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The Recovery of Left Ventricular Function after Coronary Artery Bypass Grafting in Patients with Severe Ischemic Left Ventricular Dysfunction: Off-pump Versus On-pump (심한 허혈성 좌심실 기능부전 환자에서 관상동맥우회술시 체외순환 여부에 따른 좌심실 기능 회복력 비교)

  • Kim Jae Hyun;Kim Gun Gyk;Baek Man Jong;Oh Sam Sae;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.116-122
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    • 2005
  • Background: Adverse effects of cardiopulmonary bypass can be avoided by 'Off-pump' coronary artery bypass (OPCAB) surgery. Recent studies have reported that OPCAB had the most beneficial impact on patients at highest risk by reducing bypass-related complications. The purpose of this study is to compare the outcome of OPCAB and conventional coronary artery bypass grafting (CCAB) in patients with poor left ventricular (LV) function. Material and Method: From March 1997 to February 2004, seventy five patients with left ventricular ejection fraction (LVEF) of $35\%$ or less underwent isolated coronary artery bypass grafting at our institute. Of these patients, 33 patients underwent OPCAB and 42 underwent CCAB. Preoperative risk factors, operative and postoperative outcomes, including LV functional change, were compared and analysed. Result: Patients undergoing CCAB were more likely to have unstable angina, three vessel disease and acute myocardial infarction among the preoperative factors. OPCAB group had significantly lower mean operation time, less numbers of total distal anastomoses per patient and less numbers of distal anastomoses per patient in the circumflex territory than the CCAB group. There was no difference between the groups in regard to in-hospital mortality $(OPCAB\; 9.1\%\;(n=3)\;Vs.\;CCAB\;9.5\%\;(n=4)),$ intubation time, the length of stay in intensive care unit and in hospital postoperatively. Postoperative complication occurred more in CCAB group but did not show statistical difference. On follow-up echocardiography, OPCAB group showed $9.1\%$ improvement in mean LVEF, 4.3 mm decrease in mean left ventricular end-diastolic dimension (LVEDD) and 4.2 mm decrease in mean left ventricular end-systolic dimension (LVESD). CCAB group showed $11.0\%$ improvement in mean LVEF, 5.1 mm decrease in mean LVEDD and 5.5 mm decrease in mean LVESD. But there was no statistically significant difference between the two groups. Conclusion: This study showed that LV function improves postoperatively in patients with severe ischemic LV dysfunction, but failed to show any difference in the degree of improvement between OPCAB and CCAB. In terms of operative mortality rate and LV functional recovery, the results of OPCAB were as good as those of CCAB in patients with poor LV function. But, OPCAB procedure was advantageous in shortening of operative time and in decrease of complications. We recommend OPCAB as the first surgical option for patients with severe LV dysfunction.

Coronary Artery Bypass Surgery with Radial Artery -Early Results (요골동맥을 이용한 관상동맥우회술 -조기성적)

  • 나찬영;이영탁;박국양;이해영;김욱성;박?현;홍민수;심재천;권오춘
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.275-281
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    • 1997
  • The radial artery as a graft for myocardial revascularization was introduced by Carpentier in the early 1970s. Mid-term results were unfortunately discoura ing, and the clinical experience with this graft was interrupted. At the end of the 1980s, these authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a radial artery graft in Seiong General Hospital. Left internal mammary artery was concomitantly used as a pedicled Vift in 34 patients. Fifteen patients (42%) had a complete arterial waft revascularization. A total of 12) distal anastomoses were performed (average 3.4 per patient), including 36 left internal mammary artery wafts (two sequential in 2 patients), and 23 saphenous vein grafts. The remaining 64 distal anastomoses were perFormed with radial artery grafts (mean 1.8 per patient). The radial arteries were anastomosed to the circumflex (n=38), diagonal (n= 18), right coronary(n=G), and left anterior descending coronary artery(n=2). The percent ge of radial artery graft anastomoses (64) to the total anastomoses(123) was 52%. The radial artery was used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures coronary endarterectomy (14), coronary artery patch angioplasty (4), mitral valve repair (1), and repair of ventricular septal rupture (1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand aftcr removal of the radial artery. Only 1 patient required reexploration of the am, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiovaphic controls were obtained in 11 patients(31%) postoperative 79 to 210 days (mean 126 days). The patency rate were as follows : left internal mammary artery (100%), saphcnous vein (100%), and radial artery(95%). We concluded that the radial artery is useful alternative graft, but long term clinical and angiographic studies are required to derterminc whether wider application is warranted.

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THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS OF THE PHENOMENON PRODUCED DURING RETRACTION OF FOUR MAXILLARY INCISORS (상악 4절치의 후방견인시 나타나는 현상에 관한 유한요소법적 분석)

  • Cheon, Ok-Jin;Kim, Tae-Woo;Suhr, Cheong-Hoon
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.525-541
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    • 1995
  • This study was designed to investigate force systems and tooth movements produced by retraction archwire during retraction of four maxillary incisors after the maxillary canine retraction into the maxillary first premolar extraction space using the computer-aided three-dimensional finite element method. A three-dimensional finite element model, consisting of 2248 elements and 3194 nodes, was constructed. The model consisted of maxillary teeth and surrounding periodontal membranes, .022'$\times$.028'-slot brackets, and 5 types of retraction archwires(.019'$\times$.025' stainless steel archwire) modeled using the beam elements. The contact between the wire and the bracket slot was modeled using the gap elements because of the non-linear elastic behaviors of the contact between them. The forces and moments, End displacements produced by retraction archwire were measured at various conditions to investigate the difference according to types of loops, magnitudes of activation force, gable angle, and anterior lingual root torque. The results were expressed quantitative and visual ways in the three-dimensional method. The following conclusions can be drawn from this study.1. When the tear-drop loop archwire was activated, the mesio-distal and lingual translational movements of the teeth helped to close the extraction space, but unwanted movements of the teeth including intrusions and extrusions, and rotational movements in each direction occurred. 2. Activation of T-loop archwire compared with those of other types of retraction archwires produced the least translational movements of the teeth helped to space closure and also the least unwanted movements of the teeth. 3. Increasing amount of activation in the tear-drop archwire led not only to increase of translational movements of the teeth helped to space closure, but also to increase of unwanted movements of the teeth. 4. Addition of gable bend in the tear-drop archwire helped anterior teeth to translational movements in the mesio-distal direction, but increased unwanted movements of the teeth 5. Addition of anterior lingual root torque in the tear-drop archwire helped central and lateral incisor to improve their facio-lingual inclination, but increased unwanted movements of the teeth.

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The Effects of Enzyme Complex on Performance, Intestinal Health and Nutrient Digestibility of Weaned Pigs

  • Yi, J.Q.;Piao, X.S.;Li, Z.C.;Zhang, H.Y.;Chen, Y.;Li, Q.Y.;Liu, J.D.;Zhang, Q.;Ru, Y.J.;Dong, B.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.8
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    • pp.1181-1188
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    • 2013
  • Two experiments were conducted to evaluate the effect of supplementing a corn-soybean meal-based diet with an enzyme complex containing amylase, protease and xylanase on the performance, intestinal health, apparent ileal digestibility of amino acids and nutrient digestibility of weaned pigs. In Exp. 1, 108 piglets weaned at 28 d of age were fed one of three diets containing 0 (control), 100, or 150 ppm enzyme complex for 4 wks, based on a two-phase feeding program namely 1 to 7 d (phase 1) and 8 to 28 d (phase 2). At the end of the experiment, six pigs from the control group and the group supplemented with 150 ppm enzyme complex were chosen to collect digesta samples from intestine to measure viscosity and pH in the stomach, ileum, and cecum, as well as volatile fatty acid concentrations and composition of the microflora in the cecum and colon. There were linear increases (p<0.01) in weight gain, gain: feed ratio and digestibility of gross energy with the increasing dose rate of enzyme supplementation during the whole experiment. Supplementation with enzyme complex increased the digesta viscosity in the stomach (p<0.05) and significantly increased (p<0.01) the concentrations of acetic, propionic and butyric acid in the cecum and colon. Enzyme supplementation also significantly increased the population of Lactobacilli (p<0.01) in the cecum and decreased the population of E. coli (p<0.05) in the colon. In Exp. 2, six crossbred barrows (initial body weight: $18.26{\pm}1.21$ kg), fitted with a simple T-cannula at the distal ileum, were assigned to three dietary treatments according to a replicated $3{\times}3$ Latin Square design. The experimental diets were the same as the diets used in phase 2 in Exp. 1. Apparent ileal digestibility of isoleucine (p<0.01), valine (p<0.05) and aspartic acid (p<0.05) linearly increased with the increasing dose rate of enzyme supplementation. In conclusion, supplementation of the diet with an enzyme complex containing amylase, protease and xylanase improved piglet performance. This is likely a result of improvement in nutrient digestibility, volatile fatty acid concentrations and bacteria ratio in the large intestine.

Rhizoctonia Blight of Azolla japonica Caused by Rhizoctonia solani (Rhizoctonia solani에 의한 큰물개구리밥(Azolla japonica) 마름병)

  • Lee, Jung-Han;Cha, Jea-Yul;Noh, Gil-Han;Han, Ki-Soo;Bae, Dong-Won;Kwon, Young-Sang;Lim, Chae-Shin;Jeong, Sung-Woo;Kwon, Jin-Hyeuk;Park, Chung-Gyoo;Kwak, Youn-Sig
    • Research in Plant Disease
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    • v.17 no.3
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    • pp.405-409
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    • 2011
  • Azolla Lam. is a small aquatic fern with deeply bilobed leaves, which are consisted of a thick greenish, with chlorophyll, upper (dorsal) lobe and a thinner, translucent lower (ventral) lobe, without chlorophyll, submerged in the water. Azolla blight was observed at a lotus pond. Mycological characteristics of the fungus associated with Azolla blight was immediately determined as Rhizoctonia sp. by the thickness and branching of hypha at right angles at the point toward the distal end of septa, with branching hypha is constricted. The fungus produced brown mycelia and dark brown sclerotia on PDA. The optimum temperature for mycelial growth and sclerotia formation were $25^{\circ}C$ and $30^{\circ}C$, respectively. The optimum temperature for fungal infection was $30^{\circ}C$, when spray inoculated. Phylogenetic analysis of rDNA-ITS revealed that the fungus was identified as Rhizoctonia solani (AG-1 IA) closest to one causing rice sheath blight disease. This is the first report on the blight disease of Azolla caused by R. solani in Korea.

Experimental Studies on the Excretion of Uric acid in Rabbit (가토의 요산배설에 관한 실험적연구)

  • Hong, Yoon-Pyo
    • The Korean Journal of Pharmacology
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    • v.7 no.1
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    • pp.67-76
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    • 1971
  • The excretion of uric acid in man has been of great interest because of its importance as an end product in purine metabolism as well as of its role in causing gout. There are many differences in the modes of renal handling of urate among various species of animals. Uric acid actively secreted by the renal tubules of most vertebrate including amphibians, reptiles, and birds. On the other hand, in most mammals net tubular reabsorption of urate appears to be occurred with some exception, such, as Dalmatian dog. In the rabbits, however, the mechanism of renal excretion of uric acid has long been a subject of controversial results. Within a given group it was possible to find individuals with either net secretion or net reabsorption of urate depend on the experimental conditions. Excretion of urate can be depressed or enhanced by a variety of drugs belonging mainly to the aromatic acid group. Diodrast, probenecid, cinchophen and salicylates have been reported as uricosuric agents, on the other hand, lactate, benzoate, pyrazinoic acid, acetazolamide and chlorothiazide are known to be contraindicated to use for the patient with gout since these agents depress the excretion of uric acid from the kidney. However, complex and sometimes the paradoxical effects on the urate excretion by those above mentioned drugs are not uncommon. The experiments were designed to investigate the mechanisms of renal handling of urate as well as the effects of variety of drugs on the tubular transport of uric acid in the rabbits. Male or female white rabbits, from 1.5 to 2.5 kg in weight, were used. The experimental methods used in these studies were clearance, stop-flow, and retrograde injection techniques. The effects of saline, salicylate, chlorothiazide and probenecid were investigated in each experimental conditions. Results of the experiments were summarized as follows; 1. In the rabbits, the rate of urate clearance was always lower than the rate of inulin clearance. The filtration fraction of the urate was one third on an average, therefore, it is estimated that approximately two thirds of filtered urate was reabsorbed. 2. In the kidneys of rabbits, the urate clearance was increased significantly by administration of chlorothiazide and decreased by probenecid. The administration of salicylate had no effect on the rate of urate clearance. The filtration fraction of urate was increased by chlorothiazide and decreased by probenecid. 3. In the stop-flow studies, the U/P ratio of urate was higher than the U/P ratio of inulin in the proximal region, indicating the secretion of uric acid in the proximal tubules. The proximal peak was increased by chlorothiazide and inhibited by probenecid.4. In the retrograde injection studies, the reabsorption of urate in the proximal region was observed, and these reabsorptive transport of urate was depressed by either probenecid or by chlorothiazide. 5. No distal tubular activity was observed under any of these experimental conditions concerning urate transport. The results of these experiments show that probenecid inhibits both secretory and reabsorptive transport of uric acid in the kidney of the rabbits. The enhancement of secretory transport of urate by chlorothiazide in the clearance study was due to the secondary action of chlorothiazide which inhibits the reabsorptive transport of urate in the proximal tubules. It is evident that the urate transport in the kidneys of rabbits is bidirectional nondiffusive flux both secretory and reabsorptive directions in the proximal tubules.

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Covered Stenting Is an Effective Option for Traumatic Carotid Pseudoaneurysm with Promising Long-Term Outcome

  • Wang, Kai;Peng, Xiao-xin;Liu, Ao-fei;Zhang, Ying-ying;Lv, Jin;Xiang, Li;Liu, Yun-e;Jiang, Wei-jian
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.590-597
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    • 2020
  • Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

A New Species of Skate (Chondrichthyes : Rajidae), Okamejei mengae from the South China Sea (남중국해산 홍어과 (연골어강, 홍어과) 어류 신종, Okamejei mengae sp. nov.)

  • Jeong, Choong-Hoon;Nakabo, Tetsuji;Wu, Han Ling
    • Korean Journal of Ichthyology
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    • v.19 no.1
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    • pp.57-65
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    • 2007
  • A new species of the rajid genus Okamejei is described from a single specimen (295 mm TL) from off Shantou, Gwangdong in the South China Sea. The new species differs from all other congeners in the following combination of characters: snout pointed, dorsal head length 6.7 times interorbital width, tail moderately wide and long, its length 48.5% TL, interdorsal distance less than length of first dorsal fin base, postdorsal tail short as 5.8% TL, small evenly distributed dark brownish spots, without ocelli on dorsal surface of disc, pores of ampullae of Lorenzini on ventral surface distributed from snout tip to distal end of metapterygium, scapulocoracoid high, its height about 1.4 times rear corner height, trunk vertebrae 23, predorsal tail vertebrae 50 and pectoral fin radials 96.

Asexual Propagation of Kalopanax pictus by Root Cutting (근삽에 의한 음나무의 무성번식)

  • Kim, Chul-Woo;Song, Jae-Mo;Bae, Chan-Ho;Park, Bong-Jae;Moon, Heung-Kyu;Hwang, Suk-In;Yi, Jae-Seon
    • Journal of Forest and Environmental Science
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    • v.18 no.1
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    • pp.1-6
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    • 2001
  • This research was carried out to establish the large quantity propagation system for Kalopanax pictus using root cutting. The results are as follows. As there was no significant difference in the promotion of adventitious shoot development from the root cuttings of Kalopanax pictus among kinds (IBA, NAA and Kinetin) and concentrations (0 to 2000 mg/L) of growth regulators, no application is recommended, which showed more than 90% of shoot development. Horizontal and vertical placement of rooting showed more than 93% of shoot occurrence, but the latter showed more desirable growth traits in the number of shoot development, number of leaf, petiole length, and leaf length and leaf width Polarity was observed and thus normal vertical placement of root cutting is preferred. However, root cuttings placed upside down showed the shoot development at the distal end, which indicates further sophisticated test is necessary to investigate this phenomenon.

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A Comparison of Accuracy between MRI and Arthroscopic Finding in the Diagnosis of Acute ACL Tear (급성 전방십자인대 손상의 진단에 있어 관절경 소견과의 비교분석을 통한 자기공명영상의 유용성)

  • Choi, Chong-Hyuk;Yoon, Han-Kook;Kim, Bo-Ram;Yoon, Choon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.46-50
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    • 2005
  • Purpose: The purpose of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute anterior cruciate ligament (ACL) injury and its tear pattern in comparison with arthroscopic finding. Materials and Methods: Sixty consecutive patients with acute ACL injury were taken NRI followed by arthroscopic examination between January 2002 and June 2004. MRI findings were reviewed according to the presence of ACL discontinuity, diffuse swelling or thickening, focal edema, collapse on distal end, and any combined tear. The pathologic findings were then confirmed arthroscopically. The diagnostic accuracy of MRI on ACL tear pattern was analyzed by obtaining its positive predictive value. Results: All fifty two cases with presence of discontinuity on MRI showed ACL rupture arthroscopically. The location of ACL tear, diffuse swelling and focal edema on MRI also corresponded with arthroscopic findings respectively. However, the diagnostic accuracy of MRI was relatively lower in the presence of other ACL patterns such as collapses and combined tear. Conclusion: Preoperative MRI findings seem to be in accordance with arthroscopic findings and is significantly accurate in detection of location and diffuse swelling and focal edema of ACL tear.

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