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A Study on the Determination of Scan Speed in Whole Body Bone Scan Applying Oncoflash (Oncoflash를 적용한 전신 뼈 영상 검사의 스캔 속도 결정에 관한 연구)

  • Yang, Gwang-Gil;Jung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.56-60
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    • 2009
  • Purpose: The various studies and efforts to develop program are in progress in the field of nuclear medicine for the purpose of reducing scan time. The Oncoflash is one of the programs used in whole body bone scan which allows to maintain the image quality while to reduce scan time. When Those applications are used in clinical setting, both the image quality and reduction of scan time should be considered, therefore, the purpose of this study was to determine the criteria for proper scan speed. Materials and Methods: The subjects of this study were the patients who underwent whole body bone scan at the departments of nuclear medicine in the Asan Medical Center located in Seoul from 1st to 10th, July, 2008. The whole body bone images obtained in the scan speed of 30cm/min were classified by the total counts into under 800 K, and over 800 K, 900 K, 1,000 K, 1,500 K, and 2,000 K. The image quality were assessed qualitatively and the percentages of those of 1,000K and under of total counts were calculated. The FWHM before and after applying the Oncoflash were analyzed using images obtained in $^{99m}Tc$ Flood and 4-Quadrant bar phantom in order to compare the resolution according to the amount of total counts by the application of the Oncoflash. Considering the counts of the whole body bone scan, the dosed 2~5 mCi were used. 152 patients underwent the measurement in which the counts of Patient Postioning Monitor (PPM) were measured with including head and the parts of chest which the starting point of whole body bone scan from 7th to 26th, August, 2008. The correlations with total counts obtained in the scan speed of 30cm/min among them were analyzed (The exclusion criteria were after over six hours of applying isotopes or low amount of doses). Results: The percentage of the whole body bone image which has the geometric average of total counts of under 1,000K among them obtained in the scan speed of 30cm/min were 17.6%(n=58) of 329 patients. The qualitative analysis of the image groups according to the whole body counts showed that the images of under 1,000K were assessed to have coarse particles and increased noises. The analysis on the FWHM of the images before and after applying the Oncoflash showed that, in the case of PPM counts of under 3.6 K, FWHM values after applying the Oncoflash were higher than that before applying the Oncoflash, whereas, in the case of that of over 3.6 K, the FWHM after applying the Oncoflash were not higher than that before applying the Oncoflash. The average of total counts at 2.5~3.0 K, 3.1~3.5 K, 3.6~4.0 k, 4.1~4.5 K, 4.6~5.0 K, 5.1~6.0 K, 6.1~7.0 K, and 7.1 K over (in PPM) were $965{\pm}173\;K$, $1084{\pm}154\;K$, $1242{\pm}186\;K$, $1359{\pm}170\;K$, $1405{\pm}184\;K$, $1640{\pm}376\;K$, $1,771{\pm}324\;K$, and $1,972{\pm}385\;K$, respectively and the correlations between the counts in PPM and the total counts of image obtained in the scan speed of 30 cm/min demonstrated strong correlation (r=.775, p<.01). Conclusions: In the case of PPM coefficient over 3.6 K, the image quality obtained in the scan speed of 30cm/min and after applying the Oncoflash was similar to that obtained in the scan speed of 15 cm/min. In the case of total counts over 1,000 K, it is expected to reduce scan time without any damage on the image quality. In the case of total counts under 1,000 K, however, the image quality were decreased even though the Oncoflash is applied, so it is recommended to perform the re-image in the scan speed of 15 cm/min.

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Changes Occurred in Protein and Amino Acid Compositions during Postmortem Aging of White and Dark Muscle of Yellowtail at $2^{\circ}C$ (방어 보통육과 혈합육의 단백질 및 아미노산조성의 사후변화)

  • KIM Chang-Yang;CHOI Yeung-Joon;PYEUN Jae-Hyeung
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.15 no.2
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    • pp.123-136
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    • 1982
  • We investigated the changes in protein and free amino acid compositions of the muscles, and amino acid composition of the muscle proteins during postmortem storage of dorsal white and lateral dark muscles of Yellowtail, Seriola quinqueradita, which were kept at $2^{\circ}C$. We present an extensive discussion on the relationship between the changes of freshness and those of protein compositions in the white and the dark muscle of the red-fleshed fish by analyzing polyacrylamide gel electrophoretograms of $NaDodSO_4-solubilized$ sarcoplasmic and myofibrillar proteins extracted from the both muscles. By assessing K-value, total volatile basic nitrogen and pH value as a criterion of freshness, we found that the dark muscle undergoes a more rapid decrease in its freshness compared to that of the white muscle. The contents of the sarcoplasmic and the myofibrillar protein were decreased with postmortem aging of the muscles while those of the residual intracellular protein were increased, and these changes were somewhat faster in the dark muscle than in the white muscle. From the analysis of the electrophoretograms and their densitograms, we found that the sarcoplasmic proteins of the white and the dark muscle were respectively composed of 16 and 12 components. The sarcoplasmic protein of the white muscle lapsed for 10 days showed an increase of 18,000 and 41,000 dalton components, and a gradual decrease of 23,000 and 23,500 dalton components, whereas the sarcoplasmic protein of the dark muscle lapsed for 9 days showed a decrease of 49,000 dalton component, an appearence of a newly formed component of 47,000 dalton, and a disappearance of 26,000 dalton component. The electrophoretograms of the myofibrillar proteins shelved that the white and the dark muscle were composed of 17 and 16 components, respectively. Depending on the lapsed time of postmortem under the controlled condition, the myofibrillar proteins of the white muscle showed an increase of 40,000 dalton component, a gradual decrease of 37,500 dalton component, an appearance of a newly forming component of 32,000 dalton and a disappearance of 26,000 dalton component. On the other hand, the myofibrillar proteins of the dark muscle showed an increase of 58,000 and 64,000 dalton bands, a disappearance of light chain-2 protein and an appearance of a newly forming protein of 32,000 dalton. These changes on the electrophoretic patterns in the dark muscle were more rapid than those in the white muscle. In almost all of the cases, we observed that the changes in the sarcoplasmic protein were faster than those in the myofibrillar protein. The analysis of amino acid of the both muscle proteins showed that the white muscle was rich in glutamic acid, aspartic acid, leucine, arginine, lysine, etc. but was poor in proline and tryptophan. No significant difference was found in the amino acid composition of protein of both the white and the dark muscles. The sample of white muscle lapsed for 10 days shows a remarkable decrease in glutamic and aspartic acids, while that of the dark muscle lapsed for 9 days shows an appreciable decrease in alanine, glycine and arginine. The free amino acid compositions of the white and the dark muscles are respectively characterized with $63\%$ of histidine and $67\%$ of taurine with respect to the total free amino acids of the yellowtail at-death, respectively. The white muscle lapsed for 10 days showed an increase of histidine, valine and taurine, and a slight decrease of alanine, leucine and glycine. The dark muscle lapsed for 9 days shelved an increase of taurine, phenylalanine and glycine, and a decrease of histidine, alanine and serine.

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Perception of common Korean dishes and foods among professionals in related fields (한식 관련 분야 전문가들의 한국인 상용 음식과 식품에 대한 인식)

  • Lee, Sang Eun;Kang, Minji;Park, Young-Hee;Joung, Hyojee;Yang, Yoon-Kyoung;Paik, Hee Young
    • Journal of Nutrition and Health
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    • v.45 no.6
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    • pp.562-576
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    • 2012
  • Han-sik is a term in Korean that may indicate any Korean dish or food. At present, there is no general consensus on the definition of Han-sik among scholars or professionals in related fields. The aim of this study was to investigate perceptions of Han-sik by professionals in the fields of food, nutrition, and culinary arts using 512 dishes and foods commonly consumed by Koreans using the 4th Korean National Health and Nutrition Survey. A total of 117 professionals out of 185 initially contacted professionals participated in this online survey. We calculated the rate of respondents with a positive answer, that is "It is Han-sik', on each dish and food from the 512 items in 28 dish groups. Items were categorized into five groups according to their Han-sik perception rate: over 90%, 75-89%, 50-74%, 25-49%, and below 25%. Most items in the three dish groups 'Seasoned vegetables, cooked (Namul Suk-chae)', 'Kimchis', and 'Salt-fermented foods (Jeotgal)' showed high perception rates of Han-sik, with a higher than 90% positive response. Items in 'Soups', 'Stews', and 'Steamed foods' dish groups also showed high perception rates of Han-sik. However, no item showed a greater than 90% Han-sik perception rate in 'Fried foods (Twigim)', 'Meat, poultry and fishes', 'Legumes, nuts, and seeds', 'Milk and milk products', 'Sugars and confectioneries', and 'Soup'. Most items in the 'Milk and milk products', 'Sugars and confectioneries', and 'Soup' groups belonged to the lowest perception rate of below 25%. There was a significant difference in the proportion of items perceived as Han-sik by the length of living abroad to (p < 0.05). In summary, the perception rate of Han-sik seemed to be affected by the cooking method, ingredients, and length of time living abroad by the professionals. Further studies targeting subjects with different characteristics and socioeconomic status are warranted to define the concept of Han-sik.

A comparative study of the puberty suppression effect of gonadotropin-releasing hormone agonist in precocious or early puberty girls (중추성 성조숙증 및 조기 사춘기 여아에서 성선자극호르몬 방출호르몬작용제의 용량에 따른 사춘기 억제 효과 비교)

  • Shim, Kye-Shik;Bae, Chong-Woo;Yang, You-Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.634-639
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    • 2008
  • Purpose : There has been considerable disagreement regarding the most appropriate dosage of gonadotropin-releasing hormone agonist in cases of central precocious puberty. The aim of this study was to determine the appropriate dosage for suppression of the puberty in girls with central precocious or early puberty. Methods : Twenty-two girls with early puberty were randomly subjected to 3 types of dosages of leuprolide acetate for at least 6 months. The number of cases in groups 1, 2, and 3 were 7, 7, and 8, and dosages were 70, 90, and $110{\mu}g/kg/-month$, respectively. Height, weight, bone age, Tanner stage of breast development, and serum levels of LH, FSH, estradiol, and progesterone were measured before treatment and after 6 months of treatment. The number of cases of puberty suppression was compared using a modified puberty suppression score with a nonparametric chi-square test. Results : There were no significant differences of chronologic and bone ages among the groups. There was a significant decrease in height SDS gain after 6 months in group 3 (P<0.05) compared with groups 1 and 2. Serum levels of LH, FSH, estradiol and progesterone were all significantly decreased after treatment in all 3 groups (P<0.05). The number of cases of puberty suppression in each group were 4 (57%), 5 (71%), and 8 (100%). There was a significantly increased proportion of suppression of puberty in group 3 (P<0.05). Conclusion : It was necessary to use a higher dose of gonadotropin-releasing hormone agonist to suppress early puberty in girls; however further longitudinal study will be needed for their prognosis of final adult height.

Studies on the Post-hatching Development of the Testis in Korean Native Chickens (한국 재래 닭 부화 후 고환 발달에 관한 연구)

  • Jang, B.G.;Tae, H.J.;Choi, C.H.;Park, Y.J.;Park, B.Y.;Park, S.Y.;Kang, H.S.;Kim, N.S.;Lee, Y.H.;Yang, H.H.;Ahn, D.C.;Kim, I.S.
    • Korean Journal of Poultry Science
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    • v.33 no.3
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    • pp.171-179
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    • 2006
  • Changes in the chicken testis from hatching to adulthood were studied in Korean native chickens of 1, 2, 4, 6, 8, 10, 12, 14, 16, 18, 21, 24, 28, 32, 44, 52 and 64 weeks (n=13 chickens per group) of age. The present study was to investigate in more detail the post-hatching development of testis in Korean native chickens. Testes of chickens were fixed by whole body perfusion using a fixative containing 2.5% glutaraldehyde in cacodylate buffer, processed and embedded in Epon-araldite. Using $1{\mu}m$ sections stained with methylene blue-azure II, qualitative and quantitative(stereological) morphological studies were performed. Sperm production was measured by routine technique. The average volume of a testis of 1 week old Korean native chickens was determined as 0.015 g and the parameter increased linearly from 1 week to 21 weeks days (28.9 g), and did not change from 21 weeks to 64 weeks. The volume density of the seminiferous tubules increased with age from 32.6% at week 1 to 92.89% at week 64. The volume density of the interstitium represents 67.4% of the testicular parenchyma at week 1. This proportion progressively diminished during development to reach a value of 7.11% at week 64. Total sperm production per testis increased significantly from 18 weeks to 28 weeks and remained unchanged. Sperm production per 1 g testis increased significantly from 18 weeks to 28 weeks, did not change significantly from 28 weeks to 52 weeks, and declined significantly at 64 weeks of age. The average diameter of the seminiferous tubules gradually increased with age from 1 week $(42.4{\mu}m)$ to 21 weeks $(412.8{\mu}m)$. The length of the seminiferous tubules was 0.34 m at 1 week, increased significantly in subsequent age groups and reached 72.2 m by weeks 64. The stage of germ cell development in seminiferous tubules was classified as 1) spermatogonia $(1\sim8\;weeks)$, 2) spermatogonia and spermatocytes $(10\sim12\;weeks)$, 3) spermatogonia, spermatocytes and round spermatids $(14\sim16\;weeks)$, and 4) speramatogonia, spermatocytes, spermatids and spermatozoa $(18\sim64\;weeks)$. These results clarified the pattern of changes in the testicular development in Korean native chickens from hatching to adulthood as 1) neonatal-prepubertal $(1\sim12\;weeks)$, 2) puberty$(14\sim18\;weeks)$, and adult$(21\sim64\;weeks)$.

A Statistical model to Predict soil Temperature by Combining the Yearly Oscillation Fourier Expansion and Meteorological Factors (연주기(年週期) Fourier 함수(函數)와 기상요소(氣象要素)에 의(依)한 지온예측(地溫豫測) 통계(統計) 모형(模型))

  • Jung, Yeong-Sang;Lee, Byun-Woo;Kim, Byung-Chang;Lee, Yang-Soo;Um, Ki-Tae
    • Korean Journal of Soil Science and Fertilizer
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    • v.23 no.2
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    • pp.87-93
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    • 1990
  • A statistical model to predict soil temperature from the ambient meteorological factors including mean, maximum and minimum air temperatures, precipitation, wind speed and snow depth combined with Fourier time series expansion was developed with the data measured at the Suwon Meteorolical Service from 1979 to 1988. The stepwise elimination technique was used for statistical analysis. For the yearly oscillation model for soil temperature with 8 terms of Fourier expansion, the mean square error was decreased with soil depth showing 2.30 for the surface temperature, and 1.34-0.42 for 5 to 500-cm soil temperatures. The $r^2$ ranged from 0.913 to 0.988. The number of lag days of air temperature by remainder analysis was 0 day for the soil surface temperature, -1 day for 5 to 30-cm soil temperature, and -2 days for 50-cm soil temperature. The number of lag days for precipitaion, snow depth and wind speed was -1 day for the 0 to 10-cm soil temperatures, and -2 to -3 days for the 30 to 50-cm soil teperatures. For the statistical soil temperature prediction model combined with the yearly oscillation terms and meteorological factors as remainder terms considering the lag days obtained above, the mean square error was 1.64 for the soil surfac temperature, and ranged 1.34-0.42 for 5 to 500cm soil temperatures. The model test with 1978 data independent to model development resulted in good agreement with $r^2$ ranged 0.976 to 0.996. The magnitudes of coeffcicients implied that the soil depth where daily meteorological variables night affect soil temperature was 30 to 50 cm. In the models, solar radiation was not included as a independent variable ; however, in a seperated analysis on relationship between the difference(${\Delta}Tmxs$) of the maximum soil temperature and the maximum air temperature and solar radiation(Rs ; $J\;m^{-2}$) under a corn canopy showed linear relationship as $${\Delta}Tmxs=0.902+1.924{\times}10^{-3}$$ Rs for leaf area index lower than 2 $${\Delta}Tmxs=0.274+8.881{\times}10^{-4}$$ Rs for leaf area index higher than 2.

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Multiple Daily Fractionated RT for Malignant Glioma (악성 성상세포종과 다형성 교아종 치료에 있어서 다분할 방사선 치료와 단순분할 방사선치료에 대한 성적비교)

  • Yang Kang Mo;Chang Hye Sook;Ahn Seoung Do;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.151-158
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    • 1994
  • Since Jan. 1992, authors have conducted a pilot study to treat malignant glioma with multiple daily fractionated(MDF) radiation therapy and this paper presents the outcome compared MDF to conventional factionated(CF) radiation therapy Between Sep. 1989 and Jan. 1993, forty three patients with high grade glioma of brain except brain stem glioma were treated: nineteen patients were treated with CF radiation therapy and 24 patients were treated with MDF radiation therapy. In CF radiation therapy, total dose was 6300cGy/35fx in 7 weeks, which 5040cGy was delivered to the initial target volume and 1260cGy to reduced target volume. And in MDF radiation therapy, total dose was 6400cGy/40fx in 4 weeks, which 3200cGy was delivered to the initial target volume as 160cGy 2 times daily 6hr apart. All patients had histologically confirmed anaplastic astrocytoma(AA) of glioblastoma multiforme (GBM) with stereotactic biopsy or craniotomy for subtotal or gross tumor resection. The range of follow-up was 7 months to 4 years with a median follow-up of 9 months. The Median survival from surgery was 9 months for all patients. The median survival was 9 months and 10 months for MDF group and CF group and 10 months and 9.5 months for glioblastoma multiforme and anaplastic astrocytoma, respectively. In 36 patients with follow-up CT scan or MRI scan, disease status was evaluated according to treatment groups, Four patients(GBM:3, AA:1) of 21 patients in MDF group, were alive with no evidence of disease, while none of patient was alive with no evidence of disease in CF group. The progression of disease had occurred in 20 patients, 11 patients and 9 patients in MDF group and CF group, respectively All of these patients showed in-field progression of disease, Four of 11 patients($27\%$) in MDF group showed the new leasion outside of the treatment field, while 5 of 9 patients($56\%$) in CF group. In our study the prognosis was not influenced by age, KPS, grade, extent of surgery and different fractional scheduled radiation therapy. Authors concluded that MDF regimen was well tolerated and shortened the treatment period from 7 weeks to 4 weeks without compromising results. We believe that further follow-up is needed to assess the role of MDF.

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The Effect of PL Leadership and Characteristics of Project on Project Participants' Satisfaction and Performance (PL 리더십 성향과 프로젝트 특성요인이 프로젝트 참여 만족 및 성과에 미치는 영향)

  • Yang, Hee-Dong;Kim, Myung-Jin;Kang, So-Ra
    • Asia pacific journal of information systems
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    • v.20 no.4
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    • pp.53-79
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    • 2010
  • The study was originated from recognition that project participants' satisfaction should be Improved to raise project performance and to make progress of a successful project since the above dissatisfaction was operated as a danger factor of the project. The study selected one large-scale sample project and attempted measuring characteristics of the project, participants' satisfaction and project performance with the whole project participants. The study analyzed correlations between individual level (team members) and group level (development team), and examined what effect a sub project manager under complicated hierarchical organization of the large-scale project, namely PL (project leader)'s leadership style had on each individual project participant's satisfaction and what effect project uncertainty in organization/technology environment had on project participants' satisfaction and project performance. The study verified that development team (group) had an effect on team member (individual)-level project participants' satisfaction by disclosing that there was a significant dispersion among groups within project participants' satisfaction by each individual. It is analyzed that it is necessary to make improvement through approach by each pertinent team to raise individual-level project participants' satisfaction. The study also verified PL's ideal leadership under strict methodology and hierarchical control of the large-scale project. Based on the verification of the hypotheses, the results of the analysis were produced as follows. First, the development team affects the satisfaction level that an individual has when he/she participates in a project. This suggests that the satisfaction with project participation should be improved at the team level. In addition, the project management style and leadership orientation of the manager of a sub project who is mostly affected by the team proved to have a direct influence on the satisfaction with project participation and project performances. Second, both the performance-oriented leadership and the relationship-oriented leadership of the PL of the development team were verified to have a significant effect on the satisfaction of the team members associated with project participation. In other words, when the team members recognize that the PL of the development team shows both the performance-oriented leadership and the relationship-oriented leadership, their satisfaction with project participation increases accordingly. Third, it was verified that the uncertainty of the organizational environment significantly affects the satisfaction level when the PL of the development team exerts a relationship-oriented and performance-oriented leadership. The higher the uncertainty of the organizational environment is, the more the satisfaction with project participation decreases whereas the relationship-oriented leadership has a more positive effect on the satisfaction than the performance-oriented leadership style. Fourth, when the PL of the development team exerts the relationship-related and performance-related leadership, the uncertainty of the technological environment has a significant influence on the satisfaction level. The higher the uncertainty of the technological environment is, the more the satisfaction with project participation decreases whereas the performance-oriented leadership has a more positive effect on the satisfaction than the relationship-oriented leadership style. The result of the research on the uncertainty of the project environment suggests that when the development team leader exerts a relationship-oriented and performance-oriented leadership style, the uncertainty of the organizational environment has a significant effect on the satisfaction with project participation; the higher the uncertainty of the organizational environment, the more the satisfaction level decreases, and the relationship-oriented leadership style affects the satisfaction level more positively than the performance-oriented leadership style. In addition, when the development team leader displays a relationship-oriented and performance-oriented leadership style, the uncertainty of the technological environment has a significant effect on the satisfaction with project participation; the higher the uncertainty of the technological environment. the more the satisfaction level decreases. The performance-oriented leadership style as well affects the satisfaction level more positively than the relationship-oriented leadership style. Based on the above results, the research provides the following implications when handling multiple concurrent projects. First, the satisfaction with the participation in the multiple concurrent projects needs to be enhanced at the team (group) level. Second. the manager of the project team, particularly the middle managers should have both a performance-oriented and relationship (task and human)-oriented attitude and exert a consolidated leadership in order to improve the satisfaction of team members with project participation and their performances. Third, as the uncertainty factor of the technological and organizational environment among the characteristics factors of the project has room for methodological improvement depending on one's effort even though there are some complications, we need to continuously prevent and control the risks resulting from the uncertainties of the technological and organizational environment of the project in order to enhance the satisfaction of project participation and project performances. Fourth, the performance (task)-oriented leadership is required when there is uncertainty in a technological environment while the relationship (human)-oriented leadership is required when there is uncertainty in an organizational environment. This research has the following limitations. First, this research intended to select one large-sized sample project and measure the project characteristics, the satisfaction of all the participants associated with project participation, and their performances. Therefore, it is inappropriate to generalize and apply the result of this result onto other numerous projects. Second, as this case study entailed a survey to measure the characteristics factors and performance of the project, since the result value was based on the perception of project team members, the data may have insufficient objectivity. Third, though this research targeted on all the project participants, some development teams did not provide sufficient data and questionnaires were collected from some specific development teams among the 23 development teams, causing a significant deviation in the response rate among the development teams. Therefore, we need to continuously conduct the follow-up researches making comparisons among the multiple projects, and centering on the characteristics factors of the project and its satisfaction level.

Ideal Right Ventricular Outflow Tract Size in Tetralogy of Fallot Total Correction (팔로네징후 완전교정술 시 이상적인 우심실 유출로 크기에 관한 분석)

  • Kim Jin-Sun;Choi Jin-Ho;Yang Ji-Hyuk;Park Pyo-Won;Youm Wook;Jun Tae-Gook
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.588-597
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    • 2006
  • Background: The surgical repair of a tetralogy of Fallot (TOF) has been performed successfully with a favorable early and late outcome. However, the later development of pulmonary regurgitation and stenosis remains a problem. The development of pulmonary regurgitation and stenosis may be changed by the size of right ventricular outflow tract (RVOT) reconstruction at the initial total correction. Hence, it is necessary to investigate the ideal size of RVOT reconstruction. Material and Method: This prospective study was carried out to determine how a surgical strategy and the RVOT size affect the occurrence of pulmonary regurgitation and stenosis. From January 2002 to December 2004, 62 patients underwent the TOF total correction. The RVOT size (diameter of pulmonary valve annulus) of each case was measured after the RVOT reconstruction and converted to a Z value. A pre-scheduled follow up (at discharge, 6 months, 1 year, 2 years and 3 years) was carried out by echocardiography to evaluate the level of pulmonary regurgitation and stenosis. Result: The patients were divided to two groups (transannular group n=12, nontransannular group n=50) according to the method of a RVOT reconstruction. The Z value of RVOT=iameter of pulmonary valve annulus) (transannular group -1, $range\;-3.6{\sim}-0.8;$ nontransannular group -2.1, $range\;-5.2{\sim}-1.5)$ and the average pRV/LV after surgery ${(transannular group 0.44{\pm}0.09,\;nontransannular group\;0.42{\pm}0.09)}$ did not show any significant difference between two groups. The occurrence of pulmonary regurgitation above a moderate degree was more frequent in the transannular group (p<0.01). In nontransannular group, the development of pulmonary regurgitation more than moderate degree occurred to the patients with larger RVOT size (Z value>0, p<0.02) and the progressing pulmonary stenosis more than mild to moderate degree developed in the patients with smaller RVOT size (Z value<-1.5, p<0.05). A moderate degree of pulmonary stenosis developed for 4 nontransannular patients. Three underwent additional surgery and one underwent a balloon valvuloplasty. Their Z value of RVOT were -3.8, -3.8 -2.9, -1.8, respectively. Conclusion: When carring out a TOF total correction, transannular RVOT reconstruction group has significantly more pulmonary regurgitation. In the nontransannular RVOT reconstruction. the size of the RVOT should be maintained from Z value -1.5 to 0. If the Z value is less than -1.5, we should follow up carefully for the possibility of pulmonary stenosis.

The Effect of a Bypass Operation for Atherosclerotic Arterial Obstructive Disease at the Lower Extremity (동맥경화성 하지 동맥 폐색증에 대한 우회로 수술의 효과)

  • Choi, Won-Suk;Park, Jae-Min;Lee, Yang-Haeng;Han, Il-Yong;Jun, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.610-618
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    • 2008
  • Background: There are various treatment modalities for atherosclerotic arterial obstructive disease at the lower limbs, for example, conservative physical therapy, medication, operation etc. Yet it has been established that an arterial bypass operation is the most effective treatment. The aim of this study is to evaluate the effect of arterial bypass operation within our experience and to determine the indicators of treatment. Material and Method: Ninety six patients received arterial bypass operation for atherosclerotic arterial obstructive disease from June 2002 to April 2006. We evaluated the feasibility of arterial bypass operation based on the improvement of symptoms and the ankle-brachial index (ABI) and the surgical outcomes, as based on the complications, the amputation rates and the patency rates. We also assessed the possible risk factors such as gender, age, a smoking history, co-morbidities, the anastomotic sites, the graft size and the graft type. We retrospectively reviewed the medical records of the patients. The total mean follow-up period was $29.4{\pm}13.1$ months. Result: The mean age was $65.95{\pm}9.61$ and there were 88 male patients. The most common clinical manifestation was ischemic resting pain in the lower extremities. The underlying combined diseases were hypertension (61%), diabetes (43%), cardiac problems (35%) and smoking (91.7%). The most frequent site of arterial obstruction was the superficial femoral artery (44 cases, 40%). A femoropopliteal artery bypass operation with a Polytetrafluoroethylene(PTFE) synthetic graft was done in 44 cases (40%) and the great saphenous vein graft was used in 11 cases. The postoperative ABI increased significantly from $0.30{\pm}0.11$ preoperatively to $0.63{\pm}0.11$ (p<0.001) postoperatively. In 8 cases, amputations above the ankle level were necessary. The graft patency rates were 86.4% and 68.0% after 1 and 3 years, respectively. There were 29 cases (30.21%) of patency failure; the male gender, smokers and hypertension were significantly more frequent in the failure group. Of these, hypertension was the most powerful risk factor (p=0.042). Conclusion: The arterial bypass operation is an effective treatment modality for controlling the symptoms such as pain and claudication, and for preventing major amputations for the patients with atherosclerotic arterial obstructive disease. This study suggests quitting smoking, strict blood pressure control, selection of an appropriate graft, regular outpatient follow up and proper medication would offer higher patency rates and more favorable outcomes.