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Effect of Ischemic Preconditioning for Preventing Ischemic Injury of the Spinal Cord (척추 신경의 허혈성 손상 예방을 위한 허혈성 전처치의 효과)

  • 홍종면;차성일;송우익;홍장수;임승운;임승운;임승평
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.823-830
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    • 2001
  • Background: Paraplegia is a serious complication of thoracic or thoracoabdominal aortic operations, which is related to ischemic injury of the spinal cord induced by low perfusion pressure during cross clamping of the aorta. Ischemic preconditioning of heart or brain with reversible sublethal ischemic injury induces resistance to subsequent lethal ischemia. The aim of this study is to investigate whether ischemic tolerance could be induced by the preconditioning of the spinal cord using swine model. Material and Method: The animals were randomly assigned to three groups: sham group(n=3), control group(n=6) and pre-conditioning group(n=8). In the sham group, we performed the left thoracotomy only without any ischemic injury. In the preconditioning group, the swine received reversible spinal cord ischemic injury by aortic clamping for 20 minutes, whereas control group had no previous aortic cross- clamping. Forty-eight hours later, the aorta was clamped for 30 minutes in both groups. Neurological examination was done 24 hours later, then the animals were euthanized for histopathology and malonedialdehyde(MDA) spectrophotometry assay of the spinal cord. Result: Statistically significant difference in neurological outcome was observed between the control and preconditioning groups at 24 hours after ischemic injury. The incidence of paraplegia and severe paresis was 100% in the control group, and 62.5% in the preconditing group(p=0.028). There was no statistically significant difference in histopathology and MDA assay of the ischemic spinal cord between these two groups with borderline statistical difference in MDA assay(p=0.0745). Conclusion: In the present swine study, ischemic preconditioning could induce tolerance against 30 minute ischemic insult of the spinal cord, although the animals did not completely recover(stand-up or walk). We expect that combining this preconditioning with other currently existing protection methods might lead to a synergistic effect, which warrants further investigation.

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Repair of Complete Atrioventricular Septal Defect with Surgical Modification (변형술식에 의한 완전방실중격결손의 교정)

  • 김웅한;김수철;이택연;한미영;정철현;박영관;김종환
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.628-636
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    • 1999
  • Background: Recent advances in understanding the anatomy of the complete atrioventricular septal defect(including right-dominant unbalanced atrioventricular septal defect) have led to alternative methods of repairing these defects. Material and Method: From May 1997 to July 1998, 8 consecutive infants(age range, 2 to 28 months, mean body weight 6.0$\pm$2.2 kg) received a single-stage intracardiac repair of the complete atrioventricular septal defect with modified surgical methods. Depending on the specific anatomic structure, the procedure was simplified in 3 patients by a direct closure of the ventricular element of the defect(Group I). Two patients judged unsuitable for direct closure due to a potential left ventricular outflow tract obstruction had received a standard two-patch repair(Group II). The remaining 3 patients with right-dominant unbalanced complete atrioventricular septal defect underwent biventricular repair; to enlarge the orifice of the left atrioventricular valve, the ventricular septal patch was placed slightly more to the right of the ventricular crest, a left sided bridging leaflet was augmented with an autologous pericardial patch, and the leaflet was repaired with a double- orifice(Group III . Result: In all 8 patients, the postoperative echocardiography demonstrated good hemodynamics. Seven patients were weaned from the ventilators after a mean 3$\pm$1 days, and 1 patient was weaned after 24 days due to a reoperation and emphysematous lung problem. A reoperation was performed in 1 patient for progressive left atrioventricular valve regurgitation due to leaflet tearing. There were no early and late mortalities. At the time of the latest review, judging from the echocardiographic criteria, left atrioventricular valve stenosis was mild in 1 patient(mean pressure gradient 6.5 mmHg, 13.5%), left atrioventricular valve regurgitation was absent or grade I in 7 patients(87.5%). The right atrioventricular valve regurgitation was absent or grade I in all 8 patients(100%). Conclusion: Infants with complete atrioventricular septal defect were treated with either a simplified approach with direct closure of the ventricular element of the defect or a modified surgical technique for a right-dominant unbalanced atrioventricular septal defect, depending on the anatomic structure. The results were no operative mortalities and low morbidity.

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Radionuclide Cisternographic Findings in Patients with Spontaneous Intracranial Hypotension (자발성 두개내 저압 환자의 방사성 동위원소 뇌조조영술 소견)

  • Jung, Dong-Jin;Kim, Jae-Seung;Ryu, Jin-Sook;Shin, Jung-Woo;Im, Joo-Hyuk;Lee, Myoung-Chong;Jung, Sun-Joo;Moon, Dae-Hyuk;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.482-489
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    • 1998
  • Purpose: Radionuclide cisternography may be helpful in understanding pathophysiology of postural head-ache and low CSF pressure in patients with spontaneous intracranial hypotension. The purpose of this study was to characterize radionuclide cisternographic findings of spontaneous intracranial hypotension. Materials and Methods: The study population consists of 15 patients with spontaneous intracranial hypotension. Diagnosis was based on their clinical symptoms and results of lumbar puncture. All patients underwent radionuclide cisternography following injection of 111 to 222 MBq of Tc-99m DTPA into the lumbar subarachnoid space. Sequential images were obtained between 112 hour and 24 hour after the injection of Tc-99m DTPA. Radioactivity of the bladder, soft tissue uptake, migration of radionuclide in the subarachnoid space, and extradural leakage of radionuclide were evaluated according to the scan time. Results: Radionuclide cisternogram showed delayed migration of radionuclide into the cerebral convexity (14/15), increased soft tissue uptake (11/15), and early visualization of bladder activity at 30min (6/10) and 2hr (13/13). Cisternography also demonstrated leakage site of CSF in 4 cases and 2 of these were depicted at 30min. Epidural blood patch was done in 11 patients and headache was improved in all cases. Conclusion: The characteristic findings of spontaneous intracranial hypotension were delayed migration of radionuclide and early visualization of the soft tissue and bladder activity. These scintigraphic findings suggest that CSF leakage rather than increased CSF absorption or decreased production may be the main pathophysiology of spontaneous intracranial hypotension. Early and multiple imaging including the bladder and soft tissue is required to observe the entire dynamics of radionuclide migration.

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Mid- and Long Term Outcome of Fontan Procedure: Extracardiac Conduit Fontan versus Lateral Tunnel Fontan (폰탄 술식의 중장기 성적: 심장외 도관 술식과 가측터널 술식의 비교)

  • Kwak, Jae-Gun;Kim, Dong-Jung;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.805-810
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    • 2007
  • Background: This paper reviews our experience retrospectively to examine the clinical results and effectiveness of lateral tunnel (LT) and extracardiac conduit (ECC) Fontan procedures at a single institution. Material and Method: One hundred and sixty five Fontan procedures were performed (67 LT and 98 ECC) between January 1996 and December 2006. Preoperative and postoperative hemodynamic values, arrhythmia, hospital and intensive care unit stay, chest tube drain, morbidity and mortality were reviewed. Result: The overall operative mortality in the LT and ECC groups was 4.5% (3) and 2.0% (2), respectively. There was a significant difference in the immediate postoperative transpulmonary gradient (LT $8.5{\pm}2.5$ vs ECC $6.6{\pm}2.4$, p-value<0.001) and central venous pressure (LT $18.3{\pm}3.8$ vs ECC $15.6{\pm}2.4$, p-value=0.001) between the two groups. The mean follow-up in the LT and ECC groups was $74.1{\pm}31.5$ and $38.1{\pm}29.1$ months, respectively. There was one late death. The actuarial survival at 10 years in the LT and ECC groups was 92% and 89%, respectively. In arrhythmia, the ECC patients showed a slightly low incidence but the difference was not statistically significant. Conclusion: Both the LT and ECC Fontan procedures showed comparable early and mid-term outcomes in terms of the surgical morbidity and mortality, postoperative hemodynamics, and mid-term survival. The ECC Fontan procedure reduces the risk of arrhythmia in the follow up period.

Geophysical Study on the Ultramafic Rocks of Chungnam Province, Korea: Characteristics of Seismic Velocity (충남지역 초염기성 암체의 지구물리학적 연구: 탄성파 속도 특성)

  • Suh, Man-Cheol;Woo, Young-Kyun;Song, Suck-Hwan;Tianyao, Hao
    • Journal of the Korean earth science society
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    • v.21 no.3
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    • pp.349-358
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    • 2000
  • Compressional and shear wave velocities (Vp and Vs) and densities have been measured for serpentinite, amphibolite, amphibole and biotite schist, and gneiss from western part of Chungnam Province at room temperature. Ranges of the density are 2.6${\sim}$2.86g/cm$^3$ for serpentinite, 2.25${\sim}$2.81g/cm$^3$ for talc, and 2.74${\sim}$3.07g/cm$^3$ for metamorphic rocks. Of these rocks, talc shows wider ranges than serpentinite and amphibolites due to its metamorphic process from serpentinite. Values of Vp and Vs are 5719${\sim}$6062m/s and 2898${\sim}$3351m/s for serpentinites, 4019${\sim}$5478m/s and 2241/${\sim}$2976m/s for talc, 5375${\sim}$6372m/s and 3042${\sim}$3625m/s for amphibolite, 5290${\sim}$5499m/s and 2968${\sim}$3137m/s for schist, and 4788m/s and 2804m/s for gneiss, respectively. Velocity of P wave increases 1.47 times faster than S wave with increase of density. The results of seismic velocity measurement show anisotropy, higher velocity across than along the schistocity of rocks, especially in metamorphic rocks. This fact indicates that there were regional metamorphism related with tectonic forces. Values of seismic velocity increase with increasing pressure from 20 MPa to 70 MPa, especially in metamorphic rocks. Overall recalculated Vp and Vs values suggest that the serpentinite indicates for upper mantle in the respects of seismic characteristics, in spite of high degree of serpentinization. In addition, those of the amphibolite do for low crust, and gneiss and schist for upper crust.

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Analysis of Na and Cl Contents in Children’s Favorite Foods (어린이 선호 간식의 Na와 Cl 함량 분석)

  • Lee, Ok-Hee;Chung, Yong-Sam;Moon, Jong-Wha
    • Journal of Nutrition and Health
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    • v.43 no.5
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    • pp.524-532
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    • 2010
  • The Na, component of salt, can increase the risk of high blood pressure and hypertension. Especially, children are exposed to an increased risk of high sodium intake, because they often consume Na-rich processed foods and commercially prepared foods in the street. However, the database for the sodium and chloride content for these children's favorite foods is insufficient. In this study, the Na and Cl contents in 89 children's favorite foods were analyzed by using Instrumental Neutron Activation Analysis (INAA) method. The analyzed food items were presented after being classified into 33 kinds of food groups. The Na contents in 100 g children's favorite foods ranged from 0.3 mg to 35.1mg in fruits, 28.9mg to 82.5mg in milks, 127.2 mg to 602.2 mg in breads, cakes, sandwiches, and rice cakes, 2.5 mg to 1169.9 mg in candies, cookies and ice creams, 226.9 mg to 693.7 mg in commercially prepared street foods, and 103.4 mg to 875.8 mg in fast foods of westernized restaurant. Among children's favorite food groups, 100 g fried chicken, hotdog, burgers, and donuts contained an average Na of 536 mg, 553 mg, 794 mg, and 562.2 mg, respectively, so they are classified as 'high Na foods'. In contrast, 100 g fruits and dairy products contained Na an average 4.9 mg and 43.4 mg, respectively, being classified as 'low Na foods'. One serving of ramen, mandu noodle, and burger pizza can supply over 667mg Na, which is one third of the KDRI targeted intake. Likewise, the Cl contents in children's favorite foods were diverse according to food groups. The Cl contents in the analyzed foods differed from the 1.5 times of Na content, which is assumed in general. This study showed that the Na and Cl contents in children's favorite foods are very diverse. Conclusively, a strategy to reduce Na contents in the fast foods such as noodles and westernized restaurant foods is necessary for children health.

Homocysteine, insulin, vitamin B12 and folic acid levels in obese children (비만아에서 혈청 호모시스테인, 인슐린, 비타민 B12, 엽산 농도에 대한 연구)

  • Park, Jee Yoon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.475-481
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    • 2006
  • Purpose : As the prevalence of childhood obesity is increasing, hypertension, hyperlipidemia, insulin resistance and diabetes mellitus have become problems. High homocysteine levels and low vitamin $B_{12}$ supplementation are acknowledged to have a role in coronary artery disease, but there are few studies on homocysteine, insulin and vitamin $B_{12}$ levels in obese children. We aimed to study whether homocysteine, insulin, vitamin $B_{12}$, folic acid levels could have any difference and relation in obese children. Methods : The disease group consisted of 27 children from 8 to 11 years old, whose obesity index was over 130. The control group consisted of 30 healthy children of the same age group. Obesity index and body mass index were calculated by height and body weight of the children, and their systolic and diastolic blood pressures at resting state were checked. Total cholesterol, triglyceride, homocysteine, insulin, vitamin $B_{12}$, folic acid levels were studied after 10 hours of fasting. Intracellular fluid, extracellular fluid, protein, mineral, muscle mass, lean body fat, fat mass and fat percentages were checked by bioelectrical impedance. Results : Homocysteine levels were higher in obese children($8.1{\pm}2.1{\mu}mol/mL$ vs. $4.9{\pm}1.0{\mu}mol/mL$). Insulin levels were also higher in obese children($26.8{\pm}11.2{\mu}IU/mL$ vs. $12.5{\pm}5.24{\mu}IUl/mL$). Vitamin $B_{12}$ was lower in obese children($798.6{\pm}174.3pg/mL$ vs. $967.8{\pm}405.0pg/mL$). But there was not a difference in the folic acid levels between the two groups. In obese children, systolic blood pressure (r=0.535), triglyceride(r=0.517), total cholesterol(r=0.408), folic acid(r=0.408), vitamin $B_{12}$(r=0.338) and abdomoanl fat %(r=0.306) had a positive correlation. Conclusion : We found definite differences of insulin, homocysteine, and vitamin $B_{12}$ plasma levels in obese children, but we need more study to use those parameters as risk factors of metabolic syndrome in pediatric obese patients.

Geochemical Studies of $CO_2$-rich Waters in Chojeong area II. Isotope Study (초정지역 탄산수의 지화학적 연구 II. 동위원소)

  • 고용권;김천수;배대석;최현수
    • Journal of the Korean Society of Groundwater Environment
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    • v.6 no.4
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    • pp.171-179
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    • 1999
  • The $CO_2$-rich waters in the Chojeong area are characterized by low pH (5.0~5.8), high $CO_2$pressure (about 1 atm) and high amounts of total dissolved iou (up to 989 mg/L) and chemically belong to Ca-HC $O_3$type. The oxygen. deuterium and tritium isotope data indicate that the mixing process occurred between $CO_2$-rich water and surface water and/or shallow groundwaters and also suggest that the $CO_2$-rich water has been derived from meteoric waters. According to $\delta$$^{13}$ C values (-8.6~-5.3$\textperthousand$). the $CO_2$ in the water is attributed from deep seated $CO_2$gas. The high dissolved carbon (-14.4~-6.8$\textperthousand$. $\delta$$^{13}$ C) in groundwater of the granitic terrain might be affected by $CO_2$-rich water, whereas the dissolved carbon (-17.9~-15.2$\textperthousand$. $\delta$$^{13}$ C) in groundwater of the metamorphic terrain is likely controlled by soil $CO_2$ and from the reaction with calcite in phyllite. Sulfur isotope data (+3.5~+11.3$\textperthousand$,$\delta$$^{34}$ $S_{SO4}$) also support the mixing process between $CO_2$-rich water and shallow groundwater. Strontium isotopic ratio ($^{87}$ Sr/$^{86}$ Sr) indicates that the $CO_2$-rich water (0.7138~0.7156) is not related to vein calcite (0.7184) of Buak mine or calcite (0.7281~0.7346) in phyllite. By nitrogen isotope ($\delta$$^{15}$ $N_{NO3}$) the sources of nitrogen (up to 55.0 mg/L, N $O_3$) in the $CO_2$-rich water are identified as fertilizer and animal manure. It also indicates the possibility of denitrification during the circulation of nitrogen in the Chojeong area. The possible evolution model of the $CO_2$-rich water based on the hydrochemical and environmental isotopic data was proposed in this study. The $CO_2$-rich waters from the Chojeong area were primarily derived from the reaction with granite by supply of deep seated $CO_2$. and then the $CO_2$-rich water was mixed and diluted with the local groundwater.ter.

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Construction and Tests of the Vacuum Pumping System for KSTAR Current Feeder System (KSTAR 전류전송계통 진공배기계 구축 및 시운전)

  • Woo, I.S.;Song, N.H.;Lee, Y.J.;Kwag, S.W.;Bang, E.N.;Lee, K.S.;Kim, J.S.;Jang, Y.B.;Park, H.T.;Hong, Jae-Sik;Park, Y.M.;Kim, Y.S.;Choi, C.H.
    • Journal of the Korean Vacuum Society
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    • v.16 no.6
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    • pp.483-488
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    • 2007
  • Current feeder system (CFS) for Korea superconducting tokamak advanced research(KSTAR) project plays a role to interconnect magnet power supply (MPS) and superconducting (SC) magnets through the normal bus-bar at the room temperature(300 K) environment and the SC bus-line at the low temperature (4.5 K) environment. It is divided by two systems, i.e., toroidal field system which operates at 35 kA DC currents and poloidal field system wherein 20$\sim$26 kA pulsed currents are applied during 350 s transient time. Aside from the vacuum system of main cryostat, an independent vacuum system was constructed for the CFS in which a roughing system is consisted by a rotary and a mechanical booster pump and a high vacuum system is developed by four cryo-pumps with one dry pump as a backing pump. A self interlock and its control system, and a supervisory interlock and its control system are also established for the operational reliability as well. The entire CFS was completely tested including the reliability of local/supervisory control/interlock, helium gas leakage, vacuum pressure, and so on.

Thermophysiological Responses of Wearing Safety Hat for Working at a Hot Environment (서열환경하에서 안전모 착용시의 인체생리학적 반응)

  • 박소진;김희은
    • Journal of the Korean Society of Clothing and Textiles
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    • v.26 no.1
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    • pp.74-82
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    • 2002
  • The present study is aimed to investigate the effect of the safety hat on the balance of body temperature by observation of the physiological response under hot working environment. The experiment was carried out in a climate chamber of 3$0^{\circ}C$, 50%RH for 70 minutes. To compare the two kinds of safety hat, 5 healthy male subjects worn safety hat without hole (called 'without hole') or safety hat with hole (called 'with hole') according to a randomized cross-over design. The main results of this study are as fellows: Rectal temperature and heart rate were significantly lower level in 'with hole'than in 'without hole'. The mean skin temperature was significantly higher in 'without hole'than in 'with hole'. Blood pressure were significantly low in 'with hole'. Sweat rate which was measured by weight loss before and after experiment was higher in 'without hole'. In subjective ratings, subjects replied more hot, more uncomfortable and more wet, they felt more fatigue in condition of 'without hole'. Work ability which was measured by a grip strength dynamometer was higher in 'with hole'. Safety hat which can be used for safety of the brain in work place is meaningful device of behavioral thermoregulatory response under the hot working environment. The safety hat which is designed for proper ventilation and hygiene can maintain the homeostasis of body temperature by releasing body temperature efficiently.