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Diagnostic Usefulness of N-Terminal Probrain-type Natriuretic Peptide to Detect Congestive Heart Failure Patients (울혈성 심부전 환자에서 N-Terminal Probrain-type Natriuretic Peptide의 진단적 유용성)

  • Son, Gye-Sung
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.2
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    • pp.88-95
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    • 2005
  • Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

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Comparison of Breast Measurement Ratios Before and After Breast Augmentation Using Photogrammetric Ratio Measurements (PRM)

  • Yi, Kyong-Hwa;Sohn, Boo-Hyun
    • Journal of the Ergonomics Society of Korea
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    • v.36 no.4
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    • pp.305-323
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    • 2017
  • Objective: The purpose of this study was to determine breast shape and ratio of breast enlargement women prior to development of breast enlargement patient's bra. Background: Although there are many previous studies on women's breast that did not undergo breast augmentation surgery, no studies have examined the breast type and proportion of women with breast augmentation. Method: In this study, we analyzed ratios and angles with photographs taken before and after breast augmentation on the frontal and lateral views of the breast, UPF and projection were analyzed too. We also compared the pre-operative and post-operative rates with those of previous breast studies, as well as the post-operative breast types for the desirable breast types. Results: The length and width of the breast base and the height of the breast projection increased after the operation. The rate of increase in width is larger than the vertical distance in the breast base, and the rate of increase in height of the projection is larger than the increase in the width. Specifically, in the vertical distance, the rate of increase in the lower portion is larger than that in the upper portion. In the width, the rate of increase on the inside is larger than that on the outside. Conclusion: The angles of the static relationship with the projection increased and the angles of the minor relation decreased. The changes in the size of the breast were visually observed in the overlapping of the triangle shape before and after the surgery. The changes were composed of the line connecting the angle and the measurement points. The pre-operative upper pole fullness (UPF) was mostly 0 and - 1, but after the surgery, +1, 0, -1, +2 were distributed, while post-operative levels of projection were distributed in the order of level 3> level 1> level 2. In comparison with the desirable breast type, it was found that the anatomical type was a more natural breast type than the round type of implant. Application: These results can be useful as basic data for the breast analysis of breast enlargement patients and their bra patterns.

Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments

  • Ozyurek, Taha;Tek, Vildan;Yilmaz, Koray;Uslu, Gulsah
    • Restorative Dentistry and Endodontics
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    • v.42 no.4
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    • pp.332-341
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    • 2017
  • Objectives: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. Materials and Methods: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with ${\chi}^2$ tests using SPSS 21.0 software. Results: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

Electrocardiographic follow-up after mitral valve replacement (심장판막치환환자의 심전도적 술후 추적)

  • 김종환
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.231-243
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    • 1984
  • Despite its known limitation in the diagnostic value, the electrocardiography is one of the most common and routine examinations in the management of the patients with cardiac problems. The clinical results of 291 patients who underwent isolated mitral valve replacement from October 1978 to June 1983 were already reported. Their electrocardiograms were studied to assess the value of electrocardiographic examination in following the patients after valve replacement. The patients were divided into 5 groups beforehand according to the types of valve lesion on the bases of preoperative diagnosis and operative findings: Groups I: stenosis, I1: stenosis-dominant mixed, II1: equally mixed, IV: insufficiency-dominant mixed, and V: insufficiency. Their preoperative cardiac rhythm was sinus in 39.2% and atrial fibrillation in 59.1% of the patients. Seventy-three [42.4%] of the patients with atrial fibrillation gained sinus rhythm after operation, occurring in 67 from the day of surgery, and 42 returned to atrial fibrillation while 37 kept sinus rhythm at the follow-up end [mean follow-up period, 13.4\ulcorner1.4 months]. The P waves on the electrocardiograms of the preoperative sinus rhythm in 114 patients were normal in 5.3% and the findings of left atrial enlargement in 94.7% of the cases. They were normal in 42.1% and the findings of left atrial enlargement in 57.9% of the 140 patients with sinus rhythm at the follow-up. The preoperative major chamber enlargement was the right ventricle in Group I while it was the left ventricle in Group V, and it was in-between in Groups II-IV. The postoperative regression of the findings in ventricular enlargement was statistically significant only in Groups I and V. These results may suggest the importance of the serial electrocardiograms in following the patients with mitral valve replacement on the bases of outpatient. The electrocardiographic follow-up data were presented in patients with suspected or proved tissue valve failures.

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A Study on Aesthetic Characteristics of Enlargement Hair Type - Compare the Enlarged Hair Type in the late Chosun Dynasty and that in Rococo - (확대형 두발양식의 미적특성에 관한 연구 - 조선후기와 로코코시대의 비교분석 -)

  • Yim, Lynn;Kim, Eun-Jung
    • Journal of the Korean Society of Costume
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    • v.57 no.4 s.113
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    • pp.143-158
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    • 2007
  • This study considers enlargement phenomenon in hair style as one of Costume types and analyzes its artistic characteristics based on the comparison between Hair style in the late Chosun Dynasty and that of the Rococo. First, its formative property, one of the common aesthetic characteristics, breaks the concept of traditional balance in Clothing and emphasizes its transformation, changes, and space beauty. This formative property shows the Enlargement and exaggeration beyond the concept of Space. Its sensuous property reflects women's psychological minds; exaggeration and sensualism. Artistic property doesn't focus on hair style only or clothing style only and considers hair style as renter of beauty as well as its important element. It shows the traditional beauty of nature and creativity in the Chosun Dynasty. Second, its formative property, one of the differential aesthetic characteristics, shows these following differences considering the aesthetic characteristics in the late Chosun Dynasty and that of the Rococo; mutual transformation, independent transformation, focus on distortion, harmony in scale, disharmony between irregularity and exception, extension and separation in space, etc. Sensuous property shows the temperate beauty and metaphorical sense, affected by the Practical Science, in the late Chosun Dynasty while it shows the secular sense and exaggerated beauty, affected by the Enlightenment, in the Rococo. Artistic property shows the harmony with the Clothing style, balanced wearing lines, and natural beauty, as one part of Clothing, in the late Chosun Dynasty. However it shows creativity, as separate part from Clothing, in the Rococo.

Midterm results of aortic root enlargement with AVR in patients with narrow aortic root and AS (협소 대동맥 판륜을 가진 환자에서의 대동맥치환술시 판륜 확장술의 중기 성적)

  • 박광훈;김하늘루;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.285-289
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    • 2000
  • Background: For AVR using conventional prosthetic valves in adult patients with a narrow aortic root, aortic root enlargement is necessary to reduce postoperative pressure gradient across the aortic valve (ΔP). An evaluation of early and mid-term results of aortic root enlargement with AVR and echocardiographic follow up of ΔP and left ventricular function was performed. Method: From Aug. 1991 to Feb. 1998, eighteen patients aged 17 to 59 years(mean, 38$\pm$12 years) underwent Manouguian procedure with AVR. Aortic annular circumstance was enlarged 10.0mm to 18.0mm(mean, 12.6$\pm$6.3mm). Eight patients(44.0%) had NYHA class III status before operation, and seven cases of them underwent concomitant MVR. Valve pathology was ASr in 6 cases, AS in 4 cases, nd ASr+MSr in 8 cases. Replaced valve size was 21mm in 8 cases and 23 mm in 10 cases, and St. Jude Medical mechanical valve was used in 10 cases and Carbomedics in 8 cases. Result: Follow-up duration was 6 to 57 months (mean, 26$\pm$18 months), and total follow-up was 287 patient-year. There were one hospital death and one late death, therefore, actuarial survival rate was 85.7% at 56 months. Peak ΔP wad decreased significantly at postoperative mid-term period as 13$\pm$5mmHg, compared with thepreoperative one (42$\pm$8mmHg) (p<0.01). LVM(gm/$m^2$) was also diminished as 35.8%(115$\pm$36gm/$m^2$)at postoperative mid-term period, compared with preoperative one (179$\pm$56gm/$m^2$)(p<0.05). Conclusion: There were no specific complications related to the procedure. And we could have adequate enlargement of aortic annulus to suitable prosthetic valve that have no effect of patient-prosthese mismatch.

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Pullout Behavior Characteristics of Enlarged Cylinder Type Anchor Using Numerical Analysis (수치해석을 이용한 확공형 앵커의 인발거동 특성)

  • Moon, Joon-Shik;Lee, Min-Joo
    • Journal of the Korean Geosynthetics Society
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    • v.16 no.4
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    • pp.113-118
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    • 2017
  • Numerical analysis was carried out using a finite element analysis program to analyze the behavior characteristics of enlarged cylinder type anchor. It was found that the ultimate resistance of enlarged cylinder type anchor increases with the enlargement angle from numerical analysis for various enlargement angle cases. In the case of $30-60^{\circ}$ of enlargement angle, the deformation and stress distribution characteristics in anchor are similar regardless of enlargement angle. However, when the same tensile force is applied, there is a difference in the degree of frictional resistance because of difference of displacement of top of grouting zone. Also, it was found that the maximum compressive force and tensile force were generated at the cone of the upper portion of the grouting zone, and tensile fracture of the upper grouting portion is likely to occur.

Intra-European Trade Flow and Trade Structure (유럽연합 확대와 역내 교역흐름 및 교역구조 변화)

  • Moon, Nam-Cheol
    • Journal of the Economic Geographical Society of Korea
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    • v.12 no.4
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    • pp.406-420
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    • 2009
  • European economic integration and geographical enlargement brought change in the intra-european trade flow and a trade structure. The first, an european enlargement contributes to the increase in intra-european trade, but its effect relatively becomes smaller successive enlargement. The second, the intra-industry trade increases in the intra-european trade according as an european economic integration and enlargement make possible the economy of scale. In the intra-industry trade, the horizontal intra-industry trade decreases and the vertical intra-industry trade increases. The third, the Western Europe's trade is generally an intra-industry trade, the trade of Southern Europe, Central and Eastern Europe is an inter-industry trade. But the South Europe's trade and Central and Eastern Europe's trade change from the inter-industry trade to the intra-industry trade.

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Economic Feasibility Analysis of a Tunnel Section Enlargement Method That Does Not Halt Traffic Flow (교통류 보존형 터널단면 확대 시공기술의 경제적 타당성 분석)

  • Lee, Seung Soo;Kim, Dong-Gyou;Seo, Jong Won
    • The Journal of Engineering Geology
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    • v.25 no.4
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    • pp.459-472
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    • 2015
  • A recently developed tunnel section enlargement method can maintain traffic flow during construction by using a protector. By keeping traffic flowing, it can minimize the lost time and costs associated with diversions and also the accompanying environmental pollution. On the other hand, installing the protector can lengthen the construction period and increase the direct cost. This paper presents a method for analyzing the economic feasibility of tunnel section enlargement methods considering the direct construction cost and the indirect social cost. The indirect costs are divided into categories of: vehicle driving cost, travel time delay cost, and environmental pollution cost. The economic efficiency of existing technology is compared with the new method in an case study of Namsan Tunnel 3.