Yi Gijong;Lee Kyo-Joon;Yang Hong-Seok;Ahn Ji-Young;Yoo Kyung-Jong
Journal of Chest Surgery
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v.39
no.1
s.258
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pp.48-55
/
2006
Background: The benefits of preoperative use of aspirin and plavix in coronary patients have been well documented. Due to their bleeding tendency, there have been many discussions about when to stop the antiplatelet agent before operation. We evaluated the effects of preoperative continuous use of aspirin and plavix in OPCAB patients. Material and Method: 123 patients underwent OPCAB from March, 2004 to Feb., 2005. We divided them into two groups; those who had continuous administration of aspirin and plavix during the preoperative period (n=45, 36.6$\%$) and those who discontinued them at least one day before the operation (n=78, 63.4$\%$). We then compared the platelet count, hemoglobin/hematocrit level, graft patency, postoperative bleeding and related complications, and operation time between the two groups. The patients were also divided into long-term users ($\geq$ 1 month) and short-term users (< 1 month), with the aforementioned factors equally compared. Result: There was no statistical difference between the two groups regarding postoperative bleeding, related complications, graft patency, operation time and mortality. Continuous users showed significantly low platelet levels on immediate post operation (p=0.02), postoperative day (POD) $\sharp$1 (p=0.002) and POD $\sharp$2 (p=0.021), respectively. But there was no difference on POD $\sharp$7. Long-term users showed statistically significant difference in pre- and postoperative platelet count, but none in postoperative bleeding and related complications. Conclusion: Continuous use of aspirin and plavix did not increase postoperative bleeding or related complications. Also graft patency and mortality had no statistical differences in continuous users. We think that there is no need to stop aspirin and plavix before OPCAB.
Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
Journal of Chest Surgery
/
v.36
no.8
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pp.559-565
/
2003
By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.
Purpose: This study was to explore barriers to effective pain management in general population. Methods: Total 163 Participants completed the Barrier Questionnaire-II (BQ-II), a 27-item on a six point scale, from May to June in 2007. BQ-II consisted of four subscales which were 1) physical effects (PE) addressing beliefs that side effects of analgesics are inevitable and concerns about tolerance, fatalism (Fa) addressing fatalistic beliefs about cancer pain and its management, Communication (Co) addressing the beliefs of 'good patient' and concerns of distracting physician from underlying disease, and harmful effects (HE) addressing fear of addiction and harmful effect to immune system of pain medicine. Results: The BQ-II total had an internal consistency of 0.877 in this study. HE was the biggest barrier (3.03) followed by PE (2.73), Fa (2.15), and Co (1.71). Items appeared as great concerns were 'there is a danger of becoming addicted to pain medication'(3.58), 'using pain medicine blocks your ability to know if you have any new pain' (3.18), 'pain medicine is very addictive' (3.09), 'when you use pain medicine your body becomes used to its effects and pretty soon it won't work any more' (3.09), and 'drowsiness from pain medicine is difficult to control' (3.09). Only 12 respondents (7.4%) reported that they took any type of pain education, however, those who took pain education represented significantly lower barriers to pain management than who did not (P=.029). Conclusion: This result suggests the strategies for public education to surmount cancer pain.
Mutations in the APP gene lead to enhanced cleavage by ${\beta}-$ and ${\gamma}-secretase$, and increased $A{\beta}$ formation, which are closely associated with Alzheimer's disease (AD)-like neuropathological changes. Recent studies have shown that exercise training can ameliorate pathogenic phenotypes ($A{\beta}-42$, BDNF, GLUT-1 and HSP70) in experimental models of Alzheimer's disease. Here, we have used NSE/APPsw transgenic mice to investigate directly whether exercise training ameliorates pathogenic phenotypes within Alzheimer's brains. Sixteen weeks of exercise training resulted in a reduction of $A{\beta}-42$ peptides and also facilitated improvement of cognitive function. Furthermore, GLUT -1 and BDNF proteins produced by exercise training may protect brain neurons by inducing the concomitant expression of genes that encode proteins (HSP-70) which suppress stress induced neuron cell damages from APPsw transgenic mice. Thus, the improved cognitive function by exercise training may be mechanistically linked to a reduction of $A{\beta}-42$ peptides, possibly via activation of BDNF, GLUT-1, and HSP-70 proteins. On the basis of the evidences presented in this study, exercise training may represent a practical therapeutic management strategy for human subjects suffering from Alzheimer's disease.
Production of highly valuable immunotherapeutic proteins such as monoclonal antibodies and vaccines using plant biotechnology and genetic engineering has been studied as a popular research field. Plant expression system for mass production of such useful recombinant therapeutic proteins has several advantages over other existing expression systems with economical and safety issues. Immunotherapy of multiple monoclonal antibodies, which can recognize multiple targeting including specific proteins and their glycans highly expressed on the surface of cancer cells, can be an efficient treatment compared to a single targeting immunotherapy using a single antibody. In this study, we have established plant production system to express two different targeting monoclonal antibodies in a single transgenic plant through crossing fertilization between two different transgenic plants expressing anti-colorectal cancer mAbCO17-1A and anti-breast cancer mAbBR55, respectively. The F1 seedlings were obtained cross fertilization between the two transgenic parental plants. The presence, transcription, and protein expression of heavy chain (HC) and light chain (LC) genes of both mAbs in the seedlings were investigated by PCR, RT-PCR, and immunoblot analyses, respectively. Among all the seedlings, some seedlings did not carry or transcribe the HC and LC genes of both mAbs. Thus, the seedlings with presence and transcription of HC and LC genes of both mAbs were selected, and the selected seedlings were confirmed to have relatively stronger density of HC and LC protein bands compared to the transgenic plant expressing only each mAb. These results indicate that the F1 seedling plant with carrying both mAb genes was established. Taken together, plant crossing fertilization can be applied to generate an efficient production system expressing multiple monoclonal antibodies for immunotherapy in a single plant.
This thesis study of the medical concept Qiu Zheng Lu (求正錄) is discussed in the Lei Jing Fu Yi (類經附翼), a book authored by Zhang Jie Bin (張介賓) a medical doctor during the Chinese Ming (明) dynasty (1368-1683). The meaning of Qiu Zheng Lu (求正錄) is "searching for the rightness." In his book Zhang Jie Bin (張介賓) intended to clarify Qiu Zheng Lu (求正錄) by delineating the concept into four categories. These are: Sanjiao Baoluo Mingmen Bian (三焦包絡命門 辨) the theory of the triple warmer, the Pericardium, the Gate of Life ; Da Bao Lun (大寶論) the theory of the great treasure of the human body; Zhen Yin Lun (眞陰論) the theory of true-yin fluid; and Shi Er Zang Mai Hou Bu Wei Lun (十二臟脈候部位論) the theory of the part of the pulse and its condition in regards to the twelve viscera. Sanjiao Baoluo Mingmen Bian (三焦包絡命門辨), the theory of the triple warmer, the Pericardium, the Gate of Life. The triple warmer (三焦: Sanjiao) is composed of three parts: the upper, middle, and lower. This concept is also connected with the functions and roles of the vital organs. The upper burner is related to the heart and lungs. The middle burner is related to the liver and spleen. Whereas, the lower burner is related to the kidneys. Bao-Luo (包絡) is the Pericardium, the envelope of the heart, serving as the protector of the heart. Ming-Men (命門) is the Gate of Life, reffering to the vitals of life. It functions as kidney-yang which is considered as the origin of yang-energy of the human body, and serves partly as the function of cortico-adrenal gland in modern medicine. Zhang Jie Bin (張介賓) discussed the Da Bao Lun (大寶論) as the most important function in the human body because the Da Bao (大寶/great treasure) is the true-yang (眞陽) which is the affective force for physiological functions, and as the source of energy for life activities. Moreover, true-yang (眞陽) functions both as a heater and thermometer that warms the human body and indicates vitality by levels of body warmth respectively. The Zhen Yin Lun (眞陰論) theory states that if true-yang (眞陽) is energy, then true-yin (眞陰) is the source of energy. This can be likened to a tree with roots which absorbs nutrients from the ground (source), and spreads the nutrients (energy) through its branches. Thus, true-yin (眞陰) is the root cause for later functional activities of true-yang (眞陽). In Shi Er Zang Mai Hou Bu Wei Lun (十二臟脈候部位論) the theory of the pulse (脈 /Mai) and its condition in regards to the twelve viscera, Zhang Jie Bin (張介賓) insisted that when a diagnoses by the pulse is made the five vital organs and the six viscera (五臟六腑) of a human body should be harmoniously arranged in accordance with its respective part of the pulse. Furthermore, Zhang Jie Bin (張介賓) supported his theory with evidence from earlier Chinese medical doctors. And, by stating that human beings must cultivate and preserve their true-yin (眞陰) and true-yang (眞陽) energies he therefore created four new prescriptions called: Zuoguiyin (左歸飮), Youguiyin (右歸飮), Zuoguiwan (左 歸丸), Youguiwan (右歸丸). To further clarify his theory Zhang Jie Bin (張介賓) considered that the function of true-yang (眞陽) and true-yin (眞陰) is expressed by Ming-Men (命門). This theory is that for humans to be spiritually and physically healthy they must live in accord with natural law. Also, within the framework of natural law, astronomical and geographical factors must be considered for complete, holistic, health. Thus, Ming-Men is the basis for healthy living in the modern world.
Malachite green was measured in 200 freshwater fish collected from local markets in Seoul using HPLC-DAD and LC-MS/MS. LC-MS/MS method was validated by linearity, accuracy, precision and limits of detection and quantification according to the CODEX's recommendation and HPLC-DAD method was applied according to the Food Code. Malachite green levels above the quantification limit of the LC-MS/MS were determined 18.5% (37) but just 1 fish was shown to contain malachite green by HPLC-DAD. Of 83 domestic fish, 21 fish were detected malachite green (25.3%). Of 117 fish from China, just 16 fish were detected malachite green (13.4%). In detection rate by species carp (35.0%), Crucian carp (30.4%), cat fish (28.0%), Korean bull head (23.8%), snake head (20.0%), eel (10.5%) and loach (7.8%) were in order. Especially, fish collected at summer were shown to contain malachite green frequently; the detection rate was 54.8%.
An investigation of various olive oils available in Korea was carried out to assess their quality properties such as color, oxidative stability, fatty acid composition, tocopherol content, sterol content and benzo(a)pyrene content. In color measurement, by using a Lovibond color scale and Hunter color difference meter, both a and b values of extra virgin olive oil were higher than those of pure olive oil by Tintometer (Lovibond PFX995). However, extra virgin olive oil showed higher a value and lower L value than pure olive oil by the Hunter color difference meter. In the rancimat test, the induction period of extra virgin olive oil $(38.03{\sim}8.47hr)$ was longer than that of pure olive oil $(32.40{\sim}9.94hr)$. In fatty acid composition, C18:1 $(72.01{\sim}78.53wt%)$ was present in the greatest amount, with lesser amounts of C18:2 $(4.88{\sim}10.36wt%)$ and C18:3 $(0.56{\sim}1.09wt%)$. The tocopherol content ranged from ${\alpha}-Toc\;4.09{\sim}13.89mg/100g$, ${\beta}-Toc\;0.57{\sim}1.34mg/100g$, and ${\gamma}-Toc$$3.41{\sim}8.03mg/100g$, and ${\alpha}-tocopherol$ was found to be the main isomer in all oil samples. Therefore, there was little difference in the fatty acid composition and tocopherol content among the different types of olive oils. In sterol content, ${\beta}-sitosterol$$(124.52{\sim}19.33mg/100g)$ and campesterol $(1.10{\sim}0.62mg/100g)$ of extra virgin olive oil were higher than that of pure olive oil $({\beta}-sitosterol\;92.68{\sim}17.44mg/100g,\;campesterol\;0.59{\sim}0.35mg/100g)$. Benzo(a)pyrene was found in almost all samples, with $0.287{\sim}0.106{\mu}g/kg$ in extra virgin olive oil and $1.204{\sim}2.130{\mu}g/kg$ in pure olive oil.
Son, Sohee;Kang, Ji-Man;Kim, Jong Min;Sung, Sein;Kim, Yi-Seoul;Lee, Haejeong;Kim, BitA Reum;Lee, Yeon Kyoung;Ko, Sun Young;Shin, Son Moon;Kim, Yae-Jean
Pediatric Infection and Vaccine
/
v.24
no.3
/
pp.134-140
/
2017
Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.
Kim, Jae Choon;Kim, Su Ji;Yun, Ki Wook;Choi, Eun Hwa;Yi, Nam Joon;Suh, Kyung Suk;Lee, Kwang-Woong;Lee, Hoan Jong
Pediatric Infection and Vaccine
/
v.25
no.2
/
pp.82-90
/
2018
Purpose: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients. Methods: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1-5 months, and between 6-12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded. Results: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1). Conclusions: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.
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