72 research outputs found
In vitro andin vivo application of PLGA nanofiber for artificial blood vessel
Poly(lactic-co-glycolic acid) (PLGA) tubes (5 mm in diameter) were fabricated using an electro spinning method and used as a scaffold for artificial blood vessels through the hybridization of smooth muscle cells (SMCs) and endothelial cells (ECs) differentiated from canine bone marrow under previously reported conditions. The potential clinical applications of these artificial blood vessels were investigated using a canine model. From the results, the tubular-type PLGA scaffolds for artificial blood vessels showed good mechanical strength, and the duallayered blood vessels showed acceptable hybridization behavior with ECs and SMCs. The artificial blood vessels were implanted and substituted for an artery in an adult dog over a 3-week period. The hybridized blood vessels showed neointimal formation with good patency. However, the control vessel (unhybridized vessel) was occluded during the early stages of implantation. These results suggest a shortcut for the development of small diameter, tubular-type, nanofiber blood vessels using a biodegradable material (PLGA).ope
Spontaneous Recovery of Renal Function after Off-pump Coronary Artery Bypass Grafting in Chronic Renal Failure Patients
Background: Off-pump coronary artery bypass grafting (OPCAB) has shown better outcome in chronic renal failure (CRF) patients by avoiding the effects of cardiopulmonary bypass. We evaluated renal function after OPCAB in CRF patients.
Material and Method: 656 patients underwent OPCAB between January, 2001 and December, 2004. Data were collected in 26 CRF patients (Cr > 1.7 mg/dL). Preoperative/postoperative creatinine (Cr) levels, creatinine clearance and postoperative data were evaluated. We divided the patients into group 1 (Cr < 3 mg/dL) and group 2 (Cr โฅ 3 mg/dL).
Result: Three patients started dialysis after surgery. Preoperative mean creatinine level (4.19ยฑ3.4 mg/dL) was elevated to 4.36ยฑ2.7 mg/dL at the third postoperative day and decreased below Preoperative level at the fifth postoperative day. In group 1 (mean Cr level=1.87ยฑ0.25 mg/dL), Cr level reached its peak level of 2.19ยฑ0.52 mg/dL at the fourth postoperative day (p=0.017), with subsequent decrease. Patients without pre- or postoperative dialysis (n=15) showed peak Cr elevation on postoperative day four (p=0.017) and subsequent decrease (p=0.01). Postoperative creatinine clearance showed reverse correlation with creatinine level.
Conclusion: Creatinine level was elevated at third/fourth postoperative day, but decreased 5 days after surgery. Thus, if urgent dialysis is not indicated, postoperative renal replacement therapy in CRF patients may be better to be considered after four days observation.ope
The Effects of Family Background and Career Development of Adolescents on Occupational Satisfaction
๋ณธ ์ฐ๊ตฌ์์๋ ํ๊ตญ๊ต์ก๊ณ ์ฉํจ๋(KEEP) ๋ฐ์ดํฐ๋ฅผ ํ์ฉํ์ฌ ์ง๋ก๋ฐ๋ฌ ํน์ฑ๊ณผ ์ง์
๋ง์กฑ๋์์ ์ธ๊ณผ๊ด๊ณ๋ฅผ ๋ถ์ํ์๋ค. ๋ณธ ์ฐ๊ตฌ์ ๋ถ์๋ฐฉํฅ์ ๊ฐ์ ๋ฐฐ๊ฒฝ์ธ ๋ถ๋ชจํ๋ ฅ๊ณผ ๊ฐ์ ์๋, ๊ณ ๋ฑํ๊ต ์๊ธฐ์ ํ์
ํ๋, ๊ทธ๋ฆฌ๊ณ ์์์ ์ฒด๊ฐ์ด ์ ๊ณต์ผ์น์ ์ง์
๋ง์กฑ์ ์ด๋ค ์ํฅ์ ๋ฏธ์น๋์ง๋ฅผ ํ์ธํ๋ ๊ฒ์ด๋ค. ํนํ ์ง์
์ ๊ณ ๊ต ๊ณ์ด์ ํ์ ๋ฐ๋ผ ๋ฌ๋ผ์ง ์ ์๊ธฐ ๋๋ฌธ์ ๊ณ์ด์ ๋ฐ๋ฅธ ์ฐจ์ด๋ฅผ ๋น๊ตํ์๋ค. ๋ถ์๋ณ์ธ์ ๊ฐ์ ๋ฐฐ๊ฒฝ, ๊ณ ๊ตํ์
, ์์์ ์ฒด๊ฐ, ์ ๊ณต์ผ์น, ๊ทธ๋ฆฌ๊ณ ์ง์
๋ง์กฑ๋์ด๋ค. ๋ถ์๋ฐฉ๋ฒ์ ๊ตฌ์กฐ๋ฐฉ์ ์๋ชจํ์ ํตํ ๊ฒฝ๋ก๋ถ์์ด๋ฉฐ, ๋ถ์ ํ๋ก๊ทธ๋จ์ LISREL์ด๋ค.
๋ถ์ ๊ฒฐ๊ณผ๋ ๊ณ์ด, ์ฆ ์ธ๋ฌธ๊ณ์ ์ ๋ฌธ๊ณ ํจ๋ ๊ฐ์ ์ธ๊ณผ๊ด๊ณ ๋งฅ๋ฝ์ ์ฐจ์ด๋ฅผ ๋ํ๋ด๊ณ ์์ผ๋, ๋ ๋ชจํ์ ๊ณตํต์ ์ธ ๊ฒฐ๊ณผ๋ ์ ๊ณต์ผ์น๊ฐ ์ง์
๋ง์กฑ๋์ ์ ์ํ ์ํฅ์ ๋ฏธ์น๊ณ ์๋ค. ๋ณธ ์ฐ๊ตฌ ๊ฒฐ๊ณผ๋ ํ๊ต์์ ์ง์
์ธ๊ณ๋ก ์ดํํ๋ ๊ณผ์ ์์ ๋์์ด ๋ ์ ์๋ ๊ต์ก ๋ฐ ํ์ต ์ ๋ณด๋ฅผ ์ ๊ณตํ ๊ฒ์ผ๋ก ํ๋จ๋๋ค.This study examines the effects of family background and career development of adolescents on occupational satisfaction using KEEP data from the 1st to the 9th waves. It is hypothesized that there are causal relations among occupational satisfaction, family background, academic performance, self-identity, and major-job congruence. In particular, this study compares the occupational satisfaction in terms of differences between two types of high schools. The method used in this study is SEM by LISREL program.
As a result, there is distinctive difference between academic and vocational high school in the effects of family background and career development of adolescents on occupational satisfaction. However, there is no difference between the two schools in the effects of major-job congruence to occupational satisfaction. The results of this study are expected to provide suggestions for identifying training and learning information necessary for adolescents in the transition process from school to world of work
The Effects of Occupational and Educational Aspirations on Educational Attainment
๋ณธ ์ฐ๊ตฌ๋ ํ๊ตญ๊ต์ก๊ณ ์ฉํจ๋(KEEP) ๋ฐ์ดํฐ๋ฅผ ํ์ฉํ์ฌ ์ง์
ํฌ๋ถ์ ๊ต์กํฌ๋ถ๊ฐ ๊ต์ก์ฑ์ทจ์ ๋ฏธ์น๋ ์ํฅ์ ํ์ธํ์๋ค. ๋ถ์๋ฐฉํฅ์ ๊ณ ๊ต์๊ธฐ ์ง์
ํฌ๋ถ ๊ทธ๋ฆฌ๊ณ ๊ต์กํฌ๋ถ๊ฐ 2014๋
ํ์ฌ ์์ ์ ์ต์ข
ํ๋ ฅ์ ๋ฏธ์น๋ ํจ๊ณผ๋ฅผ ์ธ๊ณผ๊ด๊ณ๋ก ๋ถ์ํ์๋ค. ๋ํ ํ์์ ์ง์
ํฌ๋ถ์ ๊ต์กํฌ๋ถ ๊ทธ๋ฆฌ๊ณ ๊ต์ก์ฑ์ทจ์ ๋ํ ๊ฐ์ ๋ฐฐ๊ฒฝ์ ํจ๊ณผ๋ฅผ ํต์ ํ๊ธฐ ์ํ์ฌ ๋ถํ๋ ฅ, ๋ถ์ง์
, ๊ฐ๊ตฌ์๋์ ์ธ์๋ณ์๋ก ํฌ์
ํ์๋ค. ๊ทธ๋ฆฌ๊ณ ์ง์
ํฌ๋ถ์ ๊ต์กํฌ๋ถ ๊ทธ๋ฆฌ๊ณ ๊ต์ก์ฑ์ทจ๊ฐ ๊ณ์ด์ ๋ฐ๋ผ ์ด๋ป๊ฒ ๋ค๋ฅธ ๋งฅ๋ฝ์ ๊ฐ๊ฒ ๋๋์ง ํ์ํ๊ธฐ ์ํ์ฌ ์ธ๋ฌธ๊ณ์ ์ค์
๊ณ๋ก ๋ถ๋ฆฌํ์ฌ ๋ชจํ์ ์ค์ ํ๊ณ ๋ถ์ํ์๋ค. ์ด์ ๊ฐ์ด ๊ต์ก์ฑ์ทจ์ ์ํฅ์ ๋ฏธ์น๋ ํจ๊ณผ ํ์์ LISREL ํ๋ก๊ทธ๋จ์ ์ฌ์ฉํ์ฌ ๊ตฌ์กฐ๋ฐฉ์ ์ ๋ชจํ์ผ๋ก ๋ถ์ํ์๋ค.
๋ถ์๊ฒฐ๊ณผ ๊ฐ์ ๋ฐฐ๊ฒฝ, ๊ต์กํฌ๋ถ, ์ง์
ํฌ๋ถ ๊ทธ๋ฆฌ๊ณ ๊ต์ก์ฑ์ทจ์ ์ธ๊ณผ๊ด๊ณ ๋งฅ๋ฝ์ด ์ธ๋ฌธ๊ณ์ ์ ๋ฌธ๊ณ๊ฐ ๋ค๋ฅด๊ฒ ๋ํ๋๋ ๊ฒ์ ํ์ธํ ์ ์๋ค. ๋ณธ ์ฐ๊ตฌ ๊ฒฐ๊ณผ๋ ํ๊ตญ์ฌํ ๊ฐ์ ๋ฐฐ๊ฒฝ๊ณผ ๊ต์ก ๊ทธ๋ฆฌ๊ณ ์ง์
๊ณผ์ ๊ด๋ จ์ฑ ํ์์ ๋์์ด ๋ ๊ฒ์ผ๋ก ํ๋จ๋๋ค.This study examines the effects of occupational and educational aspirations on educational attainment using the 1st and 10th waves of KEEP data. It is hypothesized that there are causal relations among family background, educational aspirations, occupational aspirations and academic performance. In particular, this study compares the educational attainment in terms of differences between two types of high schools. The method used in this study is path analysis with LISREL program.
As a result, there was a distinctive difference between academic and vocational high schools in the effect of family background and occupational aspirations. However, the difference between two types of schools was not significant in the effect of educational aspirations on educational attainment. This study is expected to provide suggestions for identifying training and learning information necessary for adolescents in the transition process from school to world of work
Late Migration of Amplatzer Septal Occluder Device to the Descending Thoracic Aorta
Percutaneous closure of atrial septal defect (ASD) has become an increasingly common procedure. Serious complications of the procedure, such as cardiac migration, are rare, and usually occur <72 hours after device placement. In this report, we present the case of a patient who underwent successful surgical treatment for the migration of an ASD occluder device to the thoracic aorta 12 months after ASD closure.ope
Long term results of ST-segment elevation myocardial infarction versus non-ST-segment elevation myocardial infarction after off-pump coronary artery bypass grafting: propensity score matching analysis.
There is no consensus as to which acute myocardial infarction subtype poses a greater risk after coronary artery bypass grafting (CABG). We compared the early and the long term results of off-pump coronary artery bypass grafting (OPCAB) between patients with STEMI (group I, n = 83), and NSTEMI (group II, n = 237). Group I had higher EuroSCORE, prevalence of emergency surgery, preoperative intra-aortic balloon pump use, preoperative emergency percutaneous transluminal coronary angioplasty, and preoperative thrombolytic use than group II. There were no significant differences in 30-day mortality and major adverse cardiac and cerebrovascular event (MACCE) between groups. Overall 8-yr survival was 93% and 87% in groups I and II, respectively. Freedom from MACCE after 8 yr was 92% and 93% in groups I and II, respectively. After propensity score matching analysis, there were no significant differences in preoperative parameters, postoperative in-hospital outcomes, and long-term clinical outcomes. Surgical results of OPCAB in patients with acute myocardial infarction show good results in terms of long-term survival and freedom from MACCE, with no significant differences in clinical outcomes between STEMI and NSTEMI groups.ope
Stroke Recurrence in a Patient Twelve Years after Repair of a Secundum Atrial Septal Defect
Background: Secundum atrial septal defect (ASD) is a common congenital heart defect in
adults. Patients with ASDs at high risk of cardiovascular complications undergo either surgical
repair or percutaneous device closure.
Case Report: We report the case of an 85-year-old male with unusual recurrent cerebral
infarctions. The patient has undergone repair of secundum ASD 12 years ago. Evaluation by
transesophageal echocardiography revealed a mobile mass at the patch repair site in the left
atrium. The mass was surgically removed due to recurrent stroke during the anticoagulation.
Conclusion: This case emphasizes the importance of regular cardiac checkup and the need to
consider cardioembolic source as being part of the etiology of stroke recurrence, even if the
event occurs many years after intracardiac shunt closures.ope
Total Arterial Off-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts
Background: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypoperfusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method.
Material and Method: Between February 2003 and October 2004, 71 patients underwent total arterial OPCAB using multiple arterial Y composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 61 patients by multi-slice computed tomography.
Result: An average of 2.5ยฑ0.6 arteries and 3.7ยฑ0.7 distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was 17.4ยฑ29.7 IU/L. Overall graft patency was 99.1% (214/216)(LIMA: 100%, RA: 98.4%, RIMA: 100%).
Conclusion: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.ope
Off Pump Total Arterial Myocardial Revascularization
Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG.
Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of 59.3ยฑ11.9 years (36โผ83). Mean ejection fraction was 55.4ยฑ14.0% (15โผ86). Angiography showed left main disease or triple-vessel disease in 81.9% of the patients. Indications of using arterial conduits was stenosis โฅ50% of left anterior descending artery, stenosis โฅ80% of branches of left circumflex artery, and stenosis โฅ90% of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates.
Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were 2.86ยฑ0.78. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients (1.8%), renal failure in 4 patients (1.2%), perioperative myocardial infarction in 3 patients (0.9%), reoperation for bleeding in 3 patients (0.9%). There was no postoperative stroke. Patency rate of arterial conduits was 99.3% (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries.
Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.ope
The Effect of Milrinone on the Right Ventriclular Function in Patients with Reduced Right Ventricular Function Undergoing Off-pump Coronary Artery Bypass Graft Surgery
This investigation evaluated the effect of continuous milrinone infusion on right ventriclular (RV) function during off-pump coronary artery bypass graft (OPCAB) surgery in patients with reduced RV function. Fifty patients scheduled for OPCAB, with thermodilution RV ejection fraction (RVEF) <35% after anesthesia induction, were randomly allocated to either milrinone (0.5 ยตg/kg/min) or control (saline) group. Hemodynamic variables and RV volumetric data measured by thermodilution method were collected as follows: after anesthesia induction (T1); 10 min after heart displacement for obtuse marginal artery anastomosis (T2); after pericardial closure (T3). Cardiac index and heart rate increased and systemic vascular resistance significantly decreased in milrinone group at T2. Initially lower RVEF of milrinone group was eventually comparable to control group after milrinone infusion. RVEF did not significantly change at T2 and T3 in both groups. RV end-diastolic volume in milrinone group consistently decreased from the baseline at T2 and T3. Continuous infusion of milrinone without a bolus demonstrated potentially beneficial effect on cardiac output and RV afterload in patients with reduced RV function during OPCAB. However, aggressive augmentation of intravascular volume seems to be necessary to maximize the effect of the milrinone in these patients.ope
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