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Statistical Analysis of Patients Referred to Pediatric Cardiology Clinic for Diagnosis of Heart Disease (심장질환의 진단을 위해 의뢰된 환아들에 대한 자료 분석)

  • Choi, Kwang-Hae;Lee, Young-Hwan
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.49-54
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    • 2000
  • Background: Echocardiography is rapidly establishing itself as the primary diagnostic technique for investigation of children with heart diseases, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analyzed data on the patients referred to the pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. Methods: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. Results: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(67 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6% (26R cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral ed to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia01.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia. 13 cases(3.0%); normal heart. 144 cases(33.6%). Conclusion: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patients were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Therefore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

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The Study on Chinese Comics Characteristics (중국 만화 <삼모 유랑기> 의 특성 연구)

  • Jin, Li-Na;Kim, Mi-Rim
    • Cartoon and Animation Studies
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    • s.48
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    • pp.333-358
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    • 2017
  • Mainland China is under different conditions both socially and politically than other countries, so there is a lack of practical researches on cartoon characters. With a profound interest, the researcher has selected a character that is realistic and loved by many Chinese. The subject of the study is "Shan Mao Series." Out of 16 seasons, the most famous one is the Chronicle of Shan Mao's Wander. I analyzed the character thoroughly, dealing with the beginning of the character, the process of character development, and a reality shown in the chronicle, etc. on chapter II, and the character's image component on chapter III. Chinese modern cartoons were affected by a situational anxiety because of foreign powers and war. Thus satire cartoons went in fads among the public. The epitome of a typical cartoon was the Shan Mao Series. From 1935, when the character was first created, to now it has eaten into Chinese people's hearts. It's because the story happens during a war period and it deals with a playful, humorous main character's life and these facts show the hidden side of the unfair social system. Most of readers prefer a smart, playful, righteous, and brave character. Shan means three and mao, hair in Chinese, so Shan Mao is a child who has three hair. The character is not just a simple cartoon character; it has developed into a national figure among many Chinese. The reason why the researcher has chosen the series created by Zhang Leping, the author of the cartoon, is because a good cartoon, good animation, and even good movie stimulate the feelings that we get from our surroundings. The character which is created in China seems very unique and bizarre but there is a sense of friendliness. Also its character image and scenes make people laugh and it has become a typical symbol of a modern cartoon in China.

Effects of Potassium-Channel Opener on Thallium-201 Kinetics: In-vitro Study in Rat Myocyte Preparations and In-vivo Mice Biodistribution Study (K-통로개방제가 배양심근세포와 생쥐 체내의 Thallium-201역동학에 미치는 영향)

  • Lee, Jae-Tae;Kim, Eun-Ji;Ahn, Byeong-Cheol;Sohn, Kang-Kyun;Lee, Kyu-Bo;Ha, Jeoung-Hee;Kim, Chun-K.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.507-515
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    • 1996
  • Background : Potassium channel opener (K-opener) opens ATP-sensitive K'-channel located at cell membrane and induces potassium efflux from cytosol, resulting in intracellular hyperpolarization. Newly synthesized K-opener is currently examined for pharmacologic potency by means of rubidium release test from smooth muscle strip pre-incubated with Rb-86. Since in-vivo behavior of thallium is similar to that of rubidium, we hypothesized that K-opener can alter T1-201 kinetics in vivo. Purpose : This study was prepared to investigate the effects of pinacidil (one of potent K-openers) on the T1-201 uptake and clearance in cultured myocyte, and in-vivo biodistribution in mice. Methods : Spontaneous contracting myocytes were prepared to imitate in-vivo condition from 20 hearts of 3-5 days old Sprague-Dawley rat and cultured for 3-5 days before use ($5{\times}10^5$ cells/ml). Pinacidil was dissolved in 10% DMSO solution at a final concentration of 100nM or l0uM and was co-incubated with T1-201 in HBSS buffer for 20-min to evaluate its effect on cellular T1-uptake, or challenged to cell preparation pre-incubated with T1-201 for washout study. Two, 40 or $100{\mu}g$ of pinacidil was injected intravenously into ICR mice at 10 min after $5{\mu}Ci$ T1-201 injection, and organ uptake and whole body retention rate were measured at different time points. Results : Co-incubation of pinacidil with T1-201 resulted in a decrease in T1-201 uptake into cultured myocyte by 1.6 to 2.5 times, depending on pinacidil concentration and activity of T1-201 used. Pinacidil enhanced T1-201 washout by 1.6-3.1 times from myocyte preparations pre-incubated with T1-201. Pinacidil treatment appears to be resulted in mild decreases in blood and liver activity in normal mice, in contrast, renal and cardiac uptake were mildly decreased in a dose dependent manner. Whole body retention ratios of T1-201 were lower at 24 hour after injection with $100{\mu}g$ of pinacidil than control. Conclusion : These results suggest that treatment with K-opener may affect the interpretation of T1-201 myocardial images, due to decreasing thallium accumulation and enhancing washout from myocardium.

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THE CURRENT STATUS OF BIOMEDICAL ENGINEERING IN THE USA

  • Webster, John G.
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.27-47
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    • 1992
  • Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

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Influence of Personal Characteristics and Background Characteristics on Entrepreneurship and Perceived Business Performance in Entrepreneurs as Independent Business Owners of Network Marketing (네트워크 마케팅 독립사업자 창업가의 개인 특성, 배경 특성이 기업가정신과 인지된 경영성과에 미치는 영향)

  • Yoon, Hae Sook;Song, In Bang;Kim, Yeon Jong
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.4
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    • pp.233-244
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    • 2018
  • The purpose of this study was to improve awareness of network marketing business in South Korea, which takes a quite negative view of network marketing, to raise awareness of "starting up a business" as independent business owners, to assist them in building their own subjecthood in network business and entrepreneurial identity, and ultimately to give some suggestions on how to improve their self-directed entrepreneurial competency and the quality of their business management. To make an empirical analysis of 121 independent business owners of Korean native network marketing, the personal and background variables of the entrepreneurs were selected as independent variables, and entrepreneurship was selected as a mediator variable. The selected dependent variables were financial and non-financial business performances. A multiple regression analysis was conducted by inputting the variables. The findings of the study were as follows: It produced an effect of more financial performance when the innovation of the independent business owners of network marketing was better, and this innovation was possible to have only when they improved in entrepreneurial efficacy and locus of control. In contrast, only authenticity had an effect on boosting non-financial business performance among the factors of entrepreneurship. To have authenticity, it's necessary to strengthen achievement needs and awareness of locus of control among the personal characteristics of the independent business owners of network marketing. Among the factors of entrepreneurship, there was better authenticity when their personal networks were broader among their background characteristics. In addition, self-efficacy that was one of personal characteristics made a direct contribution to the enhancement of non-financial performance. As a result, independent business owners of network marketing are required to hold a strong belief in their own business, to be active in business activities and to have a high efficacy as spontaneous principal agents, and they also are required to have more adventurous, planned, active and propulsive achievement needs that enable them to attain the goals of their business and keep moving forward. Besides, they should foster their locus-of-control competency that is to control, endure and be responsible for a variety of phenomena or incidents that they face, and there will be better financial performance or non-financial performance only when they demonstrate their self-belief and confidence and when they have faith in and conviction about themselves. For independent business owners of network marketing, a consumer-centered thinking that entails authenticity and trustworthiness and touches the hearts of customers is a more effective marketing strategy than an egocentric thinking as sellers when they approach customers. And they are expected to make progress in terms of the quality of business management when their business attachment or enthusiasm is great enough to match their own efficacy with entrepreneurial identity or strike a balance between them.

Establishment of Featal Heart Surgery with an Improvement of the Placental Blood Flow in Cardiopulmonary Bypass Using Fetal Lamb Model (양태아를 이용한 심폐우회술에서의 태반혈류개선을 통한 태아심장수술의 기반기술 확립)

  • 이정렬;박천수;임홍국;배은정;안규리
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.11-18
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    • 2004
  • Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.

Early histological change in hard tissue from orthodontic force placed on microscrews in ovariectomized rats (난소 적출 백서에 식립된 마이크로스크류에 교정력 부여 시 나타난 초기 경조직 변화에 관한 연구)

  • Lee, Dea-Seung;Chang, Moon-Jung;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.103-113
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    • 2006
  • Most elderly women experience a decrease in their bone density due to a deficiency of calcium intake, ovariectomy, or menopause. This study evaluated the usability of the microscrew as a skeletal anchorage system in these orthodontic treatment cases, using rats as a research group. The 4 month old sprague-dawley species rats were divided into two groups, the OS (Ovariectomy Screw), and the SS (Sham operation Screw) group. In both the OS and SS groups, microscrews were implanted into the palatal bone between the upper molar teeth and two upper incisors were retracted using NETE coil spring with 75 g of force. After 3days, the again after 7 days, 7 rats in each group were sacrificed. Three days before they were sacrificed, Alizarin red S was intraperitoneally injected, and their maxillary bone, tibia and blood from their hearts were taken. The components of the extracted blood were biochemically analyzed and non-decalcified grinding resin sections for maxillary bone and tibia were made. The sections were examined with a polarization microscope, and fluorescent microscope. Smaller concentrations of Ca and P, the inorganic substances closely related to bone density, were found in the extracted blood of the OS group. Both OS and SS groups showed a possibility of bone remodeling with a high concentration of ALP after 7 days. An increase in bone density on the tension and compression sides of the microscrew and the tension side of the tooth for both OS and SS groups was confirmed with a polarization microscope. However, the bone density of the pressure side of the tooth and apical side was decreased. More deposits of Alizarin red S in the bone after 7 days rather than 3 days seen with a fluorescent microscope suggested the existence of new bone formation.

Comparison of Performance of Laying Hens in Molting Methods (유도 환우 방법에 따른 산란계의 생산성 비교)

  • Hong, E.C.;Na, J.C.;Kim, H.K.;Park, H.D.;Choi, Y.H.;Kang, G.H.;Suh, O.S.;Choi, H.C.;Nho, W.G.;HwangBo, J.
    • Korean Journal of Poultry Science
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    • v.35 no.4
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    • pp.391-398
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    • 2009
  • The objective of the present study was to compare of the effects of four molting methods on performance of laying hens. In total, 120 White Leghorn layers (62 weeks of age) were used. The four molting methods consisted of 10 days of feeding and the first 3 days of water withdrawal (FW1, 2) followed by ad libitum access to a layer diet 1 and 2 from day 11; 28 days of restricted feeding (NFW1); 28 days without withdrawing their feed (NFW2). Egg production of postmolt decreased until $3{\sim}4$ days at FW1 and FW2 treatments and until $16{\sim}18$ days at NFW1 and NFW2. 50% recovery of egg production were 7, 6, 7 and 5 week at FW1, FW2, NFW1, and NFW2 treatments, respectively. At day 14 of postmolt, the weight of livers, hearts, and oviducts decreased at molting treatments (P<0.05). Egg quality was improved on egg weight, eggshell thickness, eggshell break strength, and Haugh unit except egg yolk color (P<0.05).

Protective Effect of Antioxidants on the Reoxygenation Injury in Hypoxic Myocardium of Rat (저산소 심장의 산소 재공급에 따른 심근 손상에 있어서 항산화제의 보호 효과)

  • Yoon, Hyung-Ku;Lim, Jung-Kyoo;Kim, Myung-Suk
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.53-61
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    • 1988
  • The effect of antioxidants on the myocardial cellular damage which occurs during reoxygenation of hypoxic myocardium was examined in isolated rat hearts. The roles of oxygen free radical and lipid peroxidation in reoxygenation injury of myocardium were also investigated. In Langenorff preparation of isolated rat heart, which was made hypoxic by perfusion with the substrate free, hypoxic cardioplegic solution ($37^{\circ}C$, 90 min), the release of cytosolic enzymes (creatine phosphokinase, lactic dehydrogenase) and a lipid peroxidation product, malondialdehyde into the coronary effluent were abruptly increased by reoxygenation. The release of enzymes was closely parallel to that of MDA. These increases of enzymes and lipid peroxidation product were suppressed to various degrees in the presence of scavengers of superoxide anion (superoxide dismutase, 10,000 U), hydrogen peroxide (catalase, 25,000 U) and hydroxyl radical (dimethyl sulfoxide, 10%). A natural antioxidant, ${\alpha}-tocopherol$(4.5 uM) and a synthetic one, butylated hydroxytoluene (2 uM) suppressed the release of cytosolic enzymes with the concomittent reduction of lipid peroxidation as measured by malondialdehyde release into the coronary effluent. These effects of antioxidants were dose dependent, and were more pronounced when the antioxidants were administered throughout hypoxic and reoxygenation periods than given during reoxygenation period only. These results suggest that cytotoxic oxygen free radicals produced in the myocardium during reoxygenation may be responsible fur the myocardial cellular injury by enhancing the lipid peroxidation of cellular membranes. Furthermore, the antioxidants may exert protective effect against reoxygenation damage of hypoxic myocardium through the inhibition of lipid peroxidation reaction.

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Experimental Fetal Cardiopulmonary Bypass in the Fetal Lamb Model (태아양 모델을 이용한 실험적 태아 심폐우회술)

  • 이정렬;임홍국;김원곤;김종성;최정연;김용진
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.495-503
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    • 1999
  • Background: We tested the technical feasibility of fetal cardiac bypass and collected baseline data on the fetal hemodynamics and placental functions related to the cardiopulmonary bypass in the fetal lamb model. Material and Method: Eleven fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Eight served as a group in which placenta was excluded from the extracorporeal circulation by clamping the umbilical cord during the bypass(the oxygenator group) and in the remaining three, the placenta worked as the only source of oxygen supply(the placenta group). Observations were made every 10 minute during a 30-minute bypass and 30-minute post bypass period. No prostaglandin inhibitors were used both in ewes and in fetuses. Result: Weights of the fetuses ranged from 1.9 to 5.2 kg. In the oxygenator group, means of arterial pressure, PaO2, atrial pressure, heart rate, and bypass flow rate ranged 69.8 to 82.6 mmHg, 201.7 to 220.9 mmHg, 4.1 to 4.3 mmHg, 169 to 182/min, and 140.3 to 164.0 ml/kg/min, respectively during bypass, but rapid deterioration of the fetal cardiac functions and the placental gas exchange was observed after the cessation of bypass. In the placenta group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of PaCO2 increased from 61.9 to 129.6 mmHg during bypass. Flow rate was suboptimal(74.3 to 97.0 ml/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. Conclusion: In this study, the technical feasibility of fetal cardiopulmonary bypass was confirmed in the fetal lamb model. However, further studies with modifications of the bypass including an addition of prostaglandin inhibitor, an application of the total spinal anesthesia on the fetus, a creation of more concise bypass circuit, and a use of active pump are mandatory to improve the outcome.

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