excavated from the tombs of Songguk-ri, Buyeo are estimated to have been made using this mold as they closely resemble the Neungsan-ri mold. Stone was likely the preferred material for molds to make bronze artifacts as it was easy to sink a die. Regarding the bifid ornamental hairpin cast excavated in Neungsan-ri, they obtained stones in nearby areas 20~50km from their location, made bronze artifacts, and distributed them to nearby sites during the Goryeo dynasty. These artifacts suggest that the casting technology of using a stone mold was still employed then.

A Study on the Development of Ultra-precision Small Angle Spindle for Curved Processing of Special Shape Pocket in the Fourth Industrial Revolution of Machine Tools (공작기계의 4차 산업혁명에서 특수한 형상 포켓 곡면가공을 위한 초정밀 소형 앵글 스핀들 개발에 관한 연구)

  • Lee Ji Woong
    • Journal of Practical Engineering Education
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    • v.15 no.1
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    • pp.119-126
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    • 2023
  • Today, in order to improve fuel efficiency and dynamic behavior of automobiles, an era of light weight and simplification of automobile parts is being formed. In order to simplify and design and manufacture the shape of the product, various components are integrated. For example, in order to commercialize three products into one product, product processing is occurring to a very narrow area. In the case of existing parts, precision die casting or casting production is used for processing convenience, and the multi-piece method requires a lot of processes and reduces the precision and strength of the parts. It is very advantageous to manufacture integrally to simplify the processing air and secure the strength of the parts, but if a deep and narrow pocket part needs to be processed, it cannot be processed with the equipment's own spindle. To solve a problem, research on cutting processing is being actively conducted, and multi-axis composite processing technology not only solves this problem. It has many advantages, such as being able to cut into composite shapes that have been difficult to flexibly cut through various processes with one machine tool so far. However, the reality is that expensive equipment increases manufacturing costs and lacks engineers who can operate the machine. In the five-axis cutting processing machine, when producing products with deep and narrow sections, the cycle time increases in product production due to the indirectness of tools, and many problems occur in processing. Therefore, dedicated machine tools and multi-axis composite machines should be used. Alternatively, an angle spindle may be used as a special tool capable of multi-axis composite machining of five or more axes in a three-axis machining center. Various and continuous studies are needed in areas such as processing vibration absorption, low heat generation and operational stability, excellent dimensional stability, and strength securing by using the angle spindle.

Initial Experience of the Emergency Bypass System ($EBS^{(R)}$) for the Patients with Cardiogenic Shock due to an Acute Myocardial Infarction (급성 심근경색으로 인한 심인성 쇼크 환자에 대한 경피적 순환 보조장치($EBS^{(R)}$) 적용의 초기경험)

  • Ryu, Kyoung-Min;Kim, Sam-Hyun;Seo, Pil-Won;Ryu, Jae-Wook;Kim, Seok-Kon;Kim, Young-Hwa;Park, Seong-Sik
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.329-334
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    • 2008
  • Background: Percutaneous cardiopulmonary support. (PCPS) has the potential to rescue patients in cardiogenic shock who might otherwise die. PCPS has been a therapeutic option in a variety of the clinical settings such as for patients with myocardial Infarction, high-risk coronary intervention and postcardiotomy cardiogenic shock, and the PCPS device is easy to install. We report our early experience with PCPS as a life saving procedure in cardiogenic shock patients due to acute myocardial infarction. Material and Method: From January 2005 to December 2006, eight patients in cardiogenic shock with acute myocardial infarction underwent PCPS using the CAPIOX emergency bypass system($EBS^{(R)}$, Terumo, Tokyo, Japan). Uptake cannulae were inserted deep into the femoral vein up to the right atrium and return cannulae were inserted into the femoral artery with Seldinger techniques using 20 and 16-French cannulae, respectively. Simultaneously, autopriming was performed at the $EBS^{(R)}$ circuit. The $EBS^{(R)}$ flow rate was maintained between $2.5{\sim}3.0L/min/m^2$ and anticoagulation was performed using intravenous heparin with an ACT level above 200 seconds. Result: The mean age of patients was $61.1{\pm}14.2$ years (range, 39 to 77 years). Three patients were under control of the $EBS^{(R)}$ before percutaneous coronary intervention (PCI), three patients were under control of the $EBS^{(R)}$ during PCI, one patient was under control of the $EBS^{(R)}$ after PCI, and one patient was under control of the $EBS^{(R)}$ after coronary bypass surgery. The mean support time was $47.5{\pm}27.9$ hours (range, 8 to 76 hours). Five patients (62.5%) could be weaned from the $EBS^{(R)}$ after $53.6{\pm}27.2$ hours. (range, 12 to 68 hours) of support. All of the patients who could successfully be weaned from support were discharged from the hospital. There were three complications: one case of gastrointestinal bleeding and two cases of acute renal failure. Two of the three mortality cases were under cardiac arrest before $EBS^{(R)}$ support, and one patient had an intractable ventricular arrhythmia during the support. All of the discharged patients are still surviving at $16.8{\pm}3.1$ months (range, 12 to 20 months) of follow-up. Conclusion: The use of $EBS^{(R)}$ for cardiogenic shock caused by an acute myocardial infarction could rescue patients who might otherwise have died. Successfully recovered patients after $EBS^{(R)}$ treatment have survived without severe complications. More experience and additional clinical investigations are necessary to elucidate the proper installation timing and management protocol of the $EBS^{(R)}$ in the future.

Fracture load and marginal fitness of zirconia ceramic coping by design and coloration (유색 및 백색 지르코니아 세라믹 코핑의 코핑 디자인에 따른 파절 하중과 변연 적합성)

  • Shin, Mee-Ran;Kim, Min-Jeong;Oh, Sang-Chun
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.406-415
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    • 2009
  • Purpose: The purpose of this study was to compare the marginal fitness and fracture load of the zirconia copings according to the design with different thickness and coloration. Material and methods: The evaluation was based on 80 zirconia copings. Zirconia copings were fabricated in design with different thicknesses using CAD/CAM system (Everset, KAVO dental GmbH, Biberach, Germany). The designs of copings were divided into four groups. The first group consisted of copings with uniform thickness of 0.3 mm. The thickness in the second group was 0.3 mm on the buccal surface and 0.6 mm on the lingual surface. The third group consisted of coping with uniform thickness of 0.6 mm. The thickness in the fourth group was 0.6 mm on the buccal surface and 1mm on the lingual surface. Each group consisted of 10 colored and 10 uncolored copings. Half of the copings (40) processed with a milling system according to the specific design were sent to be given a color (A3) through saturation in special dye by a manufacturing company. Just after sintering, the marginal discrepancies of copings were measured on the buccal, lingual, mesial and distal surfaces of metal die, under a Video Microscope System (sv-35, Sometech, Seoul, Korea) at a magnification of $\times$ 100. It was remeasured after the adjusting of the inner surface. Next, all copings were luted to the metal dies using reinforced cement {GC FujiCEM (GC Corp. Tokyo, Japan)} and mounted on the testing jig in a Universal Testing Machine (Instron 4467, Norwood, MA, USA). The results were analyzed statistically using the one-way ANOVA test. Results: The obtained results were as follow: 1. The measured value of marginal discrepancy right after sintering was the greatest in the contraction of the buccal area in all groups, except for group I2. 2. There was no significant difference of marginal fitness among the groups in the colored zirconia group (P<.05). 3. When the marginal fitness among the groups in the uncolored zirconia group was considered, group II2 had the smallest marginal discrepancy. 4. When the colored and uncolored groups with the same design were compared, there was a significant difference between I1 and II1 groups. In group 2, 3, and 4, the uncolored zirconia had the greatest marginal fitness (P<.05). 5. After adjustment of inner surface, there was no significant difference in the marginal fitness in all groups when color and design of the zirconia coping were compared. 6. The fracture load of CAD/CAM zirconia copings showed significant difference in group 1, 2, 3, and 4. I4 and II4 had the strongest fracture load. 7. When groups with different color and same design were compared, all colored groups showed greater fracture load (P>.05), with no significance. Conclusion: There was difference in the marginal fitness according to the design and coloration of zirconia copings right after sintering, but it was decided that the copings may well be used clinically if the inner surface are adjusted. The copings should be thick enough for the reinforcement of fracture strength. But considering the esthetics of the visible surfaces (labial and buccal surface), the thickness of copings may be a little thin, without giving any significant effect on the fracture strength. This type of design may be considered when giving priority to preservation of tooth or esthetics.

A Transcendental Pragmatic Interpretation on the Notion of 'Injon' in Daesoon Thought (대순사상의 인존(人尊)에 대한 화용론적(話用論的) 해석)

  • Baek, Choon-hyoun
    • Journal of the Daesoon Academy of Sciences
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    • v.39
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    • pp.33-67
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    • 2021
  • This paper aims at revealing the core concept of Injon (Human Nobility). The concept of Injon is one of the salient fundamental ideas which makes Daesoon Jinrihoe recognizable as Daesoon Jinrihoe. The concept of Injon has the basic meaning of 'human nobility,' but within the context wherein the nobility of humankind is considered to be greater than the nobility of Heaven and Earth. Although the religious and ideological interpretations of Injon (human nobility) that have developed over time have been quite diverse and abundant, these interpretations are all limited in that they generally assume the relationship between 'Heaven and Earth' and 'Humanity' to be antagonistic. However, if human nobility is relativized in that manner, it can reduce the potential broader meanings of mutual beneficence and the earthly paradise of the later world. These interpretations are grounded in the view of semiotic interpretation. Such interpretations have composed their view point via the semiotic meaning of the words. The semiotic point of view suggests that meanings of words consist in the relation of the word and the object to which it denotes. We will introduce a new view point which can be termed the transcendental view point. This view focuses on how the exact interpretation of words and sentences depends on the comprehension of the triad of systematic relations among the word, object, and speaker. In the Daesoon Thought, the Former World is considered to be the world wherein all creations unfolded according to the principle of mutual contention. This led to the accumulation of grievances and grudges which condensed and filled the Three Realms of Heaven, Earth, and Humanity. The Former World was dominated by Western material civilization, selfishness, and exclusivism. It was also a world where humans suffered from various natural disasters such as floods, droughts, plagues, and wildfires. The Former World lost the constant Dao and was overwhelmed with all kinds of disasters and calamities. That world fell into various kinds of wretchedness. The causes which made the Former World so cruel came from humans misunderstanding their relation to nature and life in general; including human life. The anthropocentric modern cosmology insisted that the human race was the only one to have the powers and rights to exercise dominion over nature. On the other hand, there is the Later World, which means the ideal and perfect, immanent eternal world for all humankind in Daesoon Thought. This world consists of life, peace, and equality and is also characterized by three typical attributes: goodness, peace, and all kinds of life. All living beings previously struggled for survival, but in the Later World, those lifeforms will embrace each other; even across different realms. In Daesoon Thought, the world and cosmos contain diverse forms of life, and human have both an earthly life and life in the after world should they die before the Later World. There are also the lives of divine beings and animals, and other such living entities. Daesoon Thought subsumes pan-vitalism, which allows they acknowledgement of myriad possible lifeforms. The concept of the Later World in Daesoon Thought, which mainly revealed in The Canonical Scripture and the words of Sangje (Kang Jeungsan), suggests that all kinds of life, including humans, animals, and even spirits in the afterworld, can live together in a perfect coming earthly paradise which is immanent. The concept of Injon can be interpreted though the view of transcendental pragmatics as an alternative to the typical views discussed in Daesoon Thought. Thinkers should attempt to improve current discourse on Injon in Daesoon Thought by focusing on the point that all kinds the original teachings demonstrate a value of all lifeforms. Therein, Injon would indicate not only the human nobility and dignity but also the nobility and dignity of divine beings, divine humans, and all other forms of life that have existed across time. The dimension of time allows for recognition of lifeforms from the Former World, the afterworld, and the Later World. This revised appraisal of Injon could further accommodate denizens of the afterworld, animals, ghosts and spirits, the earth and cloud souls of humans, and other lifeforms held to exist in the cosmology of Daesoon Thought.