Accuracy of cardiac output measurements during off-pump coronary artery bypass grafting: according to the vessel anastomosis sites

Sung Yong Park,Dae Hee Kim,Han Bum Joe,Ji Young Yoo,Jin Soo Kim,Min Kang,Yong Woo Hong 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.62 No.5

Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB. Background: During beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites. Methods: This study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO. Results: CO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques. Conclusions: In the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB.

Priming of mononuclear cells with a combination of growth factors enhances wound healing <i>via</i> high angiogenic and engraftment capabilities

Jin, Enze,Kim, Jong-Min,Kim, Sung-Whan John WileySons Ltd 2013 Journal of cellular and molecular medicine Vol.17 No.12

<P>Recently, we demonstrated that a specific combination of growth factors enhances the survival, adhesion and angiogenic potential of mononuclear cells (MNCs). In this study, we sought to investigate the changes of the angiogenic potential of MNCs after short-time priming with a specific combination of growth factors. MNCs were isolated using density gradient centrifugation and incubated with a priming cocktail containing epidermal growth factor (EGF), insulin-like growth factor (IGF)-1, fibroblast growth factor (FGF)-2, FMS-like tyrosine kinase (Flt)-3L, Angiopoietin (Ang)-1, granulocyte chemotactic protein (GCP)-2 and thrombopoietin (TPO) (all 400 ng/ml) for 15, 30 and 60 min. Wounds in nonobese diabetic-severe combined immune deficiency (NOD-SCID) mice were created by skin excision followed by cell transplantation. We performed a qRT-PCR analysis on the growth factor–primed cells. The angiogenic factors vascular endothelial growth factor (VEGF)-A, FGF-2, hepatocyte growth factor (HGF), platelet-derived growth factor (PDGF) and interleukin (IL)-8 and the anti-apoptotic factors IGF-1 and transforming growth factor-β1 were significantly elevated in the MNCs primed for 30 min. (T30) compared with the non-primed MNCs (T0). The scratch wound assay revealed that T30- conditioned media (CM) significantly increased the rate of fibroblast-mediated wound closure compared with the rates from T0-CM and human umbilical vein endothelial cells (HUVEC)-CM at 20 hrs. <I>In vivo</I> wound healing results revealed that the T30-treated wounds demonstrated accelerated wound healing at days 7 and 14 compared with those treated with T0. The histological analyses demonstrated that the number of engrafted cells and transdifferentiated keratinocytes in the wounds were significantly higher in the T30-transplanted group than in the T0-transplanted group. In conclusion, this study suggests that short-term priming of MNCs with growth factors might be alternative therapeutic option for cell-based therapies.</P>

Differential Manifestation of Ocular Phenotypes in TALEN-mediated p19arf Knockout FVB/N and C57BL/6J mouse lines

Jin‑Sung Park,Joo‑Il Kim,Hyun‑Jin Lim,Soo‑Kyung Ryu,Euna Kwon,Kang‑Min Han,Ki‑Taek Nam,Han‑Woong Lee,Byeong‑Cheol Kang 한국유전학회 2020 Genes & Genomics Vol.42 No.9

Background p19arf, primarily known as a tumor suppressor, has also been reported to play an essential role in normal development of mouse eyes. Consistently, lack of p19arf has been associated with ocular defects, but the mixed background of the knockout (KO) mouse strain used raised a concern on the accuracy of the phenotypes observed in association with the targeted gene due to genetic heterogeneity. Object We carried out a study to investigate into the efect of genetic background on the manifestation of p19arf KO associated phenotypes. Methods We characterized the phenotypes of novel p19arf KO mouse lines generated in FVB/N and C57BL/6J using a transcription activator-like efector nuclease (TALEN) system in comparison to the reported phenotypes of three other p19arf-defcient mouse lines generated using homologous recombination. Results Ninety-fve percent of FVB/N-p19arf KO mice showed ocular opacity from week 4 after birth which worsened rapidly until week 6, while such abnormality was absent in C57BL/6J-p19arf KO mice up to the age of 26 weeks. Histopathological analysis revealed retrolental masses and dysplasia in the retinal layer in FVB/N-p19arf KO mice from week 4. Besides these, both strains developed normally from birth to week 26 without increased tumorigenesis except for a subcutaneous tumor found in a C57BL/6J-p19arf KO mouse. Conclusion Our fndings demonstrated surprisingly variable manifestation of p19arf-linked phenotypes between FVB/N and C57BL/6J mice, and furthermore between our mouse lines and the established lines, indicating a critical impact of genetic background on functional study of genes using gene targeting strategies in mice.

사상체질론의 정신의학적 타당성에 대한 연구

민성길,김동기,박진균,전세일 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.3

연구목적 : 건간한 의대상 312명과 신경증적 장애를 가진 환자 288명을 대상으로 하였다. 사상체질의 구별은 노정우 및 김달래 두 전문가에 의한 판정, 그리고 경희의대 사상체질 설문지(QSCC Ⅱ)에 의한 판정 등 3가지 방법에 의하였다. 연구 대상에게 정신과적 증상척도(SCL-90), 체질특성척도 및 성격척도를 사용하여 자가 평가하게 하였다. 각종 척도들의 타당도와 신뢰도는 입증되었다. 이 척도들을 통계적으로 분석하고 고전적 설명과 어느 정도 일치하는 지를 검토하였다. 연구결과 : 1) 3가지 분류방법간에 차이가 컸었다. 그 중 전문가의 직접적 면담에 의한 감별보다 QSCCⅡ 설문지형이 비교적 감별력이 컸다. 3) QSCCⅡ가 감별력이 비교적 크다고 하더라도 그 결과가 소음군의 대인공포-강박증, 불면-식용상실, 무력-예민-소화기-한기-피부증후군 그리고 정력부족등 신경증적 증상과 소극-비사교적, 내향형 성격 및 이성적 성격특징 등 몇가지 특징을 감별하는 데에만 비교적 유의하였고, 태음군의 특정인 독특한 신념, 온기, 활달-사교적 성격에 대해서는 부분적으로 그 특징을 감별하였다. 또한 소양군의 활달-사교형 성격과 감정형 성격의 특징 등은 극히 부분적으로 감별하였다. 결 론 : 이러한 결과는 현존하는 사상체질 구분방법에 일치점이 결여되어 있다는 것, 각종척도를 사용한 결과는 사상체질에 관한 고전적 설명을 부분적으로만 입증하고 있다는 것, 따라서 사상체질구분에 대한 향후보다 객관적인 연구가 필요하다는 것을 시사한다. Object : This study is to examine the validity of constitutional classification of Sa-sang medical theory. This theory classifies the human constitution to 4 types according to classical oriental philosophy on yin and yang. Subjects and Method : Subjects were 312 medical students and 288 neurotic patients with diagnosis of neurotic, stress related and somatoform disorders and minor depressive episodes according to ICD-10. Medical students were classified to 4 Sa-sang Constitution Classification(QSCCⅡ). For assessmnent of symptoms and signs, Korean version of SCL-90, a constitution scale and personality scale which were designed for this study were used. These instruments were found to be reliable and valid through statistical analysis. Subjects were asked to rate these scales. The data were analysed with factor analysis and factor scores were compared among 4 Sa-sang constitutions by ANOVA and t-test. The data from patient group were analysed with factor analysis and the results were compared with the Sa-sang medical theory. Results : Results of classification by 3 ways were inconsistent showing a significant difference among them. Among them, QSCCⅡ was most reliable. In QSCC Ⅱ, only the factor scores of factors of homophobia-obsession, weakness-sensitiveness-indigestion-chillness-skin syndrome, sexual weakness, passive-unsociable personality, introverted personality and rational, personality, were significantly high in So-um (small yin) group of medical students. A factor of warmnes and active-sociable personality were significantly high in Tae-um(big yin)group. Also active-sociable and effective pesonality was partly related with So-yang(small yang)group. Conclusion : These results suggest that those present classification methods inconsistent, that these methods are proving only parts of Sa-sang medical theory, and that objective and scientific studies are needed for reliability and validity of Sa-sang medical theory.

Effect of Jaeumkanghwatang (JEKHT), a Polyherbal Formula on the Pharmacokinetics Profiles of Tamoxifen in Male SD Rats (1)

Min A Kwak,Soo Jin Park,Sung Hwan Park,Young Joon Lee,Sae Kwang Ku 대한한의학회 2016 대한한의학회지 Vol.37 No.2

대장직장 종양에 대한 내시경 점막하 절제술의 연대순 임상 결과와 학습 곡선

이상민 ( Sang Min Lee ),김은수 ( Eun Soo Kim ),박경식 ( Kyung Sik Park ),조광범 ( Kwang Bum Cho ),김동춘 ( Dong Choon Kim ),강유진 ( Yu Jin Kang ),이유진 ( Yoo Jin Lee ),이정민 ( Jung Min Lee ),최은성 ( Eun Sung Choi ),최재혁 ( Ja 대한소화기학회 2014 대한소화기학회지 Vol.64 No.4

Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm2). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation. (Korean J Gastroenterol 2014;64:198-205)

COPA(cuffed oropharyngeal airway)를 이용한 마취 유도 시 근이완제 사용 유무에 따른 반응

김상태,배진호,김상범,임승운,민병상,신영덕 대한마취과학회 2000 Korean Journal of Anesthesiology Vol.38 No.3

Background : COPA (cuffed oropharyngeal airway) is a convenient device for airway management in patients undergoing general anesthesia for elective surgery in supine position. It causes less pharyngeal trauma than LMA(Laryngeal mask airway). The purpose of this study was to compare the effect of COPA with and without muscle relaxant. Methods : Forty patients with ASA physical status I and II for elective surgery were randomly assigned to two groups. Anaesthesia was induced with propofol (2 mg/kg) and vecuronium (1.5 mg/kg) and was administered intravenously in Group I but not in Group II. Mask ventilation was done for 5 min with 0: 5 L/min. COPA was placed and heart rate, and systolic, mean, diastolic blood pressure and peak inspiratory pressure were measured at 1 min interval for 5 min. Anaesthesia was maintained with pro- pofol 150 ㎍/kg/min, fentanyl 1 ㎍/kg/hr, O_2 2 L/min and N_2O 2 L/min. Results : There were no significant differences between Group I and Group II in heart rate, systolic, mean and dstolic blood pressure. PIP (Peak inspiratory pressure) was increased and hiccups occurred significantly (p $lt; 0.05) in Group II. Complete airway obstruction occurred in one patient of Group I and severe coughing, body movements and gagging occurred during induction and insertion in Group II. conclusions : With the use of appropriate muscle relaxant, we can use COPA without increased inspiratory pressure or significant complication. (Korean J Anesthesiol 2000; 38: 399~403)

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Dry etching of polydimethylsiloxane using microwave plasma

Hwang, Sung Jin,Oh, Dong Joon,Jung, Phill Gu,Lee, Sang Min,Go, Jeung Sang,Kim, Joon-Ho,Hwang, Kyu-Youn,Ko, Jong Soo IOP 2009 JOURNAL OF MICROMECHANICS AND MICROENGINEERING - Vol.19 No.9

<P>This paper presents a new polydimethylsiloxane (PDMS) dry-etching method that uses microwave plasma. The applicability of the method for fabricating microstructures and removing residual PDMS is also verified. The etch rate of PDMS was dominantly influenced by the gas flux ratio of CF<SUB>4</SUB>/O<SUB>2</SUB> and the microwave power. While the PDMS etch rate increased as the flux ratio of CF<SUB>4</SUB> was increased, the etch rate decreased as the flux ratio of O<SUB>2</SUB> was increased. The maximum etch rate of 4.31 µm min<SUP>−1</SUP> was achieved when mixing oxygen (O<SUB>2</SUB>) and tetrafluoromethane (CF<SUB>4</SUB>) at a 1:2 ratio at 800 W power. The PDMS etch rate almost linearly increased with the microwave power. The ratio of the vertical etch rate to the lateral etch rate was in a range of 1.14–1.64 and varied with the gas fluxes. In consideration of potential applications of the proposed PDMS etching method, array-type PDMS microwells and network-type microprotrusion structures were fabricated. The contact angle was dramatically increased from 104° (non-etched PDMS surface) to 148° (etched PDMS surface) and the surface was thereby modified to be superhydrophobic. In addition, a thin PDMS skin that blocked holes and PDMS residues affixed in nickel microstructures was successively removed.</P>

Sustained-release praziquantel tablet : pharmacokinetics and the treatment of clonorchiasis in beagle dogs

Hong, Sung-Tae,Lee, Sang Hyup,Lee, Seung-Jin,Kho, Weon-Gyu,Lee, Mejeong,Li, Shunyu,Chung, Byung-Suk,Seo, Min,Choi, Min-Ho 梨花女子大學校 藥學硏究所 2003 藥學硏究論文集 Vol.- No.12

Praziquantel is rapidly absorbed and secreted; and thus fractional doses are recommended for the treatment of cestode and trematode infections. In the present study, we developed a new praziquantel tablet formula allowing sustained-release (SRP). In vitro dissolution of SRP tablets showed that praziquantel at 300 ㎎/tablet combined with hydroxypropyl methylcellulose dissolved completely at a constant rate over 10 h, whereas the conventional praziquantel tablet (PZQ) was only 40% dissolved. Pharmacokinetic studies in dogs confirmed that SRP was absorbed more slowly than PZQ. The mean value of the area under the concentration/time curve from 0 h to the final observation time, the maximum concentration in serum, and the time of maximum concentration in serum for SRP were 3.471.500 ng/min for 0.25 ㎖, 10,300 ng for 0.25 ㎖, and 192 min. while the values for PZQ were 688,600 ng/min for 0.25㎖, 2,500 ng for 0.25㎖, and 135 min. The cure rate in dogs with a heavy infection (500 metacercariae) treated with a single dose of SRP (150 ㎎/tablet) at 50 ㎎/㎏ was 80%, while in dogs treated with a single dose of SRP (300 ㎎/tablet) at 30 mg/kg it was 60%, and the cure rate with PZQ was 20%. In each case. the egg reduction rate was similar (over 90%). No abnormal liver functions or hepatic or renal pathologies were observed in dogs administered with SRP at 30 ㎎/㎏. The SRP tablet showed sustained release and slow absorption; and it had an improved anthelmintic efficacy against Clonorchis sinensis in experimental dogs. compared with conventional praziquantel.