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A Pressure Adjustment Protocol for Programmable Valves

  • Kim, Kyoung-Hun;Yeo, In-Seoung;Yi, Jin-Seok;Lee, Hyung-Jin;Yang, Ji-Ho;Lee, Il-Woo
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.370-377
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    • 2009
  • Objective : There is no definite adjustment protocol for patients shunted with programmable valves. Therefore, we attempted to find an appropriate method to adjust the valve, initial valve-opening pressure, adjustment scale, adjustment time interval, and final valve-opening pressure of a programmable valve. Methods : Seventy patients with hydrocephalus of various etiologies were shunted with programmable shunting devices (Micro Valve with $RICKHAM^{(R)}$ Reservoir). The most common initial diseases were subarachnoid hemorrhage (SAH) and head trauma. Sixty-six patients had a communicating type of hydrocephalus, and 4 had an obstructive type of hydrocephalus. Fifty-one patients had normal pressure-type hydrocephalus and 19 patients had high pressure-type hydrocephalus. We set the initial valve pressure to $10-30\;mmH_2O$, which is lower than the preoperative lumbar tapping pressure or the intraoperative ventricular tapping pressure, conducted brain computerized tomographic (CT) scans every 2 to 3 weeks, correlated results with clinical symptoms, and reset valve-opening pressures. Results : Initial valve-opening pressures varied from 30 to $180\;mmH_2O$ (mean, $102{\pm}27.5\;mmH_2O$). In high pressure-type hydrocephalus patients, we have set the initial valve-opening pressure from 100 to $180\;mmH_2O$. We decreased the valve-opening pressure $20-30\;mmH_2O$ at every 2- or 3-week interval, until hydrocephalus-related symptoms improved and the size of the ventricle was normalized. There were 154 adjustments in 81 operations (mean, 1.9 times). In 19 high pressure-type patients, final valve-opening pressures were $30-160\;mmH_2O$, and 16 (84%) patients' symptoms had nearly improved completely. However, in 51 normal pressure-type patients, only 31 (61%) had improved. Surprisingly, in 22 of the 31 normal pressure-type improved patients, final valve-opening pressures were $30\;mmH_2O$ (16 patients) and $40\;mmH_2O$ (6 patients). Furthermore, when final valve-opening pressures were adjusted to $30\;mmH_2O$, 14 patients symptom was improved just at the point. There were 18 (22%) major complications : 7 subdural hygroma, 6 shunt obstructions, and 5 shunt infections. Conclusion : In normal pressure-type hydrocephalus, most patients improved when the final valve-opening pressure was $30\;mmH_2O$. We suggest that all normal pressure-type hydrocephalus patients be shunted with programmable valves, and their initial valve-opening pressures set to $10-30\;mmH_2O$ below their preoperative cerebrospinal fluid (CSF) pressures. If final valve-opening pressures are lowered in 20 or $30\;mmH_2O$ scale at 2- or 3-week intervals, reaching a final pressure of $30\;mmH_2O$, we believe that there is a low risk of overdrainage syndromes.

Quality Change during Harvest Time and Storage of Various Cabbages Grown on High Land by Different Transplanting Times (정식시기에 따른 고랭지 양배추의 수확 및 저장중 품질변화)

  • Eum, Hyang-Lan;Lee, Young-Hoon;Hong, Sae-Jin;Shin, Il-Sheob;Yeoung, Young-Rok
    • Journal of Bio-Environment Control
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    • v.21 no.2
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    • pp.95-101
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    • 2012
  • This study was conducted to investigate the effect of climate conditions during cultivation and harvesting on the quality and storability of fresh bulb cabbage (Brassica oleracea L. var. capitata). Plug seedlings of six cabbage cultivars were transplanted to Gangneung-Wonju University high elevation research station in Gangwon province (780 m above sea level, lat. $37.5^{\circ}N$.) and harvested with four different harvest times like August 3 ($1^{st}$), August 13 ($2^{nd}$), August 23 ($3^{rd}$), and September 10 ($4^{th}$), respectively from 50 days after transplanting. Weight loss, Hunter color factors, firmness, and soluble solids content (SSC) of the cabbage bulbs were investigated during storage at $3^{\circ}C$ (85% RH) and $25^{\circ}C$ (60% RH). Decreased bulb weight and poor quality cabbages were apparent at the late transplanting (July 14) and harvest (September 10) respectively. Quality index such as firmness and SSC at August 23 ($3^{rd}$) harvested cabbage was better than August 3 ($1^{st}$) and August 13 ($2^{nd}$) cabbages due to the good weather condition just before harvesting. The cv. 'Speed king' and 'Minix 40' showed good qualities among the cultivars, especially when the bulbs were harvested during sunny day conditions from one week before harvesting. Also SSC was influenced by weather condition before harvesting rather than transplanting date, while firmness was influenced by transplanting and harvest date. However, the differences among the cultivars were not significant. The potential of storage as maintaining the quality was different, depending on weather conditions at harvest time. Generally the storage periods of six cultivars were around 3~5 days and 9~10 days at room and low temperature, respectively. However, the August 3 ($1^{st}$) harvested cabbage lost their marketable quality very fast because of rainy and cloudy weather condition before harvesting and also storability of bulbs was 2 days and 4 days at room temperature and $3^{\circ}C$, respectively. Quality index was also not significant difference among cultivars.

Simulation and Measurement of Signal Intensity for Various Tissues near Bone Interface in 2D and 3D Neurological MR Images (2차원과 3차원 신경계 자기공명영상에서 뼈 주위에 있는 여러 조직의 신호세기 계산 및 측정)

  • Yoo, Done-Sik
    • Progress in Medical Physics
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    • v.10 no.1
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    • pp.33-40
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    • 1999
  • Purpose: To simulate and measure the signal intensity of various tissues near bone interface in 2D and 3D neurological MR images. Materials and Methods: In neurological proton density (PD) weighted images, every component in the head including cerebrospinal fluid (CSF), muscle and scalp, with the exception of bone, are visualised. It is possible to acquire images in 2D or 3D. A 2D fast spin-echo (FSE) sequence is chosen for the 2D acquisition and a 3D gradient-echo (GE) sequence is chosen for the 3D acquisition. To find out the signal intensities of CSF, muscle and fat (or scalp) for the 2D spin-echo(SE) and 3D gradient-echo (GE) imaging sequences, the theoretical signal intensities for 2D SE and 3D GE were calculated. For the 2D fast spin-echo (FSE) sequence, to produce the PD weighted image, long TR (4000 ms) and short TE$_{eff}$ (22 ms) were employed. For the 3D GE sequence, low flip angle (8$^{\circ}$) with short TR (35 ms) and short TE (3 ms) was used to produce the PD weighted contrast. Results: The 2D FSE sequence has CSF, muscle and scalp with superior image contrast and SNR of 39 - 57 while the 3D GE sequence has CSF, muscle and scalp with broadly similar image contrast and SNR of 26 - 33. SNR in the FSE image were better than those in the GE image and the skull edges appeared very clearly in the FSE image due to the edge enhancement effect in the FSE sequence. Furthermore, the contrast between CSF, muscle and scalp in the 2D FSE image was significantly better than in the 3D GE image, due to the strong signal intensities (or SNR) from CSF, muscle and scalp and enhanced edges of CSF. Conclusion: The signal intensity of various tissues near bone interface in neurological MR images has been simulated and measured. Both the simulation and imaging of the 2D SE and 3D GE sequences have CSF, fat and muscle with broadly similar image intensity and SNR's and have succeeded in getting all tissues about the same signal. However, in the 2D FSE sequence, image contrast between CSF, muscle and scalp was good and SNR was relatively high, imaging time was relatively short.

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Studies on the Prevention of Menace to Public Health by the Ornamental Tree -Especially in South Area of Korea- (조경수목(造景樹木)에 의(依)한 공해방지(公害防止)에 관(関)한 연구(硏究) -특(特)히 남부지역(南部地域)을 중심(中心)으로-)

  • Kim, Oue-Ryong;Kim, Jae-Saing
    • Journal of Korean Society of Forest Science
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    • v.55 no.1
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    • pp.37-46
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    • 1982
  • These studies were carried out to know the measure of damage having an effect on the ornamental trees owing to sulfurous acid gas($So_2$) which injures much forest trees among air pollutions in south area of Korean and to know the difference of smoke resistance on the five representative species among them and therefore to establish the preventive measure of air pollutions in industrial complex of south area of Korea by the ornamental trees. The reaction formula utilized was $Na_2So_2+H_2So_4$ $Na_2So_4+H_O+So_4$. The results obtained were as follows. 1) The ornamental trees surveyed in the industrial complexes of Ul-San, Chang-Won and Po-hang belonged to 51 species, 161,699 trees in all. The most five species among 51 sorts of woody plants were Populus tomentiglandulosa, Buxus microphylla, Forsythia korenan, Juniperus chinensis and Pinus densiflora. 2) The relation between the concentration of sulfurous acid gas($So_2$) and the damage rate upon investigation in each species: In case of low concentration the destructive quantities of cells of woody plants, and the more increased the concentrations, the more increased the amount of damage. 3) The difference of smoke resistance among five species showed to be the strongest in Buxus micorphylla, the second rand Pupulus tomentiglandulosa, the third rand Forsythia koreana, the fourth rank Juniperus chinensis and the weakest in Pinus densiflora. 4) The ornamental trees of industrial complex expecially in south area of Korea in future should be planted gradually broad-leaved trees which have strong sprout, smoke resistance and thick leaved rather than comifers. 5) I think that the area of city forest in industrial complex requires about $50m^2$ per head of population and about 100m width of green belt between industrial area and residential district.

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Agronomical Studies on the Thermal Conditions for Double Cropping of Rice (수도이기작재배 가능성에 대한 기상적 조사연구 - 적산온도를 중심으로 -)

  • Kang-Sae Lee;Jong-Kyu Hwang
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.14
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    • pp.53-64
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    • 1973
  • The studies reported herein were conducted to investigate the effect of thermal conditions in double-cropping of rice. The accumulated daily mean and minimum air temperatures, for the period of the last 30 years, were examined at the 10 different meteorogical stations which are located in the southern part of Korea. The results obtained could be summarized as follows: 1. The first cropping. a. It seemed to be free from any frost-damage of rice at the seeding stage at Yeosu, Pusan and Cheju. However, it was found that there were some dangers of frost damage for about 30 to 40 day at Iri, Chonju and Kwangju, for 18 to 28 days at Daeku and Ulsan, and for 4 to 14 days at Mokpo and Pohang, respectively. b. The early critical transplanting date seemed to be from middle to late-April in the first cropping. As compared with the ordinary lowland seedlings, the semi-protected and upland ones could be planted 5 and 10 days earlier, respectively. c. The early critical heading date was about late-June and there were some low-temperature damages for 8 to 25 days at young-ear formation stage of rice plant, depending upon location. d. The early critical ripening date (the early critical transplanting date of the 2nd cropping) was from late-July to early-August. It took about 32 to 39 days in ripening. There was a tendency of SS${\fallingdotseq}$SL$15^{\circ}C$ (${\theta}$15) and the minimum of $10^{\circ}C$ (${\theta}$10), the ten locations could be devided into two ripening groups of ${\theta}$15>${\theta}$10 and ${\theta}$15<${\theta}$10. c. The late critical ripening date was around October 9 at Iri, Chonju, Kwangju and Daeku and around October 28 at Mokpo, Yeosu, Pusan and eheju. Three to four days were more required for a complete ripening of rice, as compared with the above dates. d. There was an overlap of about 12 to 42 days between the first and second cropping when early-maturing varieties requiring an accumulated mean air temperature of $1, 550^{\circ}C$, from transplanting to heading, were grown. Therefore, some varieties which could head with an accumulated daily mean air temperature of 1, 000 to $1, 200^{\circ}C$, should be either developed or some new cultural technology be established in order to have a successful double cropping in rice.

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Triple Detector SPECT Imaging with $^{99m}Tc-DMSA$ in Adult Patients with Urinary Tract Infection (성인 요로 감염 환자에서 $^{99m}Tc-DMSA$ 삼중검출기 SPECT 영상의 유용성)

  • Ryu Jin-Sook;Bae, Won-Gyu;Moon Dae-Hyuk;Lee, Myung-Hae;Kim, Soon-Bae,;Park, Su-Kil;Park, Jung-Sik;Hong, Chang-Gi D.;Cho, Kyung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.290-298
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    • 1992
  • Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

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The Anticancer Effect and Mechanism of Photodynamic Therapy Using 9-Hydroxypheophorbide-a and 660 nm Diode Laser on Human Squamous Carcinoma Cell Line. (9-hydroxypheophorbide-a와 660 nm 다이오드 레이저를 이용한 광역학치료의 항암효과와 치료기전에 대한 연구)

  • Ahn, Jin-Chul
    • Journal of Life Science
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    • v.19 no.6
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    • pp.770-780
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    • 2009
  • A new photosensitizer, 9-Hydroxypheophorbide-a (9-HpbD-a), was derived from Spirulina platensis. We conducted a series of experiments, in vitro and in vivo, to evaluate the anticancer effect and mechanism of photodynamic therapy using 9-HpbD-a and 660 nm diode lasers on a squamous carcinoma cell line. We studied the cytotoxic effects of pheophytin-a, 9-HpbD-a, 9-HpbD-a red and 660 nm diode lasers in a human head and neck cancer cell line (SNU-1041). Cell growth inhibition was determined by using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay. The effects of 9-HpbD was higher than those of 9-HpbD-a red or pheophytin-a in PDT. We then tested the cytotoxic effects of 9-hydroxypheophorbide-a (9-HpbD-a) in vitro. The cultured SNU-I041 cells were treated with serial concentrations of 9-HpbD-a followed by various energy doses (0, 0.1, 0.5, 3.2 J/$cm^{2}$) and by various interval times (0, 3, 6, 9, 12 hr) until laser irradiation, then MTT assay was applied to measure the relative inhibitory effects of photodynamic therapy (PDT). Optimal laser irradiation time was 30 minutes and the cytotoxic effects according to incubation time after 9-HpbD-a treatment increased until 6 hours, after which it then showed no increase. To observe the cell death mechanism after PDT, SUN-I041 cells were stained by Hoechst 33342 and propidium iodide after PDT, and observed under transmission electron microscopy (TEM). The principal mechanism of PDT at a low dose of 9-HpbD-a was apoptosis, and at a high dose of 9-HpbD-a it was necrosis. PDT effects were also observed in a xenografted nude mouse model. Group I (no 9-HpbD-a, no laser irradiation) and Group II (9-HpbD-a injection only) showed no response (4/4, 100%), and Group III (laser irradiation only) showed recurrence (1/4,25%) or no response (3/4, 75 %). Group IV (9-HpbD-a + laser irradiation) showed complete response (10/16, 62.5%), recurrence (4/16, 25%) or no response (2/16, 12.5%). Group IV showed a significant remission rate compared to other groups (p<0.05). These results suggest that 9-HpbD-a is a promising photosensitizer for the future and that further studies on biodistribution, toxicity and mechanism of action would be needed to use 9-HpbD-a as a photosensitizer in the clinical setting.

Statistical Studies on the Gestation and Delivery of the Pregnant Women and on the Neonates (한국부인의 임신.분만 및 신생아에 대한 통계적 연구)

  • Choi, Joong-Myung
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.193-202
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    • 1984
  • Clinical and statistical observations were performed on 1,930 cases of pregnant women who were admitted for delivery in the Department of Obstetrics, Kyung Hee University Hospital during 1 year (1982) and on 1,961 cases of neonates who were born to the former. The results were obtained as follows: 1. Concerning maternal age distribution, the commonest age group was that of $25{\sim}29$ and the proportion of the age group $20{\sim}29$ was 82.4% of all. 2. Concerning obstetrical history, the proportion of the women who had no prior experience of delivery nor abortion was the highest, 45.5%. 3. Concerning abortion history, 36.1% of the women had experienced it and the mean number was 1.8. 4. Type of delivery was as follows: Spontaneous delivery; 58.1%, Vacuum extracted delivery; 22.4%, Cesarean section; 18:8%, Breech delivery; 0.7%. 5. Gestational period distribution of the neonates was as follows: Under 37 weeks (Preterm); 7.1%, Between 38 and 42 weeks (Term); 87.2%, More than 43 weeks (Postterm); 5.7%. 6. Sex ratio of male to female of the neonates was 1.03:1. 7. Birth weight distribution was as follows: Under 2,500gm.; 9.0%, Between 2,501 and 4,000 gm.; 85.5%, More than 4,001gm.; 5.5%. 8. The measured growth data of neonates were as follows: Body weight; 3.28kg. for male, 3.18kg. for female, Body height; 50.40cm for male, 49.77cm for female, Chest circumference; 32.54cm for male. 32.17cm for female, Head circumference; 33.49cm for male, 33.11cm for female. 9. The mean values of Apgar score per 1 minute were 7.70 for male and 7.63 for female. 10. The incidence rate of neonatal jaundice was 50.0% and no difference in sex respectively, but more prevalent in preform baby. 11. The incidence rate of neonatal diseases was 8.9% and the commonest disease was neonatal infection (35.6%). 12. Concerning multiple pregnancy, ratio to single births was 1 : 64.3 and the sex ratio of male to female was 1 : 1.03. 13. The incidence rate of congenital anomaly was 2.4% and the commonest anomaly was digestive system anomaly (30.9%). 14. The neonatal mortality rate was 11.73 per 1,000 neonates, and the majority of neonatal deaths were in low birth weight and preform neonates (78.3%). 15. The causes of neonatal deaths in decreasing order of frequency were abnormal ventilation (39.1%), prematurity (30.4%), congenital anomaly (13.0%) and etc.

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Multiple Linear Analysis for Generating Parametric Images of Irreversible Radiotracer (비가역 방사성추적자 파라메터 영상을 위한 다중선형분석법)

  • Kim, Su-Jin;Lee, Jae-Sung;Lee, Won-Woo;Kim, Yu-Kyeong;Jang, Sung-June;Son, Kyu-Ri;Kim, Hyo-Cheol;Chung, Jin-Wook;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.317-325
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    • 2007
  • Purpose: Biological parameters can be quantified using dynamic PET data with compartment modeling and Nonlinear Least Square (NLS) estimation. However, the generation of parametric images using the NLS is not appropriate because of the initial value problem and excessive computation time. In irreversible model, Patlak graphical analysis (PGA) has been commonly used as an alternative to the NLS method. In PGA, however, the start time ($t^*$, time where linear phase starts) has to be determined. In this study, we suggest a new Multiple Linear Analysis for irreversible radiotracer (MLAIR) to estimate fluoride bone influx rate (Ki). Methods: $[^{18}F]Fluoride$ dynamic PET scans was acquired for 60 min in three normal mini-pigs. The plasma input curve was derived using blood sampling from the femoral artery. Tissue time-activity curves were measured by drawing region of interests (ROls) on the femur head, vertebra, and muscle. Parametric images of Ki were generated using MLAIR and PGA methods. Result: In ROI analysis, estimated Ki values using MLAIR and PGA method was slightly higher than those of NLS, but the results of MLAIR and PGA were equivalent. Patlak slopes (Ki) were changed with different $t^*$ in low uptake region. Compared with PGA, the quality of parametric image was considerably improved using new method. Conclusion: The results showed that the MLAIR was efficient and robust method for the generation of Ki parametric image from $[^{18}F]Fluoride$ PET. It will be also a good alternative to PGA for the radiotracers with irreversible three compartment model.

Comparison of Growth, Yield and Quality by Green Crop Treatments in Rice (Oryza sativa L.) Organic Cultivation (벼 유기재배 시 녹비작물 처리에 의한 작물의 생육, 수량 및 품질 비교)

  • Cha, Kwang-Hong;Oh, Hwan-Jung;Park, Heung-Gyu;An, Kyu-Nam;Park, Ro-Dong;Jung, Woo-Jin
    • Korean Journal of Organic Agriculture
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    • v.19 no.1
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    • pp.55-64
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    • 2011
  • To investigate a comparison of rice yield and quality by a utilization of green crops using barley and hairyvetch, this study was carried out in rice (Oryza sativa L.) organic cultivation field. Convention barley harvest (CBH), Green barley crop (GBC), Green barley+Green Hairyvetch crop (GB+HVC), and Non-Green crop (NGC) were treated in rice cultivation field. The results obtained as following: 1) Culm length and pancile length in Convention barley harvest (CBH) cultivation were longer than organic cultivation but were not significant difference in all treatments. Yields of milled rice in Green barley crop (GBC) and Green barley+Green Hairyvetch crop (GB+HVC) were by 90.3% and 95.9%, respectively. 2) Protein contents in Green barley crop (GBC) and Green barley+Green Hairyvetch crop (GB+HVC) were by 5.7% lower than 6.6% in Convention barley harvest (CBH) cultivation. Amylose contents in all treatment were similar as range 18.8% to 19.1%. Whiteness contents in Green barley crop (GBC) and Green barley+Green Hairyvetch crop (GB+HVC) were slightly higher by 38.9% and 39.1%, respectively, than 37.7% in Convention barley harvest (CBH) cultivation. 3) Palatability values in Barley harvest (BH) and Non-Green crop (NGC) were slightly higher by 82.0 and 83.8, respectively, than 77.6 in Convention barley harvest (CBH) cultivation. 4) Head rice in Non-Green crop (NGC) was 95.5%, while that of Convention barley harvest (CBH), Green barley crop (GBC), and Green barley+Green Hairy-vetch crop (GB+HVC) were slightly low as range 93.8% to 94.2%. White core and belly rice in Convention barley harvest (CBH) cultivation was the highest level by 1.7%. 5) Leaf blast, neck blast, sheath blight, rice stem maggot, rice leaf roller, rice leaf-tier, and green rice leafhopper were occurred lightly in rice field.