• Title/Summary/Keyword: Resistance Factors

Search Result 1,990, Processing Time 0.044 seconds

Ecological Importance of Water Budget and Synergistic Effects of Water Stress of Plants due to Air Pollution and Soil Acidification in Korea (한국에서 수분수지의 생태적 중요성과 대기오염 및 토양 산성화로 인한 식물의 수분스트레스 증대 효과)

  • 이창석;이안나
    • The Korean Journal of Ecology
    • /
    • v.26 no.3
    • /
    • pp.143-150
    • /
    • 2003
  • Korea has plentiful precipitation but rainfall events concentrate on several months of rainy season in her weather condition. Korea, therefore, experiences drought for a given period every year. Moreover the soil has usually low water holding capacity, as it is composed coarse particles originated from the granite. Response of several oaks and the Korean red pine (Pinus densiflora) on water stress showed that water budget was significant factor determining vegetation distribution. In addition, dehydration level due to cold resistance mechanism of several evergreen plants during the winter season was closely related to their distribution in natural condition. Experimental result under water stress showed that the Korean red pine was very tolerant to desiccation but the seedlings showed high mortality during the dry season. The mortality tended to proportionate to soil moisture content of each site. A comparison between soil moisture content during June when it is severe dry season and moisture content of the culture soil when the pine seedlings reached the permanent wilting point due to water withheld proved that high mortality during the dry season was due to water deficit. Water potential of sample plants measured during the exposure experiment to the air pollutant showed a probability that water related factors would dominate the occurrence of visible damage and the tolerance level of sample plants. In both field survey and laboratory experiment, plants exposed to air pollution showed more rapid transpiration than those grown in the unpolluted condition. The result would due to injury of leaf surface by air pollutants. Aluminum (Al/sup 3+/) increased in the acid soil not only inhibits root growth but also leads to abnormal distribution of root system and thereby caused water stress. The water stresses due to air pollution and soil acidification showed a possibility that they play dominating roles in inducing forest decline additionally to the existing water deficit due to weather and soil conditions in Korea. Sludge, which can contribute to improve field capacity, as it is almost composed of organic matter, showed an effect ameliorating the retarded growth of plant in the acidified soil. The effect was not less than that of dolomite known in widely as such a soil ameliorator. Litter extract contributed also to mitigate the water stress due to toxic Al/sup 3+/. We prepared a model showing the potential interaction of multiple stresses, which can cause forest decline in Korea by synthesizing those results. Furthermore, we suggested restoration plans, which can mitigate such forest decline in terms of soil amelioration and vegetation restoration.

Changes of Hemodynamic and Central Pulmonary Artery Dimension After Bidirectional Cavopulmonarv Shunt (양방향성 체정맥-폐동맥 단락술후 혈역학 및 중심 폐동맥 크기의 변화)

  • 이정렬;이해원
    • Journal of Chest Surgery
    • /
    • v.29 no.12
    • /
    • pp.1306-1315
    • /
    • 1996
  • This study reviewed the changes of hemodynamlcs and centrAl pulmonary artery dimension in 54 patients who underwent bidirectional cavopulmonary shunt(BCPS) between February 1992 and December 1995 at Seoul National University Childrell's Hospital. Ag and body weight of patients averaged 36.8 $\pm$ 37.7 months and 8.0$\pm$3.0 kg, respectively Eightynine percent of patients had more than 2 violations of the risk factors for Fontan operation, resulting overall hospital mortality of 16.6%(9154). Serial hemodynamic and anglographic examinations before and mean 16.3 $\pm$ 14.3 months iirter BCPS were compared. The arterial oxygen saturation improved from a preoperative value of 71 9: 10.1 % to 79.H $\pm$ 8. 5% (n:4), p<0.05). The values of arterial oxygen saturation were lower as the age of the patients with BCPS in place was older(n=22, R'=0.341, p=0.004). A mean pulmonary artery pressure and pulmonary vascular resistance reduced from 31 $\pm$17 to 1).5$\pm$3.SmmHg(n=22, p<0.05) and from ).2$\pm$2.1 to 2.3$\pm$2.7 unit (n=7. p>0.05), respectively. Follow-up study showed a significant Increase of absolute values of ipsilateral pulmoanry artery (n: 14, p<0.05), but no change of contralateral pulmonary artreries (n: 14. p=not significant(HSI). However, there w re significant decreases in diameters of both ipsilateral and contralateral pulmonary arteries standardized by patients' body surface areas(16.8% decrease, n: 14, p< 0. 05 for ipsilatreal, 25.1%, n=14, p<0.05 for contralateral). Pulmonary artery indices for cross sectional areas of both pulmonary arterises decreased 9.3 $\pm$ 13.8% with showing a trend of more decrease as the follow-up duration was longer, We conclude that the bidirectional cavopulmonary shunt provide an excellent.

  • PDF

Effects of 12 weeks of home-based exercise program in patients with ankylosing spondylitis (강직성 척추염 환자에 대한 12주간의 가정기반 운동 프로그램의 효과)

  • Cho, Kyoung-Hwan;Jeon, Yunah
    • Journal of the Korean Applied Science and Technology
    • /
    • v.38 no.3
    • /
    • pp.771-785
    • /
    • 2021
  • This study was performed to provide detailed and comprehensive information on inflammation-related blood indicators, joint range of motion, pain scale, and psychological indicators by patient characteristics by performing a 12-week home-based exercise program for ankylosing spondylitis patients. For the purpose of this study, 10 patients with ankylosing spondylitis were selected by age (30s vs. 40s vs. 50s), gender (male vs. female), and duration (less than 5 years vs. 5 years or more). The home-based exercise program was a combination of aerobic exercise and Pilates-based resistance exercise, and was performed 4 times a week for 12 weeks at an intensity of 50-70% of maximal heart rate (MHR). As a result, after 12 weeks of home-based exercise intervention, the blood C-reactive protein (CRP) concentration of patients with ankylosing spondylitis decreased (-35.6%, p=.002), and the blood inflammation level was improved, and each joint (hip, lumbar, cervical) improved mobility (p<.05). In addition, the bath ankylosing spondylitis disease activity index (BASDAI) was decreased by -67% (p=.001) and the visual analogue scale (VAS) was decreased by -64.8% (p=.001), stiffness and pain has been alleviated. In particular, as the degree of depression decreased by -65.5% (p=.001) and the degree of anxiety by -55.2% (p=.003), 12 weeks of home-based exercise improved not only physical changes but also psychological factors. On the other hand, there was no difference in exercise effect according to age, gender, and disease duration in ankylosing spondylitis patients (p>.05). These results suggest that the 12-week home-based exercise applied in this study can be an effective exercise program that can be universally used for ankylosing spondylitis patients regardless of patient characteristics.

Ecological Studies on the Transition of Sheath Blight of Rice in Korea (한국(韓國)에서의 벼 잎집무늬마름병 발생변동(發生變動)에 관(關)한 생태학적(生態學的) 연구(硏究))

  • Yu, Seung-hun
    • Korean Journal of Agricultural Science
    • /
    • v.4 no.2
    • /
    • pp.283-316
    • /
    • 1977
  • In an attempt to obtain a basic information to develop an effective integrated system of controlling sheath blight of rice in Korea, the transition of this disease, the variation of cultural characters and pathogenicity of the pathogen, environmental conditions affecting the disease outbreak and varietal resistance have been investigated. 1. Rice sheath blight which has been minor disease in the past was widely spread, especially since 1971. This disease has promptly spread all over the country and infected 65.2% of total rice growing area in 1976. Various factors are considered to be related to such transition of this disease. Above all, increace of application of nitrogenous fertilizer, early season and earlier cultivation of rice, introduction of more susceptible "Tongil" varieties etc. must be important factors influencing the outbreak of this disease. 2. Great variations in cultural characteristics-such as mycelial growth rate, color of the medium, amount of the aerial mycelium, shape and color of the sclerotia- and in the pathogenicity of isolates of the pathogen, Thanatephorus cucumeris Dank were observed. The optimum temperature for mycelial growth also varied with isolates, from $25^{\circ}C$ to $30^{\circ}C$. There were not necessarily any correlation between curtural characteristics and pathogenicity of isolates of Thanatephorus cucumens. 3. Mycelial grow th of isolates of Thanatephorus cucumens on the PDA medium were correlated with the air temperatures of the region where the isolates were collected. The isolates from the regions with high temperature grew well on PDA medium at $35^{\circ}C$ than those from the region with low temperature, on the other hand, the isolates from the regions with the low temperature grew well on the same medium at $12^{\circ}C$ than those from the regions with high temperature. 4. Pectin polygalacturonase (PG) and cellulase (Cx) were most active on the 3rd day after inoculation on the leaves of rice plant with Thanatephorus cucumeris, whereas pectin methylestrase (PE) was most active on the 4th day after inoculation. Relationship between the activities of PE of isolates and the strength of pathogenicity of isolates was obtained, but PG and cellulase activities were not correlated with pathogenicity of isolates. 5. The tolerence of sclerotia from in-vitro culture to low temperature varied with their water content, the dried cultural sclerotia were more tolerent than wet ones, Dried cultural sclerotia maintained almost 100% germinability for 45 days at $-20^{\circ}C$, whereas wet sclerotia lost viability at $-5^{\circ}C$. The germination ratio of the sclerotia after overwintering changed from 18% to 70% according to the water content of the test paddy fields and the ratio was low in wet paddy condition. 6. To investigate the host range of this fungi in and near paddy field, 17 weeds were inoculated with fungi. The lesions of sheath blight disease was obserbed on Sagittaria trifolia L., Echinochloa crusgalli P. Beauv., Monochoria vaginal is Presl, Polygonum Hydropiper L., Eclipta prostrata L., Digitaria sanguinalis Scapoli. 7. When the level of nitrogen applied was doubled over standard level, total nitrogen content in rice sheath increased, ami when silicate was applied, starch content in rice sheath decreased, inducing the rice plants more susceptible to sheath blight disease. Increased dressing of potash ferilizer reduced the incidence of sheat blight disease. 8. The percentage of infected stems in the early period increased more in the narrow hill plot than in the wide hill plot, but in the late period this tendency was inversed; the percentage of infected stems as well as severity in the wide hill plot increased more compared to the narrow hill plot, and the disease severity in the one plant per hill plot was also low. The number of stems in the wide hill plot was more than the number of stems in the narrow hill plot. This indicates that the microclimate, such as the relative humidity, in the narrow hill plot was more favorable for the development of this disease. 9. There was a high negative correlation between the disease severity of varieties to the sheath blight and the maturity of the varieties, that is, the early varieties were more susceptible than the late ones, and much-tillering varieties usually showed more infection than less tillering varieties. 10. No relationship was obtained between the percentage of infected stems in the early period and the severity after heading, whereas a distinct relationship was obtained between former and latter after Aug. 10.

  • PDF

Weaning Following a 60 Minutes Spontaneous Breathing Trial (1시간 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.3
    • /
    • pp.361-369
    • /
    • 1995
  • Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

  • PDF

An Analysis of the Comparative Importance of Systematic Attributes for Developing an Intelligent Online News Recommendation System: Focusing on the PWYW Payment Model (지능형 온라인 뉴스 추천시스템 개발을 위한 체계적 속성간 상대적 중요성 분석: PWYW 지불모델을 중심으로)

  • Lee, Hyoung-Joo;Chung, Nuree;Yang, Sung-Byung
    • Journal of Intelligence and Information Systems
    • /
    • v.24 no.1
    • /
    • pp.75-100
    • /
    • 2018
  • Mobile devices have become an important channel for news content usage in our daily life. However, online news content readers' resistance to online news monetization is more serious than other digital content businesses, such as webtoons, music sources, videos, and games. Since major portal sites distribute online news content free of charge to increase their traffics, customers have been accustomed to free news content; hence this makes online news providers more difficult to switch their policies on business models (i.e., monetization policy). As a result, most online news providers are highly dependent on the advertising business model, which can lead to increasing number of false, exaggerated, or sensational advertisements inside the news website to maximize their advertising revenue. To reduce this advertising dependencies, many online news providers had attempted to switch their 'free' readers to 'paid' users, but most of them failed. However, recently, some online news media have been successfully applying the Pay-What-You-Want (PWYW) payment model, which allows readers to voluntarily pay fees for their favorite news content. These successful cases shed some lights to the managers of online news content provider regarding that the PWYW model can serve as an alternative business model. In this study, therefore, we collected 379 online news articles from Ohmynews.com that has been successfully employing the PWYW model, and analyzed the comparative importance of systematic attributes of online news content on readers' voluntary payment. More specifically, we derived the six systematic attributes (i.e., Type of Article Title, Image Stimulation, Article Readability, Article Type, Dominant Emotion, and Article-Image Similarity) and three or four levels within each attribute based on previous studies. Then, we conducted content analysis to measure five attributes except Article Readability attribute, measured by Flesch readability score. Before conducting main content analysis, the face reliabilities of chosen attributes were measured by three doctoral level researchers with 37 sample articles, and inter-coder reliabilities of the three coders were verified. Then, the main content analysis was conducted for two months from March 2017 with 379 online news articles. All 379 articles were reviewed by the same three coders, and 65 articles that showed inconsistency among coders were excluded before employing conjoint analysis. Finally, we examined the comparative importance of those six systematic attributes (Study 1), and levels within each of the six attributes (Study 2) through conjoint analysis with 314 online news articles. From the results of conjoint analysis, we found that Article Readability, Article-Image Similarity, and Type of Article Title are the most significant factors affecting online news readers' voluntary payment. First, it can be interpreted that if the level of readability of an online news article is in line with the readers' level of readership, the readers will voluntarily pay more. Second, the similarity between the content of the article and the image within it enables the readers to increase the information acceptance and to transmit the message of the article more effectively. Third, readers expect that the article title would reveal the content of the article, and the expectation influences the understanding and satisfaction of the article. Therefore, it is necessary to write an article with an appropriate readability level, and use images and title well matched with the content to make readers voluntarily pay more. We also examined the comparative importance of levels within each attribute in more details. Based on findings of two studies, two major and nine minor propositions are suggested for future empirical research. This study has academic implications in that it is one of the first studies applying both content analysis and conjoint analysis together to examine readers' voluntary payment behavior, rather than their intention to pay. In addition, online news content creators, providers, and managers could find some practical insights from this research in terms of how they should produce news content to make readers voluntarily pay more for their online news content.

The Reserch on Actual Condition of Crime of Arson Which Occurs in Korea and Its Countermeasures (방화범죄의 실태와 그 대책 - 관심도와 동기의 다양화에 대한 대응 -)

  • Choi, Jong-Tae
    • Korean Security Journal
    • /
    • no.1
    • /
    • pp.371-408
    • /
    • 1997
  • This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

  • PDF

Analysis of Foodborne Pathogens in Food and Environmental Samples from Foodservice Establishments at Schools in Gyeonggi Province (경기지역 학교 단체급식소 식품 및 환경 중 식중독균 분석)

  • Oh, Tae Young;Baek, Seung-Youb;Koo, Minseon;Lee, Jong-Kyung;Kim, Seung Min;Park, Kyung-Min;Hwang, Daekeun;Kim, Hyun Jung
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.44 no.12
    • /
    • pp.1895-1904
    • /
    • 2015
  • Foodborne illness associated with food service establishments is an important food safety issue in Korea. In this study, foodborne pathogens (Bacillus cereus, Clostridium perfringens, Escherichia coli, pathogenic Escherichia coli, Listeria monocytogenes, Salmonella spp., Staphylococcus aureus, and Vibrio parahaemolyticus) and hygiene indicator organisms [total viable cell counts (TVC), coliforms] were analyzed for food and environmental samples from foodservice establishments at schools in Gyeonggi province. Virulence factors and antimicrobial resistance of detected foodborne pathogens were also characterized. A total of 179 samples, including food (n=66), utensil (n=68), and environmental samples (n=45), were collected from eight food service establishments at schools in Gyeonggi province. Average contamination levels of TVC for foods (including raw materials) and environmental samples were 4.7 and 4.0 log CFU/g, respectively. Average contamination levels of coliforms were 2.7 and 4.0 log CFU/g for foods and environmental swab samples, respectively. B. cereus contamination was detected in food samples with an average of 2.1 log CFU/g. E. coli was detected only in raw materials, and S. aureus was positive in raw materials as well as environmental swab samples. Other foodborne pathogens were not detected in all samples. The entire B. cereus isolates possessed at least one of the diarrheal toxin genes (hblACD, nheABC, entFM, and cytK enterotoxin gene). However, ces gene encoding emetic toxin was not detected in B. cereus isolates. S. aureus isolates (n=16) contained at least one or more of the tested enterotoxin genes, except for tst gene. For E. coli and S. aureus, 92.7% and 37.5% of the isolates were susceptible against 16 and 19 antimicrobials, respectively. The analyzed microbial hazards could provide useful information for quantitative microbial risk assessment and food safety management system to control foodborne illness outbreaks in food service establishments.

The Clinical Application and Results of Palliative Damus-Kaye-Stansel Procedure (고식적 Damus-Kaye-Stansel 술식의 임상적 적용 및 결과)

  • Lim, Hong-Gook;Kim, Soo-Jin;Kim, Woong-Han;Hwang, Seong-Wook;Lee, Cheul;Shinn, Sung-Ho;Yie, Kil-Soo;Lee, Jae-Woong;Lee, Chang-Ha
    • Journal of Chest Surgery
    • /
    • v.41 no.1
    • /
    • pp.1-11
    • /
    • 2008
  • Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

Genetic Polymorphisms of the $\beta_2$-Adrenergic Receptor in the Severity of Bronchial Asthma (기관지 천식 환자에서 천식 증상의 정도에 따른 $\beta_2$ 교감신경 수용체의 유전자 다형성)

  • Shim, Jae-Jeong;Kim, Jei-Hyung;Lee, Seung-Yong;Kwan, Young-Hwan;Lee, So-Ra;Lee, Sang-Youb;Kang, Se-Yong;Kang, Yong-Koo;Cho, Jae-Youn;In, Kwang-Ho;Won, Nam-Hee;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.45 no.1
    • /
    • pp.77-89
    • /
    • 1998
  • Background: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of $\beta_2$-Adrenergic Receptor ($\beta_2$AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the $\beta_2$AR has recently been seguenced. The $\beta_2$AR genotype at the polymorphic loci of codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the $\beta_2$AR and its functions are being elucidated. Purpose : The gene encoding the $\beta_2$AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. Methods: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the $\beta_2$AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16,27,34, and 164. Results: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of $\beta_2$AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of $\beta_2$AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1 %,10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the $\beta_2$AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. Conclusion: The arginine 16 to glycine polymorphism of the $\beta_2$AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the $\beta_2$AR gene and nocturnal asthma.

  • PDF