72 research outputs found

    In vitro andin vivo application of PLGA nanofiber for artificial blood vessel

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    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

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    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 โ‰ฅ 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

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    ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ํ•œ๊ตญ๊ต์œก๊ณ ์šฉํŒจ๋„(KEEP) ๋ฐ์ดํ„ฐ๋ฅผ ํ™œ์šฉํ•˜์—ฌ ์ง„๋กœ๋ฐœ๋‹ฌ ํŠน์„ฑ๊ณผ ์ง์—…๋งŒ์กฑ๋„์™€์˜ ์ธ๊ณผ๊ด€๊ณ„๋ฅผ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๋ถ„์„๋ฐฉํ–ฅ์€ ๊ฐ€์ •๋ฐฐ๊ฒฝ์ธ ๋ถ€๋ชจํ•™๋ ฅ๊ณผ ๊ฐ€์ •์†Œ๋“, ๊ณ ๋“ฑํ•™๊ต ์‹œ๊ธฐ์˜ ํ•™์—…ํ™œ๋™, ๊ทธ๋ฆฌ๊ณ  ์ž์•„์ •์ฒด๊ฐ์ด ์ „๊ณต์ผ์น˜์™€ ์ง์—…๋งŒ์กฑ์— ์–ด๋–ค ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š”์ง€๋ฅผ ํ™•์ธํ•˜๋Š” ๊ฒƒ์ด๋‹ค. ํŠนํžˆ ์ง์—…์€ ๊ณ ๊ต ๊ณ„์—ด์„ ํƒ์— ๋”ฐ๋ผ ๋‹ฌ๋ผ์งˆ ์ˆ˜ ์žˆ๊ธฐ ๋•Œ๋ฌธ์— ๊ณ„์—ด์— ๋”ฐ๋ฅธ ์ฐจ์ด๋ฅผ ๋น„๊ตํ•˜์˜€๋‹ค. ๋ถ„์„๋ณ€์ธ์€ ๊ฐ€์ •๋ฐฐ๊ฒฝ, ๊ณ ๊ตํ•™์—…, ์ž์•„์ •์ฒด๊ฐ, ์ „๊ณต์ผ์น˜, ๊ทธ๋ฆฌ๊ณ  ์ง์—…๋งŒ์กฑ๋„์ด๋‹ค. ๋ถ„์„๋ฐฉ๋ฒ•์€ ๊ตฌ์กฐ๋ฐฉ์ •์‹๋ชจํ˜•์„ ํ†ตํ•œ ๊ฒฝ๋กœ๋ถ„์„์ด๋ฉฐ, ๋ถ„์„ ํ”„๋กœ๊ทธ๋žจ์€ LISREL์ด๋‹ค. ๋ถ„์„ ๊ฒฐ๊ณผ๋Š” ๊ณ„์—ด, ์ฆ‰ ์ธ๋ฌธ๊ณ„์™€ ์ „๋ฌธ๊ณ„ ํŒจ๋„ ๊ฐ„์˜ ์ธ๊ณผ๊ด€๊ณ„ ๋งฅ๋ฝ์— ์ฐจ์ด๋ฅผ ๋‚˜ํƒ€๋‚ด๊ณ  ์žˆ์œผ๋‚˜, ๋‘ ๋ชจํ˜•์˜ ๊ณตํ†ต์ ์ธ ๊ฒฐ๊ณผ๋Š” ์ „๊ณต์ผ์น˜๊ฐ€ ์ง์—…๋งŒ์กฑ๋„์— ์œ ์˜ํ•œ ์˜ํ–ฅ์„ ๋ฏธ์น˜๊ณ  ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋Š” ํ•™๊ต์—์„œ ์ง์—…์„ธ๊ณ„๋กœ ์ดํ–‰ํ•˜๋Š” ๊ณผ์ •์—์„œ ๋„์›€์ด ๋  ์ˆ˜ ์žˆ๋Š” ๊ต์œก ๋ฐ ํ•™์Šต ์ •๋ณด๋ฅผ ์ œ๊ณตํ•  ๊ฒƒ์œผ๋กœ ํŒ๋‹จ๋œ๋‹ค.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

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    ๋ณธ ์—ฐ๊ตฌ๋Š” ํ•œ๊ตญ๊ต์œก๊ณ ์šฉํŒจ๋„(KEEP) ๋ฐ์ดํ„ฐ๋ฅผ ํ™œ์šฉํ•˜์—ฌ ์ง์—…ํฌ๋ถ€์™€ ๊ต์œกํฌ๋ถ€๊ฐ€ ๊ต์œก์„ฑ์ทจ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ์„ ํ™•์ธํ•˜์˜€๋‹ค. ๋ถ„์„๋ฐฉํ–ฅ์€ ๊ณ ๊ต์‹œ๊ธฐ ์ง์—…ํฌ๋ถ€ ๊ทธ๋ฆฌ๊ณ  ๊ต์œกํฌ๋ถ€๊ฐ€ 2014๋…„ ํ˜„์žฌ ์‹œ์ ์˜ ์ตœ์ข…ํ•™๋ ฅ์— ๋ฏธ์น˜๋Š” ํšจ๊ณผ๋ฅผ ์ธ๊ณผ๊ด€๊ณ„๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋˜ํ•œ ํ•™์ƒ์˜ ์ง์—…ํฌ๋ถ€์™€ ๊ต์œกํฌ๋ถ€ ๊ทธ๋ฆฌ๊ณ  ๊ต์œก์„ฑ์ทจ์— ๋Œ€ํ•œ ๊ฐ€์ •๋ฐฐ๊ฒฝ์˜ ํšจ๊ณผ๋ฅผ ํ†ต์ œํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ๋ถ€ํ•™๋ ฅ, ๋ถ€์ง์—…, ๊ฐ€๊ตฌ์†Œ๋“์„ ์™ธ์ƒ๋ณ€์ˆ˜๋กœ ํˆฌ์ž…ํ•˜์˜€๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ง์—…ํฌ๋ถ€์™€ ๊ต์œกํฌ๋ถ€ ๊ทธ๋ฆฌ๊ณ  ๊ต์œก์„ฑ์ทจ๊ฐ€ ๊ณ„์—ด์— ๋”ฐ๋ผ ์–ด๋–ป๊ฒŒ ๋‹ค๋ฅธ ๋งฅ๋ฝ์„ ๊ฐ–๊ฒŒ ๋˜๋Š”์ง€ ํƒ์ƒ‰ํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์ธ๋ฌธ๊ณ„์™€ ์‹ค์—…๊ณ„๋กœ ๋ถ„๋ฆฌํ•˜์—ฌ ๋ชจํ˜•์„ ์„ค์ •ํ•˜๊ณ  ๋ถ„์„ํ•˜์˜€๋‹ค. ์ด์™€ ๊ฐ™์ด ๊ต์œก์„ฑ์ทจ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ํšจ๊ณผ ํƒ์ƒ‰์€ LISREL ํ”„๋กœ๊ทธ๋žจ์„ ์‚ฌ์šฉํ•˜์—ฌ ๊ตฌ์กฐ๋ฐฉ์ •์‹ ๋ชจํ˜•์œผ๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋ถ„์„๊ฒฐ๊ณผ ๊ฐ€์ •๋ฐฐ๊ฒฝ, ๊ต์œกํฌ๋ถ€, ์ง์—…ํฌ๋ถ€ ๊ทธ๋ฆฌ๊ณ  ๊ต์œก์„ฑ์ทจ์™€ ์ธ๊ณผ๊ด€๊ณ„ ๋งฅ๋ฝ์ด ์ธ๋ฌธ๊ณ„์™€ ์ „๋ฌธ๊ณ„๊ฐ€ ๋‹ค๋ฅด๊ฒŒ ๋‚˜ํƒ€๋‚˜๋Š” ๊ฒƒ์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ๋Š” ํ•œ๊ตญ์‚ฌํšŒ ๊ฐ€์ •๋ฐฐ๊ฒฝ๊ณผ ๊ต์œก ๊ทธ๋ฆฌ๊ณ  ์ง์—…๊ณผ์˜ ๊ด€๋ จ์„ฑ ํƒ์ƒ‰์— ๋„์›€์ด ๋  ๊ฒƒ์œผ๋กœ ํŒ๋‹จ๋œ๋‹ค.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

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    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.

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    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

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    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

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    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

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    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 (36โˆผ83). Mean ejection fraction was 55.4ยฑ14.0% (15โˆผ86). Angiography showed left main disease or triple-vessel disease in 81.9% of the patients. Indications of using arterial conduits was stenosis โ‰ฅ50% of left anterior descending artery, stenosis โ‰ฅ80% of branches of left circumflex artery, and stenosis โ‰ฅ90% 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

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    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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