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.

고온가열처리에 의한 바다방석고둥 ( Omphalius pfeifferi capenteri ) 의 식품성분 변화

하진환(Jin Hwan Ha),송대진(Dae Jin Song),김풍호(Poong Ho Kim),허민수(Min Soo Heu),조문래(Moon Lae Cho),심효도(Hyo Do Sim),김혜숙(Hey Suk Kim),김진수(Jin Soo Kim) 한국수산과학회 2002 한국수산과학회지 Vol.35 No.2

바다방석고둥을 원료로 한 신제품 개발에 관한 일련의 기초 연구로 저장성 부여를 위하여 시도하는 고온가열처리 조건 (F_0 5분, F_0 10분, F_0 15분 및 F_0 20분)에 따른 바다방석고둥의 성분변화에 대하여 살펴보았다. 바다방석고둥 통조림은 살균을 5분 이상 처리하는 경우 저장 중 팽창관이 발생하지 않았고, 또한 생균수가 검출되지 않아 저장성이 있었다. 고온가열처리 정도가 증가할수록 바다방석고둥의 일반성분 중 수분함량은 감소하였고, 조단백질 함량은 증가하였으며, 조지방 및 조회분 함량은 거의 변화가 없었다. 또한 바다방석 통조림은 고온가열처리 정도가 증가할수록 이취에 관여하는 휘발성염기질소 함량, pH와 색조에 관여하는 갈변도는 증가하였고, 영양에 관여하는 구성아미노산, 무기질과 맛에 관여하는 유리아미노산, TMAO, total creatinine 및 수율 둥은 감소하였다. 이들을 색조, 조직감 및 맛에 대하여 관능검사한 결과 자숙 처리한 시료에 비하여 모든 항목에서 F_0 10분까지는 차이가 없었으나, 그 이상 가열처리한 경우 품질이 저하하였다고 인지되었다. 이상의 결과로 미루어 보아 바다방석고둥을 고온가열처리하여 신제품을 개발하고자 하는 경우 F_0 값이 10분 이상이면 바람직하지 않은 것으로 판단되었다. The top shell, Omphalius pfeifferi capenteri meat vacuum-packed in can (diameter× height, 74.1 ㎜ × 50.7 ㎜) were heated at 115℃ up to F_0 values of 5 min, 10 min, 15 min and 20 min, and the changes in food components were studied. After 14 days storage at 37℃ and 55℃, no growth of microorganism and panelling were recognized from the canned meats which were sterlized at 115℃ with F_0 value of 5 min and over. In the case of proximate composition of the canned meats, the moisture content decreased with the increase of F_0 value, while crude protein increased. The increase of volatile basic nitrogen content, pH and degree of browning and the decrease of mineral, total amino acid, free amino add, trimethylamine oxide, total creatinine contents and yields were observed during thermal processing. In sensory evaluation on color, texture and taste in the canned meats, no significant difference was observed among a boiled sample and the canned meats heated at F_0 value of 10 min and below. But, in the canned meats heated at F_0 value of over 15 min, its sensory scores decreased with the increase of F_0 value. From these results, the reasonable F_0 value for preparation of the heat-treated top shell meats was in the range of 5∼10 min.

성인 지역사회 폐렴의 원인 미생물에 대한 전향적 다기관 연구 : Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi

김민자,정희진,손장욱,심희선,박대원,박승철,우준희,강재명,김유겸,신완식,김양리,이환종,김지희 대한감염학회 2001 감염 Vol.33 No.1

Background : Despite rigorous investigations, the etiology of community-acquired pneumonia remains unknown in about 50% of hospitalized patients. The diagnosis of the etiological agent is becoming more challenging and more critical as number of newer pathogens have been recognized in recent years. In the 3-year period prospective study we investigated adult patients with community-acquired pneumonia for Legionella, Leptospira, Hantaan virus and Orientia tsutsugamushi as potential etiologic agents. Methods : A prospective multicenter study was performed from May 1997 to April 2000. A total of 431 patients with community-acquired pneumonia under the inclusion criteria were examined for specific microbial diagnosis; sputum culture and PCR, and serologic teats including indirect immunofluorescence antibody (IFA) test for Legionella, and hemagglutination tests for Leptosoira, Hantaan virus and O. tsutsugamushi. Etiologic diagnosis was determined on the basis of the review of case record forms and specific laboratory diagnostic criteria. Results : During the study period a total of 385 sputum and 283 serum samples were examined. Legionella pneumonia was diagnosed in 2.3% (10/431) of the cases examined : 1.4% cases with PCR-positive (5/367) and 2.1% with positive IFA test (6/283). Leptospirosis and scrub typhus were diagnosed in 0.4% (1/252) and 2.0% (5/252), respectively. All 5 cases with scrub typhus occurred in late fall, and rash or eschar was not found. None of cases was Hantaan virus infection. Conclusion : The results suggest that Legionella, Leptospira, and O. tsutsugamushi should be considered in the etiologic diagnosis and empirical antibiotic therapy of community-acquired pneumonia. (Korean J Infect Dis 32:24∼31, 2001)

생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

Purification and Characterization of a Xylanase from Bacillus sp . KK-1

Dae Joon Kim,Ki Hong Yoon Seung Ho Kim,Ki Haeng Cho,Bon Hong Min 생화학분자생물학회 1995 BMB Reports Vol.28 No.4

A thermophilic Bacillus sp. strain KK-1 isolated from soil produced an extracelluar xylanase. From the culture supernatant of Bacillus sp., the xylanase was purified to homogeneity by ammonium sulfate precipitation and DEAF-Sephadex A-50 chromatography. The molecular weight of the purified xylanase was estimated to be 45 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel permeation chromatography. The apparent K_m values for xylanase, using oat spelt xylan and birchwood xylan as substrates, were 7.1 ㎎/㎖ and 3.2 ㎎/㎖, and V_(max) values were 27.0 μ㏖·min^(-1)·㎎^(-1) and 29.0 μ㏖·min^(-1)·㎎^(-1), respectively. The xylanase hydrolyzed oat spelt xylan to mostly xylobiose, xytotriose, and xylose. The amino acid composition indicated that the xylanase contained high amounts of amino acid residues of glutamic acid and glutamine (Glx) and aspartic acid and asparagine (Asx).

Analysis of Lignans in Acanthopanax sessiliflorus Fruits and Their Fermented Wine by HPLC

Kim, Hye-Min,Kim, Ju-Sun,Cho, Seon-Haeng,Kang, Sam-Sik,Cheoi, Dae-Sung,Lee, Sang-Hyun The Korean Society of Medicinal Crop Science 2006 韓國藥用作物學會誌 Vol.14 No.5

High performance liquid chromatography (HPLC) was used for the determination of lignans, eleutherosides B and E, in Acanthopanax sessiliflorus fruits and their fermented wine. The lignans were quantified by a reversed-phase system using a gradient of $H_2O$ and acetonitrile as a mobile phase within 20 min. The analysis was successfully carried out within 20 min. The contents of eleutherosides Band E as main active principles of Acanthopanax species were measured in A. sessiliflorus fruits (1.15 and $8.49\;{\mu}g/mg$, respectively), their fermented wine (0.45 and $1.33\;{\mu}g/mg$, respectively) and wine residues (no detection).

Dopant-Activation and Damage-Recovery of Ion-Shower-Doped Poly-Si through $PH_3/H_2$ after Furnace Annealing

Kim, Dong-Min,Kim, Dae-Sup,Ro, Jae-Sang,Choi, Kyu-Hwan,Lee, Ki-Yong The Korean Infomation Display Society 2004 Journal of information display Vol.5 No.1

Ion shower doping with a main ion source of $P_2H_x$ using a source gas mixture of $PH_3/H_2$ was conducted on excimer-laser- annealed (ELA) poly-Si. The crystallinity of the as-implanted samples was measured using a UV-transmittance. The measured value of as-implanted damage was found to correlate well with the one calculated through/obtained from TRIM-code simulation. The sheet resistance was found to decrease as the acceleration voltage increased from 1 kV to 15 kV at a doping time of 1 min. However, it increases as the acceleration voltage increases under severe doping conditions. Uncured damage after furnace annealing is responsible for the rise in sheet resistance.

직업적 노출에 의한 스티븐스-존슨 증후군에서 트리클로로에틸렌의 노출수준 : 3예의 사례와 문헌고찰을 중심으로

이선웅,김은아,김대성,고동희,강성규,김병규,김민기 大韓産業醫學會 2008 대한직업환경의학회지 Vol.20 No.2

배경: TCE는 심각한 전산적 피부염과 관련 있는 것으로 몇몇 사례들을 통해서 보고되어 왔으나,기존의 사례 보고들에서 노출평가가 수행된 사례는 드물었고 추정되는 노출량 역시 매우 다양하였다. 본 연구에서는 TCE 노출에 의한 것으로 판단되는 스티븐스-존슨 증후군 3예를 확인하고 각 사례들에 대한 작업재연을 통해 노출수준을 추정하였으며,이를 통해 TCE의 직업적 노출수준과 스티븐스-존슨 증후군을 포함하는 전신적 박탈성 피부염 발생의 관계를 이해하고자 하였다. 증례: 사례 1은 24세 필리핀인 여자로 TCE를 이용한 탈지작업을 시작한 35일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스 존슨 증후군과 독성간염으로 진단되었고 증상발생 39일 간부전으로 사망하였다. 증상발생 전 약물 복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준 은 TWA 21.9 ppm과 32.3 ppm이었다. 사례 2는 47세 한국인 남자로 TCE를 이용한 탈지 작업을 시작한 20일 후 발진을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 중독성 표피괴사증 또는 스티븐스 -존슨 증후군, 전격성간염 및 동반된 패혈증으로 진단되었고 증상발생 42일 간부전 및 패혈증으로 사망하였다. 증상발생 전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 30.1 ppm이었으며 세척조 주위의 지역시료는 TWA 116.5 ppm∼229. 7 ppm 이었다. 사례 3은 22세 베트남인 여자로 TCE를 이용한 탐지작업을 시작한 30일 후 발전을 포함한 피부증상이 발생하였고 증상이 진행되면서 간기능 이상이 발견되었다. 환자는 스티븐스-존슨 증후군 및 동반된 독성간염으로 진단되었고 증상발생 37일 증세 호전되어 퇴원하였다. 증상발생전 약물복용력은 없었고 바이러스 감염 등의 비직업적 원인은 찾을 수 없었으며,작업재연을 통한 TCE의 개인 노출수준은 TWA 107.2 ppm이었다. 고찰: TCE에 노출된 일부의 사람들에서 노출 후 2주에서 5주 사이에 심각한 급성 간염이 동반되는 스티븐스­존슨 증후군이 발생할 수 있음을 확인 하였고,이번의 연구결과와 기존의 연구를 종합 할 때 TCE에 대한 감수성이 있는 사람의 상당수는 노출기준 이상의 고 노출에 노 출 후 스티븐스- 존슨 증후군이 발생함을 확인할 수 있었다. 따라서. TCE에 대한 고 노출을 막기 위해 TCE 세척작업에 대한 작업환경 확인과 개선이 우선적으로 필요하며,동시에 노출 후 증상발생기간의 일관성과 노출기준 이하의 저 노출에서의 감작 가능성을 배제할 수 없음을 고려하여,작업시작 후 1개월경의 특수건강검진 역시 고려되어야 할 것으로 판단된다. Back ground: Trichloroethylene (TCE) has been reported to be related to severe generalized exfoliative dermatitis frequently accompanied by toxic hepatitis. The measurements of environmental exposure were limited in the previous case reports and the reported exposure values were also diverse. We reviewed three cases of Stevens-Johnson syndrome associated with TCE. The work environment was measured by the Korea Occupational Safety and Health Agency (KOSHA) after the cases occurred. From the study results, we intended to clarify the relationship between TCE exposure level and Stevens-Johnson syndrome. Case report: Case 1. A 24-year-o1d Filipino female worker developed a skin rash 35 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. She died of hepatic failure 39 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 22.0 to 32.3 ppm (Personal exposure level) with TWA. Case 2. A 47-year-o1d Korean male worker developed a skin rash, 20 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. He was diagnosed with Stevens-Johnson syndrome, toxic hepatitis and sepsis. He died of hepatic failure and sepsis 42 days after the onset ofthe first symptom. He had no previous history of taking medicine or viral infection. The work environment measured 30.1 ppm (Personal exposure level) and 116.5∼229.7 ppm (area exposure level close to the degreasing rnachine) with TWA. Case 3. A 22-year-old Vietnamese female worker developed a skin rash 30 days after starting to use TCE for degreasing. The skin rash developed into a bullous eruption and the liver function findings were abnormal. She was diagnosed with Stevens-Johnson syndrome and toxic hepatitis. Her symptoms improved and she was discharged 37 days after the onset of the first symptom. She had no previous history of taking medicine or viral infection. The work environment measured 107.2 ppm (Personal exposure level) with TWA. Discussion: These three case reports and the previously reported cases indicated that the majority of people susceptible to TCE develops Stevens-Johnson syndrome after high-level TCE exposure (above the TWA occupational exposure limit of 50 ppm). Therefore, work environmental survey and improvements to the TCE degreasing process are essential to prevent high exposure. Furthermore, considering the consistency of the latency period in symptoms and the possibility of sensitization in low-level exposure, we recommend that the first specific health examination also should be conducted 1 month after workers have commenced working.

Identification and Characterization of a Bacteriocin Produced by an Isolated Bacillus sp. SW1-1 that Exhibits Antibacterial Activity against Fish Pathogens

Kim, Young-Ok,Park, In-Suk,Kim, Dae-Jung,Nam, Bo-Hye,Kim, Dong-Gyun,Jee, Young-Ju,An, Cheul-Min The Korean Society for Applied Biological Chemistr 2014 Applied Biological Chemistry (Appl Biol Chem) Vol.57 No.5

The selected isolate, Bacillus sp. SW1-1 showed antibacterial activity against both Gram-positive and Gram-negative bacteria involved in fish diseases, including Edwardsiella tarda, Streptococcus iniae, S. parauberis, Vibrio anguillarum, and V. harveyi. The Maximum bacteriocin production was observed at $30^{\circ}C$ after 24 h with brain heart infusion medium (pH 7.0). The bacteriocin SW1-1 was purified by 50% ammonium sulfate precipitation, followed by HiPrep diethylaminoethyl 16/10 FF and Sephacryl S-100 High resolution column chromatography. The substance was characterized as a bacteriocin-like inhibitory substance with a molecular mass of 38 kDa. Bacteriocin SW1-1 was sensitive to the proteolytic action of pepsin, trypsin, chymotrypsin, and protease types I and XIV, and relatively heat labile, despite the fact that bacteriocin activity was still detected after heating at $100^{\circ}C$ for 30 min. The activity of bacteriocin SW1-1 was stable in the pH range of 2.0-11.0, and relatively unaffected by organic chemicals. The bacteriocin SW1-1 had a bacteriolytic mechanism, resulting in cell wall degradation of E. tarda. These characteristics indicate that this bacteriocin may be a potential candidate for alternative agent to control important pathogens of fish diseases in aquaculture.

Disruption of rsmA Gene of Pectobacterium carotovorum subsp. carotovorum LY34 and Effect on Pathogenicity

Kim, Min Keun,Kang, Tae Ho,Kim, Sung Kyum,Jeong, Yu Seok,Yun, Han Dae,Kim, Hoon The Korean Society for Applied Biological Chemistr 2012 Applied Biological Chemistry (Appl Biol Chem) Vol.55 No.6

The rsmA gene was cloned from soft-rot bacterium Pectobacterium carotovorum subsp. carotovorum LY34 (Pcc LY34), and its role in pathogenicity was investigated by marker exchange mutagenesis. From a cosmid library of Pcc LY34 genomic DNA, a positive clone carrying the rsmA gene was selected, and the gene was cloned by polymerase chain reaction (PCR) amplification. The gene is 186 bp in size and encodes a protein of 62 amino acids with a predicted molecular mass of 6,839 Da. The calculated pI of the RsmA is 8.16. The phylogenetic tree showed that the RsmA of Pcc LY34 appeared genetically identical to the CsrA of Pectobacterium atrosepticum SCRI1043 (100% identity) and similar to the CsrA of Yersinia pestis KIM10+(98.3%). The gene was disrupted by the $Km^r$ gene, and the cells became mutated (i.e., $RsmA^-$ mutant). The pathogenicity test revealed that the disease rating of the $RsmA^-$ mutant only differed slightly from that of the wild type on a slice of potato tuber and a Chinese cabbage stalk. These results suggest that RsmA is not an essential factor for the pathogenicity of Pcc LY34 and that the rsmA gene of Pcc LY34 is not completely derepressed in the $RsmA^-$ mutant for virulence-related genes, contrary to the results of Erwinia carotovora subsp. carotovora $RsmA^-$ mutant, which proved hypervirulent for celery petioles. These results showed that the microenvironmental conditions of the host and/or strain of pathogen are important for the coordination of virulence gene expression.