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Aortic Valvuloplasty Using Leaflet Extension Technique (판막첨 연장술을 이용한 대동맥판막 성형술의 중기성적 평가)

  • Ahn, Hyuk;Kim, Hyun-jo
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.656-662
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    • 1997
  • Aortic valvuloplasty has recently gained attention as an attractive alternative procedure for aortic valvular disease. Between March 1995 to August 1996, 14 patients with pure aortic regurgitation(AR) underwent aortic alvuloplasty using leaflet extension with glutaraldehydepreserved autologous pericardium. There were 11 males and 3 females, and the mean age was 34.8 $\pm$ 15.3 years. Preoperative echocardiography and cardiac catheterization revealed that the degree of AR was mean 3.4$\pm$0.65, and more than moderate degree of mitral regurgitation(MR) were detected in 4 patients. In 12 patients, 3 leaflets were extended and in another 2 patients only one deformed leaflet was extended. Concomitant mitral valvuloplasty (MVP) was performed in 4 patients. The competency of the aortic valve after completion of repair was evaluated by the transesophageal echocardiography in operating theater, and there was no aortic and mitral stenosis or regurgitation. In an early postoperative echocardiography, trivial AR was detected in 3 patients and mild MR in 1 patient. The end-systolic and end-diastolic dimensions of the left ventricle were decreased significantly(p<0.05) as compared with those of preoperative values. T ere was no mortality and no significant postoperative complication encountered. Late complication developed in 2 patients during the follow-up period(mean 7.9$\pm$ 5.9 months). One patient underwent AVR on postoperative 7th month due to endocarditis, and the another patient with Behcet's disease underwent Ross operation at postoperative 4th month. In conclusion, AVP of leaflet extension technique offers an excellent early clinical result and represents a good alterna!ivy surgical treatment for the pure AR especially in young age group, although long-term follow-up is necessary to determine the durability of glutaraldehyde-preserved autologous pericardium as a valve leaflet.

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Effects of Soil Organic Matter Content on Activity Change, Vertical Migration, and Persistence of Two Nematicides, Carbofuran and Ethoprophos, to Root-Knot Nematode, Meloidogyne incognita (토양중 유기물함량 차이에 따른 고구마뿌리혹선충(Meloidigyne incognita)에 대한 Carbofuran과 Ethoprophos의 효력변동, 수직이동성 및 잔효성조사)

  • Song, Cheol;Hwang, In-Taek;Jang, Kyoung-Soo;Cho, Kwang-Yun
    • Korean journal of applied entomology
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    • v.38 no.1
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    • pp.47-52
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    • 1999
  • Effects of organic matter content in soil on activity. vertical migration. and persistence of two nernaticides. carbofuran and ethoprophos. to root-knot nematode, Mrloitlog!~iei ~lcognita.w ere investigated. As the organic matter content increased. activity of the nernaticides tended to be reduced. Both nematicides exhibited control values of more than 80'k' to M. iix.o,yilit~iln 0-2 cm depth soil layer from the surface. regi~rdless of organic matter content in soil. In 2-4 cm depth soil layer. however. the control value of the neniaticides varied with the organic niatter content in soil. The control value of carbofuran in the soil layer was ranged from I0 to 30'2,. depending on the soil organic niatter content. In contrast. ethoprophos had no control value against M. i/ic.o,ytlitcr in the \oil layer, except that the nematicide had a control value of 30% when the organic matter content was 0.4%. Furthermore. ethoprophos had no effect on controlling M. i/ic.o,gtiitrr in soil layer of below 4cm. whereas control values of carbofuran were approximately from 5 to 20% in all test soils having different organic matter contents. These results indicate that carbofuran has more vertical migration effect than ethoprophos. Persistence of the two neniaticides was also decreased with increasing soil organic matter content. Half life of carbofuran was 2-3 weeks in soil containing 0.4% organic matter, whereas it was found to be I week in soils containning 0.8 ant1 1.6% of organic matter. On the other hand. activity of ethoprophos was reduced to half in 3-3 weeks and in 2-3 weeks in soil containing 0.4 and 0.8%, and 1.6%) of organic matter, respectively. However, no activity of the both nernaticides was found in soil containing 3.2% of organic matter.

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A study on health education content analysis in middle school curriculum (중학교 교과과정에 따른 보건교육 내용 분석 연구)

  • You, Jai Bok
    • Journal of the Korean Society of School Health
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    • v.3 no.1
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    • pp.59-72
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    • 1990
  • The study reserches the related contents of the health education in the existing gymnastics and the domestics textbook, catches learning-Ulaching contents by the health-control function and compares the contents with the health-education curriculum of the Texas State in America. This study is questioned and reserched the general features of the teachers who is change in the health education, their attitudes about the teaching of it, and the recognition degree about their health education. The results above is like the following. 1. Learning-teaching contents by the health-control function. The domestics and gymnastics which contains the health education contents, is not discripted continually and at the same time is short of the contents in the health-control function according to the students' individual domains. Also the recent serious problems, (that is, Smoking, Drinking and Medical poisoning, Emotion, and Psychic domains) were no mentioned. 1) In gymnastics textbook, the physical domains are mentioned 8, 9 in juinor, and senior class, the affective, psychic domains only senior class and the social domains only 1 grade except junior and senior class. Growth-development function is concentratedly stated only 1 grade in physical domains and there is no stated in. The social domains are referred a little in senior class. In cure-recovery functions, the physical domains is being taught in 2, and 3 grade, but not 1 grade. Specially, the social domains are being taught in all grade, but, the affective domains are not at all 2) In the subject of domestics, the physical domains of the daily life functions are taught in all the years, but the emotional, mental domains are taught a little in 1 and 2 grades. The growth-development functions are being taught about the nutrition-health, in the physical parts of all graries, and the emotional-mental, social domains are being taught some in 7 and 8 grade except 3 grade, he cure-recovery functions ere taught in only 1 grade, the contents of rehabilitative functions are not being taught like gymnastics. 2. The general characteristics of the health-education teachers and the health-education. In the calss field, the average age of gymnastics-teachers is from 35 to 40 years old, and it of domestics teachers is from 24 to 29 years old. 1) In the class-hours a week, the gymnastics teachers take lessons 3 hours (75.6%) and the domestics teachers 4 hours (65.6%). In "the health-lessons hours alloted"in a semister, 3 or 4 hours is 38.7% and no hours is 18.0% in gymnastics teachers. On the other hand, there is no hours to teach the health-education in domestics teachers. About the opinion: the health subject must be taught as a independent subject, 42.9% of the gymnastics teachers agreed and 45.3 % of the domestics teachers did. 2) The factors which have an influence upon the health-teachers #. In age, the class lesson hours of a week(r= .0014), the confident manner about the lessons(r= .0485) and the necessity of the lessons (r= .0316) are closely related one another. #. In sexes, the lesson hours a class(r= .0000), the alloted hours of health lesson a semister(r= .0000) the confident manner about the class(r= .0001). the quantity of lesson(r= .0001): and, the teacher's belief(r= .0264) are co-related one another. #. In subject in change. the class hours a week(r= .0000), the alloted hours of health-lesson a semister(r= .0000) the quantity of the lesson(r= .0114) are co-related each other. #. In majority, the class lesson hours a week(r= .0000) the alloted hours of health lesson a semister(r= .0000) the quantity of the lesson are co-related each other. The quantity of lesson and the confidence about the lesson (r= .3223) and the quantity of lesson and the interest of lesson (r= .2450) are co-related each other.

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Quantitative Analysis of Amylose and Protein Content of Rice Germplasm in RDA-Genebank by Near Infrared Reflectance Spectroscopy (근적외선 분광분석법을 이용한 벼 유전자원의 아밀로스 함량과 단백질 함량 정량분석)

  • Kim, Jeong-Soon;Cho, Yang-Hee;Gwag, Jae-Gyun;Ma, Kyung-Ho;Choi, Yu-Mi;Kim, Jung-Bong;Lee, Jeong-Heui;Kim, Tae-San;Cho, Jong-Ku;Lee, Sok-Young
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.53 no.2
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    • pp.217-223
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    • 2008
  • Amylose and protein contents are important traits determining the edible quality of rice, especially in East Asian countries. Near-Infrared Reflectance Spectroscopy (NIRS) has become a powerful tool for rapid and nondestructive quantification of natural compounds in agricultural products. To test the practically of using NIRS for estimation of brown rice amylose and protein contents, the spectral reflectances ($400{\sim}2500\;nm$) of total 9,483 accessions of rice germplasm in Rural development Administration (RDA) Genebank ere obtained and compared to chemically determined amylose and protein content. The protein content of tested 119 accessions ranged from 6.5 to 8.0% and 25 accessions exhibited protein contents between 8.5 to 9.5%. In case of amylose content, all tested accessions ranged from 18.1 to 21.7% and the grade from 18.1 to 19.9% includes most number of accessions as 152 and 4 accessions exhibited amylose content between 20.5 to 21.7%. The optimal performance calibration model could be obtained from original spectra of brown rice using MPLS (Modified Partial Least Squares) with the correlation coefficients ($r_2$) for amylose and protein content were 0.865 and 0.786, respectively. The standard errors of calibration (SEC) exhibited good statistic values: 2.078 and 0.442 for amylose and protein contents, respectively. All these results suggest that NIR spectroscopy may serve as reputable and rapid method for quantification of brown rice protein and amylose contents in large numbers of rice germplasm.

Prevention of Discoloration and Storage Stability in Canned Ark Shell (새고막 통조림 변색방지 및 저장중 품질변화)

  • 배태진;김귀식
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.243-248
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    • 1998
  • Ark shell was known as shellfish that had hemoglobin as blood pigment and the action of mecidine, was consumed the great part of it as raw material, though it was produced about 13,000 M/T per year. Ark shell was processed the infinitesimal quantity as conned product, bout canned ark shell had problem that occurrenced discoloration after heat treatment during processing and storage. This discoloration mechanism during processing and storage was not cleared. This study was carried out to understand characteristics of the hemoglobin as blood pigment and carotenoid as meat pigment in ark shell and management of proper processing conditions for prevention of oxidation and discoloration by thermal treatment. When treated by digestion of 0.1% BHA, 0.1% Tenox-II, 0.5% Na2EDTA, 0.05% NDGA and 3% salt soln., 0.1% BHA solution was most suitable for stability of carotenoid that the retention ratio of carotenoids were 63.1% after heating to 116$^{\circ}C$ for 120 minutes. In preparation of canned ark shell and storage at 37$\pm$1$^{\circ}C$ for 60 days, the chemical composition, pH and salinity ere stable. And contents of total carotenoid were decreased slightly from 0.83mg% to 0.727mg%. The viable cell count were 6.92$\times$103 cfu/ml at raw ark shell, after processed and storage were not detected. The predominant amino acids in the raw ark shell were glutamic acid(19.7%), arginine(16.0%), glycine(12.6%), alanine(12.2%) and aspartic acid(7.6%). When 60 days stored, the contents of amino acid were stable. And the predominant nuclotide and their related compounds in the raw ark shell were hypoxanthine(2.14$\mu$mol/g), IMP(1.94$\mu$mol/g) and ATP(0.87$\mu$mol/g), and storage at 37$\pm$1$^{\circ}C$ for 60 days, the quantity order were same as raw material.

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Automatic Detection of Stage 1 Sleep (자동 분석을 이용한 1단계 수면탐지)

  • 신홍범;한종희;정도언;박광석
    • Journal of Biomedical Engineering Research
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    • v.25 no.1
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    • pp.11-19
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    • 2004
  • Stage 1 sleep provides important information regarding interpretation of nocturnal polysomnography, particularly sleep onset. It is a short transition period from wakeful consciousness to sleep. Lack of prominent sleep events characterizing stage 1 sleep is a major obstacle in automatic sleep stage scoring. In this study, we attempted to utilize simultaneous EEC and EOG processing and analyses to detect stage 1 sleep automatically. Relative powers of the alpha waves and the theta waves were calculated from spectral estimation. Either the relative power of alpha waves less than 50% or the relative power of theta waves more than 23% was regarded as stage 1 sleep. SEM (slow eye movement) was defined as the duration of both eye movement ranging from 1.5 to 4 seconds and regarded also as stage 1 sleep. If one of these three criteria was met, the epoch was regarded as stage 1 sleep. Results f ere compared to the manual rating results done by two polysomnography experts. Total of 169 epochs was analyzed. Agreement rate for stage 1 sleep between automatic detection and manual scoring was 79.3% and Cohen's Kappa was 0.586 (p<0.01). A significant portion (32%) of automatically detected stage 1 sleep included SEM. Generally, digitally-scored sleep s1aging shows the accuracy up to 70%. Considering potential difficulties in stage 1 sleep scoring, the accuracy of 79.3% in this study seems to be robust enough. Simultaneous analysis of EOG provides differential value to the present study from previous oneswhich mainly depended on EEG analysis. The issue of close relationship between SEM and stage 1 sleep raised by Kinnariet at. remains to be a valid one in this study.

Die Korrelation zwischen der DG und GB-Theorie (의존문법과 생성문법 간의 상호관계)

  • Rhie Jum-Chool
    • Koreanishche Zeitschrift fur Deutsche Sprachwissenschaft
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    • v.5
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    • pp.143-166
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    • 2002
  • Das Ziel dieses Aufsatzes liegt darin, auf Grund der Theorien von einigen Grammatikern die Korrelation zwischen der Dependenzgrammatik (=DG) und GB­Theorie(=GB) zu beschreiben. Nach Eroms(2000) sind VPn in eine engere Phrase, die die $Erg\"{a}nzungen$ in obliquen Kasus bindet, und eine $\"{a}u{\ss}ere$, die Subjektsvalenz abbindet, zu trennen. Dem INFL-Phrasenkopf der GB entspricht das Finitheitsmorphem in der DG. In der $herk\"{o}mmlichen$ DG steht das Verb an der Spitze des Satzes, aber Eroms(2000) stellt S an die Satzspitze. Die S(mit S., S?, S!) sind $n\"{a}mlich$ oberstes Element des Satzes, von dem alle anderen $W\"{o}rter\;abh\"{a}ngig$ sind. Die Konjunktionen regieren ihren Satz, bzw. der Satz wird durch sie gesteuert. Damit ist die Analogie zur X-bar-Syntax $vollst\"{a}ndig$. Nach Vater(l996) lasst sich die Struktur der deutschen VP systernatisch nach dem X-bar-Schema darstellen, wobei die Zuordnung der Objekte mehrere $M\"{o}glichkeiten\;zul\"{a}sst$. X-bar-Regeln allein $k\"{o}nnen$ nicht die Vielfalt $m\"{o}glicher$ VP-Strukturen erzeugen. Hier greifen V-bar-Regeln und Valenz ineinander. Vater(l996) $schl\"{a}gt$ vor, den von $\'{A}gel(1993)$ vorgeschlagenen Unterschied zwischen Valenzpotenz und Valenzrealisierung zu $ber\"{u}cksichtigen$, um die verschiedenen syntaktischen und morphologischen Realisierungen zwischen verschiedenen Sprachen in den Griff zu bekommen. $\'{A}gel(1993, 2000)$ nimmt in Anlehnung an $L\'{a}szlo(l988)$ zwei Realisierungsebenen der Valenz, die Mikroebene(=die der morphologischen Aktanten) und die Makroebene(=die der syntaktischen Aktanten) an. Der $Tr\"{a}ger$ auf Mikroebene ist der Mikroaktant, also der Teil des Verbflexivs, der $Tr\"{a}ger$ auf Makroebene ist der Makroaktant, also das syntaktische Subjekt. Die Begriffe 'Mikroebene' und 'Makroebene' werden sowohl statisch und als auch dynamisch interpretiert. Auf Grund dieser Begriffe versucht $\'{A}gel(1993, 2000)$, nach Parallelen der Valenzrealisierung in S und NP zu suchen. Aber die Untersuchung der $Valenzrealisierungsverh\"{a}ltnisse$ in der NP wird zu einem scheinbaren typologischen Gegensatz zwischen S und NP $f\"{u}hren$. Um diesen Gegensatz $aufzul\"{o}sen$, wird das Konzept 'finites Substantiv' $eingef\"{u}hrt$, das analog zum Konzept 'finites Verb' ist. Dabei wird die sog. starke Adjektivflexion in einen Teil der Substantivflexion uminterpretiert. Die GB-Theorie definiert sich als eine Theorie der sog. mentalen Grammatik, des $Sprachverm\"{o}gens$. Da als der Gegenstand der DG die sog. objektive Grammatik angesehen werden kann, scheint der grundlegende Unterschied zwischen den $Gegenst\"{a}nden$ beider Theorien in der Opposition 'intem(=mental vs. extern (=objektiv)' zu liegen. Da die GB eine 'naturwissenschaftlicher' organisierte Theorie ist als die empirische Richtung der DG, ware eine Vergleichsgrundlage in der Tat nicht einfach zu etablieren. Obwohl die beiden Theorien von $v\"{o}llig$ anderen Voraussetzungen und Zielsetzungen ausgehen, gibt es zwischen der DG und der GB $\"{U}berlappungen$ und zunehmende $Ann\"{a}herungen$. Generell ist es notwendig, dass Teileinsichten aus einer Theorie in eine andere Theorie $\"{u}bernommen$ werden. In diesem Aufsatz konnten wir durch die Untersuchung der Korrelation von beiden Theorien partielle Konvergenzen erkennen. Nach Engel(l994) gibt es keine Grammatik 'an sich', sie wird von Grammatikern gemacht. Grammatiken sind Menschenwerk und Linguistenwerk. Wir sind auf der Suche nach 'einer besseren Grammatik.'

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Comparison and Analysis between Human Breast Cancer Cells and Hepatoma Cells for the Effects of Xenobiotic Nuclear Receptors (Constitutive Androstane Receptor, Steroid and Xenobiotic Receptor, and Peroxisome-Proliferator-Activated Receptor γ ) on the Transcriptional Activity of Estrogen Receptor (유방암 세포와 간암세포에 있어서 에스트로겐 수용체의 전사조절기능에 대한 Xenobiotic 핵 수용체 (Constitutive Androstane Receptor, Steroid and Xenobiotic Receptor, Peroxisome-Proliferator-Activated Receptor γ )의 영향 비교분석)

  • 민계식
    • Journal of Life Science
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    • v.13 no.3
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    • pp.314-323
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    • 2003
  • The purpose of this study was to examine the effects of xenobiotic nuclear receptors, CAR, SXR, and PPAR${\gamma}$ on the transcriptional activity of estrogen receptor in human breast cancer cell lines and compare with those in human hepatoma cell line. Two different breast cancer cell lines, MCF-7 and MDA-MB-231 were cultured and effects of CAR, SXR, and PPAR${\gamma}$ on the ER-mediated transcriptional activation of synthetic (4ERE)-tk-luciferase reporter gene were analyzed. Consistent with the previous report, CAR significantly inhibited ER-mediated transactivation and SXR repressed modestly whereas the PPAR${\gamma}$ did not repress the ER-mediated transactivation. However, in breast cancer cells neither of the xenobiotic receptors repressed the ER-mediated transactivation. Instead, they tend to increase the transactivation depending on the cell type and xenobiotic nuclear receptors. In MCF-7, SXR but neither CAR nor PPAR${\gamma}$ slightly increased ER-mediated transactivation whereas in MDA-MB-231, CAR and PPAR${\gamma}$ but not SXR tend to increase the transactivation of the reporter gene. These results indicate that the effects of ER cross-talk by the CAR, SXR, and PPAR${\gamma}$ , are different in breast cancer cells from hepatoma cells. In conclusion, the transcriptional regulation by estrogen can involve different cross-talk interaction between estrogen receptor and xenobiotic nuclear receptors depending on the estrogen target cells.

Electron Microscopic Studies on Olfactory Bulbs in the Vertebrates by Phylogenetics (계통발생에 따른 척추동물의 뇌후구에 대한 전자현미경적 연구)

  • Choi, W.B.;Chung, Y.H.;Seo, J.E.
    • Applied Microscopy
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    • v.15 no.2
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    • pp.31-68
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    • 1985
  • Authors are trying to unveil the ultrastructural organization of olfactory bulb, which has been summerized under light microscopic level or communicated only in some detail in different view point until now. For the critical point of view, since the phylogenetical approach will give the ultimate value in the correlative study between structural and functional bases (Brodal, 1969), the present study was carried out light and electron microscopic analyses of the structures of the neurons and synaptic organizations in olfactory bulbs from different animals in phylogenetical scale. We selected each one species from five animal classes: the house rabbit(Oryctolagus cuniculus var. domesticus [Gmelin]) from Mammalia, the domestic fowl (Gallus gallus domesticus Brisson) from Aves, the viper (Agkistrodon hylys [G.P. Pallas]) from Reptilia, a frog (Bombiana orientalis Boulenger) from Amphibia and the crussian carp (Carassius carassius [Linne]) from Pisces. For light microscopic study, samples were fixed in 10% formalin and paraffin sections were stained with hematoxylin-eosin. For the electron microscopic study, the tissues were fixed by perfusion through the heart or immersion with 1% paraform-aldehyde-glutaraldehyde mixture (phosphate buffer, pH 7.4), and final tissue block trimmed under dissecting microscope were osmicated (1% OsO4), they were embedded in Araldite or Epon 812, and ultrathin sections were made by LKB-V ultratome following the inspection of semi-thin sections stained with toluidine blue-borax solution. Ultra-thin sections contrasted with uranyl acetate and lead citrate were observed with JEM 100CX electron microscope. We have summerized our morphological analyses as follows: 1. The olfactory bulb of rabbit, viper and frog shows the eight layers of fila olfactoria, glomerular, external granular, external plexiform, mitral cell, internal plexiform, internal granular, medullary but domestic fowl shows the five layers of glomerular, fibrillar, mitral, granular and medullary and the three layers of fibrilla, glomerular and medullary in crussian carp. The sharpness of demarcation between the layers shows deferential tendency according to phylogenetical order. 2. Mitral cells of vertebrate have large triangular or oval shape with spherical nuclei which contain not so much chromatin. The cytoplasm contains numerous cell organelles, of which Nissl's bodies or granular endoplasmic reticula arranged as parallel strands. Development of granular endoplasmic reticula were declined as the phylogentical grade is going lower. 3. Tufted cells of all animal are mostly spindle or polygonal contour and contain oval nuclei which located in periphery of cytoplasm. The nuclei of rabbit, fowl, viper and frog has relatively space chromatin, but a nucleus of crussian carp contain irregularly aggregated chromatin in karyoplasm. Their cytoplasmic volume and cell organelle contents are in between those of mitral cell and granular cell. They contain moderate amount of mitochondria, granular endoplasmic reticula, a few Golgi complex, polysomes, lysosome, etc. 4. Granule of cells of all the vertebrate amimals studied exhibit similar features; cells and their dense nuclei show spherical or oval contour, and they have the thin rim of cytoplasm which contain only a few cell organelles. 5. In rabbit, the soma of mitral cells were in contact with boutons with two types of synaptic vesicles, that is, round and flat vesicles, especially flat vesicles in boutons were showing reciprocal synapses. However, in domestic fowls, vipers, frogs and crussian carps, there were found boutons showing only spherical synaptic vesicles. 6. The boutons containing round synaptic vesicles were made contact with the some of tufted cell of olfactory bulb in the rabbits, fowls, vipers and frogs, but no synaptic boutons were observed in soma of tufted cells in crussian carps. In the frogs, there were observed dendrites were contact with the soma of tufted cells. 7. In the neuropils of plexiform, granular and glomerular layers olfactory bulbs in the vertebrate, the synapses were axo-large dendrites, axo-median and small dendrites, dendrodendritic, and axo-axonal contacts. However, in the neuropil of crussian carps, synapses were observed only in glomerular layer.

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Prevention of thromboembolism with ticlopidine and aspirin after cardiac valve replacement (심장변막치환후 Ticlopidine과 Aspirin의 혈전방지 효과)

  • Kim, Gwang-Taek;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.35-42
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    • 1986
  • Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

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