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Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results (경피적 동맥관 폐쇄술에 사용된 Duct-Occlud Coil의 종류에 따른 중-단기 결과의 비교)

  • Kim, Myung Kwan;Han, Dong Ki;Choi, Jae Young;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Sul, Jun Hee;Lee, Sung Kue
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.158-164
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    • 2005
  • Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

The Usefulness of MRCP in the Evaluation of Pancreaticobiliary Diseases in Children (소아에서 담췌관 질환에 대한 자기공명 담췌관조영술의 진단적 유용성)

  • Uhm, Ji Hyun;Lee, Seung Yeon;Chung, Ki Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1381-1388
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    • 2002
  • Purpose : Magnetic resonance cholangiopancreatography(MRCP) is a noninvasive method for imaging the pancreaticobiliary tree. The aim of this study was to evalute the usefulness of MRCP for the diagnosis of pancreaticobiliary diseases in children. Methods : From October 1996 to May 2001, 67 patients with obstructive jaundice and three patients with chronic recurrent pancreatitis were evaluated with abdominal ultrasonography and MRCP. The final diagnosis was based on the operative and pathologic findings with biopsy specimen including clinical and laboratory findings. Results : A total of 70 patients, consisting of 31 males and 39 females, with a mean age of $2.6{\pm}3.3$ years were studied. The final diagnosis was biliary atresia in 25, neonatal cholestasis in 18, choledochal cyst without anomalous pancreatobiliary duct union(APBDU) in nine, choledochal cyst with APBDU in seven, cholestatic hepatitis in five, chronic recurrent pancreatitis in three, sclerosing cholangitis in two, and secondary biliary cirrhosis in one case. The overall diagnostic accuracy of abdominal ultrasonography was 75.7% and that of MRCP was 97.1%. The sensitivity and specificity of MRCP were 100% and 98% for biliary atresia, 87.5% and 100% for choledochal cyst with APBDU, 100% and 100% for choledochal cyst without APBDU, sclerosing cholangitis and chronic recurrent pancreatitis, respectively. Conclusion : MRCP is a fast, non-invasive and reliable method for diagnosing pancreaticobiliary diseases in children and will be the standard diagnostic procedure in the future.

A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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Recovery of Copper, Reuse of $TiO_2$, and Assessment of Acute Toxicity in the Photocatalytic Oxidation of Cu(II)-EDTA (Cu(II)-EDTA 광촉매 산화반응에서의 구리회수, $TiO_2$ 재사용 및 처리수 독성평가)

  • Yang, Jae-Kyu;Choi, Bong-Jong;Lee, Seung-Mok
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.8
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    • pp.844-851
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    • 2005
  • The purpose of this study was to determine feasibility of application of regenerated or recycled $TiO_2$ on the successive treatment of Cu(II)-EDTA. The recovery of copper, the reuse of $TiO_2$ and the assessment of acute toxicity was studied in the total eight successive photocatalytic reactions. Aqueous solution of $10^{-4}\;M$ Cu(II)-EDTA was treated using an illuminated $TiO_2$ at pH 6 in a circulating reactor. Two different procedures were applied in the reuse of $TiO_2$: i) recycle of $TiO_2$ without acid wash ii) regeneration of $TiO_2$ with acid wash to remove adsorbed copper in a previous experiment. The averaged decomplexation rate constant($k'_{obs}$) of Cu(II)-EDTA in recycle of $TiO_2$ without acid wash was approximately 45% less than that in regeneration of $TiO_2$ with acid wash. Removal of Cu(II) was near complete after 180 minutes in the total eight successive photocatalytic reactions using the regenerated $TiO_2$ after acid wash. In contrast, removal of Cu(II) was minimum at total fifth successive photocatalytic oxidation using the recycled $TiO_2$ without arid wash. The recovered $TiO_2$ was approximately 86% in average in each procedure. The recovered Cu(II) was 67.9% in average. The acute relative toxicity of the treated water rapidly declined at an initial reaction time up to 60 minutes but little declination was observed after 60 minutes due to little degradation of DOC. Relative toxicity of treated water using the recycled $TiO_2$ without acid wash we some what well correlated with the concentration of dissolved Cu(II). From this work, it is suggested that Cu(II)-EDTA can be effectively treated using an integrated cyclic photocatalytic oxidation with recovery of $TiO_2$ and Cu(II).

Effects of Lime and Humic Acid on the Cadmium Availability and its Uptake by Rice in Paddy Soils (논토양중 카드뮴 유효도와 수도의 흡수이행에 미치는 석회 및 Humic acid 시용효과)

  • Kim, Min-Kyeong;Kim, Won-Il;Jung, Goo-Bok;Park, Kwang-Lai;Yun, Sun-Gang;Eom, Ki-Cheol
    • Korean Journal of Environmental Agriculture
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    • v.23 no.1
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    • pp.28-33
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    • 2004
  • This study was conducted to how the effect of lime and humic acid on cadmium availability and ie uptake by plant grown in contaminated paddy soils with heavy metal. The treatment levels of lime were 2.5 and 5.0 ton/ha and that of humic acid were 1 and 2%. The contents of 0.1N HCl extractable Cd were reduced with lime and humic acid and were negatively correlated with CEC as well as soil pH. The sequential extraction procedure was used to fractionate the heavy metals in soils into the designated from exchangeable (0.5 M $KNO_3$) water soluble ($H_2O$), organically bound (0.5 M NaOH), carbonate (0.05 M $Na_{2-}$ EDTA) and sulfide/residual (4 M $HNO_3$). In soil amended with 2.5 ton/ha lime and 1% humic acia che- mical forms of Cd at tillering stage were predominant exchangeable + water soluble extractable Cd, whereas that at harvesting stage were predominant carbonate + sulfide/residual extractable Cd. The exchangeable forms of Cd in soil with lime and humic acid were negatively correlated with soil pH during the harvesting period. Total absorbed Cd of paddy rice tended to occur in the order of root > stem > leaf > brown rice. Cd contents of brown rice with lime and humic acid treatment were 0.09 and 0.08 mg/kg, respectively. That were lower than control, 0.20 mg/kg. It could be that treatment of lime and humic acid in polluted soil by heavy metals would reduce the uptake of heavy metals by piano and be a temporary method of reclamation at the highly heavy Metal contaminated soils.

Post-thaw Development of Rabbits Pronuclear Embryos by Cryopreservation (토끼 전핵배의 동결보존 후 배발달률)

  • 강다원;조성근;한재희;곽대오;이효종;최상용;박충생
    • Korean Journal of Animal Reproduction
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    • v.23 no.1
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    • pp.75-84
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    • 1999
  • This study assessed development in vitro of pronuclear(PN) stage embryos cryopreserved by the method of either vitrification or slow freezing, by using of different cryoprotectants, and equilibration and cooling rate, in rabbit. Ethyleneglycol- ficoll- sucrose(EFS) or ethyleneglycol- polyvinylpyrrolidone - galactose- (EPG-I) for vitrification, and EPG- II for slow freezing as cryoprotectant were used. The pronuclear embryos were exposed to EFS for 0 to 5 min and diluted with D-PBS and/or pre-dilution with 0.5 M sucrose. To examine the viability of frozen-thawed embryos, PN embryos were co-cultured with bovine oviductal epitherial cell(BOEC) for 5 days to hatching blastocyst stage in 39 $^{\circ}C$ 5% $CO_2$incubator. The results obtained were as follows: The dilution with 0.5 M sucrose and D-PBS after the exposure to EFS for 1.0 min resulted in no significant(P<0.05) decrease in the development of PN embryos to hatching blastocyst(72.0%), compared with controls. The development of PN embryos cryopreserved to hatching blastocyst was not significantly (P<0.05) different between EFS for 1.0 min(72.0%), EPG-I for 1.0 min(72.0%) and EPG-II for 30 min(66. 7%). The post-thaw development of PN embryos to hatching blastocyst was similarly very low as 6.1% and 11.5% in vitrification with EFS and slow freezing with EPG-II, respectively. The incidence of post-thaw zona-crack in PN embryos cryopreserved by slow freezing with plunging to liquid nitrogen at -35$^{\circ}C$ was signicantly(P<0.05) higher(25.0%), compared with -85$^{\circ}C$ (1.9%). These results indicated that the rabbit PN embryos could be cryopreserved with either vitrification or slow freezing procedure, and frozen PN embryos could be successfully developed in vitro to haching blastocyst. but the post-thaw development of cryopreserved PN embryos was still very low under the present conditions.

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Developmental Capacity of Bovine Follicular Oocytes after Ultra-Rapid Freezing by electron Microscope Grid II.Cryopreservation of In Vitro Matured Bovine Oocytes (Electron Microscopic Grid를 이용한 초급속 동결이 소 난포란의 발달능에 미치는 영향. II. 체외 성숙된 소 미수정란의 동결에 관한 연구)

  • 김은영;김남형;이봉경;윤산현;박세필;정길생;임진호
    • Korean Journal of Animal Reproduction
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    • v.22 no.1
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    • pp.1-9
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    • 1998
  • This study was carried out to confirm whether the developmental capacity of bovine mature oocytes frozen ultra-rapidly using electron microscopic(EM) grids and EFS30 can be obtained, and whether the cryoprotectants and the freezing method used in this study effect detrimentally to the bovine oocytes by indirect immunocytochemistry. As freezing solution, we used EFS30 which consisted of 30% ethylene glycol, 0.5 M sucrose, 18% ficoll and 10% FBS added in D-PBS. The results obtained in this experiment were summarized as follows: When the effects of cryoprotectant and freezing procedure on the microtuble, micrfilament and chromatin morphology of oocytes were evaluated using indirect immunocytochemistry, the results of freezing as well as exposure group were not different with that of the control oocytes. When the fertilization abnormality after ultrarapid freezing of bovine mature oocytes was examined by Hoechst staining, the rates of total penetration(96.7, 9.0%), normal two pronuclei formation(74.6, 68.9%) and mean number of sperm / oocyte(1.50, 1.44) were not different between control and freezing group. In addition, when the developmental capacity of frozen-thawed of oocytes(85.5%) was survived, 74.5% of them were cleaved and 31.4% of cleaved embryos were developed to blastocyst. These data were similar to those of the control(76.0%, 34.6%) and exposure(74.5%, 33.0%) except survival rates. Also, when the total cell number of blastocysts produced from the each treatment at day after IVF was examined by hoechst staining, there were not different among groups. There results demonstrate that developmental capacity of frozen-thawed bovine mature oocytes can be successfully obtained by ultra-rapid freezing method using EM grid and EFS30 solution.

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Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

A study on the narrative use of transitional object-characters in the family feature animation (가족용 장편애니메이션<인사이드 아웃>에 나타난 이행대상(transitional object) 캐릭터의 서사적 활용 연구)

  • Park, Hyoung-Dong
    • Cartoon and Animation Studies
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    • s.49
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    • pp.325-357
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    • 2017
  • It can be assumed that the reasons why the animation characters, 'Olaf (in Frozen Kingdom)' and 'Minions (in Super Bad)', etc., which were very successful in the merchandising market while having won the popularity better than the main characters are very popular even though such characters appeared only by playing a funny role while assisting the adventures of the main characters are not only because of their cute appearances but also because such characters have their own core features in their inner world as the transitional object-characters. Simply expressing, a 'Transitional Object' as a concept suggested by a child psychologist, 'Donald Winnicott', means a lovey doll or an imaginary friend which temporarily replaces an infant's mother during the procedure when the infant is mentally separated from its mother. However, in case that the theory of transitional objects was applied directly to many narrative content characters for doing a study, there must have been done some studies in advance for establishing some new criteria and indexes related to the transitional object-characters of such narrative contents. Accordingly, while thinking that the 'emotional relationship' between a growth-subject and a growth mediator must be dealt with as the most important content in order to define a transitional object-character in a narration clearly, this researcher established some emotional index for judging the propensities of a transitional object-character on the basis of such way of thinking. The index is composed of 4 kinds of emotional roles (quasi-family member, growth mediator, lovey doll, an imaginary friend), 6 kinds of emotional supports (hugging, protecting, accepting, giving the initiative, improving the relationship and mutual supervising) and 4 kinds of emotional impressions (impression by contacting, impression to protect and impression accepting an attack). In case that some main characters of a family feature animation, 'Inside Out', are analyzed while the index mentioned above is applied, it was found that 'Bing Bong' and 'Sadness' have a high propensity as a transitional object-character. Especially, it could be inversely inferred in which ways some good transitional object-characters can help the narrations on growth of a family feature animation by taking a look at the character, 'Sadness' that has the highest propensity as a transitional object-character. The transitional object-character, 'Sadness' assists the narration on growth internally and externally by helping the internal maturity of a growth-subject in a way of projecting the tasks for the internal maturity of a growth-subject while helping the growth-subject to be successfully externally in a way of providing the growth-subject with some kinds of facilitating emotion. As the results from this Study, since such kinds of emotional experiences provided by such transitional object-characters are displaced to not only the relevant growth-subjects but also the audience who are emphasized with such growth-subjects as they are, such transitional object-characters play a role of hidden benefactors who induce some immersion into the narrations and provide child and adult audience with various layers of emotional satisfaction.

Comparison of defect size measured by transthoracic and transesophageal echocardiography with balloon occlusive diameter measured during transcatheter closure of atrial septal defect (경피적 심방중격결손 폐쇄술 시 경흉부 및 경식도 초음파 검사 상의 결손의 크기와 풍선 폐쇄 직경과의 관계)

  • Hur, Kyong;Kim, Jeong Eun;Kim, Yuria;Kwon, Hae Sik;Yoo, Byung Won;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.970-975
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    • 2007
  • Purpose : Accurate measurement of defect size is important in transcatheter closure of atrial septal defect (ASD). We performed this study to analyze the difference between the measured ASD size and balloon occlusive diameter (BOD) by transthoracic (TTE) or transesophageal echocardiography (TEE). Methods : We investigated 78 patients who underwent transcatheter closure of ASD. The defect size and the distance between the surrounding structures were measured by TTE and TEE. The BOD was measured by TEE during cardiac catheterization. Clinical characteristics and echocardiographic data were compared and analyzed. Results : The difference between BOD and diameter by TTE was $4.8{\pm}3.6mm$ on short axis view, $5.4{\pm}3.2mm$ on long axis view. The difference between BOD and diameter by TEE was $3.6{\pm}2.2mm$ on short axis view, $4.2{\pm}3.1mm$ on long axis view. The difference between BOD and the diameter of defects on TTE, TEE had statistically significant positive correlations with the age of the patients, distance between the, defect and posterior atrial septal wall, the distance between the defect and the mitral valve leaflet, and the diameter of defects and the length of the atrial septum on TTE (P<0.05). Conclusion : BOD of ASD can be estimated by the diameter on TTE and TEE. BOD is expected to measure larger, depending on the size of defects, the distance from surrounding structures and the location of defects on echocardiography. Our data offers important information on details of transcatheter ASD closure which can be helpful in predicting suitability and judging the procedural appropriateness during the procedure.