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A Clinical Study on the Surgical Treatment of the Rheumatic Cardiac Valve Disease (류마티스성 심장판막질환의 외과적 치료에 대한 임상적 연구)

  • 김종원;정황규;이성광;김병준;신영우
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.346-352
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    • 1998
  • Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7+/-2.9% in 1 year, 88.0+/-4.5% in 5 year, 82.3+/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

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Development of Isolation and Cultivation Method for Outer Root Sheath Cells from Human Hair Follicle and Construction of Bioartificial Skin

  • Seo, Young-Kwon;Lee, Doo-Hoon;Shin, Youn-Ho;You, Bo-Young;Lee, Kyung-Mi;Song, Key-Yong;Seo, Seong-Jun;Whang, Sung-Joo;Kim, Young-Jin;Park, Chang-Seo;Chang, Ij-Seop;Park, Jung-Keug
    • Biotechnology and Bioprocess Engineering:BBE
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    • v.8 no.2
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    • pp.151-157
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    • 2003
  • Obtaining a sufficient amount of healthy keratinocytes from a small tissue is difficult. However, ORS cells can be a good source of epithelium since they are easily obtainable and patients do not have to suffer from scar formation at donor sites. Accordingly, the current study modified the conventional primary culture technique to overcome the low propagation and easy aging of epithelial cells during culturing. In a conventional primary culture, the average yield of human ORS tells is 2.↑ $\times$ 10$^3$cells/follicle based on direct incubation in a trypsin (0.1%)/EDTA(0.02%) solution for 15 min at 37$^{\circ}C$, however, our modified method was able to obtain about 6.9 $\times$ 10$^3$cel1s/follicle using a two-step enzyme digestion method involving dispase (1.2 U/mL) and a trypsin (0.1%)/EDTA (0.02%) solution. Thus, the yield of primary cultured ORS cells could be increasd three times higher. Furthermore, a total of 2.0 $\times$ 10$^{7}$ cells was obtained in a serum-free medium. while a modified E-medium with mitomycin C-treated feeder tells produced a total of 6.3 $\times$ 10$^{7}$ Cel1s over 17 days When Starting With 7.5 $\times$ 10$^4$cells. Finally, We Confirmed the effectiveness of our ORS tell isolation method by presenting their ability for reconstructing the bioartificial skin epithelium in vitro

Effect of Photodynamic Therapy in Lung Cancer (폐암에서 광역동치료술의 효과)

  • Yoon, Sung Ho;Han, Kyung Taek;Kim, Gyung Nam;Lee, Seung Il
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.358-363
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    • 2004
  • Background : Photodynamic therapy (PDT) involves the use of photosensitizing agents for treatment of malignant disease. PDT is approved by the U.S. Food and Drug Administration for the endobronchial microinvasive nonsmall cell lung cancer and for palliation in patients with obstructing tumors. We report our experience and results of PDT in lung cancer. Method : Ten patients with lung cancer who were diagnosed in Chosun university hospital by histologic confirm through bronchoscopy were included between August 2002 and May 2003. The photosensitizer (Photogem$^{(R)}$, Lomonosov institute of Fine Chemical, Russia/dose 2.0 mg/kg body weight) was injected 48 hours prior to the PDT session. For PDT with the photosensitizer (Photogem$^{(R)}$), Diode LASER system (Biolitec Inc., Germany, wavelength; 633nm) were used. PDTs were done at 48-72 hours after photogem injection. Follow up bronchoscopy and chest X-ray or thorax computerized tomography were done for evaluate PDT response. Results : 9 of 10 patients with endobronchial obstruction showed partial remission with bronchus opening after PDT. Direct reaction of the tumor to PDT was similar in despite of its localization. It was as follows; edema, hyperemia, in-situ bleeding, fibrin film occurrence. Any other complications such as sunburns of skin, inflammation within the PDT zone were not occurred by the end of the fourth week. Conclusion : In the advanced endobronchial disease, PDT has been shown to be useful in treating endobronchial tumors that are causing clinically significant dyspnea or are likely to progress and lead to further clinical complications, such as postobstructive pneumonia.

Quantitative Sensory Test: Normal Range in Korean Adults and Application to Diabetic Polyneuropathy (정량적 감각 검사: 한국인에서의 연령별 정상 범위 및 당뇨병성 다발신경병증에서의 유용성 평가)

  • Kim, Su-Hyun;Kim, Sung-Min;Ahn, Suk-Won;Hong, Yoon-Ho;Park, Kyung-Seok;Sung, Jung-Joon;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.21-26
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    • 2010
  • Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

An experimental study of the effects of Husband s supportive behavior reinforcement education on stress relief of primigravidas (초임부의 스트레스감소에 미치는 지지강화교육의 효과에 관한 실험적 연구)

  • 안황란
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.5-16
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    • 1985
  • This study examined the effects of husband's supportive behavior reinforcement education on stress relief of primigravidas. The purpose was to reinforce husbands' supportive behavior and relieve primigravidas' stress. The purposes of this study were to determine lactors influencing Primigravidas' stress and the effect of husbands' supportive behavior reinforcement education on stress relief of primigravidas. The subjects, consisting of 140 primigravidas who registered or visited in three obstetrics and gynecology clinics in J city, were divided into at random experimental and control groups. Data were collectpe from April To July, 1984 through interviews during hospital visits, and by questionaires. The husbands' supportive behavior reinforcement education and the measurement tools were developed by the investigator from the literature and during pilot study: the instruments to measure primigravidas' stress and husbands' supportive behavior were tested for reliability and validity. Personality characteristisc were measured by Chestnuts' Stress Management instrument. T-test, ANOVA, ω², and Pearson Correlation were used in analysing the data to confirm the intensity of the influence and the relation between general characteristics and primigravidas' stress. Pearson correlation and Stepwise Multiple Regression were used to confirm the predictors of primigravidas' stress. Independent variables were compared by means of t-test and χ³-test to confirm significant discrepancy of experimental and control groups. T-test, paired t-test, pearson correlation were used in analyzing the data to confirm the effect of husband's supportive behavior reinforcement education on stress relief of primigravidas. The results of the study are summarized. Results from analyzing the effect of husbands' supportive behavior reinforcement education: There was no significant difference between the general characteristics of the experimental and control groups. And husbands' supportive behavior, personality, marital Satisfaction, natural abortion variables influenced at primigravidas' stress. A hypothetical test by comparative analysis of the measurement of primigravidas' stress and husbands' support behavior between the experimental and the control group before and after the experiment to confirm the effect of husbands' supportive behavior reinforcement education resulted in the following: The first hypothesis that husbands' supportive behavior reinforcement education will increase husbands' support behavior to relieve primigravidas' stress was supported. The second hypothesis that husbands' supportive behavior reinforcement education will relieve primigravidas' stress was supported. As a result, it u·as shown that husbands' supportive behavior reinforcement education relieved primigravidas' stress, and the hypotheses were supported. The third hypothesis that the higher the degree of husbands' supportive behavior, the lower the primigravidas' stress was supported. It was concluded that husbands' supportive behavior reinforcemen education increase husbands' supportive behavior and relieves Primigravidas' stress.

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20(S)-protopanaxadiol promotes the migration, proliferation, and differentiation of neural stem cells by targeting GSK-3β in the Wnt/GSK-3β/β-catenin pathway

  • Lin, Kaili;Liu, Bin;Lim, Sze-Lam;Fu, Xiuqiong;Sze, Stephen C.W.;Yung, Ken K.L.;Zhang, Shiqing
    • Journal of Ginseng Research
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    • v.44 no.3
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    • pp.475-482
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    • 2020
  • Background: Active natural ingredients, especially small molecules, have recently received wide attention as modifiers used to treat neurodegenerative disease by promoting neurogenic regeneration of neural stem cell (NSC) in situ. 20(S)-protopanaxadiol (PPD), one of the bioactive ingredients in ginseng, possesses neuroprotective properties. However, the effect of PPD on NSC proliferation and differentiation and its mechanism of action are incompletely understood. Methods: In this study, we investigated the impact of PPD on NSC proliferation and neuronal lineage differentiation through activation of the Wnt/glycogen synthase kinase (GSK)-3β/β-catenin pathway. NSC migration and proliferation were investigated by neurosphere assay, Cell Counting Kit-8 assay, and EdU assay. NSC differentiation was analyzed by Western blot and immunofluorescence staining. Involvement of the Wnt/GSK3β/β-catenin pathway was examined by molecular simulation and Western blot and verified using gene transfection. Results: PPD significantly promoted neural migration and induced a significant increase in NSC proliferation in a time- and dose-dependent manner. Furthermore, a remarkable increase in anti-microtubule-associated protein 2 expression and decrease in nestin protein expression were induced by PPD. During the differentiation process, PPD targeted and stimulated the phosphorylation of GSK-3β at Ser9 and the active forms of β-catenin, resulting in activation of the Wnt/GSK-3β/β-catenin pathway. Transfection of NSCs with a constitutively active GSK-3β mutant at S9A significantly hampered the proliferation and neural differentiation mediated by PPD. Conclusion: PPD promotes NSC proliferation and neural differentiation in vitro via activation of the Wnt/GSK-3β/β-catenin pathway by targeting GSK-3β, potentially having great significance for the treatment of neurodegenerative diseases.

The Effect of a Video Exercise Program on Cancer-related Fatigue, Physical Function and Emotional Status in Patients with Cancer during Chemotherapy (동영상 운동프로그램이 항암 화학요법을 받는 암환자의 피로와 신체기능 및 정서상태에 미치는 효과)

  • Cho, Mee Young;Park, Ji Young;Lee, Chung Eun;Song, Su Kyung;Lee, Sun Hi;Byun, Eun Sung;Kim, Ji Youn;Park, Ok Sun;Kim, Soon Ho;Kang, Young Lynn;Han, Soo Young;Lee, Hyang Kyu;Choi, Hye Jin
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.3
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    • pp.368-380
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    • 2012
  • Purpose: The purpose of this study was to evaluate the effects of a home-based video exercise program on cancer-related fatigue, physiological and psychological status in patients with colon and rectal cancers undergoing chemotherapy. Methods: The study design was a non-equivalent control group non-synchronized design. Data were collected from patients with colo-rectal cancers in Yonsei cancer center from July 5th to October 31st in 2011. There were 40 participants; 20 in the experimental group and 20 in the control group. The structured questionnaire was used to measure fatigue, physical function and emotional status. Data were analyzed using SPSS 18.0 and a chi-squre test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed- rank test were conducted to examine the homogeneity and the research hypotheses. Results: There was a statistically significant difference in White Blood Cell count in the experimental group compared with that of the control group. The exercise group showed a slight decrease of White Blood Cell count compared with that of the control group after 4 week program (z=-2.935, p=.003). However, there were no significant differences in fatigue, physiological and psychological status between the two groups. Conclusion: In this study, the developed video exercise program was effective in markedly slightly decreasing White Blood Cell count in patients with colo-rectal cancers undergoing chemotherapy. Therefore, utilizing the video exercise program can be an useful method to promote health among patients with cancer in clinical practice.

A Study on the Fee-Based Model Development of Day Care Centers for the Elderly (유료 노인 낮보호 시설 모형개발에 관한 연구)

  • Chung, Shin-Sook;Chung, Yeon-Kang
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.5-18
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    • 1999
  • The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

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Effects of Aquatic Exercise Program on the Shoulder Joint Function, Physical Symptom and Quality of Life in Postmastectomy Patients (수중운동 프로그램이 유방절제술 환자의 어깨관절 기능, 신체적 자각증상 및 삶의 질에 미치는 효과)

  • Yoo Yang-Sook
    • Journal of Korean Public Health Nursing
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    • v.13 no.2
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    • pp.101-114
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    • 1999
  • This study was designed to investigate the effects of an aquatic exercise program on the shoulder joint function. physical symptom. quality of life and stress among the patients who received modified radical mastectomy between 6 to 12 months prior to their visits. The subjects were 31 women aged between 40 and 60 who visited the out-patient department at Kang Nam St. Mary's Hospital for follow-up care. and were not under the treatment of intravenous cancer chemotherapy or radiation therapy. and had no complications. Twelve of them were assigned to the control group. while nineteen subjects to the experimental group. The aquatic exercise program was developed by the author with the assistance of exercise specialists. The program includes warming uP. aerobic and cooling down exercises in water. The aquatic exercise program for the experimental group was carried out 3 times a week with 60 minutes in each time for 8 weeks from September 20th to November 15th. 1995 in a regular swimming pool in Seoul. Changes in the range of motion of the shoulder joint. muscle strength. physical symptom. quality of life. and stress were examined after the completion of treatment. The data were collected through isokinetic muscle strength evaluation and questionnaire survey before and after the treatment. Paired and unpaired t-test were adopted to analyze the data. The results were as follows ; 1. The increment in the range of motion of the shoulder joint in the experimental group after the exercise was significantly greater than those in the control group. 2. The peak torque of shoulder girdle muscles increased significantly after the exercise in the experimental group only. 3. The physical symptom score decreased significantly after the exercise in the experimental group only. 4. The experimental group revealed significantly higher level of quality of life and lower level of stress after the exercise compared with those before the exercise. whereas the control group showed no significant changes in those levels. These findings may indicate that the aquatic exercise program is effective in increasing the range of motion of the shoulder joint and muscle strength and quality of life. and also effective in decreasing physical symptoms. and the level of stress in postmastectomy patients. Accordingly. the acquatic exercise program' can be adopted as an effective nursing intervention for postmastectomy rehabilitation.

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Quality Control of Radiation Dosimetry Service (개인피폭선량 측정기관의 품질관리기준 개발)

  • Lee, Jun-Haeng;Lee, Sang-Bock;Chang, Kun-Jo;Lee, Kwang-Yong;Lee, Hyun-Koo;Kim, Hyeog-Ju;Jin, Gye-Hwan
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.253-259
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    • 2009
  • We have developed standards based on international criterions for the quality control of dose tested by the measurement institutions of individual exposure doses through improving the reliability of data on the exposure dose of individuals working in radioactive environment and securing the accuracy and reliability of individual dose measurements. Laws related to radiation dose applied to domestic institutions refer to ANSI N13.11.1993, but currently, in U.S. and some other countries the measurement of radiation doses is based on ANSI N13.11.2001 that reduced test categories and tightened the standards. We made efforts to simplify the standards and to reduce the number of dosimeters required in experiment, and avoided preventing or hindering the use of future technologies not approved under the current law such as glass dosimeter and optical stimulation dosimeter. The Quality Management Manual of Radiation Dosimetry Service, Assessment Manual of Radiation Dosimetry Service Accreditation Program, and the Personnel Dosimetry Performance. Criteria for Testing are documents applicable in supervising laboratories.

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