BACKGROUND: Heart transplantation is considerated for a selected certain group of complicated congenital heart disease in neonates because corrective surgery is very difficult and has high mortality. Precise planning of transplantation is necessary to adequately fit the donor heart to the recipient. MATERIAL AND METHOD: We have performed 4 neonatal pig heart transplantations to test the technical feasibility. Experiment 1: The transplantation was performed using the same technique as the adult heart transplantation. Experiment 2: The transplantation for hypoplastic left heart syndrome was simulated as we reconstructed the whole aortic arch with donor aorta. Experiment 3: The heart transplantation was done with radical pulmonary artery reconstruction. Experiment 4: The experiment was performed for a long term survival. RESULT: Preoperative planning was very important for adequate fitting. All animals could be weaned from cardiopulmonary bypass, however, two animals died due to bleeding at pulmonary artery and left atrium. CONCLUSION: We concluded that the neonatal heart transplantation can be applied in some complicated Further using animal model is mandatory.
Adult ; Animal Experimentation* ; Animals* ; Aorta ; Aorta, Thoracic ; Cardiopulmonary Bypass ; Heart Atria ; Heart Defects, Congenital* ; Heart Transplantation* ; Heart* ; Hemorrhage ; Humans ; Hypoplastic Left Heart Syndrome ; Infant, Newborn* ; Models, Animal ; Mortality ; Pulmonary Artery ; Tissue Donors

Alveolitis is believed to be a primary response after dust inhalation. Activated inflammatory cells by dust and their mediators are major participants in the evolution of pneumoconiosis. Therefore evaluation of degree of alveolitis is useful for assessing disease activity and estimating of prognosis in pneumoconiosis. This study focused on the workers with pneumoconiosis who are working and worked in manufacturing industries because the occupying fraction by them among total pneumoconioses patients in our country is increasing recently. In order to identify and validate biomarkers to early diagnosis and better predict for the suceptible workers, the release of tumor necrosis factor (TNF alpha ), interleukine-8 (IL-8), platelet-derived growth factor-AA(PDGF-AA) and transforming growth factor-beta TGF beta ) from alveolar macrophages and blood monocytes, their concentration in BAL (bronchoalveolar lavage) fluid, pulmonary function test and Gallium index of lung were performed on 25 patients with pneumoconiosis who worked in manufactory industries. The results of this study were as follows ; 1. No significant differences were demonstrated between large opacity group and small opacity group, however pulmonary diffusing capacity in large opacity group was significantly lower than that in small opacity group. 2. (67)Gallium index was significantly correlated with increase of category in pnemoconiosis(r=0.83, p<0.05). 3. Numbers of total cells (r=0.583, p<0.05) and alveolar macrophages (r=0.499, p<0.05) in BAL were significantly correlated with the category of pneumoconiosis. 4. Spontaneous (r=0.474, p<0.05) and LPS (r=0.463, p<0.05) stimulated release of TNF alpha from macrophage, IL-8 (r=0.464, p<0.05) and TGF beta r=0.460, p<0.05) in BAL fluid were significantly correlated with category of pneumoconiosis. 5. Significantly positive correlation was demonstrated between spontaneous (r=0.443, p<0.05) and LPS (r=0.573, p<0.05) stimulated release of TNF alpha with the category of pneumoconiosis. 6. Release of TNF alpha from alveolar macrophages(r=0.61, p<0.05) and blood monocytes (r=0.48, p<0.05), IL-8 concentration in BAL fluid (r=0.52, p<0.05) and (67)Gallium index (r=0.53, p<0.05) were consider to sensitive biomarkers for alveolitis by dust.
Biological Markers* ; Dust* ; Early Diagnosis ; Gallium ; Humans ; Inhalation ; Interleukin-8 ; Lung ; Macrophages ; Macrophages, Alveolar ; Monocytes ; Pneumoconiosis* ; Prognosis ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Tumor Necrosis Factor-alpha

This study was conducted to investigate knowledge and attitude factor related to hearing conservation and to evaluate the effect of knowledge and attitude about noise on hearing conservation behavior and hearing loss among workers exposed to noise. We investigated the questionnaires of knowledge and attitude about noise and hearing conservation behavior and hearing loss among 355 study subjects from March, 1998 to June, 1998. The results were as follows; We extracted following 5 factors from 26 questionnaire items of knowledge and attitude about noise; knowledge of noise and concern to the control noise (factor 1), general perceived susceptibility (factor 2), relative perceived susceptibility compared with colleagues(factor 3), concern to the hearing protective devices(factor 4), concern to the hearing and noise assessment (factor 5). Knowledge and attitude factors affecting the hearing conservation behavior were general perceived susceptibility in the case of wearing hearing protective devices and knowledge of noise and concern to the control noise in the case of suggestion for hearing conservation. But, in the case of intentional avoiding noise exposure, concern to the hearing protective devices was a significant factor with concern to the hearing and noise assessment. Knowledge and attitude factors affecting hearing loss in 1 kHz were relative perceived susceptibility compared with colleagues and concern to the hearing protective devices, and in 4 KHz were relative perceived susceptibility compared with colleagues and general perceived susceptibility.
Ear Protective Devices ; Hearing Loss* ; Hearing* ; Noise* ; Questionnaires

PURPOSE: In the present study the effects of amiloride on the growth of human gastric adenocarcinoma cell line, AGS cells were examined with or without the addition of 5-fluorouracil (5-FU) in vitro. MATERIALS AND METHODS: The growth of AGS cells was examined by counting number of cells on two and four days post-treatment with 50 micrometer, 100 micrometer, 200 micrometer, 400 micrometer, 800 micrometer, amiloride, and 0.1 microgram/ml, 0.3 microgram/ml 5-FU, after plating AGS cells into 6 well plates at a density of 10 x 10(4) cells/well. The reversibility of the effects of amiloride was examined on two to eight days post-treatment with 400 micrometer amiloride after seeding 2 x 10(4) cells/dish. Cell cycle analysis was performed after four day-treatment with 400 micrometer amiloride. RESULTS: Amiloride (50~800 micrometer) significantly inhibited the growth of AGS in a dose-dependent fashion (p<0.05). The inhibitory effect of amiloride on growth of AGS was reversible since removal of amiloride after 24 hours treatment led to resumption of rapid growth up to control levels. Amiloride combined with 5-FU markedly inhibited the growth of AGS in a dose-dependent fashion compared to that of amiloride or 5-FU alone (p<0.05). The fraction of S phase, G0-G1 phase and G2-M phase was 19.3%, 55.7%, 18.8%, in the amioride group (400 micrometer) and 43.9%, 37.4%, 25.1% in the control group, respectively, showing significantly higher G1 fraction in amiloride group compared to control. CONCLUSION: This is the first paper which reported that amiloride inhibited in vitro growth of human gastric adenocarcinoma cells and that its effect of growth inhibition may be synergistic with 5-FU. Amiloride given with or without 5-FU may be useful agent in the treatment of gastric carcinomas. The inhibitory effects of amiloride on the growth of AGS may be mediated in part by blocking G1-S transition of cell cycle.
Adenocarcinoma ; Amiloride* ; Cell Cycle ; Cell Line ; Fluorouracil ; Humans* ; S Phase

Fibroblast viability of a natural tissue valve for replacing a defective heart valve through allograft or xenograft has been suggested to affect its clinical durability. In this study, the cell viability and enzymatic activity of porcine heart valve leaflets were examined in regard to concerning to the preservation process [variable warm ischemic time (WIT), cold ischemic time (CIT), and cryopreservation]. Porcine heart enblocs were obtained and valve dissection was performed after 2, 12, 24, or 36 hours, in respective groups A, B, C, and D, as WIT. Each group was stored for 24 hours as CIT and cryopreserved. Leaflets were dissected from a valved conduit after each process, and cell viability and enzymatic activity in the leaflet were investigated using trypan blue staining and API ZYM kits. WIT extension significantly decreased fibroblast viability (p < 0.05, 92.25 +/- 2.7% at 2 hours, 84.9 +/- 6.7% at 12 hours, 57.0 +/- 10.2% at 24 hours, 55.9 +/- 7.9% at 36 hours), while CIT for 24 hours was also influenced significantly (p < 0.05), whereas cryopreservation demonstrated no effect on cellular viability. In enzyme activity observation, several enzymes related to lipid or nucleotide degradation (esterase, esterase lipase, particularly phosphatase, phosphohydrolase) were remarkably changed following the valve-fabrication process. After 24 hours CIT, these enzymatic activities in groups B, C and D significantly increased, but the activities decreased after cryopreservation. Particularly, both the viability and enzymatic activity showed remarkable changes after CIT in group B (WIT = 12 hours). These results suggest that WIT is more important than CIT in maintaining viability of the valve, and that completing all the cryopreservation process within 12 hours after acquisition is recommended.
Animal ; Cryopreservation* ; Heart Valves/physiology* ; Heart Valves/enzymology* ; Swine ; Tissue Survival/physiology*

BACKGROUND: Valve replacement using cryopreserved valved homograft is increasing because of resistance of infection and excellent hemodynamics. The viability of fibroblast which is related with warm ischemic time affects the durability of implanted cryopreserved valved homograft. We evaluated how long the warm schemic time is acceptable by examining the viability of cells depending upon warm ischemic time. MATERIAL AND METHOD: 1. Retrieval of tissues; Thirty-two slaughted porcine heart and lung enblocs were stored at refrigerator(4~8 degreesC) for various time period(Warm Ischemic Time), and the heart was dissected and stored in Hartman solution at 4 degreesCfor 24 hours(Cold Ischemic Time) as the simulation of retrieval and dissection of human heart. The hearts were assigned to groups A(2 hours), B(12 hours), C(24 hours), D(36 hours) depending on warm ischemic time. 2. Sterilization; The valved homografts were sterilized in the RPMI 1640 solution with antibiotics. 3. Freezing and Storage; The homografts were freezed by computerized freezer, stored 7 days at liquid nitrogen tank, and thawed. 4. Evaluation of the viability; The viability was evaluated by Triphan blue test after warm ischemic time, after cold ischemic time and after thawing. 5. Analysis; The viability of fibroblast was analysed by pearson correlation test of SAS program. RESULT: 1. The viability between after cold ischemic time and after thawing was not different(p=0.619) for the adequacy of sterilization, freezing and thawing. 2. The viability which was evaluated after warm ischemic time, cold ischemic time and thawing, and the various warm ischemic times are strongly correlated as R is -0.857, -0.673 and -0.549 respectively. The viability of tricuspid valve is well related with the viability of aortic valve. CONCLUSION: 1. The longer the warm ischemic time, the lesser the viability of fibroblast. The viability of fibroblast after cryopreservation was decreased less 60% if the warm ischemic time was over 12 hours. 2. The method of cryopreservation is acceptable for maintaining the viability of fibroblast, and the viability of tricuspid valve may be the indicator of the viability of aortic valve. 3. However, the study for the optimal viability which is necessary to the durabiltiy of implanted valved homograft is needed.
Allografts ; Anti-Bacterial Agents ; Aortic Valve ; Cold Ischemia ; Cryopreservation ; Fibroblasts ; Freezing ; Heart ; Hemodynamics ; Humans ; Lung ; Nitrogen ; Sterilization ; Tricuspid Valve ; Warm Ischemia*

BACKGROUND: There are only limited numbers of reports about long-term results of tricuspid valve replacement (TVR) with bioprosthetic and mechanical prostheses. We analyzed risk factors for tricuspid valve replacement and compared long-term clinical results of bioprosthetic and mechanical valves in tricuspid position. MATERIAL AND METHOD: We reviewed 77 cases of TVR, which were performed between October 1978 and December 1996. Mean age was 38.8 15.9 years. Bioprostheses were implanted in 26 cases and mechanical prostheses were implanted in 51 cases. RESULT: The operative mortality was 15.6% and late mortality was 12.3%. Survival for bioprosthetic and mechanical valve group at 5, 10 and 13 years was 81.3% vs. 100%, 66.1% vs. 100%, 60.6% vs. 100% (p= 0.0175). Free from valve related re-operation for bioprosthetic and mechanical valve group at 5, 10 and 13 years was 100 % vs. 93.9%, 100% vs. 93.9% and 58.3% vs. 93.9% (p=0.3274). Linealized incidences of valve related re-operation for bioprosthetic and mechanical valve group was 2.27 %/patient-years and 1.10 %/patient-years. Risk factor analysis showed that presence of preoperative ascites, hepatomegaly larger than 2 finger breaths, poor preoperative NYHA functional class and number of tricuspid valve replacement were risk factors for early mortality, and the use of bioprosthetic valve and number of open heart surgery were risk factors for late mortality. CONCLUSION: Long-term survival of mechanical valve was superior to bioprosthetic valve in tricuspid position. We recommend mechanical valve in tricuspid position if the patient can be closely followed up.
Ascites ; Bioprosthesis ; Fingers ; Heart Valve Prosthesis ; Hepatomegaly ; Humans ; Incidence ; Mortality ; Prostheses and Implants ; Risk Factors ; Thoracic Surgery ; Tricuspid Valve*

With a purpose to difine risk factors of respective subtypes of cerebrovascular disease, a case-control study was performed in 1,251 cases with cerebrovascular disease who were admitted to twelve large institutions over the country during the year of 1988. All cases were subtype-proven by computerized tomography. Three hundred and eighty three patients were selected as control among the patients who were admitted to the same hospitals during the same period. The variables were collected prospectively and the data were processed by univariate and multiple logistic regression analyses and the significance was tested by chi-square methods. In the univariate analysis, female sex, being a physical worker, history of hypertension either treated or not and previous stroke history were significantly related with cerebral hemorrhage. Male sex, being aged 60 or more, living in city area, being a mental worker, history of hypertension either treated or not, history of stroke, being a diabetic and positive family history of stroke were significantly related with cerebral infarction. In multiple logistic regression analysis hypertension and alcohol drinking were strong independent risk factors for cerebral hemorrhage. Hypertension, being aged 60 or more, and living in urban area were also independent risk facrots for cerbral infarction. Of the other variables analyzed, socioeconomic class, smoking history or body mass index did not constitute significnat risks for either cerebral hemorrhage or cerebral infarction.
Alcohol Drinking ; Body Mass Index ; Case-Control Studies ; Cerebral Hemorrhage ; Cerebral Infarction ; Female ; Humans ; Hypertension ; Infarction ; Korea* ; Logistic Models ; Male ; Prospective Studies ; Risk Factors* ; Smoke ; Smoking ; Stroke

An increased plasma aldosterone concentration, with suppressed plasma renin activity (PRA), is an abnormal finding in primary hyperaldosteronism. A suppressed PRA is caused by aldosterone- dependent sodium retention and extracellular volume expansion. A case of primary hyperaldosteronism, due to adenoma, with increased PRA, was observed. An adrenalectomy and intraoperative renal biopsy was performed. In our patient, histologically proven renal arteriosclerosis was the probable cause of the escape of the PRA from the suppression by an aldosterone-producing adenoma. Normal blood pressure was not attained after the adrenalectomy. However, the blood pressure was then controlled by small doses of antihypertensive drug before resection of the tumor. In this case, the patient was treated with spironolactone, but the blood pressure was not correctly controlled. After the adrenalectomy, the blood pressure was well controlled with smaller dose of calcium channel blockers. So, an early adrenalectomy may be beneficial as soon as the diagnosis of an aldosterone-producing adenoma is confirmed, even in patients with hypertensive nephrosclerosis.
Adenoma ; Adrenalectomy ; Aldosterone ; Arteriosclerosis ; Biopsy ; Blood Pressure ; Calcium Channel Blockers ; Diagnosis ; Humans ; Hyperaldosteronism* ; Nephrosclerosis ; Plasma* ; Renin* ; Sodium ; Spironolactone ; United Nations

BACKGROUND: Liquid nitrogen freezing techniques have already met with widespread success in biology and medicine as a means of long-term storage for cells and tissues. The use of cryoprotectants such as glycerol and dimethylsulphoxide to prevent ice crystal formation, with carefully controlled rates of freezing and thawing, allows both structure and viability to be retained almost indefinitely. Cryopreservation of various tissues has various controlled rates of freezing. MATERIAL AND METHOD: To find the optimal freezing curve and the chamber temperature, we approached the thermodynamic calculation of tissues in two ways. One is the direct calculation method. We should know the thermophysical characteristics of all components, latent heat of fusion, area, density and volume, etc. This kind of calculation is so sophisticated and some variables may not be determined. The other is the indirect calculation method. We performed the tissue freezing with already used freezing curve and we observed the actualfreezing curve of that tissue. And we modified the freezing curve with several steps of calculation, polynomial regression analysis, time constant calculation, thermal response calculation and inverse calculation of chamber temperature. RESULT: We applied that freezing program on mesenchymal stem cell, chondrocyte, and osteoblast. The tissue temperature decreased according to the ideal freezing curve without temperature rising. We did not find any differences in survival. The reason is postulated to be that freezing material is too small and contains cellular components. We expect the significant difference in cellular viability if the freezing curve is applied on a large scale of tissues. CONCLUSION: This program would be helpful in finding the chamber temperature for the ideal freezing curve easily.
Biology ; Chondrocytes ; Cryopreservation ; Dimethyl Sulfoxide ; Freezing* ; Glycerol ; Hot Temperature* ; Ice ; Mesenchymal Stromal Cells ; Nitrogen ; Osteoblasts ; Thermodynamics ; Transplantation, Homologous