Comparing hemostatic resuscitation management of intraoperative massive bleeding with traumatic massive bleeding: a computer simulation

Lee Young Sun,Kim Kyu Nam,Lee Min Kyu,Sun Jung Eun,Hyun Jin Lim,전종헌 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.4

Background: Appropriate blood component transfusion might differ between intraoperative massive bleeding and traumatic massive bleeding in the emergency department because trauma patients initially bleed undiluted blood and replacement typically lags behind blood loss. We compared these two blood loss scenarios, intraoperative and traumatic, using a computer simulation. Methods: We modified the multi-compartment dynamic model developed by Hirshberg and implemented it using STELLA 9.0. In this model, blood pressure changes as blood volume fluctuates as bleeding rate and transcapillary refill rate are controlled by blood pressure. Using this simulation, we compared the intraoperative bleeding scenario with the traumatic bleeding scenario. In both scenarios, patients started to bleed at a rate of 50 ml/min. In the intraoperative bleeding scenario, fluid was administered to maintain isovolemic status; however, in the traumatic bleeding scenario, no fluid was supplied for up to 30 min and no blood was supplied for up to 50 min. Each unit of packed red blood cells (PRBC) was given when the hematocrit decreased to 27%, fresh frozen plasma (FFP) was transfused when plasma was diluted to 30%, and platelet concentrate (PC) was transfused when platelet count became 50,000/ml. Results: In both scenarios, the appropriate ratio of PRBC:FFP was 1:0.47 before PC transfusion, and the ratio of PRBC:FFP:platelets was 1:0.35:0.39 after initiation of PC transfusion. Conclusion: The ratio of transfused blood component did not differ between the intraoperative bleeding and traumatic bleeding scenarios.

Comparison of Melanoma Subtypes among Korean Patients by Morphologic Features and Ultraviolet Exposure

( Hong Sun Jang ),( Jee Hung Kim ),( Kyu Hyun Park ),( Jae Seok Lee ),( Jung Min Bae ),( Byung Ho Oh ),( Sun Young Rha ),( Mi Ryung Roh ),( Kee Yang Chung ) 대한피부과학회 2014 Annals of Dermatology Vol.26 No.4

Background: Genetic alterations have been identified in melanomas according to different levels of sun exposure. Whereas the conventional morphology-based classification provides a clue for tumor growth and prognosis, the new classification by genetic alterations offers a basis for targeted therapy. Objective: The purpose of this study is to demonstrate the biological behavior of melanoma subtypes and compare the two classifications in the Korean population. Methods: A retrospective chart review was performed on patients found to have malignant melanoma in Severance Hospital from 2005 to 2012. Age, sex, location of the tumor, histologic subtype, tumor depth, ulceration, lymph node invasion, visceral organ metastasis, and overall survival were evaluated. Results: Of the 206 cases, the most common type was acral melanoma (n=94, 45.6%), followed by nonchronic sun damage-induced melanoma (n=43, 20.9%), and mucosal melanoma (n=40, 19.4%). Twenty-one patients (10.2%) had the chronic sun-damaged type, whereas eight patients (3.9%) had tumors of unknown primary origin. Lentigo maligna melanoma was newly classified as the chronic sun-damaged type, and acral lentiginous melanoma as the acral type. More than half of the superficial spreading melanomas were newly grouped as nonchronic sun-damaged melanomas, whereas nodular melanoma was rather evenly distributed. Conclusion: The distribution of melanomas was largely similar in both the morphology-based and sun exposure-based classifications, and in both classifications, mucosal melanoma had the worst 5-year survival owing to its tumor thickness and advanced stage at the time of diagnosis. (Ann Dermatol 26(4) 485~490, 2014)

온풍 조건에서 수분 탈락 정도에 따른 피부 분류 및 개선 방안에 대한 연구

권오선 ( Oh Sun Kwon ),강현종 ( Hyun Jong Kang ),한승민 ( Seung Min Han ),윤지선 ( Ji S Eon Yoon ),조웅희 ( Woong Hee Cho ),오주영 ( Joo Young Oh ),임준만 ( Jun Man Lim ),송영숙 ( Young Sook Song ),박선규 ( Sun Gyoo Park ) 대한화장품학회 2020 대한화장품학회지 Vol.46 No.2

피부를 탄력있고 부드럽게 하는 역할은 각질층에 존재하는 수분량에 의해 좌우된다. 피부 수분량은 냉온풍, 건조환경 등 다양한 환경 변화에 의해 영향을 받음이 알려져 있으나, 개인 피부 차이에 따른 피부수분량 변화와 회복 정도에 대해서는 많은 연구가 이루어 지지 않은 실정이다. 본 연구에서는 온풍 조건하에서 피시험자들의 피부 수분 탈락 및 회복 정도를 비교 평가하여 새로운 피부 타입을 제시하고, 온풍 조건에서 저하되는 피부 수분량을 개선 시켜주는 효능 물질을 개발하고자 하였다. 온풍 환경 조성을 위해, 건강한 피험자(남: 10 명, 여: 39 명, 25 세 - 63 세)의 전완부에 온풍(30 cm, 40 ℃, 6 m/s)을 30 min 간 피부에 노출시켜, 피부 수분량의 변화를 평가하였다. 26명(남: 4 명, 여: 22 명, 평균 연령: 42.7 ± 9.4)이 온풍 노출전에 비하여 온풍 노출 후 수분량이 유의하게 감소하며, 노출 후 30 min이 지나도 회복이 되지 않았다. 온풍노출 후 수분량이 떨어지는 피험자(여: 10 명)를 대상으로 보수력이 높은 크림을 3 주간 전완부에 적용한 이후 동일 온풍 조건하에서 피부 수분량을 측정한 결과, 노출 30 min 후 피부 수분량이 온풍 노출 전 수준으로 회복됨을 확인하였다. 본 연구를 통하여 피부는 건조 조건에서 쉽게 수분을 잃어버리는 피부(탈수형 피부)가 존재하는 것을 확인하였다. 이는 앞으로 화장품 개발을 보습 기능뿐만 아니라, 이러한 환경변화에 따른 피부수분이 쉽게 빠져나가는 피부(탈수형 피부)의 특성에 맞는 제품의 효능 개발이 필요함을 보여준다. Elasticity and softness of the skin depend on the level of moisture present in the stratum corneum, which is known to be affected by various environmental changes, such as cold and hot winds and dry environments. However, not many studies have been conducted on changes in skin moisture and the degree of recovery due to individual skin differences. In the present study, we aimed to investigate the effect of warm air heating on skin hydration levels and develop moisturizing formulas to improve lowered skin hydration levels. In order to deliver warm air heating condition, heating dryer (40 ℃, 6 m/s, 30 cm apart from forearm) was applied into inner forearm of healthy subjects (male: 10, female: 39, age: 25 - 63) Among 49 subjects, 26 subjects showed significantly lowered skin hydration levels until 30 min after warm air heating exposure (lowered group). In addition, moisturizing cream with high water holding capacity was applied to forearm of 10 subjects in lowered group for 3 weeks and skin hydration levels after warm air heating were significantly improved at the levels of before application of warm air heating. From this study, we found out that there is a skin type that skin hydration levels are significantly decreased under warm air heating condition (dehydrated skin) and this dehydrated skin can be improved by moisturizing formulas with high water holding capacity.

열처리에 의한 Morganella morganii와 Photobacterium phosphoreum 유래 Histidine Decarboxylase의 불활성화

박원민(Won-Min Pak),김꽃봉우리(Koth-Bong-Woo-Ri Kim),김민지(Min-Ji Kim),박지혜(Ji-Hye Park),배난영(Nan-Young Bae),박선희(Sun-Hee Park),안동현(Dong-Hyun Ahn) 한국식품영양과학회 2016 한국식품영양과학회지 Vol.45 No.3

Histamine을 생성하는 Morganella morganii와 Photobacterium phosphoreum으로부터 crude histidine decarboxylase(HDC)를 추출하여 65~121°C로 열처리한 다음 균의 생육 및 효소 활성 변화에 대해 살펴보았다. 그 결과 M. morganii와 P. phosphoreum은 모든 열처리 조건에서 비 가열 처리구와 비교 시 균의 생육이 저해됨을 확인하였다. M. morganii와 P. phosphoreum 유래 HDC의 효소 활성은 65°C에서 90% 이상의 효소 활성이 저해됨을 확인하였고, 온도가 증가함에 따라 유의적으로 활성이 억제되는 것으로 나타났다. SDS-PAGE 결과에서는 65~100°C 범위에서 비가열 처리구와 비교 시 조효소액의 단백질 패턴의 변화가 크지 않았으나, 121°C에서 단백질 band의 강도가 크게 약해졌다. Native-PAGE에서는 65°C 처리 조건에서부터 단백질 패턴의 변화가 크게 나타났다. 따라서 가열처리(65~121°C)는 histamine 생성균인 M. morganii와 P. phosphoreum의 생육을 억제할 뿐만 아니라 HDC의 효소 활성도가 저해됨을 확인하여, 식품산업에서 적용되고 있는 열처리 조건에서 histamine 생성 억제에 큰 효과가 있는 것으로 생각한다. This study was performed to investigate the effects of various thermal treatments on the growth of Morganella morganii and Photobacterium phosphoreum and activity of crude histidine decarboxylase (HDC) obtained from M. morganii and P. phosphoreum. Crude HDC and the two strains were treated at 65°C/30 min, 80°C/10 min, 100°C/10 min, and 121°C/10 min. Activity of crude HDC decreased with increasing temperature. Viable cells counts of M. morganii and P. phosphoreum were not detected in any heated samples. SDS-PAGE patterns of heated HDC did not show significant differences up to 100°C. However, at 121°C, protein band intensity was weakened. In native-PAGE, there was a major change in the pattern of HDC at 65°C. These results suggest that thermal treatment can help to reduce histamine production by reducing HDC activity and growth of M. morganii and P. phosphoreum.

젊은 성인에서 흡연에 의한 상완동맥 내피기능의 부전에 관한 연구

이상철,권영주,방덕원,이선해,이보영,김지욱,김영훈,온영근,현민수,김성구 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Background and Objectives : Cigarette smoking is a major factor and the most modifiable risk factor for atherosclerosis. Endothelial dysfunction is an early event in atherosclerosis, before the structural change of the systemic arteries. We hypothesized that endothelial dysfunction might be present in the systemic arteries of young adult smokers and that this might be dose-dependent phenomenon. Therefore, we try to certify that smoking is associated with endothelial dysfunction in healthy young adults without other risk factor of atherosclerosis. Subjects and Methods : we studied noninvasively 29 subjects aged 3 to 4 decades without other risk factor of atherosclerosis, they were composed of the two groups, current smokers(n=15) and nonsmokers(n=14). Smoking history varied from 3 to 20 pack years. Using high-resolution ultrasound, vessel diameter and mean flow rate were measured at rest, during reactive hyperemia(with flow-mediated endothelium-dependent dilation), and after sublingual nitroglycerin(NG-induced endothelium-independent vasodilation). Result : Flow mediated endothelium dependent dilation was observed in the control subjects (9.4±3.44%) but was impaired in the smokers(5.8±2.51%)(p=0.004). NG-induced endothelium independent dilation is no difference in all subjects. Conclusion : Cigarette smoking is associated with endothelial dysfunction in healthy young adults.

Effects of Chungkookjang Extract on Growth Hormone Secretion from GH3 Mouse Pituitary Cell and Growth Hormone Receptor Signaling Pathway

Sun Il Choi(최선일),Ji Eun Kim(김지은),In Sik Hwang(황인식),Hye Ryun Lee(이혜련),Young Ju Lee(이영주),Hong Joo Son(손홍주),Dong Seob Kim(김동섭),Kyu Min Park(박규민),Dae Youn Hwang(황대연) 한국생명과학회 2012 생명과학회지 Vol.22 No.9

뇌하수체 전엽에서 성장호르몬의 생산과 분비는 세포의 분열과 분화 그리고 이동을 조절하는 몇 가지 천연물질에 의해 유도된다. 따라서 발효과정을 통해 제조된 청국장이 성장호르몬의 대사에 미치는 영향을 평가하기 위하여 성장호르몬 분비능과 반응성을 뇌하수체 세포와 성장호르몬 표적세포에서 관찰하였다. 6가지 종류의 콩 품종으로 제조된 청국장 추출물 중에서, 대원, 대풍, 태광의 3종류 청국장 추출물은 5 mg/ml 농도에서 GH3 세포로부터 성장호르몬의 분비를 촉진하였다. 비록 세포 생존능은 이러한 추출물에 의해 유의적인 변화가 유도되지 않았으나, 성장호르몬의 분비량은 청국장 추출물의 농도에 의존적으로 증가하였다. 또한 성장호르몬의 표적 기관으로부터 유래된 MG63과 HepG2 세포는 GH3로부터 수집된 조건적 배양액에 의해 유의적으로 활성화되었다. 또한 이러한 세포에서 STAT5 발현은 대원 청국장 추출물을 처리 후, 15분 혹은 30분부터 세포질에서 유의적으로 증가하였으며, p-STAT5는 핵에서 30분 혹은 60분부터 증가하였다. 따라서 이러한 결과는 3가지 종류의 청국장 추출물은 성장호르몬의 분비를 촉진시키며, 청국장의 조건적 배양액은 성장호르몬 표적세포에서 신호전달을 유도함을 제시하고 있다. The production and secretion of growth hormone (GH) in the anterior pituitary gland can be induced by several natural products to control cell proliferation, differentiation, and migration. To investigate whether Chungkookjang (CKJ) produced by the fermentation process affects GH-related metabolism, the secretion and the response of GH were observed in pituitary cells and GH target cells. Among six CKJs manufactured by different strains of glycine max, only three CKJs, including Daewon (DW), Daepung (DP), and Taegwang (TG), induced GH secretion from GH3 cells at 5.0 mg/ml concentration. There were no significant changes detected in the viability of any of the cells treated with these CKJs. In addition, the increase in GH secretion from the GH3 cells was dependent on the concentration of the three types of CKJs. The proliferation of cell lines, including MG63 and HepG2 cells, that originated from those derived from the GH target organs was significantly activated by treatment with the GH-containing conditional medium (GCM) harvested from the three CKJ-treated GH3 cells, although their induction rate was different from each other. In these cells, p-STAT5 was maximally translocated into the nucleus of MG63 cells 30 min after DW treatment, while it was translocated in HepG2 cells at 60 min. These results suggest that these three types of CKJ could enhance the secretion of GH, as well as the GCM-derived response, in the two target organs.

Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding

Sun Young Moon,Jun Heo,Min Kyu Jung,Chang Min Cho 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1

Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaininghemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. Wecompared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediateERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding,change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusionswere needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued byangioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min. Conclusions: Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMSinsertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has arole as rescue therapy when SEMS does not work effectively.

플립칩 패키지의 신뢰성 향상에 관한 연구

이선병(Sun Byung Lee),김종민(Jong Min Kim),이성혁(Seong Hyuk Lee),신영의(Young Eui Shin) 한국생산제조학회 2007 한국공작기계학회 춘계학술대회논문집 Vol.2007 No.-

A solder joint fatigue failure of flip chip (FC) package is mainly caused by the thermal stress due to the coefficient of thermal expansion (CTE) mismatch between the silicon die and the substrate. A nonlinear finite element analysis was conducted to investigate solder joint reliability under thermal cycling loading for FC assemblies without and with underfill. The effect of the solder joint height and thermomechanical properties such as CTE and Young's modulus on reliability of FC package. For parametric study, a finite element analysis are performed for seven different CTEs and five different Young's moduli of underfill. The concentrated Von Mises stress of the underfilled FC assembly was approximately 85% comparing that of FC assembly without underfill. Also, the concentrated stresses in the solder joint was decreased with increasing solder joint height. In addition, it is found that the solder joint reliability was improved with increasing Young's Modulus of underfill. Furthermore, the solder joint reliability was improved as the CTE was close to that of solder.

금 박막의 기계적 물성에 끼치는 두께와 미세조직의 영향

전영선(Young-Sun Jeon),이상주(Sang-Joo Lee),현승민(Seung-Min Hyun),이학주(Hak-Joo Lee) 대한기계학회 2007 대한기계학회 춘추학술대회 Vol.2007 No.10

We have used Visual Image Tracing(VIT) strain measurement system coupled with a micro tensile testing unit to test thickness and microstructure dependent mechanical behavior of Au film. The advantage using this method is to monitor the real time images of specimen during the test in order to determine its Young’s modulus, yield strength and tensile strength. 0.5, 1 and 2 ㎛ thick films were deposited by sputtering system. Free standing films were prepared through lithography and etching processes. Au films were annealed at 300℃ and 350℃ to achieve microstructure evolution and Focus ion beam (FIB SEM) and transmission electron microscopy (TEM) were employed to characterize grain sizes of films. Thickness and grain sizes dependent mechanical behavior such as stress-strain curve, Young’s modulus and yield strength of Au thin film will be presented.

흡연이 Gastric Emptying Time에 미치는 영향

조민구(Min Koo Cho),정순영(Sun Young chung),김소연(So Yon Kim),문희승(Mun Hee Seung),김진석(Jin Suk Kim),이석호(Suk Ho Lee),이권전(Gwon Jun Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2

The effect of cigarette smoking on gastric emptying was examined in 25 healthy volunteers by means of Tc-sulfur colloid labeled-solid meal. The volunteers underwent GET measurement two times: before smoking and after smoking two cigarettes. Before smoking, the each average of GET T25% T50%, T75%, was 18 +- 5.2, 40 +- 6.7, 90 +- 18.4 min and after cigarette smoking the each average of GET T25%, T50%, 75% was 30 +- 8.3, 64 +- 12.6, 114 +- 7.0 min. We concluded that cigarette smoking significantly delayed gastric emptying of a solid meal (p< 0.05).