• Title/Summary/Keyword: MVP

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Analysis of Recurred Mitral Regurgitation after Mitral Repair according to Procedure or Valve Related Causes (승모판막 성형술 후 재발의 원인에 대해 술기와 판막 요인에 대한 분석)

  • Shin Hong Ju;Yoo Dong Gon;Lee Yong Jik;Park Soon Ik;Choo Suk Jung;Song Hyun;Chung Cheol Hyun;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.132-138
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    • 2005
  • Background: Mitral valve repair (MVP) is the optimal procedure for mitral regurgitation (MR), however, failure and subsequent reoperations are the limitations. The current study assessed the procedure in relation to the primary valve related causes of recurrent MR. Material and Method: MR was treated in 493 patients undergoing MVP from January of 1994 to January of 2002. The causes of MR were degenerative $(n=252,\;51.5\%),$ rheumatic $(n=156,\; 31.6\%),$ and others $(n=85,\; 16.9\%).$ Surgery comprised 446 ring annuloplasties $(90.5\%),$ 227 new chordae formations $(46\%),$ 125 quadriangular resections $(25.3\%),$ 28 chordae transfers $(5.7\%),$ and 8 Alfieri's stitches $(1.6\%).$ The mean follow up was $29.04\pm22.81$ months. Result: There were 5 early $(1.01\%)$, and 5 late deaths $(1.01\%).$ The reoperation rate was $1.42\%$. There were 45 $(9.1\%)$ recurrent MR (grade III or IV). Of these, 24 were procedure related including incomplete repair (n=14), discordant new chordae length (n=8) and others (n=2). In 21 patients, the cause was valve related including rheumatic disease progression (n=10), recurrent chordae elongation or prolapse (n=5) and others (n=6). Severe MR was higher after incomplete repair (p < 0.001), and valve related failure strongly correlated with rheumatic progression (p < 0.05). Conclusion: Since completeness of operation is the prime risk factor that determine the repair durability, intra-operative assessment of the initial repair with trans-esophageal echocardiography is essential.

Induction Chemotherapy and Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer (NSCLC) (국소 진행된 비소세포성 폐암에서 유도 화학요법 및 방사선치료)

  • Yun, Sang-Mo;Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.195-202
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    • 1999
  • Purpose : We peformed this study to evaluate the prognostic factors and the effect of induction chemotherapy in locally advanced non-small cell lung cancer (NSCLC). Materials and Methods : A retrospective analysis was done for 130 patients with locally advanced NSCLC treated with curative radiotherapy alone or induction chemo-radiotherapy from January 1986 to October 1996. Eighty-five patients were treated with radiotherapy alone, forty-five with induction chemotherapy and radiotherapy. Age, sex, performance status, histopathologic type, and stage were evenly distributed in both groups. The patients were treated with 6 MV or 10 MV X-ray. Conventional fractionation with daily fraction size 1$.8\~2.0$ Gy was done. Of the patients, 129 patients received total dose above 59.6 Gy ($56\~66$ Gy, median 60 Gy). Induction chemotherapy regimen were CAP (Cyclo-phosphamide, Adriamycin, Cisplatin) in 6 patients, MVP (Mitomycin, Vinblastine, Cisplatin) in 9 patients, MIC (Mitomycin, Ifosfamide Cisplatin) in 13 patients, and EP (Etoposide, Cisplatin) in 17 patients. Chemotherapy was done in $2\~5$ cycles (median 2). Results : Overall 1-, 2-, and 3-year survival rate (YSR) for all patients were $41.5\%,{\;}13.7\%,{\;}and{\;}7\%$, respectively (median survival time 11 months). According to treatment modality, median survival time, overall 1-, 2-, and 3-YSR were 9 months, $32.9\%,{\;}10.\5%,{\;}6\%$ for radiotherapy alone group, and 14 months, $57.8\%,{\;}20\%,{\;}7.6\%$ for induction chemotherapy group, respectively (f=0.0005). Complete response (CR) to overall treatments was $25\%$ (21/84) in radiotherapy alone and $40.5\%$ (17/42) in induction chemotherapy group (p=0.09). The Prognostic factors affecting overall survival were hemoglobin level (p=0.04), NSE (neuron-specific enolase) level (p=0.004), and respense to overall treatment(p=0.004). According to treatment modalities, NSE (neuron-specific enolase) (p=0.006) and response to overall treatment (p=0.003) were associated with overall survival in radiotherapy alone group, and response to overall treatment (p=0.007) in induction chemotherapy group. The failure Pattern analysis revealed no significant difference between treatment modalities. But, in patients with CR to overall treatment, distant metastasis were found in 11/19 patients with radiotherapy alone, and 3/13 patients with induction chemotherapy and radiotherapy (p=0.07). Locoregional failure patterns were not different between two groups (10/19 vs 6/13). Conclusion : Induction chemotherapy and radiotherapy achieved increased 2YSR compared to radiotherapy alone, At least in CR patients, there was decreased tendency in distant metastasis with induction chemotherapy. But, locoregional failures and long-term survival were not improved. Thus, there is need of more effort to increasing local control and further decreasing distant metastasis.

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Clinical Experience of Three Dimensional Conformal Radiation Therapy for Non-Small Cell Lung Cancer (비소세포성 폐암에서 3차원 입체조형 방사선 치료 성적)

  • Choi Eun Kyung;Lee Byong Yong;Kang One Chul;Nho Young Ju;Chung Weon Kuu;Ahn Seung Do;Kim Jong Hoon;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.265-274
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    • 1998
  • Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

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A Study on the Economic Efficiency of the Share Tenancy and Land Reform (정율지대(定率地代) 소작제도(小作制度)의 경제적(經濟的) 효율(效率)과 농지개혁(農地改革)에 관한 연구(硏究))

  • Kim, Jai Hong
    • Korean Journal of Agricultural Science
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    • v.12 no.2
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    • pp.333-340
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    • 1985
  • In this paper, we discuss the role of allocative efficiency and X-efficiency in determining resource allocation under the share tenency. Economic efficiency of resource allocation is related to land reform. Classical and neoclassical schools insist that land reform must be achieved for agricultural development by more efficient use of inputs. According to them, there is no incentive for tenants to use inputs until $MVP{\ell}=wage$ under the share tenancy. But "equal efficiency" school's conclusions are different. They conclude that there is no productivity differences between owner cultivation and share tenancy, owing to monopoly power of landlords and/or landlords's transaction costs. Considering X-efficiency, the share tenancy is not as efficient as the owner cultivation. On the other hand, the productivity differences may be reverse, in which landlords cultivate their lands by wage contracts. Land reform--reduction of land rent or redistribution of land--will be benefitable not only for agricultural development, but also for resource allocation in farm management.

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Altered Functions of Adrenoceptors in Splanchnic Vascular Beds in Portal Hypertensive Rat Model: Effect of Propranolol (문맥 고혈압 흰쥐에 있어서 내장혈관의 아드레나린성 수용체의 기능변동과 이에 대한 Propranolol의 효과)

  • Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.63-70
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    • 1988
  • Alterations in splanchnic circulatory hemodynamics along with reactivities to the alpha adrenoceptor agonists were assessed in association with the preventive effects of propranolol 10 days after portal ligation. Decreases in precapillary resistance (Ra) and postcapillary resistance (Rv) along with increases in mesenteric blood flow (MBF) and capillary pressure (CP) were observed in conjunction with an increment of splenic pulp pressure (SPP). Dose-dependent increase in Rv in response to noradrenaline, increases in Ra and RV to adrenaline, and increases in superior mesenteric arterial pressure (SMAP), Ra and Rv to phenylephrine observed in sham group were significantly attenuated by portal vein stenosis. In PPL-3 group (propranolol 3 mg/kg, i.p. three times daily for 10 days), MBF was significantly decreased in association with decrease in mesenteric venous pressure (MVP) when compared with those of protal ligated (PL) group, and decreased Ra and Rv in PL group were recovered toward the values of sham group. Likewise, in PPL-1 group (propranolol 5 mg/kg, i.p. once daily for 10 days), the pressor response of Rv to adrenaline was recovered up to the level of sham group. Thus, it is suggested that decreases in Ra and Rv in association with increases in MBF and CP may have a close relevance to the increased SPP, and the changes in circulatory hemodynamics and vascular reactivities were effectively reversed by longterm propranolol treatment. Based on these results, it is concluded that these changes observed in portal hypertension are closely related with the altered functions of the adrenoceptors in the splanchnic vascular beds.

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A Study on the Startup Growth Stage in Korea (스타트업 성장단계 구분에 대한 탐색적 연구)

  • Kim, Sunwoo;Kim, Kangmin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.2
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    • pp.127-135
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    • 2020
  • The purpose of this paper is to classify individual startups by growth stage based on data-based quantitative criteria. This is to provide a basis for systematic support for government startups based on accurate statistics on the startup growth process. This startups were the TIPS (Tech Incubator Program for Startup) support company, which used a relatively reliable startup. We found seed money to complete MVP (Minimum Viable Product) within 1.5 years after establishment, verified PMF (Product-Market Fit) within 1 year, attracted Series A investment within 2.5 years after establishment, and successfully commercialized it. It attracted Series B investment for stable growth within 1.5 years (Series B investment within 4 years from start-up). The results of the study, the division of government programs that support stage-based startup commercialization, that is, within three years and within seven years of establishment, is significant to date. Three directions are suggested for future research. First, develop indicators for monitoring startup growth stages. Second, it continuously updates the annual changes and tracks the growth stages of individual startups. Third, we discover the successful growth law of technology-based startups by applying in-depth case analysis of successful startups to the model.

Intensity Compensation for Efficient Stereo Image Compression (효율적인 스테레오 영상 압축을 위한 밝기차 보상)

  • Jeon Youngtak;Jeon Byeungwoo
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.42 no.2 s.302
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    • pp.101-112
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    • 2005
  • As we perceive the world as 3-dimensional through our two eyes, we can extract 3-dimensional information from stereo images obtained from two or more cameras. Since stereo images have a large amount of data, with recent advances in digital video coding technology, efficient compression algorithms have been developed for stereo images. In order to compress stereo images and to obtain 3-D information such as depth, we find disparity vectors by using disparity estimation algorithm generally utilizing pixel differences between stereo pairs. However, it is not unusual to have stereo images having different intensity values for several reasons, such as incorrect control of the iris of each camera, disagreement of the foci of two cameras, orientation, position, and different characteristics of CCD (charge-coupled device) cameras, and so on. The intensity differences of stereo pairs often cause undesirable problems such as incorrect disparity vectors and consequent low coding efficiency. By compensating intensity differences between left and right images, we can obtain higher coding efficiency and hopefully reduce the perceptual burden of brain to combine different information incoming from two eyes. We propose several methods of intensity compensation such as local intensity compensation, global intensity compensation, and hierarchical intensity compensation as very simple and efficient preprocessing tool. Experimental results show that the proposed algerian provides significant improvement in coding efficiency.

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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Effect of Crab Shell on Shelf-life Enhancement of Kimchi (게껍질의 김치보존성 향상효과)

  • 김순동;김미향;김일두
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.6
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    • pp.907-914
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    • 1996
  • To enhance the shelf-life and quality of baechu kimchi, the effects of CSP(crab shell powder) addition to kimchi was investigated. Overall qualities were deteriorated by fish odor, chewiness of particles, sharp pH increase at the early fermentation stage; therefore in order to solve these problems kimchi fermentation was carried out with kimchi containing 1, 3, 5% CSPB for salted baech weight at $10^{\circ}C$ for 300ays. Quality of kimchi was evalutated by the measurement of pH, acidity, colour L, a, and b value, the number of microbe and lactic acid bacteria, texture. Ten highly trained panelists were involved in the sensory evaluation. During the entire fermentation periods, pH, hardness, colour L, a and b value, the number of lactic acid bacteria of kimchi with CSPB were higher than those of control, but acidity was lower. Sensory quality showed that sour taste of control at 15-day fermentation was already strong. However, sour taste, crispness taste, and overall taste of kimchi with CSPB untill 20-day fermentation were good. Especially, overall taste of kimchi containing 3% CSPB at 30-day fermentation was good, but that of kimchi containing 5% showed fish odor from the early periods of fermentation.

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Lymphocyte Subpopulations and Proliferation of T cells, Phagocytic Activity of Leukocytes on Alcoholics (알코올중독자의 백혈구탐식능, 림프구아형 및 증식능)

  • 김용호;서병배;이정녀;김영훈
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.167-174
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    • 1996
  • Alcoholics increased susceptibility to microbial infection that is associated with decreased immunity. but there has been little experimental evidence to support alcoholics-induced increase of microbial infection directly in non-specific immunity. Therefore, we were used the method of phagocytic-plaque including all the stimulating factors for the phagocytosis, subtypes of lymphocytes and T-lymphocyte proliferation. The experimental groups were divided into 3 groups: (1) alcoholics who were hospitalized less than 1 week (newly hospitalized alcoholics), (2) alcoholics who were hospitalized more than 2 weeks (old hospitalized alcoholics), (3) healthy blood donors. We have studied 98 alcoholics and 35 healthy blood donors and control groups. A physician has checked the biological markers and diagnosed the body-condition alcoholics. The immunity and non-specific immunity on the alcoholics were analyzed by using the simultest kit and flow cytometry. Proliferation of the lymphocytes was analyzed by the phytohemmagglutinine mitogen. Phagocytosis and migration properties of leukocytes were identified on the layer formed by Staphylococcus aureus Cowan I strain. Biological markers of alcoholics and control groups, by such as blood glucose, ${\gamma}$-glutamyl transpeptidase and mean corpuscular volumes of red blood cells, were determined by biochemical and hematological methods. Compared with control groups, cluster of differentiation (CD)3+, CD8+ and CD19+ in alcoholic were more decreased except CD4+/CD8+ ratio. Proliferation of the T-lymphocytes, phagocytosis and migration properties of the leukocytes in alcoholics were decreased compared with those of control groups. According to the results observed in our experiment, they can be summerized as follows: 1, Cellular, humoral and non-specific immunities, are markedly decreased in alcoholics than those in control groups. 2. It is inferred that Phagocytic plaque formation is a very useful method to evaluate phagocytosis and migration properties of the alcoholic leukocytes 3. It is thought that the subtypes of lymphocytes, especially CD4+/CD8+ ratio, are essential methods to analyzed the alcoholic immunity. 4. Specific and non-specific immunity on the old hospitalized alcoholics was slightly increased, which depends upon the alcoholic medication.

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