• Title/Summary/Keyword: Model Surgery

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Continuous DC-CIK Infusions Restore CD8+ Cellular Immunity, Physical Activity and Improve Clinical Efficacy in Advanced Cancer Patients Unresponsive to Conventional Treatments

  • Zhao, Yan-Jie;Jiang, Ni;Song, Qing-Kun;Wu, Jiang-Ping;Song, Yu-Guang;Zhang, Hong-Mei;Chen, Feng;Zhou, Lei;Wang, Xiao-Li;Zhou, Xin-Na;Yang, Hua-Bing;Ren, Jun;Lyerly, Herbert Kim
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2419-2423
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    • 2015
  • Background: There are few choices for treatment of advanced cancer patients who do not respond to or tolerate conventional anti-cancer treatments. Therefore this study aimed to deploy the benefits and clinical efficacy of continuous dendritic cell-cytokine induced killer cell infusions in such patients. Materials and Methods: A total of 381 infusions (from 67 advanced cases recruited) were included in this study. All patients underwent peripheral blood mononuclear cell apheresis for the following cellular therapy and dendritic cells-cytokine induced killer cells were expanded in vitro. Peripheral blood T lymphocyte subsets were quantified through flow cytometry to address the cellular immunity status. Clinical efficacy and physical activities were evaluated by RECIST criteria and Eastern Cooperative Oncology Group scores respectively. Logistic regression model was used to estimate the association between cellular infusions and clinical benefits. Results: An average of $5.7{\pm}2.94{\times}10^9$ induced cells were infused each time and patients were exposed to 6 infusions. Cellular immunity was improved in that cytotoxic $CD8^+CD28^+$ T lymphocytes were increased by 74% and suppressive $CD8^+CD28^-$ T lymphocytes were elevated by 16% (p<0.05). Continuous infusion of dendritic cells-cytokine induced killer cells was associated with improvement of both patient status and cellular immunity. A median of six infusions were capable of reducing risk of progression by 70% (95%CI 0.10-0.91). Every elevation of one ECOG score corresponded to a 3.90-fold higher progression risk (p<0.05) and 1% increase of $CD8^+CD28^-$ T cell proportion reflecting a 5% higher risk of progression (p<0.05). Conclusions: In advanced cancer patients, continuous dendritic cell-cytokine induced killer cell infusions are capable of recovering cellular immunity, improving patient status and quality of life in those who are unresponsive to conventional cancer treatment.

Influence of Fimasartan (a Novel $AT_1$ Receptor Blocker) on Catecholamine Release in the Adrenal Medulla of Spontaneously Hypertensive Rats

  • Lim, Hyo-Jeong;Lee, Seog-Ki;Lim, Dong-Yoon
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.1
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    • pp.99-109
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    • 2013
  • The aim of this study was to determine whether fimasartan, a newly developed $AT_1$ receptor blocker, can affect the CA release in the isolated perfused model of the adrenal medulla of spontaneously hypertensive rats (SHRs). Fimasartan (5~50 ${\mu}M$) perfused into an adrenal vein for 90 min produced dose- and time-dependently inhibited the CA secretory responses evoked by ACh (5.32 mM), high $K^+$ (56 mM, a direct membrane depolarizer), DMPP (100 ${\mu}M$) and McN-A-343 (100 ${\mu}M$). Fimasartan failed to affect basal CA output. Furthermore, in adrenal glands loaded with fimasartan (15 ${\mu}M$), the CA secretory responses evoked by Bay-K-8644 (10 ${\mu}M$, an activator of L-type $Ca^{2+}$ channels), cyclopiazonic acid (10 ${\mu}M$, an inhibitor of cytoplasmic $Ca^{2+}$-ATPase), and veratridine (100 ${\mu}M$, an activator of $Na^+$ channels) as well as by angiotensin II (Ang II, 100 nM), were markedly inhibited. In simultaneous presence of fimasartan (15 ${\mu}M$) and L-NAME (30 ${\mu}M$, an inhibitor of NO synthase), the CA secretory responses evoked by ACh, high $K^+$, DMPP, Ang II, Bay-K-8644, and veratridine was not affected in comparison of data obtained from treatment with fimasartan (15 ${\mu}M$) alone. Also there was no difference in NO release between before and after treatment with fimasartan (15 ${\mu}M$). Collectively, these experimental results suggest that fimasartan inhibits the CA secretion evoked by Ang II, and cholinergic stimulation (both nicotininc and muscarinic receptors) as well as by membrane depolarization from the rat adrenal medulla. It seems that this inhibitory effect of fimasartan may be mediated by blocking the influx of both $Na^+$ and $Ca^{2+}$ through their ion channels into the rat adrenomedullary chromaffin cells as well as by inhibiting the $Ca^{2+}$ release from the cytoplasmic calcium store, which is relevant to $AT_1$ receptor blockade without NO release.

Effects of Screw Configuration on Biomechanical Stability during Extra-articular Complex Fracture Fixation of the Distal Femur Treated with Locking Compression Plate (잠김 금속판(LCP-DF)을 이용한 대퇴골 원위부의 관절외 복합골절 치료시 나사못 배열에 따른 생체역학적 안정성 분석)

  • Kwon, Gyeong-Je;Jo, Myoung-Lae;Oh, Jong-Keon;Lee, Sung-Jae
    • Journal of Biomedical Engineering Research
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    • v.31 no.3
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    • pp.199-209
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    • 2010
  • The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

The Formation of Extragraft Bone Bridging after Anterior Cervical Discectomy and Fusion : A Finite Element Analysis

  • Kwon, Shin Won;Kim, Chi Heon;Chung, Chun Kee;Park, Tae Hyun;Woo, Su Heon;Lee, Sung-Jae;Yang, Seung Heon
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.611-619
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    • 2017
  • Objective : In addition to bone bridging inside a cage or graft (intragraft bone bridging, InGBB), extragraft bone bridging (ExGBB) is commonly observed after anterior cervical discectomy and fusion (ACDF) with a stand-alone cage. However, solid bony fusion without the formation of ExGBB might be a desirable condition. We hypothesized that an insufficient contact area for InGBB might be a causative factor for ExGBB. The objective was to determine the minimal area of InGBB by finite element analysis. Methods : A validated 3-dimensional, nonlinear ligamentous cervical segment (C3-7) finite element model was used. This study simulated a single-level ACDF at C5-6 with a cylindroid interbody graft. The variables were the properties of the incorporated interbody graft (cancellous bone [Young's modulus of 100 or 300 MPa] to cortical bone [10000 MPa]) and the contact area between the vertebra and interbody graft (Graft-area, from 10 to $200mm^2$). Interspinous motion between the flexion and extension models of less than 2 mm was considered solid fusion. Results : The minimal Graft-areas for solid fusion were $190mm^2$, $140mm^2$, and $100mm^2$ with graft properties of 100, 300, and 10000 MPa, respectively. The minimal Graft-areas were generally unobtainable with only the formation of InGBB after the use of a commercial stand-alone cage. Conclusion : ExGBB may be formed to compensate for insufficient InGBB. Although various factors may be involved, solid fusion with less formation of ExGBB may be achieved with refinements in biomaterials, such as the use of osteoinductive cage materials; changes in cage design, such as increasing the area of polyetheretherketone or the inside cage area for bone grafts; or surgical techniques, such as the use of plate/screw systems.

THE SKELETAL MATURITY OF CERVICAL VERTEBRAE OF CHILDREN WITH NORMAL OCCLUSION AND SKELETAL CLASS III MALOCCLUSION (정상교합자와 골격성 III급 부정교합자의 경추골성숙도에 관한 연구)

  • Yang, Kyu-Ho;Choi, Nam-Ki;Choi, Bong-Sun;Lee, Young-Jun;Ryu, Sun-Youl;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.108-113
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    • 2004
  • This study was to evaluate and compare differences of the cervical vertebral skeletal maturity of normal occlusion and skeletal Class III malocclusion. Normal occlusion (172 girls) and skeletal Class III malocclusion(191 girls) were classified according to diagnosis stone model and lateral cephalogram of Korean girls aging from 8 to 12 years. The concavity of inferior border, vertico-horizontal ratio of cervical vertebrae were observed and measured according to age. Differences of the cervical vertebral skeletal maturity were evaluated. The results were as follows : 1. The concavity of inferior border of the 2nd to 6th vertebrae of normal occlusion and skeletal Class III had uniformly increased with age. 2. The vertico-horizontal ratio of the 3rd to 6th vertebrae of girls with normal occlusion and skeletal Class III had uniformly increased with age. 3. There was no significant difference in cervical vertebral skeletal maturity between normal occlusion and skeletal Class III malocclusion in the concavity of inferior border of the 2nd to 6th vertebrae and in the vertico-horizontal ratio of the 3rd to 6th vertebrae. The results in the study indicate that there is no significant difference of cervical vertebral skeletal maturity between girls with normal occlusion and skeletal Class III malocclusion.

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Expression Pattern of the Trefoil Factor Family 1 in Gastric Adenoma and Carcinoma (위 선종 및 선암에서 Trefoil Factor Family 1 단백의 발현 양상)

  • Park Won Sang;Kim Young Sil;Yoo Nam Jin;Park Cho Hyun;Yoo Jin Young;Lee Youn Soo;Lee Jung Young
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.4-9
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    • 2001
  • Purpose: The trefoil factor family 1 (TFF1) has a protective effect against gastric mucosal damage induced by nonsteroidal anti-inflammatory drugs or ethanol. In addition, a TFF1 knockout mouse model has exhibited circumferential adenomas with high-grade dysplasia, of which $30\%$ progressed into frankly invasive carcinomas. We tried to determine whether the expression pattern of the TFF1 could be involved in the development of sporadic gastric carcinomas. Materials and Methods: We examined TFF1 expression in a series of 43 sporadic gastric carcinomas and 18 gastric adenomas by immunohistochemistry. Results: Strong positive TFF1 staining was identified primarily in the normal gastric mucosa, mainly in the cytoplasm of the superficial and foveolar epithelium. We found TFF1 expression in $55.8\%$ (24 out of 43) of the gastric carcinomas and in $16.7\%$ (3 out of 18) of the gastric adenomas. Statistically, TFF1 immunoreactivity was significantly higher in diffuse-type ($82.4\%$) than in intestinal-type ($38.5\%$) carcinomas(p=0.0058, Fisher's exact test). Conclusion: Our findings provide sufficient evidence that the expression of TFF1 in gastric cancer may simply disclose gastric-type differentiation of neoplastic cells and provide further support for the existence of at least two pathways of malignant transformation of the gastric mucosa: one via intestinal metaplasia and adenomatous dysplasia, leading to glandular carcinomas with intestinal-type differentiation, and the other via hyperplastic changes or de novo changes, leading to diffuse carcinomas and to a subset of glandular carcinomas displaying gastric-type differentiation.

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Structural Analysis for Constructing a Balloon Type Extracoporeal Membrane Oxygenator using CFD Analysis (CFD 해석을 이용한 Balloon형 인공심폐기 설계를 위한 구조적 해석)

  • Park, Young-Ran;Shim, Jeong-Yeon;Kim, Gi-Beum;Kim, Shang-Jin;Kang, Hyung-Sub;Kim, Jin-Shang;Kim, Min-Ho;Hong, Chul-Un;Kim, Seong-Jong
    • Korean Chemical Engineering Research
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    • v.49 no.2
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    • pp.238-243
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    • 2011
  • In this study, we attempted a structural analysis in order to design a balloon type extracorporeal membrane oxygenator that can induce blood flow without using blood pumps for the purpose of complementing the weakness in the existing extracorporeal membrane oxygenator. To analyze the flow characteristic of the blood flow within the virtual model of extracorporeal membrane oxygenator, computational fluid dynamics(CFD) modeling method was used. The operating principle of this system is to make the surface of the extracorporeal membrane oxygenator keep contracting and dilating regularly by applying pressure load using a balloon, and the 'ime Function Value'that changes according to the time was applied by calculating a half cycle of sine waveform and a cycle of sine.waveform Under the assumption that the uni-directional blood flow could be induced if the balloon type extracorporeal membrane oxygenator was designed as per the method described above, we conducted a structural analysis accordingly. We measured and analyzed the velocity and pressure of blood flow at both inlet and outlet of the extracorporeal membrane oxygenator through CFD simulation. As a result of the modeling, it was confirmed that there was a flow in accord with the direction of the blood by the contraction/dilation. With CFD simulation, the characteristics of blood flow can be predicted in advance, so it is judged that this will be able to provide the most optimized design in producing an extracorporeal membrane oxygenator.

Age and Gender Differences in the Relationship of Cognitive Impairment, Vascular Risk Factors, and Subclinical Carotid Atherosclerosis from Community-based Elderly (나이와 성별에 따른 지역사회 거주 노인에서 무증상 경동맥 죽상경화증에 대한 혈관위험인자 및 인지장애와의 관련성)

  • Kim, Ji-Hee;Park, Hyun-Young;Kim, Dae-Won;Byun, Seung-Jae;Moon, Hyo-Jeong;Lee, In;Yang, Chung-Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.3
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    • pp.399-407
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    • 2012
  • To evaluate age and gender differences in the relation of cardiovascular risk factors, cognitive impairment, and subclinical carotid atherosclerosis from aged people using by a cross sectional method. Sixty-nine healthy elders living in the community who had not previously undergone carotid ultrasonography were included. We conducted life style surveys, and cognitive function tests including Korean-mini-mental state examination (K-MMSE) and clinical dementia rating-Korean. Various biomarkers from blood were assessed; fasting insulin-like growth factor-1, lipid-profile, high sensitivity C-reactive protein, total homocysteine, glucose, insulin, Homeostasis model assessment (HOMA) for insulin resistance index, vitamin B12, and folate level. Carotid intima-media thickness (C-IMT), and plaques were measured using carotid ultrasonography and aortic ultrasonography, a valid index of atherosclerosis. For the elderly subjects (aged 65-82 years), cognition impairment was more prevalent in females while subclinical atherosclerosis was more prevalentin males. Increased C-IMT has been kept in males, and C-IMT shows increasing trend and the peak at about 80 year-old in females with increasing age. The significant correlations between C-IMT and many vascular risk factors including age, triglyceride, abnormal homocysteinein male, and K-MMSE, insulin, HOMA index and abnormal aortic ultrasonography in female were different in each gender, with the exception of homocysteine (p<0.05). This data suggests that there were differences of age and gender characteristics in terms of subclinical atherosclerosis, cognitive impairment and vascular risk factors in community-living elders. Further larger and longitudinal studies across entire age are required to better understand the effects of risk factors on subclinical atherosclerosis.

Effect of Porcine Cancellous Bones on Regeneration in Rats with Calvarial Defect (랫드의 두개골 결손부에서 돼지 해면질골이 골재생에 미치는 영향)

  • Yoo, Kyeong-Hoon;Kim, Se-Eun;Shim, Kyung-Mi;Park, Hyun-Jeong;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Life Science
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    • v.20 no.8
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    • pp.1207-1213
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    • 2010
  • The purpose of this study was to evaluate the effect of porcine cancellous bone as a scaffold in a rat calvarial defect model. Critical-sized defects were created in 30 male Sprague-Dawley rats. The animals were divided into critical defect (CD, n=10), $\beta$-tricalcium phosphate (TCP) graft (BT, n=10) and porcine cancellous bone graft (PCB, n=10) groups. Each defect was filled with $\beta$-TCP mixed with fibrin glue or porcine cancellous bone powder mixed with fibrin glue. In the CD group, the defect was left empty. All rats were sacrificed at 8 weeks after bone graft surgery, and bone formation was evaluated by gross observation, plain radiography, micro-computed tomography scanning and histological evaluation. Repair of bone defect was the least in the CD group, and significant new bone formation was observed in the PCB group. Grafting of porcine cancellous bone was more efficient for regenerating new bone than grafting $\beta$-TCP.

Exercise Barriers in Korean Colorectal Cancer Patients

  • Kang, Dong-Woo;Chung, Jae Youn;Lee, Mi Kyung;Lee, Junga;Park, Ji-Hye;Kim, Dong-Il;Jones, Lee W.;Ahn, Joong Bae;Kim, Nam Kyu;Jeon, Justin Y.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7539-7545
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    • 2014
  • Background: It has been proved that participating in exercise improves colorectal cancer patients' prognosis. This study is to identify barriers to exercise in Korean colorectal cancer patients and survivors. Materials and Methods: A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. Results: The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. Conclusions: Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.