• Radiation Oncology Journal
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• 제15권3호
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• pp.187-195
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• 1997

Purpose : To analyze the involvement of apoptosis regulatory genes p53, $p21^{wart/cip1}$ bax and bcl-2 in induction of apoptosis by radiation in murine tumors. Materials and methods : The radiation-sensitive ovarian carcinoma OCa-1, and the radiation-resistant hepatocarcinorna HCa-I were used. Tumors, 8 mm in diameter, were irradiated with 25 Gy and at various times after irradiation, ranging from 1 to 48 h, were analyzed histologically for apoptosis and by western blot for alterations in the expression of these genes. The p53 status of the tumors were determined by the polymerase chain reaction-single strand conformation polymorphism assay. Results : Both tumors were positive for wild-type p53. Radiation inducesd apoptosis in OCa-1 but not in HCa-1. Apoptosis developed rapidly, peaked at 2 h after irradiation and returned to almost the background level at 48 h In OCa-1 radiation upregulated the expression of p53, $p21^{wart/cip1}$. and the bcl-2/bax ratio was decreased. In HCa-1 radiation increased the expression of both p53 and $p21^{wart/cip1}$, although the increase of the latter was small The bcl-2/bax ratio was greatly increased. In general the observed changes occurred within a few hours after irradiation, and either preceded or coincided with development of apoptosis Conclusions : The development of apoptosis required upregulation of both p53 and $p21^{wart/cip1}$ as well as a decrease in bcl-2/bax ratio. In contrast, an increase in bcl-2/bax ratio Prevented apoptosis in the presence of upregulated p53 and $p21^{wart/cip1}$ . These findings indentified the involvement of multiple oncogenes in apoptosis regulation in vivo and demonstrate the complexity that may be associated with the use of a single oncogene assessment for Predicting the outcome of cancer therapy with cytotoxic agents.

• Journal of the Korean Society of School Health
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• 제3권1호
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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.

• Journal of the Korean Society of School Health
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• 제3권1호
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• pp.101-118
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• 1990

This study was intended to investigate actual conditions and problems relating to a variety of substance which have been used by students. A Questionnaire survey was carried out with the subject of 2411 students in an academic boys' high school, academic girls' high school, technical boys' high school and technical girls' high school in Pusan, from the 15th day to 29th day of March, 1989. The summarized results were as follows. There was not a remarkable difference in distribution of these subjects in boys' & girls' high school. The common and good health condition of subjects accounted for 90 percent or higher. 24.4 percent of them also had smoking experience, 11.6 percent of which continues to smoking. The understanding rate of these substances name other than sedative, psychostimulants and antihypnotic accounted for 90 percent or higher. The experience rate taking these substances for one year showed that anodyne, digestive and nutritive tonic accounted for 70 percent, antihypnotic for 15.6 percent, sedative for 1.4 percent, respectively, and psychostimulants for 0.5 percent. Moreover. it was shown that drugs accounted for 1.5 percent, bond for 1.4 percent, and thinner for 0.5 percent. The rate of the daily experiencers who took anodyne, digestive, nutritive tonic, sedatives, and psychostimulants and so on was 7.7 percent, 6.2 percent, 5.2 percent, 5.9 percent, and 5.0 percent respectively. This fact implied that there was a serious problem in high school students' non - narcotic abuse. The usage rate of these substances for treatment purpose showed that anodyme accounted for 90 percent or higher, and digestive for 70-80 percent, respectively, where girl students showed higher rate than one of boy students. Additionally, there was higher the usage rate for other purposes. The usage rate of drugs was highest when these students felt melancholy and curiousity. Their obtaining place appeared that these students mainly obtained these drugs, bonds and thinners from a small shop or peddler and their friend while they usually obtained other substance from the pharmacy and medical institute. The first usage time of these substances appeared during the middle school (the age of 14-15) which was the highest rate. The smoker of all subjects used remarkly large substances as compared with one of no-smoker. Particularly, it appeared that the usage of drugs was very closely related to smoking. The large number of students did not use these substances for oesrable purposes even though they understood the name of these substances. For this reason, from primasy schools it is required to teach the students dependence and harmful effects caused by these substances abuse. Moreover, it was shown that these students firstly used these substances during the middle school (the age of 14-15)due to curiosity. As a result, it is very urgent to give the students health education suitabale for prevention of these substance abuse, when considering harmful effects of these substances. And so health education for no-smoking. Finally, considering that it is very easy to obtain these substances from a small shop and pharmacy, the regulation of these substances control should be considered and completed in the future.

• Journal of Chest Surgery
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• 제38권11호
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• pp.739-745
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• 2005

Background: The Maze procedure considered the most effective method of treatment for atrial fibrillation. However, the sinus conversion rates decreased due to several factors, especially enlarged left atrium. The purpose of this study was to investigate the effects of Maze procedure with aen atrial volume reduction plasty on rheumatic mitral valve disease, Material and Method: From December of 200f to July of 2004, 45 patients received mitral valve and Maze operation. The patients were placed in either group f or group 2, based on the left atrial volume reduction plasty. The presence and onset of sinus rhythm and the incidence of trans mitral A waves were monitored during the postoperative 7 days and throughout the follow up period of 3 and 6 months. Mean follow up periods were 15.8 10.1 months in group 1 and $6.1\pm2.7$ months in group 2. Result: The sinus onset were $9.88\pm12.2$ days in group 1, and $1\pm3.6$ days in group 2 (p<0.01). The sinus conversion rates in the group 1 and 2 were $65\%,\;75\%$ (p=0.07) in the postoperative 7 days, $70.5\%,\;100\%$ (p<0.01) at postoperative 3 months, and $93\%,\;100\%$ (p<0.01) at postoperative 6 months, respectively. The wave detection rates in the postoperative 7days were $31.2\%\;and\;63.6\%$, and continued to improve over time to $83.3\%\;and\;100\%$ by 6months, respectively. Conclusion: The results suggest that Maze procedure with left atrial volume reduction plasty is effective for inducing sinus rhythm and for restoring left atrial contractile function after concomitant rheumatic mitral valve surgery. However further follow up of this patients for long time is necessary.

• Journal of Chest Surgery
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• 제32권4호
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• pp.341-346
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• 1999

Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

• Journal of Chest Surgery
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• 제35권7호
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• pp.501-510
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• 2002

Background: The various pathogeneses of acute respiratory distress syndrome have been suggested but not established yet. In the present study, the role of group II phospholipase $A_2$($PLA_2$) in the pathogenesis of gut ischemia-reperfusion(I/R) induced acute lung injury (ALI), especially in the pulmonary oxidative stress with infiltration of neutrophils was investigated. Material and Method: To induce ALI, reperfusion of mesentery was done for 120 min after clamping of superior mesenteric artery for 60 min in Sprague-Dawley rats that weighed about 300g. To exmaine the role of group II $PLA_2$ in ALI, especially endothelial injury associated with the action of neutrophils, lung myeloperoxidase activity, lung leak index, bronchoalveolar lavage fluid protein were measured, and pulmonary $PLA_2$ activity changes in gut I/R were also measured. The role of group II $PLA_2$in the neutrophilic generation of free radicals was assessed by inhibiting group II $PLA_2$ with rutin, manoalide and scalaradial. Furthermore, to verify the oxidative stress in the lung, histologic and free radical detecting cytochemical electron microscopy were done. Result: After reperfusion, ALI was developed with accumulation of neutrophils in the lung, which was confirmed by the increase of myeloperoxidase activity, lung leak index and bronchoalveolar lavage protein (p<0.001). The pulmonary and intestinal group II $PLA_2$ activities significantly increased after gut I/R which were reversed by rutin(p<0.001). In vitro, cytochrome-c reduction assay denoted the inhibitory effects of rutin, scalaradial and manoalide on the production of free radicals from isolated human neutrophils. Histologically, neutrophilic accumulation and pericapillary edema in the lung after gut I/R was detected by light microscopy which was suppressed by rutin. In $CeCl_3$ cytochemical electron microscopy, the increased production of hydrogen peroxide in the lung after gut I/R was confirmed and also the production of hydrogen peroxide was decreased by rutin. Conclusion: On the basis of these experimental results, the inhibition of group II $PLA_2$ seemed to mitigate gut I/R-induced ALI by suppressing the production of free radicals from the infiltrated neutrophils. Collectively, group II $PLA_2$ seems to play a crucial role in gut I/R-induced ALI by neutrophilic oxidative stress.

• Journal of Chest Surgery
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• 제34권9호
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• pp.672-679
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• 2001

Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

• Journal of Chest Surgery
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• 제32권4호
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• pp.373-378
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• 1999

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

• Journal of Chest Surgery
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• 제40권5호
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• pp.351-355
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• 2007

Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

• Journal of Chest Surgery
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• 제42권5호
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• pp.604-609
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• 2009

Background: Recently, percutaneous cardiopulmonary support (PCPS) has been widely used to rescue patients in cardiogenic shock or cardiac arrest. However, patients with cardiopulmonary bypass (CPB) weaning failure during open heart surgery still have very poor outcomes after PCPS. We investigated clinical results and prognostic factors for patients who underwent PCPS during open heart surgery. Material and Method: From January 2005 to December 2008, 10 patients with CPB weaning failure during open heart surgery underwent PCPS using the CAPIOX emergency bypass system ($EBS^{(R)}$, Terumo Inc, Tokyo, Japan). We retrospectively reviewed the medical records of those 10 patients. Result: The average age of the patients was $60.2{\pm}16.5$ years (range, $19{\sim}77$ years). The mean supporting time was $48.7{\pm}64.7$ hours (range, $4{\sim}210$ hours). Of the 10 patients, 6(60%) were successfully weaned from the PCPS While 5 (50%) were able to be discharged from the hospital. Complications were noted in 5 patients (50%). In univariate analysis, long aortic cross clamp time during surgery, mediastinal bleeding during PCPS and high level of Troponin-I before PCPS were significant risk factors. All of the discharged patients are still surviving $34{\pm}8.6$ months (range, $23{\sim}48$ months) post-operatively. Conclusion: The use of PCPS for CPB weaning failure during open heart surgery can improve the prognosis. More experience and additional clinical studies are necessary to improve survival and decrease complications.