• Title/Summary/Keyword: Normal values

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Early Clinical Experience in Valve Replacement Using On-X Prosthetic Heart Valve (On-X 기계판막을 이용한 판막치환술의 단기성적분석)

  • 김인섭;김우식;신용철;유환국;김병열;정성철
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.742-748
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    • 2004
  • The On-X valve was recently introduced. It was the aim of this study to assess the safety and feasibility from the data derived from 28 patients who underwent aortic and/or mitral valve replacement with this prosthesis in National Medical Center. Material and Method: From May 1999 and May 2003, a series of 28 consecutive patients who had been implanted with 32 On-X prosthesis were reviewed, The operative procedure comprised of 12 MVR, 10 AVR and 6 DVR. The study followed the guidelines of AATS/STS. Mean follow-up was 27 months (total 04 patient-years). Result: Early ($\leq$30 days) mortality was 7.44% (2/28) and no late mortality occurred in the study. Total actuarial freedom from mortality at 2 years was 92.86$\pm$4.87% for all cases, 100% for MVR, 90$\pm$9.49% for AVR, and 83.3$\pm$1.52% for DVR. Thromboembolic event occurred in 2 MVR patients and that was the only complication; therefore, the linearized incidence of valve related complications was 3.17%/ patient-years for all cases and 6.5%/patient-years for MVR and the actuarial freedom from valve related complications at 2 years was 84.85$\pm$10.75%. Preoperatively, 24 (85.71%) patients were in NYHA functional class III or IV but postoperatively, 25 (89,29%) patients were in NYHA functional class I or II. The levels of hemoglobin, hematocrit, serum LDH, reticulocyte rate and indirect bilirubin were all within normal range at postoperative 3 month. In mitral position, the peak gradient was 6.1$\pm$1.8 mmHg and the mean gradient was 3.0$\pm$0.6 mmHg and EOA were 2.54$\pm$0.56 $m^2$, 2.39$\pm$0.73 $m^2$, 2.34$\pm$0.55 $m^2$, 2.40$\pm$0.63 $m^2$ at 27 mm, 29 mm, 31 mm, 33 mm respectively. In aortic postion, the peak gradient was 21.1 $\pm$14.12 mmHg and the mean gradient was 12.3$\pm$6.52 mmHg. Conclusion: Since there was no significant difference in the postoperative mortality, valve related complications and echocardiographic hemodynamic data compared to standard bileaflet design and since there was an improvement in the NYHA functional class and normal values of hemolytic indicators, it can be assumed that On-X valve is safe and feasible. However, accumulation of cases and long-term follow-up of this patient group is needed to establish this result.

The Age-related Microstructural Changes of the Cortical Gray and White Matter Ratios on T2-, FLAIR and T1- weighted MR Images (T2, FLAIR, T1 강조 MR영상에서 나이에 따른 뇌피질의 회질과 백질의 미세구조 변화)

  • Choi, Sun-Seob;Kim, Whi-Young;Lee, Ki-Nam;Ha, Dong-Ho;Kang, Myong-Jin;Lee, Jin-Hwa;Yoon, Seong-Kuk
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.32-40
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    • 2011
  • Purpose : The purpose of this study was to investigate the microstructural changes according to aging on the thickness and signal intensity (SI) of the cortical gray matter (GM) and white matter (WM) on the T2-, fluid-attenuated inversion recovery (FLAIR) and T1-weighted MR images in normal subjects. Materials and Methods : The 10, 20, 30, 40, 50, 60, 70, 80 and 90 year age groups of men and women (each 10 individuals) who underwent routine brain MRI, including the T2-, FLAIR and T1-weighted images, were selected for this study. We measured the thickness and the SI of the cortical GM and WM at the postcentral gyrus, which has an even thickness at the level of centrum semiovale, on the axial scans and we calculated the mean values of the thickness ratio of the gray/white matter (TRGW) and the signal intensity ratio of the gray/white matter (SRGW), and we compared the ratios of each age group. Results : On the T2-weighted images, the TRGWs were 0.81 and 0.79 at the age of 10 and they were 0.73 and 0.71 at the age of 90 in the men and women, respectively. So, the GM thickness was decreased more than the WM thickness was with aging. On the FLAIR images, the TRGWs were 1.09 and 1.00 at the age of 10 and they were 1.11 and 0.95 at the age of 70 in the men and women, respectively. On the T1-weighted images, the TRGWs were 0.66 and 0.80 at the age of 10, and the ratio was changed to 0.90 and 0.78 at the age of 90 in the men and women, respectively. On the T2-weighted image, the SRGWs were 1.53 and 1.43 at the age of 10, and they were 1.23 and 1.27 at the age of 90 in the men and women, respectively. On the FLAIR images, the SRGWs were 1.23 and 1.25 at the age of 10 and they were 1.06 and 1.05 at the age of 90 in the men and women, respectively. On the T1-weighted images, the SRGWs were 0.86 and 0.85 at the age of 10, and they were 0.90 and 0.87 at the age of 90 in the men and women, respectively. Conclusion : We suggest that the age-related microstructural changes of the thickness and the SI of the cortical GM and WM on the T2-, FLAIR and T1-weighted images are unique, and so this knowledge will be helpful to differentiate neurodegenerative disease from normal aging of the brain.

The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis (임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과)

  • Na, Hyun Jung;Kim, Ji Young;Lee, Gyeong Hoon;Lee, Jun Hwa;Choi, Eun Jin;Kim, Jin Kyung;Chung, Hai Lee;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1187-1192
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    • 2005
  • Purpose : The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis. Methods : Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered. Results : The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc. Conclusion : Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.

Evaluation on Usefulness of Abdomen and Chest Motion Control Device (ABCHES) for the Tumor with a Large Respiratory Motion in Radiotherapy (호흡으로 인한 움직임이 큰 종양의 방사선치료 시 Abdomen and Chest Motion Control Device (ABCHES)의 유용성 평가)

  • Cho, Yoon-Jin;Jeon, Mi-Jin;Shin, Dong-Bong;Kim, Jong-Dae;Kim, Sei-Joon;Ha, Jin-Sook;Im, Jung-Ho;Lee, Ik-Jae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.85-93
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    • 2012
  • Purpose: It is essential to minimize the respiratory-induced motion of involved organs in the Tomotherapy for tumor located in the chest and abdominal region. However, the application of breathing control system to Tomotherapy is limited. This study was aimed to investigate the possible application of the ABCHES system and its efficacy as a means of breathing control in the tomotherapy treatment. Materials and Methods: Five subjects who were treated with a Hi-Art Tomotherapy system for lung, liver, gallbladder and pancreatic tumors. All patients undertook trained on two breathing methodes using an ABCHES, free breathing methode and shallow breathing methode. When the patients could carry out the breathing control, 4D-CT scan was a total of 10 4D tomographic images were acquired. A radiologist resident manually drew the tumor region, including surrounding nomal organs, on each of CT images at the inhalation phase, the exhalation phase and the 40% phase (mid-inhalation) and average CT image. Those CT images were then exported to the Tomotherapy planning station. Data exported from the Tomotherapy planning station was analyzed to quantify characteristics of dose-volume histograms and motion of tumors. Organ motions under free breathing and shallow breathing were examined six directions, respectively. Radiation exposure to the surrounding organs were also measured and compared. Results: Organ motion is in the six directions with more than a 5 mm displacement. A total of 12 Organ motions occurred during free breathing while organ motions decreased to 2 times during shallow breathing under the use of Abches. Based on the quantitative analysis of the dose-volume histograms shallow breathing showed lower resulting values, compared to free breathing, in every measure. That is, treatment volume, the dose of radiation to the tumor and two surrounding normal organs (mean doses), the volume of healthy tissue exposed to radiation were lower at the shallow breathing state. Conclusion: This study proposes that the use of ABCHES is effective for the Tomotherapy treatment as it makes shortness of breathing easy for patients. Respiratory-induced tumor motion is minimized, and radiation exposure to surrounding normal tissues is also reduced as a result.

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Biokinetics of Carbohydrate and Lipid Metabolism in Normal Laying Hen [Part 1] -Determination of Turnover of Glucose- (정상산란계(正常産卵鷄)에 있어서 탄수화물(炭水化物)과 지질대사(脂質代謝)의 생동역학(生動力學) 제1보[第一報] -포도당 대사회전(代謝回轉)의 측정(測定)-)

  • Chiang, Y.H.;Riis, P.M.
    • Applied Biological Chemistry
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    • v.20 no.2
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    • pp.205-209
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    • 1977
  • The pool size of plasma glucose, turnover rate and other concerned items for glucose metabolism in normal laying hen were investigated by a single-injection method using $U-C^{14}-glucose$. The 11.6 nCi of pure dose was injected to a hen normally fed through the wing vein. The glucose concentration in plasma sample taken at 5 minutes after injections was 214mgper 100ml. From the plottings of logarithmic standard specific activities of plasma taken from 5 to 120 minutes against the time after injection and from the regresion analysis, metabolic states were determined. The pool size was 1.07g, turnover rate was 0.024 per minute, turnover time was 41 minutes, utilization rate was 26mg/min. (0.83 g/hr/kg B.W. 3/4) and glucose space(extracellular fluid volume) was 25.3 per cent of body weight. The values obtained from. 10-50 minutes samples were similar to those described above, which we from 5-120 minutes samples.

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Osmoregulation Capability of Juvenile Grey Mullets (Mugil cephalus) with the Different Salinities (어린 숭어 (Mugil cephalus)의 염분별 삼투조절 능력)

  • LEE Young Choon;CHANG Young Jin;LEE Bok Kyu
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.30 no.2
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    • pp.216-224
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    • 1997
  • In order to investigate the osmoregulation capability of grey mullet, Mugil cephalus with the different salinities, juvenile fish $(13.6{\pm}0.2\;TL)$ stocked in seawater (SW) were abruptly transferred to each experimental group $0\%SW(0\%_{\circ}),\;25\%SW(7.7\%_{\circ}),\;50\%SW(16.1\%_{\circ})\;and \;100\%SW(32.8\%_{\circ})$ and reared for 60 days. Blood samples were taken by the time schedule after the transfer. Plasma $Na^{+},\;K^{+},\;Cl^{-}$ and osmolality, muscle water content, and the electron microscopical observations of chloride cells were analyzed and made by the time schedule. In $100\%SW$, the maintainable levels of plasma $Na^{+},\;K^{+},\;Cl^{-}$ and osmolality were $167.1{\pm}7.7mM/l,\;9.1{\pm}2.1mM/l,\;137.8{\pm}5.6mM/l\;and\;351{\pm}18\;mOsm/kg$, respectively. These values were significantly changed at $6h\~1\;day$ after the beginning of the experiment with four different salinities. Fish from $0\%\;and\;25\%SW$ had lower osmolalities than those of fish from $50\%\;and\;100\%SW$, and showed the hyposmotic regulation pattern. At the end of the experiment (60 days after transfer), however, no significant difference was found in the concentrations of plasma $Na^{+},\;K^{+}\;and\;Cl^{-}$ among four experimental groups. Hematocrit was increased with salinity (P<0.01). After 10 days, fish from $0\%\;and\;25\%SW$ showed the hypertrophy, fusion and edema of epithelial layer in gill lamella. However, at the 15th day, epithelial layer in gill lamella was back to the normal status. On gill of fish from $0\%SW$, one apical pit held two or three chloride cells in common. Muscle water content was subsequently regulated to near the normal levels within 4 days, and there was no significant difference among four different salinities at the end of the experiment.

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Development of an Eating Habit Checklist for Screening Elementary School Children at High Risk of Energy Overintake (초등학생의 에너지 과잉섭취 위험 진단을 위한 식습관평가표 개발)

  • Yon, Mi-Yong;Hyun, Tai-Sun
    • Journal of Nutrition and Health
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    • v.41 no.5
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    • pp.414-427
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    • 2008
  • The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.

Changes in Subjective/Objective Symptoms and the Light Transmissibility of Lens Associated with Overusage of Daily Disposable Circle Contact Lenses in Normal Eyes (일회용 써클소프트렌즈의 초과 착용에 의한 정상안의 자·타각적 증상 및 렌즈 광투과율의 변화)

  • Park, Mijung;Kwon, Hae Lim;Choi, Sae Ah;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.18 no.4
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    • pp.429-439
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    • 2013
  • Purpose: This study was assessed to investigate the change of subjective and/or objective symptoms and the light transmissibility of lens caused by over-usage of daily disposable circle contact lenses (circle lens). Methods: Three daily disposable circle lenses made of etafilcon A, hilafilcon B, and nelfilcon A were applied on 20 normal eyes free from any eye diseases by when subjects complained any kind of discomfort. On the first and the last days of lens wearing, subjective discomfort, blinking rate, non-invasive break-up time, lens centration on corneal surface and visible light transmissibility of lens were recorded at every case and compared. Results: The circle lens wearers complained discomfort when they wore the circle lens more than 15 hours, in excess of 8 hours being the recommended wearing time and the most circle lens wearers quit the lens wearing when they wore more than 30 hours. On the last day of lens wearing, the representative subjective discomforts were stiffness, dryness and tiredness. When the subjects wore circle lens more than the recommended time, a tendency of increased blinking rate and decreased NIBUT was observed when it compared with the values right after lens wearing. On the last day of lens wearing, the lens centration was shown to be decentrated from the pupil center compared with the centration right after the wearing. These changes in lens centration and blinking rate were consistently shown in all cases of lens wearing however, the difference in the degree of subjective and/or objective change was present depending on lens materials and subjects. The visible light transmissibility of circle lens has largely been changed. Conclusions: From these results, it was thought that the decreased NIBUT induced dryness and stiffness and decreased visible light transmissibility caused more blinking when daily disposable circle lens was exceedingly used, which provoked lens decentration and subjective discomfort. However, the difference of subjective and/or objective change was largely varied in accordance with the lens material types and individuality and thus it may occur some unexpected problems by the individual base. Therefore, the education about the necessity to comply with the recommended wearing time and the problem will be essential.

Comparison of Three Different Helmet Bolus Device for Total Scalp Irradiation (Total Scalp의 방사선 치료 시 Helmet Bolus 제작방법에 관한 연구)

  • Song, Yong-Min;Kim, Jong-Sik;Hong, Chae-Seon;Ju, Sang-Gyu;Park, Ju-Young;Park, Su-Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.31-37
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    • 2012
  • Purpose: This study evaluated the usefulness of Helmet bolus device using Bolx-II, paraffin wax, solid thermoplastic material in total scalp irradiation. Materials and Methods: Using Rando phantom, we applied Bolx-II (Action Products, USA), paraffin wax (Densply, USA), solid thermoplastic material (Med-Tec, USA) on the whole scalp to make helmet bolus device. Computed tomography (GE, Ultra Light Speed16) images were acquired at 5 mm thickness. Then, we set up the optimum treatment plan and analyzed the variation in density of each bolus (Philips, Pinnacle). To evaluate the dose distribution, Dose-homogeneity index (DHI, $D_{90}/D_{10}$) and Conformity index (CI, $V_{95}/TV$) of Clinical Target Volume (CTV) using Dose-Volume Histogram (DVH) and $V_{20}$, $V_{30}$ of normal brain tissues. we assessed the efficiency of production process by measuring total time taken to produce. Thermoluminescent dosimeters (TLD) were used to verify the accuracy. Results: Density variation value of Bolx-II, paraffin wax, solid thermoplastic material turned out to be $0.952{\pm}0.13g/cm^3$, $0.842{\pm}0.17g/cm^3$, $0.908{\pm}0.24g/cm^3$, respectively. The DHI and CI of each helmet bolus device which used Bolx-II, paraffin wax, solid thermoplastic material were 0.89, 0.85, 0.77 and 0.86, 0.78, 0.74, respectively. The result of Bolx-II was the best. $V_{20}$ and $V_{30}$ of brain tissues were 11.50%, 10.80%, 10.07% and 7.62%, 7.40%, 7.31%, respectively. It took 30, 120, 90 minutes to produce. The measured TLD results were within ${\pm}7%$ of the planned values. Conclusion: The application of helmet bolus which used Bolx-II during total scalp irradiation not only improves homogeneity and conformity of Clinical Target Volume but also takes short time and the production method is simple. Thus, the helmet bolus which used Bolx-II is considered to be useful for the clinical trials.

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Dietary Intakes, Serum Concentrations, and Urinary Excretions of Fe, Zn, Cu, Mn, Se, Mo, and Cr of Korean Young Adult Women (일부 젊은 성인여자의 Fe, Zn, Cu, Mn, Se, Mo 및 Cr의 식사섭취, 혈청농도 및 소변배설)

  • Kim, Kyune-Hee;Lim, Hyeon-Sook
    • Journal of Nutrition and Health
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    • v.39 no.8
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    • pp.762-772
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    • 2006
  • This study was conducted to investigate dietary intakes, serum concentrations, and urinary excretions of iron (Fe), zinc (Zn), copper (Cu), manganese (Mn), selenium (Se), molybdenum (Mo), and chromium (Cr) of Korean young adult women. A total of 19 apparently healthy young adult women aged in their twenties or thirties participated voluntarily. One-tenth of all foods they consumed for 3 consecutive days were collected, all urine excreted for the same 3 days was gathered, and fasting venous blood was withdrawn for the trace mineral analyses. Of the food, blood, and urine samples, the contents of Zn, Cu, Mn, Se, Mo, and Cr were analyzed by inductively coupled plasma-mass spectroscopy (ICP-MS) and that of Fe by inductively coupled plasma-atomic emission spectroscopy (ICP-AES) after wet digestion. The intake of Fe, $6.94{\pm}2.18mg$, did not meet the estimated average requirement (EAR) for Korean women aged 20-29 years old. On the contrary, the intakes of Zn ($9.35{\pm}4.95mg$), Cu ($1.18{\pm}0.26mg$), and Mn ($3.69{\pm}0.69mg$) were sufficient for each respective EAR. However, some of the subjects did not take the EAR for Zn. The Se intake, $41.93{\pm}9.28{\mu}g$, however, was almost similar to the EAR for Se. Although there are no references for Mo and Cr, the intakes of these minerals ($134.0{\pm}49.1\;and\;136.5{\pm}147.9{\mu}g$, respectively) seemed to be excessively sufficient. Serum Fe concentration, $88.7{\pm}36.8{\mu}g/dL$, seemed to be a little bit lower than its reference median but within its normal range. Approximately one-fourth of the subjects were in anemic determined by Hb and Hct and below the deficiency serum level of Fe, $60{\mu}g/dL$. In addition, serum Se concentration, $3.73{\pm}0.60{\mu}g/dL$, was also below its reference median and normal range. However, serum concentrations of Zn ($99.6{\pm}30.6{\mu}g/dL$) and Mo ($0.25{\pm}0.10{\mu}g/dL$) were fairly good compared to each reference median. The status of Cu could be determined as good although its serum concentration ($91.6{\pm}14.6{\mu}g/dL$) was slightly below its reference median. Since there are no decisive reference values, it was not easy to evaluate serum concentrations of Mn ($0.93{\pm}0.85{\mu}g/dL$) and Cr ($8.60{\pm}7.25{\mu}g/dL$). But Mn and Cr status seemed to be adequate. Urinary Fe excretion, $4.48{\pm}1.98{\mu}g/dL$, was pretty much lower than its reference and that of Se, $2.45{\pm}1.17{\mu}g/dL$, was also lower than its average. On the other hand, those of Zn ($42.95{\pm}20.47{\mu}g/dL$) and Cu ($5.68{\pm}1.50{\mu}g/dL$) were flirty good. In case of Mn, urinary excretion, $0.31{\pm}0.09{\mu}g/dL$, was much greater than its reference. Urinary excretions of Mo ($7.48{\pm}2.95{\mu}g/dL$) and Cr ($1.37{\pm}0.41{\mu}g/dL$) were very higher compared to each reference. The results of this study revealed that Korean young adult women were considerably poor in Fe status, a bit inadequate in Se status, partly inadequate in Zn status, and flirty good in Cu, Mn, Mo and Cr status. However, there was a problem of excessive intakes of Mo and Cr. It, therefore, should be concerned to increase the intakes of Fe, Se and Zn but to decrease Mo and Cr consumption for young adult women.