Ischemic myocardial damage is inevitable to cardiac surgery. Myocardial damage after initiation of reperfusion through the coronary arteries is one of the most important determinants of a successful surgery. Adenosine is a potent vasodilator, and is also known to induce rapid cardioplegic arrest by its property of antagonizing cardiac calcium channels and activating the potassium channel. Thus, we initiated this study with adenosine to improve postischemic recovery in the isolated rat heart. We tested the hypothesis that adenosine could be more effective than potassium in inducing rapid cardiac arrest and enhancing postischemlc hemodynamic recovery. Isolated rat hearts, connected to the Langendorff appratus, were perfused with Krebs-Henseleit buffer and all hearts were subjected to arrest for 60 minutes. Three groups of hearts were studied according to the composition of cardioplegic solutions : Group A (n=10), adenosine 10mmo1/L+potassium free modified St. Thomas cardioplegia : Group B (n=10), adenosine 400mo1/L+S1. Thomas cardioplegia:Group C(control, n=10), St. Thomas cardioplegia. Adenosine-treated groups (group A & B) resulted in more rapid cardiac arrest than control group (C) (p< 0.01). There was greater improvement in recovery of coronary blood flow at 20 and 30 minutes of reperfusion in group A and at 20 minutes in group B when compared with control group(p<0.01). Recovery of systolic blood pressure at 10 minutes after reperfusion in group A and B was significantly superior to that in group C (p<0.01). Recovery of dp/dt at 10 minute after reperfusion in group A was also significantly superior to group C (p<0.05). Group A and B showed better recovery rates than control group in aortic blood flow, cardiac output, and heart rate, but there were no statistical differences. CPK levels of coronary flow in group A were significantly low (p< 0.01). We concluded that adenosine-enriched cardioplegic solutions have better effects on rapid cardiac arrest and postischemic recovery when compared with potassium cardioplegia.
Kim, Tae-Hyung;So, Yong-Seon;Kweon, Ki-Hyeon;Han, Sang-Woong;Kim, Seok-Hwan;Kim, Jong-Soon;Han, Seung-Soo
The Korean Journal of Nuclear Medicine
/
v.30
no.1
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pp.130-138
/
1996
Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.
It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.
Purpose: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. Methods: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. Results: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). Conclusion: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.
Kim, Hyung-Tae;Sung, Si-Chan;Kim, Si-Ho;Chang, Yun-Hee;Ahn, Hyo-Yeong;Lee, Hyoung-Doo
Journal of Chest Surgery
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v.44
no.2
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pp.115-122
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2011
Background: The intramural coronary artery has been known as a risk factor for early death after an arterial switch operation (ASO). We reviewed the morphological characteristics and evaluated the early and mid-term results of ASO for patients with an intramural coronary artery. Materials and Methods: From March 1994 to September 15th 2010, 158 patients underwent ASO at Dong-A and Pusan National University Hospitals for repair of transposition of the great arteries and double outlet right ventricle. Among these patients, 14 patients (8.9%) had an intramural coronary artery. Mean age at operation was $13.4{\pm}10.2$ days (4 to 39 days) and mean body weight was $3.48{\pm}0.33$ kg (2.88 to 3.88 kg). All patients except one were male. Eight patients had TGA/IVS and 4 patients had an aortic arch anomaly. Two patients (14.3%) had side-by-side great artery relation, of whom one had an intramural right coronary artery and the other had an intramural left anterior descending coronary artery. Twelve patients had anterior-posterior relation, all of whom had an intramural left coronary artery (LCA). The aortocoronary flap technique was used in coronary transfer in 8 patients, of whom one patient required a switch to the individual coronary button technique 2 days after operation because of myocardial ischemia. An individual coronary button implantation technique was adopted in 6, of whom 2 patients required left subclavian artery free graft to LCA during the same operation due to LCA injury during coronary button mobilization and LCA torsion. Results: There was 1 operative death (7.1%), which occurred in the first patient in our series. This patient underwent an aortocoronary flap procedure for coronary transfer combining aortic arch repair. Overall operative mortality for 144 patients without an intramural coronary artery was 13.2% (19/144). There was no statistical difference in operative mortality between the patients with and without an intramural coronary artery (p>0.1). There was no late death. The mean follow-up duration was $52.1{\pm}43.0$ months (0.5 to 132 months). One patient who had a subclavian artery free graft required LCA stenting 6.5 years after surgery for LCA anastomotic site stenosis. No other surviving patient needed any intervention for coronary problems. All patients had normal ventricular function at latest echocardiography and were in NYHA class 1. Conclusion: The arterial switch operation in Transposition of Great Arteries or Double Outlet Right Ventricle patients with intramural coronary can be performed with low mortality; however, there is a high incidence of intraoperative or postoperative coronary problems, which can be managed with conversion to the individual coronary button technique and a bypass procedure using a left subclavian free graft. Both aortocoronary flap and individual coronary button implantation techniques for coronary transfer have excellent mid-term results.
Korean Journal of Agricultural and Forest Meteorology
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v.12
no.3
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pp.207-216
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2010
Individual differences of ozone ($O_3$) resistance for seed production, seed germination and seedling development were examined in this study. Five in each healthy and damaged trees of Pinus thunbergii growing in air polluted area for 12 years were chosen based on visible foliar injury and growth. The cones of P. thunbergii, which were collected from healthy and damaged trees, were analyzed for physical characteristics and seeds from the cones were used to test germination percentage under $O_3$ treatment. The germinated seeds were continuously exposed to $O_3$ treatment and the lipid peroxidation and activities of antioxidative enzymes were determined for both seeds and seedlings. The $O_3$ treatment for seed germination and seedling development were conducted at three conditions: control, 150 ppb and 300 ppb of $O_3$. The non-treated seeds from the damaged trees showed 21.6% lower germination than those from the healthy ones. On the $O_3$ treatment of 300 ppb, seed germination decreased approximately 10% for the healthy trees and 19% for the damaged trees compared to that on the control. The seeds from the healthy trees showed significantly higher activities of superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) than those from the damaged trees. The activities of GR, ascorbate peroxidase (APX), and CAT decreased along with the increasing $O_3$ concentration in two tree grades. Malondialdehyde (MDA) content of seeds was not influenced by $O_3$ treatment for two tree grades. In seedling development, there were no significant differences for length and biomass of needle and root of two tree grades at both the control and 150 ppb of $O_3$. At 300 ppb of $O_3$ treatment, however, the length and biomass of needle and stem decreased for two tree grades but no significant differences was detected in root. The seedlings from the damaged trees were more sensitive to the $O_3$ treatment, showing higher activities of SOD, APX, and CAT and content of MDA compared to those from the healthy tree seedlings. Our results indicate that seed germination and seedling development are vulnerable to increasing $O_3$ concentrations and that attention must be paid to the individual selection of tree species for reforestation.
For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.
This study was conducted to establish the efficient protocols of the germination and cryopreservation of dehisced Korean ginseng seeds for long-term germplasm conservation. $GA_3$ and BA treated on seed for 24 hr facilitated germination at 5 and $10^{\circ}C$. Germination percentage of desiccated seeds was decreased under moisture content (MC) of below $7.2\%$. Dehisced ginseng seeds were dried under airflow of laminar floor cabinet and seed drying room. The high levels (more than $90\%$) of germination after cryogenic exposure were obtained after drying under vertical airflow of laminar floor for 12-30 hours (MC $10.6{\~}7.2\%$). Decrease in germination percentage of ginseng seeds due to desiccation damage and freezing injury was observed at MC of below $7.2\%$ and of above $12.1\%$, respectively. Therefore, MC of ginseng seeds need to be controlled with a range of $8{\~}10\%$ to avoid damages from both desiccation and freezing.
Cold stress influence plant growth through a wide range of growth characters. Adverse effects of low temperature to plant growth come from results of colligative and complex physiological responses to cold stress. To evaluate more exactly cold tolerance of crop plant, it is needed to observe physiological changes induced by cold stress and to analyze relationships between intraspecific variations in physiological factors related to cold tolerance and the extent of cold tolerance in the field. Therefore, the composition and unsaturation ratio of fatty acids in phospholipid, a constituent of membrane, the transition-temperature in respiratory activity of mitochodria, the chlorophyll fluorescence as a factor related to photosynthesis were investigated in rice plant and data on these factors were compared with the degree of cold tolerance obtained in the field experiment. Also, effects of hardening and Mn++ treatment were evaluated as a method to reduce chilling injuries. The unsaturation ratio of fatty acids, whether rice plants were grown in a natural condition or under the chilling stress, was higher in the cold- tolerant varieties and was significantly correlated with the degree of cold tolerance (1-9) observed in the field experiment. And it was also increased by chilling treatment or hardening treatment, due to a reduction in palmitic acid content and an increase in linolenic acid content. The transition-temperature of respiratory activity of mitochodria isolated from etiolated rice seedlings ($25^{\circ}C$, two week-grown in the dark), was correlated with the degree of cold tolerance in the field, cold -tolerant varieties showing a lower transition-temperature. It was not influenced by growth stages. The intensity of chlorophyll fluorescence was highly correlated with the degree of cold tolerance, cold-tolerant varieties having a higher fluorescence intensity. By foliar application of Mn, the transition-temperature of respiratory activity was lowered as much as 0-2$^{\circ}C$ in all tested varieties. Soil application of Mn induced more significant effect in cold-susceptible varieties with a possibility of reducing chilling injuries. On the whole, there were high correlationships among the degree of cold tolerance, the unsaturation ratio of fatty acids in phospholipid, the transition- temperature of respiratory activity and chlorophyll fluorescence except for a few varieties. The transition- temperature of respiratory activity appeared to be negatively correlated with the unsaturation ratio of fatty acids. and the chlorophyll fluorescence to be positively correlated with the unsaturation ratio. This implies that these physical and physiological factors were very closely related to cold tolerance and can be used as an effective index of the evaluation of cold tolerance of crop plant. But other factors as well as three factors discussed above are needed to be considered colligatively and altogether with a systematic analysis for the more exact evaluation of cold tolerance. in rice cultivars. in rice cultivars.
In order to evaluate the benefits of global warming on the double cropping with staple crops in North-Korea, four aspects such as the increasing rate of air temperature, the wintering temperatures for winter crops, the causing temperature of cool injury to rice and the securing of accumulated temperature for the double cropping in the different agricultural climate zones were analyzed by comparing the differences between the past 22 years from 1973 to 1994 and the recent 5 years from 2002 to 2006. The warming rate in recent daily mean air temperature of $8.96^{\circ}C$ in North Korea was higher by $0.64^{\circ}C$ than that in the past with large regional variations ranging from $1.06^{\circ}C$ in Samjiyeon of northern inland semi-alpine zone to $12.26^{\circ}C$ in Jangjeon of east central coastal zone. With the accumulated temperatures of more than $3,150^{\circ}C$ and $2,650^{\circ}C$, it was possible to apply the double cropping patterns with winter wheat and for cropping patterns with spring potato, respectively, to the whole region except for the northern inland semi-alpine zone. However, the wintering temperature higher than $-15^{\circ}C$ of average daily minimum air temperature of January, cropping patterns were impossible to northern inland semi-alpine zone and most regions of the northern mountainous zone. The days passed by below $17^{\circ}C$ in daily mean air temperature, causing the spikelet sterility at meiotic stage of rice in July, were a lot recorded from 21 to 29 days in northern inland semi-alpine zone and from 2 to 10 days in east-northern coastal zone, respectively. Therefore, a reasonable utilization of heat / temperature resources would relieve the limiting factors in double cropping for stable production of staple crops in North-Korea.
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