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Pulmonary Arterial Growth Pattern after Shunt Operation in Patients of Pulmonary Atresia with Ventricular Septal Defect Associated with Juxtaductal Stenosis (Juxtaductal stenosis가 동반된 PA/VSD환자에서 체폐단락술 부위에 따른 폐동맥 크기의 변화)

  • 이교준;박영환;최재영;조범구
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.861-866
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    • 1998
  • Background: Pulmonary atresia (PA) with ventricular septal defect has various morphology of pulmonary arteries and pulmonary blood flow sources, so pulmonary arterial hypoplasia and arborization abnormality make this anomaly difficult to manage surgically. In cases associated with juxtaductal stenosis, we evaluated the change of the pulmonary arterial and juxtaductal stenotic site after shunt operations, and would like to find useful information in surgical planning and methodology of these patients. Material and Method: Among 59 cases diagnosed as PA with ventricular septal defect associated with juxtaductal stenosis, 29 cases who had cardiac catheterization before and after shunt operation were selected from July, 1991 to July, 1996. In 10 cases of right shunt operation(Group I) and 19 cases of left shunt operation (Group II), the diameters of the descending aorta, both pulmonary arteries, and the juxtaductal stenosis site were measured before and after the shunt operation. Result: In both Group I and II, the pre- and postoperative ratio of diameters of the ipsilateral pulmonary artery to the descending aorta was from 0.78${\pm}$0.31 units to 1.01${\pm}$0.26 units and from 0.67${\pm}$0.18 units to 0.84${\pm}$0.27 units respectively, showing a signigicant increase. The contralateral pulmonary artery index was increased from 0.92${\pm}$0.28 units to 1.05${\pm}$0.15 units and from 0.94${\pm}$0.27 units to 1.08${\pm}$0.37 units respectively, but could not be confirmed statistically. In both groups, the change of juxtaductal stenosis showed an aggravating tendency but of no statistical significance from 0.43${\pm}$0.27 units to 0.39${\pm}$0.25 units and from 0.32${\pm}$0.10 units to 0.30${\pm}$0.16 units respectively, and we experienced 2 total obstruction in Group II. Because the increased pulmonary blood flow by shunt operation has a favorable effect to the pulmonary arterial growth, the shunt operation is a recommended treatment in patients with hypoplastic pulmonary arteries. But in PA with ventricular septal defects, the change of juxtaductal stenosis is very important. In conclusion, the growth of ipsilateral (shunt site) pulmonary artery was promoted by shunt operation, but there is a tendency for the juxtaductal stenosis to be aggravated. And we experienced 2 total obstruction in Group II. Conclusion: Thus, in cases operated with shunt method, much careful postoperative follow up study including angiographic evaluation is needed, and after the shunt operation on the side of pulmonary artery associated with juxtaductal stenosis, early precise planning for total correction is recommended.

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A Study on the labial & buccal surface contour in Korean permanent teeth using three-dimensional laser scanning (3차원 레이저 스캐너를 이용한 한국인 영구치의 순, 협측 치관 굴곡도에 관한 연구)

  • Ko, Sang-Duck;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.32 no.4 s.93
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    • pp.275-291
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    • 2002
  • Of various factors indicated for effective use of straight wire appliances, there was a great lack of studies both domestic and international about the curvatures of tooth crowns. This study was performed to investigate the labio/buccal clinical crown curvatures of Korean permanent teeth. For this study, three-dimensional laser scanning was performed on 36 dental casts with normal anatomic structures. Andrews plane and Facial axis of clinical crown (FACC) were designated as horizontal and vertical reference planes respectively. 2 or 3 lines, 1mm apart, were drawn superior, inferior, left and right of these reference planes. A three-dimensional coordinate table was made for points formed by crossing these lines, and averages of each coordinate point on the 36 dental casts were obtained. The curvature equation was made using three-dimensional coordinate points (x,y,z) and by this curvature equation, the curve ratio of each tooth was obtained. Curve ratio changes of each section of teeth were calculated by curve ratios of simplified curves. These two dimensional curves were simplified horizontally and vertically Conclusions for this study are as follows. 1. The basic data of labial and buccal clinical crown curvatures were obtained about Korean permanent teeth. 2. No significant difference was found between male and females. 3. Individual tooth characteristics 1) In maxillary central incisors, the difference in the curve ratio between the gingival and incisal sides was greater than for the other teeth. And the gingival side showed a greater curve ratio. 2) Maxillary canines showed more curvatures in the mesio-occlusal surface than the other surfaces. 3) In maxillary $1^{st}$ premolars, more curvatures were found in mesio-occlusal and disto-gingival surface, thus showing a twisted crown surface, but in maxillary $2^{nd}$ premolars, the crown curvatures of mesial and distal ends became parallel to each other. 4) No significant difference in crown curvatures was found between mandibular central and lateral incisors. 5) Occluso-gingival curvatures of mandibular$2^{nd}$ premolar turned out to be more rounded than mandibular $1^{st}$ premolars or maxillary $2^{nd}$ premolars. From the above conclusions, it can be deduced that the same bracket bases can be used for mandibular central and lateral incisors. But for maxillary $1^{st}\;and\;2^{nd}$ premolars and for mandibular $1^{st}\;and\;2^{nd}$ premolars, because crown curvatures showed significant differences, when making bracket bases there is ample reason to make bracket base curves differently for each type of tooth.

A Study on the Change of Body Temperature according to the Needle Remaining Time at LU9 - Through the D.I.T.I. Scan - (태연혈(太淵穴)의 유침 시간에 따른 체온 변화 -적외선체열촬영(赤外線體熱撮影)을 중심으로-)

  • Lee, Bong-Hyo;Lee, Kyung-Min;Park, Ji-Ha;Kim, Min-Seo;Kim, San-Deul;Park, Byeong-Gyu;Yang, Hyun-Dong;Yea, Sung-Ho;Lee, Ho-Jung;Choi, Jae-Won;Hong, Hye-Lin;Lee, Eun-Jung;Lim, Sung-Chul;Kim, Jae-Su;Lee, Yun-Kyu;Lee, Hyun-Jong;Jung, Tae-Young;Jung, Hyun-Jung;Kam, Chul-Woo
    • Korean Journal of Acupuncture
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    • v.29 no.2
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    • pp.188-199
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    • 2012
  • Objectives : This study was performed to find the desirable remaining time of needle in the acupuncture treatment. Methods : The 21 volunteers were given acupuncture at LU9 vertically and needles were remained for 2 min, 10 min, 15 min, 30 min, respectively. The thermographic change induced by acupuncture was measured with Digital Infrared Thermographic Image at the following acupoints: LU11, LU10, LU9, LU8, LU5, LU1, and PC7. The statistical significance of thermographic change was evaluated using paired t-test and post hoc Wilcoxon test. Results : The most significant changes after acupuncture were produced when needles were remained for 10 min or 15 min. LU11, LU5, LU1, and PC7 were the point at which all of the remaining time produced significant change commonly. At LU11, the biggest change was produced when needle was remained for 15 min, while at LU5, LU1, and PC7, the biggest change was produced when needle was remained for 30 min, and the smallest change was produced when needle was remained for 10 min at all of acupoints of LU11, LU5, LU1, and PC7. The unbalance between left side and right was decreased the most largely in 15 min group. Conclusions : The results of this study suggest that the desirable remaining time of acupuncture needle might be 15 min.

Clinical Features in Primary Mediastinal Tuberculous Lymphadenitis (조직학적으로 증명된 결핵성 림프절염에 대한 임상적 고찰)

  • Ahn, Chul-Min;Yoo, Kwang-Ha;Park, Kwang-Ju;Kim, Hyung-Joong;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.767-774
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    • 1999
  • Background : Tuberculous mediastinal lymphadenitis (TML) is a relatively commonly encountered in Korea. However, there were no datas available on TML without other combined tuberculous infections in Korea. We retrospectively analyzed clinical manifestations, radiologic findings, Chest CT scan findings, the duration of treatment, and follow up Chest CT scan findings of 23 cases who had only TML. Method : 23 cases from 1991 to 1997 with TML confirmed by biopsy and had no other combined tuberculous infections were studied retrospectively. Results : Of the 23 cases, 7 cases were male and 16 female. The male to female ratio was 1 : 2.4. Mean age was 31 years and the most prevalent age group was the 3rd decade(43%). The most common presenting symptoms were fever(39%) followed by no symptom, cough, swallowing difficulty, and chest discomfort. On simple chest X-ray, mediastinal enlargement were noted in 20 cases(90%). The most frequently involved site was the paratracheal node in 11 cases with the right to left side involvement ratio being 4.6 : 1. On chest CT scan, the most commonly enlarged node was the paratracheal node(33%) followed by the subcarinal(20%), hilar(13%), tracheobronchial (8%), subaortic(8%), supraclavicular(8%) and anterior. mediastinal nodes. 6 cases were dropt out due to incomplete follow up. Thirteen cases were treated with HERZ regimen and the mean duration of treatment was 14 months. Three cases were treated with second line drug regimens(Tarivid, Pyrazinamide, Streptomycin plus Ethambutol or Para-aminosalicylic acid) for 18 months. In HERZ groups, one case was recurred after 10 months later and retreatment was done by same HERZ regimen during 12 months. Follow up chest CT scan after completion of treatment were done in 13 cases and that revealed more than a 50% decrease in size in 77% of the cases and no interval change in 23% of the cases. Conclusion : In cases of TML without other combined tuberculous infection, the minimal duration of treatment was required 12 months by HERZ regimen and 18 months by a 2nd line regimen or more. Further studies will be needed to confirm the treatment duration for TML without other combined tuberculous infections.

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STUDY OF RAT EPIGASTRIC VESSELS ACCORDING TO THE FREEZING TIME : HISTOLOGIC, HISTOMORPHOMETRIC, IMMUNOHISTOCHEMICAL & SCANNING ELECTRON MICROSCOPIC STUDY (백서 상복부 혈관의 동결시간에 따른 변화에 대한 연구)

  • Kim, Woo-Chan;Lee, Chong-Heon;Kim, Kyung-Wook;Kim, Chang-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.89-109
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    • 1999
  • Vascular spasm which has been reported to occur in 25% of clinical cases continues to be a problem in microvascular surgery; When prolonged and not corrected, it can lead to low flow, thrombosis, and replant or free flap failure. Ischemia, intimal damage, acidosis and hypovolemia have been implicated as contributors to the vascular spasm. Although much work has been done on the etiology and prevention of vasospasm, a spasmolytic agent capable of firmly protecting against or reversing vasospasm has not been found. Therefore vascular freezing was introduced as a new safe method that immediately and permanently relieves the vasospasm and can be applied to microsurgical transfers. Cryosurgery can be defined as the deliberate destruction of diseased tissue or relief the vascular spasm in microvascular surgery by freezing in a controlled manner. 96 Sprague Dawley rats each weighing within 250g were used and divided into 2 group, experimental 1 and 2 group. In the experimental 1 group, right epigastric vessels (artery and vein) were freezed with a cryoprobe using $N_2O$ gas for 1 min. In the experimental 2 group, after freezing for 1 min, thawing for 30 secs and repeat freezing for 30 secs. Left side was chosen as control group in both group. We sacrified the experimental animals by 1 day, 3 days, 1 week, 2 weeks, 4 weeks & 5 months and observed the sequential change that occur during regeneration of epigastric vessels using a histologic, histomorphometric, immunohistochemical and SEM study after the vascular freezing. The results were as follows1. In epigastric arteries, internal diameters had statistically significant enlargement in 1 day, 3 days of Exp-1 group and 1 day, 3 days, 1 week & 2 weeks of Exp-2 group. Wall thickness had statistically significant thinning in 2 weeks of Exp-2 group. 2. In epigastric veins, internal diameters had enlargement of statistical significance in 1 day of Exp-1 and Exp-2 group. 3. The positive PCNA reactions in smooth muscle appeared in 1 week and increased until 2 weeks, decreased in 4 weeks. There was no statistical significance between Exp-1 and Exp-2 group. 4. The positive ${\alpha}$-SMA reaction in smooth muscles showed weak responses until 1 week and slowly increased in 2 weeks and showed almost control level in 4 weeks. 5. The positive S-100 reactions in the perivascular nerve bundles showed markedly decrease in 1 day, 3 days and increased after 1 week and showed almost control level in 4 weeks. Exp-1 group had stronger response than Exp-2 group. 6. In SEM, we observed defoliation of endothelial cell and flattening of vessel wall. Exp-2 group is more destroyed and healing was slower than Exp-1 group. To sum up, relief of vasospasm (vasodilatation) by freezing with cryoprobe was originated from the damage of smooth muscle layer and perivascular nerve bundle and the enlargement of internal diameter in vessels was similar to expeimental groups, but Exp-2 group had slower healing course and therefore vessel freezing in microsurgery can be clinically used, but repeat freezing time needs to be studied further.

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Meat Quality and Storage Characteristics of Finishing Pigs by Feeding Stevia and Charcoal (스테비아와 숯이 급여된 비육돈의 육질 및 저장특성)

  • Lee, Jae-Joon;Park, Sung-Hyun;Jung, Dong-Soon;Choi, Yang-Il;Choi, Jung-Soek
    • Food Science of Animal Resources
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    • v.31 no.2
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    • pp.296-303
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    • 2011
  • This study was conducted to determine the effects of stevia (Stevia rebaudiana Bertoni) and charcoal supplementation on meat quality traits in finishing pigs. A total of 420 pigs (LYD) were randomly allocated into seven treatments with three replications. The dietary treatments were T1 (control, basal diet), T2 (basal diet+0.3% stevia), T3 (basal diet+0.6% stevia), T4 (basal diet+0.3% charcoal), T5 (basal diet+0.6% charcoal), T6 (basal diet+0.3% stevia+0.3% charcoal), and T7 (basal diet+0.6% stevia+0.6% charcoal). Pigs were slaughtered conventionally on each marketing day and chilled overnigth. At 24 h postmortem, the Longissimus muscle from left side between the 6th and 14th rib was removed for the meat quality traits. The T6 group showed a higher pH, water holding capacity (p<0.05), and lower drip loss (p<0.05) than those in the T1 group. The T6 group showed lower (p<0.05) $L^*$ (lightness) and $b^*$ (yellowness) values and higher $a^*$ (redness) color value than those in the T1 group, resulting in a redder surface meat color. In the subjective evaluation, marbling and color scores improved in the T6 group compared to those in the other treatments. In the panel test, the T6 group tended to have higher tenderness and juiciness scores than those in the T1 group. In the storage characteristics, all treatments showed similar 2-thiobarbituric acid and volatile basic nitrogen values as well as total microbial counts during 7 d of cold storage. As a result, dietary supplementation with 0.3% stevia and 0.3% charcoal showed the highest meat quality traits and storage characteristics in finishing pigs.

On the Research of 17th Century Joseon Dynasty's Bulsang, a Buddist Statue, Manufacturing Technique by Examining the Daeungbojeon Hall Samse-bulsang, The Buddha of the Three Words, at the Haenam Daeheungsa Temple (해남 대흥사 대웅보전 삼세불상을 통해 본 17세기 조선시대 불상의 제작기법 연구)

  • Lee, Su-yea
    • Korean Journal of Heritage: History & Science
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    • v.47 no.1
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    • pp.164-179
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    • 2014
  • The Buddhas of the Three Words in a form of arranging Bhaiṣajyaguru and $Amit{\bar{a}}bha$ at its side based on ${\acute{S}}{\bar{a}}kyamuni$ at the center is enshrined in Daeungbojeon Hall of Daeheungsa Temple located at Haenam. So far, this Buddhas of the Three Words has been known as a wooden Buddha statue. However, as a result of X-ray screening, in left/right Buddha statues excepting main Buddha, wood and molding clay layer were observed at the same time. Therefore, this study intended to observe its internal structure, grafting method and to clarify making technique of Buddha statue during Joseon era based on image information being obtained through X-ray screening of The Buddhas of the Three Words of Daeheungsa Temple. As its result, it was revealed that form of ${\acute{S}}{\bar{a}}kyamuni$ was completed by mainly grafting 5 pieces of timber and this statue shows a typical wood grafted Buddha statue during Joseon era. Form of Bhaiṣajyaguru and $Amit{\bar{a}}bha$ were completed based on molding technique by applying clay on sculpture similar to its appearance after sculpturing more than 10 pieces of timber through its grafting. In other words, internal timber is considered to play a role of its core and grafting method of timber is more close to a technique of molding Buddha statue than to that of wooden Buddha statue during Joseon era. However, clay was directly applied on timber thinly, not applying clay thickly on it after winding straw rope on wooden core and its characteristic is that its facial area was completely composed of wooden construction only. Therefore, it is hard to rule out a possibility that the original sculpturing intention of an artist might be a wooden Buddha statue but in view of the fact that a word, 'molding' was used in a record of relics buried in statue, it could be seen that this Buddha statue might have been recognized as a molding statue at the time when creation of this statue was completed. It is considered that number of case of making statue based on this technique would be more increased when more results of X-ray screening should be accumulated and if more data should be collected, it would provide a significant evidence for identifying chronological, regional aspects of making technique of Buddha statue.

Perineal Skin Toxicity according to Irradiation Technique in Radiotherapy of Anal Cancer (항문암의 방사선치료 시 방사선 조사 기법에 따른 회음부 피부 독성)

  • You, Sei-Hwan;Seong, Jin-Sil;Koom, Woong-Sub
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.222-228
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    • 2008
  • Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.

Analysis of Tree Growth Characteristics by First and Second Thinning in Korean White Pine Plantations (잣나무 인공림의 1차 및 2차 간벌에 따른 입목생장 특성 분석)

  • Lee, Daesung;Jung, Sunghoon;Choi, Jungkee
    • Journal of Korean Society of Forest Science
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    • v.111 no.1
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    • pp.150-164
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    • 2022
  • This study was conducted to provide basic information for the development of silvicultural guidelines and manuals. This was achieved through analysis of tree and stand characteristics according to the first and second thinning in Korean white pine plantations. Data were collected from permanent plots installed at Korean white pine plantations according to thinning intensity, and residual tree and stand variables, including diameter at breast height (DBH), volume, and mortality at age 19-43, were analyzed using data repeatedly collected in 4-5 measurements by experiments. According to one-way variance of analysis, tree DBH and volume were significantly different according to thinning intensity (p<0.05). DBH distribution was skewed to the left side over time as thinning intensity was heavier. Thus, tree DBH values were larger in heavy thinning plots with increased age. The periodic annual increment (PAI) of DBH was higher with heavier thinning intensity and fewer years after thinning. The PAI range by thinning intensity was 0.48-0.95 cm/year at age 19-24. In addition, the PAI increased in heavy thinning plots after the second thinning; The PAI range by thinning intensity was 0.29-0.67 cm/year after the second thinning at age 37-42. The PAI of tree volume differed according to thinning intensity, and the PAI value did not decrease obviously, in contrast to the pattern of the DBH PAI. Stand volume was generally higher in high-density stands, and the PAI of stand volume was high in unthinned and light thinning plots. Mortality was highest in unthinned plots, and the differences in mortality according to thinning intensity increased over time. Consequently, the growth of DBH and tree volume was lower as stand density increased, but this growth was facilitated with appropriate first and second thinning operations.

Effect of LI4-LI11 Transcutaneous Electrical Nerve Stimulation on Regional Cerebral Blood Flow in Healthy Human Using SPECT and Statistical Parametric Mapping (뇌 SPECT와 SPM을 이용한 합곡-곡지 TENS 치료의 뇌혈류에 대한 효과)

  • Jeong, Dong-Won;Kim, Young-Suk;Park, Seong-Uk;Jung, Woo-Sang;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.205-212
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    • 2008
  • Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.

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