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Closure of Atrial Septal Defects through a Video-assisted Mini-thoracotomy (흉강경하 최소절개를 이용한 심방중격결손의 폐쇄)

  • Min, Ho-Ki;Yang, Ji-Hyuk;Jun, Tae-Gook;Park, Pyo-Won;Choi, Seon-Uoo;Park, Seung-Woo;Min, Sun-Kyung;Lee, Jae-Jin
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.568-572
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    • 2008
  • Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

Active Polysaccharide and Immune Enhancement of Ganoderma lucidum Mycelium Cultured in Mushroom Complete Medium Supplemented with Ginseng Extract (수삼추출물 첨가 mushroom complete medium에서 배양된 영지버섯 균사체의 면역증진 효과 및 활성다당류)

  • Kim, Hoon;Jeong, Jae-Hyun;Jeong, Heon-Sang;Hwang, Jong-Hyun;Yu, Kwang-Won
    • Korean Journal of Food Science and Technology
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    • v.43 no.5
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    • pp.633-640
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    • 2011
  • After Ganoderma lucidum was cultured in mushroom complete medium (MCM) supplemented with ginseng extract (GE), crude polysaccharide (GL-GE-CP) was fractionated from mycelium. Among GL-GE-CP from mycelium in MCM supplemented with 5, 10, and 15% GE (v/v ratio of MCM to GE), GL-GE-15-CP (15% GE) most significantly enhanced macrophage stimulation and intestinal immune system modulating activity compared with GL-CP in MCM without GE. When GL-GE-15-CP was further fractionated on DEAE-Sepharose CL-6B, GL-GE-15-CP-II displayed more potent activity than subfractions from GL-CP on macrophage stimulation, interleukin-12 production, and intestinal immune system modulation (1.75-, 5.68-, and 1.76-fold, respectively). Anti-metastasis effect against colon 26-M3.1 carcinoma cells was also enhanced by GL-GE-15-CP-II (72.8% inhibition). In addition, GL-GE-15-CP-II contained neutral sugar (83.00%) and uronic acid (9.11%), and consisted of Ara, Man, Gal and Glc (molar ratio of 0.39:0.50:0.75:1.00). Furthermore, GE supplementation helped to enhance the immunomodulation in G. lucidum, and it is assumed that neutral polysaccharides play an important role.

A Study of the Whitening Activities of Magnolia obovata Bark Ethyl Acetate Fractions as Cosmetic Ingredient (화장품 소재로서 후박 에틸아세테이트 분획물의 미백활성에 관한 효과)

  • Kang, Hee Cheol;Joo, Kwang Sik;Joo, Se Jin;Ha, Young Ae;Kim, Hack Soo;Cha, Mi Yeon
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.43 no.1
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    • pp.43-52
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    • 2017
  • EtOAc fractions of Magnolia obovata (M. obovata) Bark extracts were studied for the potential ingredient as a safe and effective whitening cosmetic material. The concentration of active substances honokiol was determined by HPLC. In vitro, the fractions reduced the extracellular and intracellular melanin contents in B16F10 cells in dose dependently and inhibited extracellular melanin secretion ($IC_{50}=11.05{\mu}g/mL$). The $12.5{\mu}g/mL$ treatment of maximum concentration effectively inhibited up to about 60% to the amount of extracullular melanin. Also, the $12.5{\mu}g/mL$ treatment of maximum concentration effectively inhibited up to about 59% to the amount of intracullular melanin ($IC_{50}=10.85{\mu}g/mL$). The $IC_{50}$ value of ${\alpha}-arbutin$ used as a positive control was $59.99{\mu}g/mL$. So, EtOAc fractions of M. obovata Bark extracts showed whitening effect when compared with the non-treatment group. In case of in vivo study, Cosmetic cream with EtOAc fractions of M. obovata Bark extracts was approved by Ethics committee of KDRI (IRB number: KDRI-IRB-1537). As a result in progress for skin sensitization as well as assessment of skin irritation through repeated patch test, skin allergens was identified as non sensitizing agents. Also, cosmetic cream with EtOAc fractions of M. obovata Bark extracts showed significant topical whitening effect and reliable skin safety when compared with the non-treatment group. In conclusion, EtOAc fractions of M. obovata Bark extracts may be a useful cosmetic ingredient for effective skin whitening.

Early and Midterm Results of Arterial Switch Operation for Double-Outlet Right Ventricle with Subpulmonary VSD (폐동맥하 심실증격결손을 동반한 양대혈관 우심실기시중에서 동맥전환술의 중단기 결과)

  • 양승인;이형두;김시호;조광조;우종수;이영석;성시찬
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.313-321
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    • 2004
  • Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (>30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

Electrical Stimulation Parameters in Normal and Degenerate Rabbit Retina (정상 망막과 변성 망막을 위한 전기자극 파라미터)

  • Jin, Gye-Hwan;Goo, Yong-Sook
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.73-79
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    • 2008
  • Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa (RP) or age related macular degeneration (AMD). Recently Korean consortium launched for developing retinal prosthesis. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we performed voltage stimulation experiment both in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: $50k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. Mono-polar electrical stimulation was applied through one of the 60 MEA channel, and the remaining channels were used for recording. The electrical stimulus was a constant voltage, charge-balanced biphasic, anodic-first square wave pulse without interphase delay, and 50 trains of pulse was applied with a period of 2 sec. Different electrical stimuli were applied. First, pulse amplitude was varied (voltage: $0.5{\sim}3.0V$). Second, pulse duration was varied $(100{\sim}1,200{\mu}s)$. Evoked responses were analyzed by PSTH from averaged data with 50 trials. Charge density was calculated with Ohm's and Coulomb's law. In normal retina, by varying the pulse amplitude from 0.5 to 3V with fixed duration of $500{\mu}s$, the threshold level for reliable ganglion cell response was found at 1.5V. The calculated threshold of charge density was $2.123mC/cm^2$. By varying the pulse duration from 100 to $1,200{\mu}s$ with fixed amplitude of 2V, the threshold level was found at $300{\mu}s$. The calculated threhold of charge density was $1.698mC/cm^2$. Even after the block of ON-pathway with L-(1)-2-amino-4-phosphonobutyric acid (APB), electrical stimulus evoked ganglion cell activities. In this APB-induced degenerate retina, by varying the pulse duration from 100 to $1200{\mu}s$ with fixed voltage of 2 V, the threshold level was found at $300{\mu}s$, which is the same with normal retina. More experiment with APB-induced degenerate retina is needed to make a clear comparison of threshold of charge density between normal and degenerate retina.

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Comparison of Retinal Waveform between Normal and rd/rd Mouse (정상 마우스와 rd/rd 마우스의 망막파형 비교)

  • Ye, Jang-Hee;Seo, Je-Hoon;Goo, Yong-Sook
    • Progress in Medical Physics
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    • v.19 no.3
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    • pp.157-163
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    • 2008
  • Retinal prosthesis is regarded as the most feasible method for the blind caused by retinal diseases such as retinitis pigmentosa or age-related macular degeneration. One of the prerequisites for the success of retinal prosthesis is the optimization of the electrical stimuli applied through the prosthesis. Since electrical characteristics of degenerate retina are expected to differ from those of normal retina, we investigated differences of the retinal waveforms in normal and degenerate retina to provide a guideline for the optimization of electrical stimulation for the upcoming prosthesis. After isolation of retina, retinal patch was attached with the ganglion cell side facing the surface of microelectrode arrays (MEA). $8{\times}8$ grid layout MEA (electrode diameter: $30{\mu}m$, electrode spacing: $200{\mu}m$, and impedance: 50 $k{\Omega}$ at 1 kHz) was used to record in-vitro retinal ganglion cell activity. In normal mice (C57BL/6J strain) of postnatal day 28, only short duration (<2 ms) retinal spikes were recorded. In rd/rd mice (C3H/HeJ strain), besides normal spikes, waveform with longer duration (~100 ms), the slow wave component was recorded. We attempted to understand the mechanism of this slow wave component in degenerate retina using various synaptic blockers. We suggest that stronger glutamatergic input from bipolar cell to the ganglion cell in rd/rd mouse than normal mouse contributes the most to this slow wave component. Out of many degenerative changes, we favor elimination of the inhibitory horizontal input to bipolar cells as a main contributor for a relatively stronger input from bipolar cell to ganglion cell in rd/rd mouse.

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Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum -Effect of the size of tricuspid valve annulus on the surgical outcome- (영아기에 발견된 심실중격이 온전한 폐동맥 폐쇄증의 외과적 수술요법 술전 삼첨판륜 크기 가 수술 결과에 미치는 영향)

  • 이정렬;윤태진
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1081-1089
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    • 1996
  • Pulmonary atresia with intact ventricular septum has continued to have a high surgical mortality and morbidity. This mAy attribute to the non-uniformity of the anomaly. We reviewed a total of 34 infants with pulmonary atresla and intact ventricular septum managed in this hospital between 1987 and 1995. Mean age and body weight were 57.2 (range, 3-208) days and 4.1 (range, B.3∼6.8) kg. The preoperative Z-value of the diameter of the tricuspid valve was less than -2 in 85.2% of patients and less than -4 in 33. 3% . It is well correlated w th right ventricular cavity size (n=27. r10.68, p< 0.05). Coronary artery-right ventricular fistulas were identified in 3 patients, and right ventricular dependency was suspected in 1 Over All hospital mortality was 23.5%(8/34), although it decreased to 16.6%(4124) in 1990s. Subsequent procedures were performed in 6 patients between 3 days and 58 months after Initial palliation : one bidirectional cavopulmonary shunt and 1 Fontan operation after systemic-pulmonary shunt, 3 transannular patch + atrial septal defect closure and 1 additional systemic-pulmonary shunt after polmonary valvectomy or valvotomy. Changes of Z-values of the diameter of tricuspid valve have been followed up in 11 patients between 1 and 66 months postoperatively. Z-values were increased In 5 out of 8 transannular right ventriculAr outflow tract enlargement group and in 1 out of 3 pulmonary valvectomy or valvotomy group. Our data suggest that tailoring a treatment to right ventricular cavity size and coronary anom lies may improve the surgical outcome. A Z-value of the tricuspid valve diameter could be used.

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An Approach to Enhance the Unfair Area in the Rural Landscape (농촌 조건불리지역의 경관개선을 위한 접근)

  • Jang, Gab-Sue;Park, In-Hwan
    • Journal of the Korean Institute of Landscape Architecture
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    • v.36 no.2
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    • pp.60-68
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    • 2008
  • Three land-use limitations including water hazard, soil erosion and fallow potential were evaluated to define an unfair area. Landscape indices in the unfair areas, defined by evaluations before and after landscape enhancement, were computed by Fragstats v3.3 and compared in order to propose a landscape enhancement plan. The results are as follows: First, as a result of the land evaluation, 388.56ha was analyzed for the 1st class(S1), 623.25ha for the 2nd class(S2), 138.08ha(S3s: 82.47ha, S3e: 51.88ha) for the 3rd class(S3), 230.44ha(N1w: 194.91ha, N1e: 23.09ha, N1es: 13.94ha) for the 4th class(N1), and 67.91ha(N2w: 60. 89ha, N2es: 7.02ha) for the 5th class(N2). The classes under the 3rd class(including the 3rd class) were determined as an unfair area, and proposed landscape enhancement for them. Second, it was proposed that unfair areas with potential water hazards(N1 w, N2w) be restored as a wetland and buffer zone. At this point, the farmers owning these fields could be compensated using the direct payment for landscape conservation(DPLC). Areas witha relatively lower slope(S3e) or a steep slope(N1e) containing soil erodibility potential were proposed to be restored as a sod-culture-applied field and substitute vegetation or potentially natural vegetation, respectively. The unfair areas having fallow potential(S3s, N1es, N2es) were proposed to apply special use crops for the S3s fields, native plants for the N1es fields, and intended fallow for the N2es fields. Third, after landscape enhancement, theforest had higher values in the indices of NP, PLAND, LSI, IJI, and TCA, while paddy and upland had lower values in most indices except NP and LSI. The forest patches increased and were more plentiful with their restoration and had much greater possibility to join with nearby patches. With continued restoration, forest patches will have a large core area and small number of patches due to the conglomeration of patches, which positively influences the species of diversity in the forest patches.

Petrology and Amphibolites(Meta-Dolerite sill) in the Mungyong Areal Korea (문경지역에 분포하는 각섬암(변성조립현무암)에 대한 암석학적연구)

  • Ahn, Kun-Sang;Shin, In-Hyun;Kim, Hee-Nam
    • Journal of the Korean earth science society
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    • v.18 no.6
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    • pp.500-514
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    • 1997
  • With respect to the amphibolites in the Mungyong area of the central part of the Ogcheon Fold Belt, detail field occurrence, texture and geochemical properties within each sills and petrogenetic environment are presented. We confirmed that the amphibolites in the Sangnaeri Formation (Ogcheon Supergroup) and limestone(Cambro-Ordovician Chosun Supergroup) sequences are metamorphosed dolerite sills which are roughly concordant to bedding of country rocks. Geologic distribution of the rocks is distinctly improved compared with those of previous investigations. There are four main sills so far observed in the study area. One is emplaced in limestone(Ls Sill, about 3 m thick) and the others are emplaced in Sangnaeri Formation, which are named First Sill(about 40 m thick), Second Sill(about 100 m thick) and Third Sill(about 40 m thick) from lower to upper horizons of the meta-pelitic sequences. The thick sills are intruded by minor sills and the Third Sill is a composite sill consisting of two main and two minor sills. Each sill has fine grained chilled marginal zones and grain size increases inwards from both contacts. The Second Sill has various vein and white patch in central part and the rock compositions vary systematically from margin to central part. $SiO_2,\;Na_2O,\;K_2O\;and\;P_2O_5$ increase, whereas $TiO_2,\;FeO,\;Al_2O_3\;and\;CaO$ decrease toward the contort. We investigate the major and trace element variations of ten selected rock compositions as intruding initial magma take occurrence and chemical properties into consideration. The compositional variations of them can not be explained by fractionation crystallization of single magma. Geologic distribution, geochemical properties and previous data suggest that amphibolite precursors(basaltic magma) of the study area were intrusive as sill-like in an intracontinental rift environment.

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Genetic Variation of some Patches of Eleutherococcus senticosus (Rupr. & Maxim) Maxim. in Korea (국내(國內) 가시오갈피 군락(群落)의 유전변이(遺傳變異) 분석(分析))

  • Hong, Kyung-Nak;Cho, Kyung-Jin;Park, Yew-Heon;Hur, Sung-Du;Hong, Yong-Pyo;Kang, Bum-Yong
    • Journal of Korean Society of Forest Science
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    • v.89 no.5
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    • pp.645-654
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    • 2000
  • The aim of this study was to described the genetic structure of Eleutherococcus senticosus in Korea. We investigated 10 patches, which are eight Korean patches and two foreign patches come from Russia and China growing at Korean habitat, using ISSR(inter-simple sequence repeats) markers. In ISSR PCR, the overall percentage of polymorphic ISSR amplicons was 76% and the mean number of amplicons per ISSR primer was 11.5, which were higher than the RAPD results for the some cultivars collected in Korea(Kim et al., 1998) ; 57% and 5.7, respectively. So ISSR markers provide more powerful tool than RAPD markers for the investigation of genetic variation in E. senticosus. There are relatively high genetic variation among patches as 62.8%, but low variation within eight Korean patches. Such pattern of genetic variation, which is not ordinary in other tree species, may be result from the narrow and limited habitats and the asexual reproduction of this species at the natural stands in Korea. Although the small sample size in this study seemed to be resulted in the high genetic variation among patches, the overall genetic interpretation of this study might not be much affected on the basis of the characteristics of the distribution and the reproduction system of E. senticosus. Analysis of genetic distance between all pairs of the patches did not reveal any trends with regard to geographic distance, which was confirmed by the results obtained from AMOVA(analysis of molecular variance) and PCA(principal component analysis). These results suggest that, in addition to the preservation of the natural stands, the conservation of larger number of patches with small number of individuals per patch is more effective for the ex situ conservation and for maintaining the genetic diversity of E. senticosus in Korea than smaller patches with large number of individuals.

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