The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.
Background: There have been several reports using animal experiments that CD1-restricted T-cells have a key role in tumor immunity. To address this issue, we studied the expression of markers for CD1c+ myeloid dendritic cells (DCs) isolated from peripheral blood in the clinical setting. Material and Method: A total of 24 patients with radiologically suspected or histologically confirmed lung cancer who underwent pulmonary resection were enrolled in this study. The patients were divided according to histology findings into three groups: primary adenocarcinoma of lung (PACL), primary squamous cell carcinoma of lung (PSqCL) and benign lung disease (BLD). We obtained 20 mL of peripheral venous blood from patients using heparin-coated syringes. Using flow-cytometry after labeling with monoclonal antibodies, data acquisition and analysis were done. Result: The ratio of CD1c+CD19- dendritic cells to CD1c+ dendritic cells were not significantly different between the three groups. CD40 (p=0.171), CD86 (p=0.037) and HLA-DR (p=0.036) were less expressed in the PACL than the BLD group. Expression of CD40 (p=0.319), CD86 (p=0.036) and HLA-DR (p=0.085) were less expressed in the PACL than the PSqCL group, but the differences were only significant for CD86. Expression of co-stimulatory markers was not different between the PSqCL and BLD groups. Expression of markers for activated DCs were dramatically lower in the PACL group than in groups with other histology (CD40 (p=0.005), CD86 (p=0.013) HLA-DR (p=0.004). Conclusion: These results suggest the possibility that CD1c+ myeloid DCs participate in control of the tumor immunity system and that low expression of markers results in lack of an immune response triggered by dendritic cells in adenocarcinoma of the lung.
Kim, Young-Chul;Lee, Shin-Seok;Chung, Ik-Joo;Kang, Yu-Ho;Choi, In-Seon;Park, Kyung-Ok;Juhng, Sang-Woo
Tuberculosis and Respiratory Diseases
/
v.41
no.4
/
pp.354-362
/
1994
Objectives and Methods : The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. Results : Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinoma: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer patients was 32.7%(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+G2M>22%) in lung cancer patients was 42.9%(15/35), but none in benign diseases. In fifty-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy. There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. Conclusions : The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.10
/
pp.136-152
/
2017
The thermodynamic models, PC-SAFT (Perturbed-Chain Statistical Associated Fluid Theory) state equation and the Two-model approach liquid activity coefficient model NRTL (Non Random Two Liquid) + Henry + Peng-Robinson, for modeling the Rectisol process using methanol aqueous solution as the $CO_2$ removal solvent were compared. In addition, to determine the new binary interaction parameters of the PC-SAFT state equations and the Henry's constant of the two-model approach, absorption equilibrium experiments between carbon dioxide and methanol at 273.25K and 262.35K were carried out and regression analysis was performed. The accuracy of the newly determined parameters was verified through the regression results of the experimental data. These model equations and validated parameters were used to model the carbon dioxide removal process. In the case of using the two-model approach, the methanol solvent flow rate required to remove 99.00% of $CO_2$ was estimated to be approximately 43.72% higher, the cooling water consumption in the distillation tower was 39.22% higher, and the steam consumption was 43.09% higher than that using PC-SAFT EOS. In conclusion, the Rectisol process operating under high pressure was designed to be larger than that using the PC-SAFT state equation when modeled using the liquid activity coefficient model equation with Henry's relation. For this reason, if the quantity of low-solubility gas components dissolved in a liquid at a constant temperature is proportional to the partial pressure of the gas phase, the carbon dioxide with high solubility in methanol does not predict the absorption characteristics between methanol and carbon dioxide.
To estimate buffer capacity and sensitivity of forest ecosystem to acid rain in Taejon, ionic components of throughfall, stemflow, soil leachate, and open rain in Pinus rigida and Quercus variabilis forest were analysed. The spatial sensitivity based on parent rock and forest type was given by IDRISI of GIS which created imagery conversion from soil and vegetation map. Parent rocks and soils were classified into acidic, sedimentary, metamorphic rock and then subdivided based on $SiO_2$ content. Average pH of vegetation leachate was higher in throughfall but lower in stemflow than open rain and higher in Quercus variabilis forest than in Pinus rigida forest. The flow of $SO{_4}^{2-}$, $NO_3{^-}$ and $Cl^-$ through vegetation leaching(throughfall plus stemflow) into soil were 7.2, 4.3, and 2.5 times, respectively, higher in Pinus rigida forest and 4.4, 2, and 2.5 times, respectively, higher in Quercus variabilis forest than in open field. But the concentration of exchangeable cations was 4.1 times higher in Pinus rigida forest and 4.6 times higher in Quercus variabilis forest than in open field. Average pH of soil leachate was lower than that of throughfall, but higher than that of stemflow. The concentration of exchangeable canons and $Al^{3+}$ in soil leachate were more in Pinus rigida forest than in Quercus variabilis forest and increase signficantly with the increase of acidic deposits. Pinus forest had more deposition and canopy interception of acidic pollutants and more nutrient loss than Quercus forest, and Quercus forest had more cation exchange and proton consumption and than consequently had less nutrient loss and better buffer capacity than Pinus forest. The 69% of forest soils was distributed on acidic rock, 25% of it on metamorphic rock, and 6% of it on intermediate and basic rock. Acidic rock residuals which had low very canon exchange capacity and high sensitivity to acid rain occupied a half of total forest land in Taejon area. Therefore forests in Taejon showed high vulnerability to acid rain and will receive much more stress with the increase of acid rain precursors.
Tooth movement by orthodontic force effects great tissue changes within the periodontium, especially by shifting the blood flow in the pressure side and resulting in a hypoxic state of low oxygen tension. The aim of this study is to elucidate the possible mechanism of apoptosis in response to hypoxia in MC3T3El osteoblasts, the main cells in bone remodeling during orthodontic tooth movement. MC3T3El osteoblasts under hypoxic conditions ($2\%$ orygen) resulted in apoptosis in a time-dependent manner as estimated by DNA fragmentation assay and nuclear morphology stained with fluorescent dye, Hoechst 33258. Pretreatment with Z-VAD-FMK, a pancaspase inhibitor, or Z-DEVD-CHO, a specific caspase-3 inhibitor, completely suppressed the DNA ladder in response to hypoxia. An increase in caspase-3-like protease (DEVDase) activity was observed during apoptosis, but no caspase-1 activity (YVADase) was detected. To confirm what caspases are involved in apoptosis, Western blot analysis was performed using anti-caspase-3 or -6 antibodies. The 10-kDa protein, corresponding to the active products of caspase-3, and the 10-kDa protein of the active protein of caspase-6 were generated in hypoxia-challenged cells in which the processing of the full length form of caspase-3 and -6 was evident. While a time course similar to this caspase-3 and -6 activation was evident, hypoxic stress caused the cleavage of lamin A, which was typical of caspase-6 activity. In addition, the stress elicited the release of cytochrome c into the cytosol during apoptosis. Furthermore, we observed that pre-treatment with SB203580, a selective p38 mitogen activated protein kinase inhibitor, attenuated the hypoxia-induced apoptosis. The addition of SB203S80 suppressed caspase-3 and -6-like protease activity by hypoxia up to $50\%$. In contrast, PD98059 had no effect on the hypoxia-induced apoptosis. To confirm the involvement of MAP kinase, JNK/SAPK, ERK, or p38 kinase assay was performed. Although p38 MAPK was activated in response to hypoxic treatment, the other MAPK -JNK/SAPK or ERK- was either only modestly activated or not at all. These results suggest that p38 MAPK is involved in hypoxia-induced apoptosis in MC3T3El osteoblasts.
Lee, Seungyeol;Kang, Jung Chun;Park, Minji;Yang, Kyounghee;Jeong, Hoon Young
Journal of the Mineralogical Society of Korea
/
v.25
no.4
/
pp.185-195
/
2012
Due to the high reduction and sorption capacity as well as the large specific surface area, nanosized mackinawite (FeS) is useful in reductively transforming chlorinated organic pollutants and sequestering toxic metals and metalloids. Due to the dynamic nature in its colloid stability, however, nanosized FeS may be washed out with the groundwater flow or result in aquifer clogging via particle aggregation. Thus, these nanoparticles should be modified such as to be built into permeable reactive barriers. This study employed coating methods in efforts to facilitate the installation of permeable reactive barriers of nanosized mackinawite. In applying the methods, nanosized mackinawite was coated on non-treated silica sand (NTS) and chemically treated silica sand (CTS). For both silica sands, the maximum coating of mackinawite occurred around pH 5.4, the condition of which was governed by (1) the solubility of mackinawite and (2) the surface charge of both silica and mackinawite. Under this pH condition, the maximum coating by NTS and CTS were found to be 0.101 mmol FeS/g and 0.043 mmol FeS/g respectively, with such elevated coatings by NTS likely linked with impurities (e.g., iron oxides) on its surface. Arsenite sorption experiments were performed under anoxic conditions using uncoated silica sands and those coated with mackinawite at the optimal pH to compare their reactivity. At pH 7, the relative sorption efficiency between uncoated NTS and coated NTS changed with the initial concentration of arsenite. At the lower initial concentration, uncoated NTS showed the higher sorption efficiency, whereas at the higher concentration, coated NTS exhibited the higher sorption efficiency. This could be attributed to different sorption mechanisms as a function of arsenite concentration: the surface complexation of arsenite with the iron oxide impurity on silica sand at the low concentration and the precipitation as arsenic sulfides by reaction with mackinawite coating at the high concentration. Compared to coated NTS, coated CTS showed the lower arsenite removal at pH 7 due to its relatively lower mackinawite coating. Taken together, our results indicate that NTS is a more effective material than CTS for the coating of nanosized mackinawite.
Journal of the Korean Society for Marine Environment & Energy
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v.19
no.2
/
pp.87-98
/
2016
During the period between July 3 and 27 of 2009, water samples were collected from the Russian coast at a depth of 30m from 26 stations (including Ulleung and Japan basins) onboard the Russian survey vessel R/V Lavrentyev following 4 lines (D, R, E, and A). The samples were analyzed for nutrients and chlorophyll a contents. All parameters exhibited higher values in warm waters than in cold waters ($NH_4:1.8-fold$, $PO_4:1.8-fold$, $SiO_2:1.2-fold$, and chlorophyll-${\alpha}$:1.9-fold), except nitrates, which was 1.4-fold higher in cold waters than in warm waters. The horizontal distribution of ammonia, phosphate, and chlorophyll-${\alpha}$ was very similar to each other and showed the highest values in the waters near Russia, where a upwelling influence of cold current and bottom water prevails, while relatively low distribution was observed at the Ulleung Basin. On the other hand, nitrates showed the highest concentration at the Ulleung Basin, which is under the direct influence of the Tsushima warm water, and showed a gradual decrease northward. The N/P ratio showed the highest value in the Tsushima middle water, rather than in the North Korean Cold Water, the Tsushima Warm Water was the primary source of nitrate flow into the East Sea. However, the average concentration of phosphate in the warm waters was < $0.2{\mu}M$, thereby limiting phytoplankton growth, while a high concentration of phosphate in cold waters showed a direct correlation with chlorophyll-${\alpha}$. The results of principal component analysis for the identification of primary factors that influence the marine environment showed that principal component I was water temperature and principal component II was influenced chlorophyll-${\alpha}$ and nutrients. Therefore, Study area has greatest influenced by water temperature, and clearly distinct cold and warm water regions were observed in the East Sea.
Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
Journal of Chest Surgery
/
v.36
no.8
/
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.
Although a variety of synthetic vascular grafts are available in modern vascular surgery, no ideal prosthesis ha,4 yet been developed. Small-caliber vascular grafts with low flow, as used in the lower extremity, continue to become thrombosed at unacceptable rates. We have developed and evaluated the new antithrombogenic blood contacting surfaces in canine model. Material and Method: Two now antithrombogenic blood contacting surfaces(Polyvinylalcohol -Polyurethane(PVA-PU) blend and natural Graphite-polyurethane(G-PU) blend) have been developed and evaluated in canine model, using vascular grafts and patches. The luminal surfaces of the test vascular grafts(5 mm ID) were fabricated by dipping a glass rod in PVA-PU blend solution(50 % PVA) using phase separation method. Mongrel dogs of either sex weighing 18-22 kg were anesthetized by endotracheal intubation using halothane and their lungs were ventilated with a volume-cycled ventilator, Maintenance anesthesia with 0.5-1.0% halothane and supplemental oxygen was used. Two pairs were used for comparison in the bilateral femoral arteries for both vascular grafts(PVA-PU vs. PU) and vascular patches(G-PU vs. PU). Bilateral groin incisions were made and the arteries were exposed and clamped. After an excision of 1 cm of the artery between clamps, a grail of 2.5 cm in length was implanted end-to-end using 6-0 polypropylene suture. The vascular patch was implanted as a form of on-lay patch. Animals were sacrificed at 1, 2, 4, 6, 8 and 16 weeks for vascular grafts and 1, 2. 4 and 6 weeks for vascular patches. Result The vascular grafts of PVA-PU blends showed patent lumina in the 2 and 16 weeks animals, while those of PU showed a patent lumen in 2 weeks animal. PVA-PU graft of 16 weeks showed a fairly clean luminal surface. A light microscopic finding of this graft demonstrated good tissue infiltration through porosity, The animals with vascular patches showed patent arteries in both groups except 2 weeks animal. Scanning electron microscopy of the luminal surfaces of G-PU patches in 4 and 6 weeks animals showed endothelial cell covering with microvilli. PU patches showed qualitatively less endothelial cell covering. Conclusion: In conclusion, PVA-PU and G-PU blends can be a promising blood contacting surfaces for application in a synthetic vascualr graft. However, further animal study is needed to determine the real long-term effects of these methods of surface modifications.
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