• 제목/요약/키워드: Fragment removal

검색결과 63건 처리시간 0.026초

Early fragment removal on in vitro fertilization day 2 significantly improves the subsequent development and clinical outcomes of fragmented human embryos

  • Kim, Seok-Gi;Kim, Youn-Young;Park, Ji-Young;Kwak, Su-Jin;Yoo, Chang-Seok;Park, Il-Hae;Sun, Hong-Gil;Kim, Jae-Won;Lee, Kyeong-Ho;Park, Hum-Dai;Chi, Hee-Jun
    • Clinical and Experimental Reproductive Medicine
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    • 제45권3호
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    • pp.122-128
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    • 2018
  • Objective: To determine whether fragment removal on in vitro fertilization (IVF) day 2 improved the subsequent development and pregnancy outcomes of fragmented embryos compared to similar-grade embryos without fragment removal. Methods: This study was a retrospective analysis involving 191 IVF cycles in which all embryos had over 10% fragmentation (grade 3 or 4) on day 2 of the IVF-embryo transfer cycle from March 2015 to December 2017. IVF cycles were divided into the fragment removal group (n = 87) and the no fragment removal group (n = 104) as a control cohort. Before fragment removal, embryos with fragmentation on day 2 were incubated in $Ca^{2+}$- and $Mg^{2+}$-free biopsy medium under paraffin oil for 30 minutes. Microsurgical fragment removal was performed with later-assisted hatching and a handmade suction micropipette that had an outer diameter of $30{\mu}m$. Results: There were no significant differences in the characteristics of the patients between the control and the fragment removal groups. After fragment removal and subsequent in vitro culture for 24 hours, the number of blastomeres ($7.1{\pm}1.7$ vs. $6.9{\pm}1.6$) was comparable between the transferred embryos in the two groups, but the morphological grade of the embryos in the fragment removal group ($1.9{\pm}0.7$) was significantly higher than that of the control group ($3.1{\pm}0.5$, p< 0.01). The clinical pregnancy (43.7%) and implantation rates (25.8%) in the fragment removal group were significantly higher than those in the control group (28.8% and 14.0%, respectively; p< 0.05). Conclusion: Early fragment removal on day 2 significantly improved the subsequent development and pregnancy outcomes of fragmented embryos.

IVF-ET 시술 시 파편제거가 파편화된 인간배아의 발달에 미치는 효과 (Effect of Fragment Removal on Development of Human Fragmented Embryos in IVF-ET Program)

  • 지희준;구정진;이주옥;류형은;김광례;박찬;노성일
    • Clinical and Experimental Reproductive Medicine
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    • 제37권4호
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    • pp.339-348
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    • 2010
  • 목적: 본 연구는 체외수정 및 배아이식술 (In vitro fertilization-embryo transfer, IVF-ET)에서 인간의 파편화된 배아를 대상으로 수행한 파편제거술이 배아의 발달과 임상적 결과에 미치는 유용한 결과를 조사하고자 수행하였다. 연구방법: 본 연구는 전향적 연구로서 한나여성의원과 미즈메디병원에서 수행되었으며 IVF-ET 시술을 받는 60명의 환자를 대상으로 하였다. 실험군으로서 29명 환자의 106개의 파편화된 배아를 대상으로 이식하기 전 미세수술적 파편 제거술을 수행하였고 대조군으로서 31명의 환자의 122개의 파편화된 배아의 파편을 제거하지 않고 이식하였다. 파편 제거술이 파편화된 배아의 형태학적 변화와 임상적 결과에 미치는 영향을 조사하였다. 결과: 실험군 배아의 평균 형태학적 등급은 G2.79였으나 파편제거술 이후 G1.63 (p<0.001)로 유의하게 향상되었다. 대부분의 파편화된 배아는 파편제거 후 이어지는 배양과정 동안 파편화 현상이 재 발생하지 않았으며 파편이 제거된 배아의 발달에 파편제거술이 유용한 효과를 미치는 것이 관찰되었다. 실험군의 착상률과 임신율은 각각 12.3%와 31.3%이었으나 대조군은 각각 6.6%와 22.5%를 나타내었다. 이러한 두 군간의 결과의 차이는 낮은 시술 건수로 인해 통계학적 유의성은 없었다. 결론: 미세수술적 파편제거술은 파편화된 배아의 형태학적 등급뿐만 아니라 지속적인 발달능력을 향상시켰다. 파편제거술은 파편에 의해 손상된 세포간 전달체계의 복원과 파편에 의한 해로운 물질의 생성 가능성을 제거함으로써 주위의 할구들에게 이로운 효과를 나타낸 것으로 생각된다.

니켈티타늄 전동파일 파절의 예방 및 처치 (Prevention and Solution of the Fracture of Nickel-Titanium Endodontic Instruments)

  • 김현철
    • 대한치과의사협회지
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    • 제54권8호
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    • pp.640-650
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    • 2016
  • Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

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Effectiveness of a Hockey-Stick Probe to Localize a Catheter Fragment in a Dog

  • Kim, Kitae;Oh, Dayoung;Shin, Dongmin;Yoon, Junghee
    • 한국임상수의학회지
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    • 제39권4호
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    • pp.173-176
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    • 2022
  • Intravenous catheterization is a common procedure in human and veterinary medicine. Occasionally, a catheter might break within the blood vessel, and the fragment may cause embolization, infections, or other severe complications, and therefore must be removed promptly. For a successful and low-risk removal, the fragment should be localized accurately; however, ultrasound may be challenging to perform on small dogs due to inadequate probes. We report the case of a 2-year-old, 2.6 kg, intact female toy poodle that presented to the veterinary medical center owing to a recent onion intake; the owner requested to induce emesis. A 24 gauge peripheral intravenous catheter was inserted into the cephalic vein prior to the emetic injection. When the clinician removed the catheter, a device breakage was observed. A tourniquet was applied immediately proximal to the elbow. Ultrasonography was performed with a high-frequency small-footprint linear array transducer, also called a hockey-stick probe, to localize the fragment. An additional ultrasound was performed before surgery to confirm the location of the catheter piece, which migrated 5 cm proximally. Afterward, a surgical intervention allowed us to retrieve the fragment. This report highlights the effectiveness of a hockey-stick probe to determine the location of a catheter fragment in small breed dogs.

Biological Nitrogen Removal System의 세균 군집 분석 (Structure of Bacterial Communities in Biological Nitrogen Removal System)

  • 김경미;이상일;이동훈
    • 미생물학회지
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    • 제42권1호
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    • pp.26-33
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    • 2006
  • 생물학적 질소 제거(Biological nitrogen removal; BNR) 시스템의 효율적인 처리 공정을 이재하기 위하여 질산화 반응조 내 세균 군집 구조를 16S rRNA 유전자의 PCR 및 terminal restriction fragment length polymorphism (T-RELP)방법을 이용하여 분석하였다. 본 연구에서 사용한 BNR 시스템은 국내에서 비교적 많이 적용되고 있는 부상여재를 이용한 고도처리 시스템, Nutrient Removal Laboratory 시스템, 반추기법을 이용한 영양염류 처리 Sequencing Batch Reactor (SBR)시스템이었고, 실험 결과 모든 시료에서 암모니아 산화 세균과 $\beta-proteobacteria$에 해당되는 말단 단편을 확인할 수 있었다. 암모니아 산화세균 군집에서 유래된 말단 단편의 염기서열을 분석한 결과 SBR공정에서는 Nitrosomonas와 Nitrosolobus에 속하는 군집 이 우점종임을 확인할 수 있었다. 그러나 다른 두 공정들에서는 $\beta-proteobacteria$에 속하는 미배양 균주와 Cardococcus australiensis와 염기서열 유사도가 높은 군집이 우점하였다. 또한, 암모니아산화 세균군집을 분석한 결과, SBR 공정이 암모니아 산화세균의 농화 배양에 가장 효과적인 것으로 나타났다. 이러한 결과는 각 BNR 시스템에 동일한 폐수가 유입되었음에도 불구하고 서로 다른 세균 군집 구조를 형성하고 있음을 의미한다.

완전 거치형 정맥도관의 완전 절단 (Complete Fracture of Totally Implantable Venous Catheter)

  • 김정태;장운하;오태윤
    • Journal of Chest Surgery
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    • 제39권12호
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    • pp.946-948
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    • 2006
  • 42세 여자 환자로 유방암으로 인한 항암치료를 위해 왼쪽 쇄골하정맥으로 완전 거치형 정맥도관(totally implantable venous catheter)을 삽입하였다. 삽입 직후 단순 흉부 방사선 사진상 도관에는 특이 소견이 없었다. 환자는 3개월 후 4번째 항암치료를 위해 입원하였으나 도관을 통해 피가 역류되지도 않고 주입되지도 않았다. 단순 흉부 방사선 사진상 도관이 쇄골 밑을 지나는 부위에서 완전 절단되어 있었다. 경피적 방법으로 도관의 원위부위를 성공적으로 제거한 후 환자는 퇴원하였다.

상대정맥내 폴리에틸렌관 잔존물 치험 1례 (A Retained Polyethylene Catheter Fragment in Superior Vena Cava - A case report-)

  • 김주현
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.134-137
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    • 1980
  • This represents a case report of the retained polyethylene catheter fragment in superior vena cava. A 39 year old male was admitted to this Korea University Hospital a short time after compression wound on abdomen with heavy cement material in emergency room, a polyethylene catheter was introduced into the right subclavian vein through a needle. But when the polyethylene catheter was attempted to withdraw the catheter was severed by the beveled tip of the needle. Later that day, chest X-ray disclosed the presence of the fragment extending from right subclavian vein to the superior vena cava. {Fig. 1 and Fig. 2]. Local exploration by way of an infraclavicular incision was unsuccessful in locating the catheter fragment. Another attempt was then made remove the catheter by means a biotome, which is originally a device for the biopsy of the myocardium, introduced through the right great saphenous vein. This procedure, though well tolerated by the patient, was in vain. After 11 days later, during that time he was taken a laparotomy with drain, another operation for removal of retained catheter fragment was performed through median sternotomy. After exposure of the right subclavian vein, innominate vein, and superior vena cava, an incision 1 cm in |length was made directly over the palpated catheter. The catheter immediately was picked upward and removed. The length of the catheter was approximately 8 cm. [Fig 3 ] There was no evidence of thromboembolism from the catheter or other complications. The patient made an uneventful recovery, and was discharged asymptomatic on the 9th postoperative day.

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소아에서 생긴 견갑골 관절와 골절편의 상방 전위에 의한 견관절 충돌 운동 장애 - 증례 보고 - (Shoulder Impingement Caused by Superiorly Displaced Glenoid Fracture Fragment at a Boy - A Case Report -)

  • 전경일;박경진;김용민;김동수;최의성;손현철;최현식;박지강
    • Clinics in Shoulder and Elbow
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    • 제9권2호
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    • pp.231-234
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    • 2006
  • We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

Posterior Epidural Migration of Thoracic Disc Fragment

  • Kim, Il-Sup;Lee, Sang-Won;Son, Byung-Chul;Sung, Jae-Hoon
    • Journal of Korean Neurosurgical Society
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    • 제43권5호
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    • pp.239-241
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    • 2008
  • Migration of a disc fragment to the posterior epidural space is rare, especially in the thoracic spine. Only four such cases of posterior epidural migration of thoracic disc fragments have been reported. The authors report a case of 66-year-old man who presented with back pain and right leg weakness due to posterior epidural migration of thoracic disc fragment. The patient was successfully treated by laminectomy and partial facetectomy with disc removal.

Field Studios of In-situ Aerobic Cometabolism of Chlorinated Aliphatic Hydrocarbons

  • Semprini, Lewts
    • 한국지하수토양환경학회:학술대회논문집
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    • 한국지하수토양환경학회 2004년도 총회 및 춘계학술발표회
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    • pp.3-4
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    • 2004
  • Results will be presented from two field studies that evaluated the in-situ treatment of chlorinated aliphatic hydrocarbons (CAHs) using aerobic cometabolism. In the first study, a cometabolic air sparging (CAS) demonstration was conducted at McClellan Air Force Base (AFB), California, to treat chlorinated aliphatic hydrocarbons (CAHs) in groundwater using propane as the cometabolic substrate. A propane-biostimulated zone was sparged with a propane/air mixture and a control zone was sparged with air alone. Propane-utilizers were effectively stimulated in the saturated zone with repeated intermediate sparging of propane and air. Propane delivery, however, was not uniform, with propane mainly observed in down-gradient observation wells. Trichloroethene (TCE), cis-1, 2-dichloroethene (c-DCE), and dissolved oxygen (DO) concentration levels decreased in proportion with propane usage, with c-DCE decreasing more rapidly than TCE. The more rapid removal of c-DCE indicated biotransformation and not just physical removal by stripping. Propane utilization rates and rates of CAH removal slowed after three to four months of repeated propane additions, which coincided with tile depletion of nitrogen (as nitrate). Ammonia was then added to the propane/air mixture as a nitrogen source. After a six-month period between propane additions, rapid propane-utilization was observed. Nitrate was present due to groundwater flow into the treatment zone and/or by the oxidation of tile previously injected ammonia. In the propane-stimulated zone, c-DCE concentrations decreased below tile detection limit (1 $\mu$g/L), and TCE concentrations ranged from less than 5 $\mu$g/L to 30 $\mu$g/L, representing removals of 90 to 97%. In the air sparged control zone, TCE was removed at only two monitoring locations nearest the sparge-well, to concentrations of 15 $\mu$g/L and 60 $\mu$g/L. The responses indicate that stripping as well as biological treatment were responsible for the removal of contaminants in the biostimulated zone, with biostimulation enhancing removals to lower contaminant levels. As part of that study bacterial population shifts that occurred in the groundwater during CAS and air sparging control were evaluated by length heterogeneity polymerase chain reaction (LH-PCR) fragment analysis. The results showed that an organism(5) that had a fragment size of 385 base pairs (385 bp) was positively correlated with propane removal rates. The 385 bp fragment consisted of up to 83% of the total fragments in the analysis when propane removal rates peaked. A 16S rRNA clone library made from the bacteria sampled in propane sparged groundwater included clones of a TM7 division bacterium that had a 385bp LH-PCR fragment; no other bacterial species with this fragment size were detected. Both propane removal rates and the 385bp LH-PCR fragment decreased as nitrate levels in the groundwater decreased. In the second study the potential for bioaugmentation of a butane culture was evaluated in a series of field tests conducted at the Moffett Field Air Station in California. A butane-utilizing mixed culture that was effective in transforming 1, 1-dichloroethene (1, 1-DCE), 1, 1, 1-trichloroethane (1, 1, 1-TCA), and 1, 1-dichloroethane (1, 1-DCA) was added to the saturated zone at the test site. This mixture of contaminants was evaluated since they are often present as together as the result of 1, 1, 1-TCA contamination and the abiotic and biotic transformation of 1, 1, 1-TCA to 1, 1-DCE and 1, 1-DCA. Model simulations were performed prior to the initiation of the field study. The simulations were performed with a transport code that included processes for in-situ cometabolism, including microbial growth and decay, substrate and oxygen utilization, and the cometabolism of dual contaminants (1, 1-DCE and 1, 1, 1-TCA). Based on the results of detailed kinetic studies with the culture, cometabolic transformation kinetics were incorporated that butane mixed-inhibition on 1, 1-DCE and 1, 1, 1-TCA transformation, and competitive inhibition of 1, 1-DCE and 1, 1, 1-TCA on butane utilization. A transformation capacity term was also included in the model formation that results in cell loss due to contaminant transformation. Parameters for the model simulations were determined independently in kinetic studies with the butane-utilizing culture and through batch microcosm tests with groundwater and aquifer solids from the field test zone with the butane-utilizing culture added. In microcosm tests, the model simulated well the repetitive utilization of butane and cometabolism of 1.1, 1-TCA and 1, 1-DCE, as well as the transformation of 1, 1-DCE as it was repeatedly transformed at increased aqueous concentrations. Model simulations were then performed under the transport conditions of the field test to explore the effects of the bioaugmentation dose and the response of the system to tile biostimulation with alternating pulses of dissolved butane and oxygen in the presence of 1, 1-DCE (50 $\mu$g/L) and 1, 1, 1-TCA (250 $\mu$g/L). A uniform aquifer bioaugmentation dose of 0.5 mg/L of cells resulted in complete utilization of the butane 2-meters downgradient of the injection well within 200-hrs of bioaugmentation and butane addition. 1, 1-DCE was much more rapidly transformed than 1, 1, 1-TCA, and efficient 1, 1, 1-TCA removal occurred only after 1, 1-DCE and butane were decreased in concentration. The simulations demonstrated the strong inhibition of both 1, 1-DCE and butane on 1, 1, 1-TCA transformation, and the more rapid 1, 1-DCE transformation kinetics. Results of tile field demonstration indicated that bioaugmentation was successfully implemented; however it was difficult to maintain effective treatment for long periods of time (50 days or more). The demonstration showed that the bioaugmented experimental leg effectively transformed 1, 1-DCE and 1, 1-DCA, and was somewhat effective in transforming 1, 1, 1-TCA. The indigenous experimental leg treated in the same way as the bioaugmented leg was much less effective in treating the contaminant mixture. The best operating performance was achieved in the bioaugmented leg with about over 90%, 80%, 60 % removal for 1, 1-DCE, 1, 1-DCA, and 1, 1, 1-TCA, respectively. Molecular methods were used to track and enumerate the bioaugmented culture in the test zone. Real Time PCR analysis was used to on enumerate the bioaugmented culture. The results show higher numbers of the bioaugmented microorganisms were present in the treatment zone groundwater when the contaminants were being effective transformed. A decrease in these numbers was associated with a reduction in treatment performance. The results of the field tests indicated that although bioaugmentation can be successfully implemented, competition for the growth substrate (butane) by the indigenous microorganisms likely lead to the decrease in long-term performance.

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