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Total Arterial 011-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts (다중 복합 Y 동맥 이식편(Multiple Y Composite Craft)을 이용한 완저너 동맥 무인공 심폐바이패스 관상동맥우회술)

  • Kim Do-kyun;Lee Kyo Jgon;Joo Hyun Chul;Li Gyjong;Ahn Jiyoung;shim Yungee;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.551-556
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    • 2005
  • Background: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypopefusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method. Material and Method: Between February 2003 and October 2004, If patients underwent total arterial OPCAB using multiple arterial V composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 6f patients by multi-slice computed tomegraphy. Result: An average of $2.5\pm0.6$ arteries and $3.7pm0.7$ distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was $17.4pm29.7\;IU/L.$Overall graft patency was $99.1\%\;(214/216)(LIMA:\;100\%,\;RA:\;98.4\%,\;RIMA:\;100\%).$ Conclusion: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.

A Research Survey on the Reserved Book System of Pilot Universities in Korea (실험대학 과제도서실 운영에 관한 조사연구)

  • 최달현
    • Journal of Korean Library and Information Science Society
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    • v.5
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    • pp.119-168
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    • 1978
  • This is a survey of the reserved book system in the pilot universities in Korea. We have surveyed only 22 university libraries among 29 pilot schools as of 1977, because of the differences in the library users, library organization, library facilities, and library materials between universities and colleges. In 1972, the Korean Ministry of Education developed a reformation plan for their higher education based on the teaching method of curriculum-oriented faculty instead of that of the faculty-oriented curriculum. The former puts emphasis on the cultivation of a student's thinking, creativity, and judgement through self-teaching to do a given assignment. The reserved book system in a college or university library is one of the most important methods necessary to accomplish the above educational aim. The survey used a questionnaire with 50 question on 28 items concerning the various aspects of the reserved book system in 22 pilot universities. the survey result discovered many problems needing correction. The following list describes the measures needed to correct the problems found in the pilot universities. 1. The management of a centralized reserved book system is much more effective and economical than the decentralized reserved book system when a university is located on the same campus. 2. In the university library, an independent reserved book department requires to gain the desired educational aims as compared with the reserved book room controlled by any other department in the library. 3. The reserved book system should not be adopted by all the departments at once but enlarged gradually, for it needs the understanding and support of faculty members and the university itself. 4. As competence is essential to the effective operation of the reserved book room, the university library should not place an unqualified person in charge of the reserved book department. 5. The librarian in charge of the reserved book department is required to do more professional works such as analysis of users, collection and analysis of syllabuses, maintenance of faculty member cooperation, establishment of measures to acquire unavailable materials, and drawing up an effective management plan. However, he is spending most of his time in clerical works, that is, non-professional works. 6. Three to five titles of each reserved book are considered reasonable and required materials should be shelved in proportion to the number of students, that is, one copy per eight or ten students if the materials are allowed to lend for two hours at a time. For the supplementary materials, the library needs to place two or three copies per subject. 7. Professors must select reserved books with care so that they can be used year after year. 8. Few universities are asking professors the number of class students and the date when the reserved material will no longer be needed on reserve. 9. The library should gather all the lists of reserved books from every professor at least three to five months before the courses open, because it takes a long time to obtain foreign materials. 10. It is desirable that the reserved book department should collect the lists and prepare the materials with promptness and consistency. 11. Instead of block buying, it is desirable to purchase reserved books at the time the library gets the reserved book list from the professors. The library should also inform faculty members whether it obtained each reserved book or not before the course open. 12. The library should make a copy of materials if a professor requires to reserve an out-of-print book or partial contents of a book, journal, and thesis. 13. An independent budger for reserved books from the budget for general materials is desired. 14. The shelf arrangement of reserved books by courses or professors under the same department is much more preferable than a classified arrangement. 15. While most of the universities adopted the open shelves system for all the reserved books, it is more effective and economical to take a compromise system, that is, closed shelves for requires materials and open shelves for supplementary materials. 18. Circulation of reserved books needs a different system between required materials and supplementary materials: two or three hours and/or overnight loan for the former and two and/or three days loan for the latter. 17. A reserved book room should be open a long time after class so that students can have sufficient time to use the room. 18. The library must take daily and monthly statistic as well as statistics on every aspect of the reserved book system in order that the library ma decide on policy and management of the reserved book room in collaboration with the university. Furthermore, regular reports on the use of the reserved book room should be made to the president and the executive council by the library to acquire their understanding and cooperation for the reserved book system. 19. Cooperation of faculty members is indispensable to the effective management of the reserved book department and it is desirable to make a committee which will fix various decisions about the system. Whenever the director of the library make his decision, he must consult with his staff in order to involve them earnestly in the operation of the system.

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Influence of application methods of one-step self-etching adhesives on microtensile bond strength (한 단계 자가 산부식 접착제의 적용 방식이 미세인장 결합강도에 미치는 효과)

  • Choi, Chul-Kyu;Son, Sung-Ae;Ha, Jin-Hee;Hur, Bock;Kim, Hyeon-Cheol;Kwon, Yong-Hun;Park, Jeong-Kil
    • Restorative Dentistry and Endodontics
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    • v.36 no.3
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    • pp.203-210
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    • 2011
  • Objectives: The purpose of this study was to evaluate the effect of various application methods of one-step self-etch adhesives to microtensile resin-dentin bond strength. Materials and Methods: Thirty-six extracted human molars were used. The teeth were assigned randomly to twelve groups (n = 15), according to the three different adhesive systems (Clearfil Tri-S Bond, Adper Prompt L-Pop, G-Bond) and application methods. The adhesive systems were applied on the dentin as follows: 1) The single coating, 2) The double coating, 3) Manual agitation, 4) Ultrasonic agitation. Following the adhesive application, light-cure composite resin was constructed. The restored teeth were stored in distilled water at room temperature for 24 hours, and prepared 15 specimens per groups. Then microtensile bond strength was measured and the failure mode was examined. Results: Manual agitation and ultrasonic agitation of adhesive significantly increased the microtensile bond strength than single coating and double coating did. Double coating of adhesive significantly increased the microtensile bond strength than single coating did and there was no significant difference between the manual agitation and ultrasonic agitation group. There was significant difference in microtensile bonding strength among all adhesives and Clearfil Tri-S Bond showed the highest bond strength. Conclusions: In one-step self-etching adhesives, there was significant difference according to application methods and type of adhesives. No matter of the material, the manual or ultrasonic agitation of the adhesive showed significantly higher microtensile bond strength.

The Accuracy of the Table Movement During a Whole Body Scan (전신 영상 검사 시행 시 테이블 이동속도의 정확성에 관한 연구)

  • Lee, Ju-Young;Jung, Woo-Young;Jung, Eun-Mi;Dong, Kyung-Rae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.86-91
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    • 2009
  • Purpose: The whole body scan in Nuclear Medicine is a widely accepted examination and procedure. Especially, it is mainly used in bone, I-131, MIBI, and HMPAO WBC scans. The diverse uses of the whole body scan range from the HMPAO WBC scan with a speed of 13cm/min, to a whole body bone scan using the Onco. Flash technique with a speed of 30cm/min. The accuracy of table movement has a strong correlation with the image quality, and inaccuracy of speed could negatively affect the image quality. The purpose of this study is to evaluate the accuracy of the table movement while considering the influence of the age of the equipment and the variability in the weight of the patients. Material and Methods: The study was conducted using two of Seoul Asan Medical Center's SIEMENS gamma cameras which are commonly used in our whole body study. The first one is the oldest gamma camera, an ECAM plus (installed in 2000), and the last is brand new one, a SYMBIA T2 (installed in 2008). Three trials were conducted with the tables moving at a different speed each time; 10, 15 and 30 cm/min. The tables' speeds were measured by checking how long it took for the table to move 10cm, and this was repeated every 10cm until the table reached 100 cm. With an average body weight of the patients of about 60~70 kg, the table speed was measured with weights of 0 kg, 66 kg and 110 kg placed on the table, then compared among conditions. Results: The coefficient of variance (CV) of the ECAM plus showed 1.23, 1.42, 2.02 respectively when the table movement speeds were set at 10, 15, and 30 centimeters per minute. Under the same conditions, the SYMBIA T2 showed 1.23, 1.83 and 2.28 respectively. As table movement speed more, the variance of CV as the speed increases. When the patient body weight was set to 0, 66 and 110kg, the CV values of both cameras showed 0.96, 1.45, 2.08 (0 Kg), 1.32, 1.72, 2.27 (66 Kg) and 1.37, 1.73, 2.14 (110 Kg). There was no significant difference (p>0.05) in 95 percent of confidence intervals and measured CV values were acceptable. However, the CV value of the SYMBIA T2 was relatively larger than the ECAM plus. Conclusion: The scan speed of the whole body scan is predetermined based on which examination is being performed. It is possible for the accuracy of the speed to be affected, such as the age of the equipment, the state of the bearings or the weight of a patient. These factors can have a negative impact on the diagnostic consistency and the image quality. Therefore, periodic quality control should be needed on the gamma cameras currently being used, focusing on the table movement speed in order to maintain accuracy and reproducibility.

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Processing of Cheonggukjang using soybean powder (콩 분말을 이용한 청국장 제조 기술 개발)

  • Jeong, Yeon-Shin;Dhakal, Krishna Hari;Hwang, Young-Hyun
    • Current Research on Agriculture and Life Sciences
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    • v.29
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    • pp.43-53
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    • 2011
  • The possibility of making Cheongukjang by the use of soy-powder and pill type re-made from soy-powder was investigated. Some of experimental results obtained are summarized as follows; 1. Regardless of three different types for the source material of Cheonggukjang, soybean seed, soy-power, and pill, the dry weight of fermented Cheonggukjang showed continuously decreasing trends along with the time of fermentation applied. 2. In all type of source materials, the length of viscous substance during fermentation was increased along with the time of fermentation, and the rate of elongation was much reduced after 48hr of fermentation. Out of four soybean varieties tested, Taekwangkong produced longest viscous substance fermented in the type of soybean seed. No viscous substance was formed when the depth of soy-powder in the fermentation box was shallow, one centimeter. 3. Not much difference was observed in the number of microbes, Bacillus licheniformis B1, in all soybean varieties. The number was proportionally increased in the type of powder but it increased rapidly from 12 hour to 24 hour with low rate of increase thereafter in the pill type. 4. Along with the time of fermentation in all types, the color of Cheonggukjang changed from yellow to dull. At the same time, the tone of color and chroma changed into reddish and yellow, respectively. 5. Along with the time of fermentation in all types, pH of Cheonggukjang changed in alkali. 6. Along with the time of fermentation, the content of isoflavone in Cheonggukjang increased by 48hr but decreased thereafter. 7. In general, the quality of Cheonggukjang fermented in types of soy-powder and pill re-made from soy-powder was lower than that of soybean seed. More study is seemed to be needed to produce high quality Cheonggukjang by the use of soy-power.

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A study of Conjunctival Cellular Changes in Dry Eye Patients by Impression Cytology (Impression cytology를 이용한 건성안의 결막 세포변화에 관한 연구)

  • Kim, Jai-Min;Kho, Eun-Gyung;Chae, Soo-Chul;Kim, Soon-Ae
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.333-343
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    • 2004
  • Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

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Verification of Skin Dose in Tomotherapy Using the Developed Phantom for Image Based Radiation Treatment System (영상 기반 치료 장비용 팬톰을 이용한 토모테라피 피부 선량 검증)

  • Park, Ji-Yeon;Chang, Ji-Na;Oh, Seung-Jong;Kang, Dae-Gyu;Jung, Won-Gyun;Lee, Jeong-Woo;Jang, Hong-Suk;Kim, Hoi-Nam;Park, Hae-Jin;Kim, Sung-Hwan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.88-96
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    • 2009
  • Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

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Quantitative Comparisons between CT and $^{68}Ge$ Transmission Attenuation Corrected $^{18}F-FDG$ PET Images: Measured Attenuation Correction vs. Segmented Attenuation Correction (CT와 $^{68}Ge$ 감쇠보정 $^{18}F-FDG$ PET 영상의 정량적 비교: 측정감쇠보정대 분할감쇠보정)

  • Choi, Joon-Young;Woo, Sang-Keun;Choi, Yong;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.49-53
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    • 2007
  • Purpose: It was reported that CT-based measured attenuation correction (CT-MAC) produced radioactivity concentration values significantly higher than $^{68}Ge$-based segmented attenuation correction (Ge-SAC) in PET images. However, it was unknown whether the radioactivity concentration difference resulted from different sources (CT vs. Ge) or types (MAC vs. SAC) of attenuation correction (AC). We evaluated the influences of the source and type of AC on the radioactivity concentration differences between reconstructed PET images in normal subjects and patients. Material and Methods: Five normal subjects and 35 patients with a known or suspected cancer underwent $^{18}F-FDG$ PET/CT. In each subject, attenuation corrected PET images using OSEM algorithm (28 subsets, 2 iterations) were reconstructed by 4 methods: CT-MAC, CT-SAC, Ge-MAC, and Ge-SAC. The physiological uptake in normal subjects and pathological uptake in patients were quantitatively compared between the PET images according to the source and type of AC. Results: The SUVs of physiological uptake measured in CT-MAC PET images were significantly higher than other 3 differently corrected PET images. Maximum SUVs of the 145 foci with abnormal FDG uptake in CT-MAC images were significantly highest among 4 differently corrected PET images with a difference of 2.4% to 5.1% (p<0.001). The SUVs of pathological uptake in Ge-MAC images were significantly higher than those in CT-SAC and Ge-MAC PET images (p<0.001). Conclusion: Quantitative radioactivity values were highest in CT-MAC PET images. The adoption of MAC may make a more contribution than the adoption of CT attenuation map to such differences.

Geochemical Studies of Geothermal Waters in Yusung Geotheraml Area (유성 지역 지열수의 지구화학적 특성 연구)

  • 김건영;고용권;김천수;배대석;박맹언
    • Journal of the Korean Society of Groundwater Environment
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    • v.7 no.1
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    • pp.32-46
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    • 2000
  • Hydrogeochemical and isotope ($\delta$$^{18}$ O, $\delta$D, $^3$H, $\delta$$^{13}$ C, $\delta$$^{34}$ S, $^{87}$ Sr/$^{86}$ Sr) studies of various kinds of waters (thermal groundwater, deep groundwater, shallow groundwater, and surface water) from the Yusung area were carried out in order to elucidate their geochemical characteristics such as distribution and behaviour of major/minor elements, geochemical evolution, reservoir temperature, and water-rock interaction of the thermal groundwater. Thermal groundwater of the Yusung area is formed by heating at depth during deep circlulation of groundwater and is evolved into Na-HCO$_3$type water by hydrolysis of silicate minerals with calcite precipitation and mixing of shallow groundwater. High NO$_3$contents of many thermal and deep groundwater samples indicate that the thermal or deep groundwaters were mixed with contaminated shallow groundwater and/or surface water. $\delta$$^{18}$ O and $\delta$D are plotted around the global meteoric water line and there are no differences between the various types of water. Tritium contents of shallow groundwater, deep groundwater and thermal groundwater are quite different, but show that the thermal groundwater was mixed with surface water and/or shallow groundwater during uprising to surface after being heated at depths. $\delta$$^{13}$ C values of all water samples are very low (average -16.3$\textperthousand$%o). Such low $\delta$$^{13}$ C values indicate that the source of carbon is organic material and all waters from the Yusung area were affected by $CO_2$ gas originated from near surface environment. $\delta$$^{34}$ S values show mixing properties of thermal groundwater and shallow groundwater. Based on $^{87}$ Sr/$^{86}$ Sr values, Ca is thought to be originated from the dissolution of plagioclase. Reservoir temperature at depth is estimated to be 100~1$25^{\circ}C$ by calculation of equilibrium method of multiphase system. Therefore, the thermal groundwaters from the Yusung area were formed by heating at depths and evolved by water-rock interaction and mixing with shallow groundwater.

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Clinical Results of Mitral Valvular Surgery in Patients with Moderate Ischemic Mitral Regurgitation Undergoing Coronary Artery Bypass Grafting (중등도의 허혈성 승모판막 폐쇄부전 환자의 관상동맥 우회로 조성술 시 승모판막 수술의 유무에 따른 원상 결과)

  • Yu Song-Hyeon;Chang Byung-Chul;Yoo Kyung-Jong;Kang Meyun-Shick;Hong You-Sun
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.611-618
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    • 2006
  • Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.