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Surgical Treatment for Carotid Artery Stenosis (경동맥 협착증의 수술적 치료)

  • Kim, Dae-Hyun;Yi, In-Ho;Youn, Hyo-Chul;Kim, Bum-Shik;Cho, Kyu-Seok;Kim, Soo-Cheol;Hwang, Eun-Gu;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.815-821
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    • 2006
  • Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

Detection of Spinal Metastases: Comparison of Bone Scan and MR Imaging (전이성 척추 악성 종양의 진단 : 골스캔과 자기공명영상의 비교)

  • Kim, Ki-Jun;Sohn, Hyung-Sun;Park, Jeong-Mi;Chung, Soo-Kyo;Lee, Jae-Moon;Kim, Choon-Yul;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.384-390
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    • 1994
  • Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

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Efficacy of I-123/I-131 Metaiodobenzylguanidine Scan as A Single Initial Diagnostic Modality in Pheochromocytoma: Comparison with Biochemical Test and Anatomic Imaging (갈색세포종의 초기 진단에서 I-123/I-131 Metaiodobenzylguanidine 스캔의 단일 검사로써의 진단 성능: 생화학적 검사, 해부학적 영상과 비교)

  • Moon, Eun-Ha;Lim, Seok-Tae;Jeong, Young-Jin;Kim, Dong-Wook;Jeong, Hwan-Jeong;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.436-442
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    • 2009
  • Purpose: We underwent this study to evaluate the diagnostic potential of I-123/I-131 metaiodobenzylguanidine (MIBG) scintigraphy alone in the initial diagnosis of pheochromocytoma, compared with biochemical test and anatomic imaging. Materials & Methods: Twenty two patients (M:F=13:9, Age: $44.3{\pm}\;19.3$ years) having the clinical evaluation due to suspicious pheochromocytoma received the biochemical test, anatomic imaging modality (CT and/or MRI) and I-123/I-131 MIBG scan for diagnosis of pheochromocytoma, prior to histopathological confirmation. MIBG scans were independently reviewed by 2 nuclear medicine physicians. Results: All patients were confirmed histopathologically by operation or biopsy (incisional or excisonal). In comparison of final diagnosis and findings of each diagnostic modality, the sensitivities of the biochemical test, anatomic imaging, and MIBG scan were 88.9%, 55.6%, and 88.9%, respectively. And the specificities of the biochemical test, anatomic imaging, and MIBG scan also were 69.2%, 69.2%, and 92.3%, respectively. MIBG scan showed one false positive (neuroblastoma) and one false negative finding. There was one patient with positive MIBG scan and negative findings of the biochemical test, anatomic imaging. Conclusion: Our data suggest that I-123/I-131 MIBG scan has higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy than those of biochemical test and anatomic imaging. Thus, we expect that MIBG scan is e tectively used for initial diagnosis of pheochromocytoma alone as well as biochemical test and anatomic imaging.

Comparing the Change in SUVmax Over Time by the Type of Ductal Breast Carcinoma (유방암 환자 중 유관에서 발병되는 암의 종류(IDC와 DCIS)별 시간경과에 따른 SUVmax 변화에 대한 비교)

  • Hyoung, Mi-Jin;Kim, Jeong Nip;Moon, Pyeong Soo;Kim, Kil Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.140-144
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    • 2014
  • Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

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Formation and Evolution of the Paleo-Seomjin River Incised-Valley System, Southern Coast of Korea: 1. Sequence Stratigraphy of Late Quaternary Sediments in Yosu Strait (한반도 남해안 고섬진강 절개곡 시스템의 형성과 진화: 1. 여수해협의 후기 제 4기층에 대한 순차층서)

  • Chun, Seung-Soo;Chang, Jin-Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.6 no.3
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    • pp.142-151
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    • 2001
  • Detailed interpretation of some high-resolution seismic profiles in Yosu Strait reveals that Late Quaternary deposits consist of three allostratigraphic units (UH, LH, PL) formed by fluvial and tidal controls. The top mud unit, UH, thins onshore, and overlies the backstepping modem Seomjin delta deposits, which is interpreted as a transgressive systems tract (757) related to Holocene relative sea-level rise. The unit LH below the unit UH is composed of delta, valley- and basin-fill facies. The delta facies (Unit $LH_1$) occurs only in Gwangyang Bay and shows two prograding sets retrogradationaly stacked, thus it is also interpreted as a transgressive systems tract(757). On the contrary, the valley- and basin-fill facies (Unit $LH_2$), interpreted as 757, occur between the units UH and PL (Pleistocene deposits) in Yosu Strait. The bounding surface between UH and $LH_2$ can be interpreted as a tidal ravinement surface on the basis of trends thinning toward inner bay and becoming young landward. Furthermore its geomorphological pattern is similar to that of recent tidal channels. This allostratigraphy in'ffsu Strait suggests that two 757 deposits (UH and $LH_2$), divided by tidal ravinement surface, have been formed in Yosu Strait, whereas in Gwangyang Bay backstepping delta deposits ($LH_1$) without tidal ravinement surface have been formed during Holocene sea-level rise. These characteristics indicate that different stacking patterns could be formed in these two areas according to different increasing rate of accommodation space caused by different geomorphology, sediment supply and tidal-current patterns even in the same period of Holocene sea-level rise.

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Ion-Exchange Chromatography of Some Toxic Heavy Metal Ions (인체유해 중금속이온의 이온교환 크로마토그라피)

  • Lee, Dai Woon;Yu, Euy Kyung
    • 한국해양학회지
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    • v.10 no.1
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    • pp.33-40
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    • 1975
  • The ion exchange sorption and elution behavior of toxic heavy metal ions, such as Hg(II) and Zn(II), have been studied in aqueous and methanolic media of MCl (M: K, Na and NH$\_$4/). The ion exchange resins studied are Dowex 1-X8, Cl$\^$-/ (50-100 or 200-400 mesh) and Dowex 50W-X8, M$\^$+/ form (M: K, Na, NH$\_$4/ and H). the sorption and elution of metal ion on the resin is largely due to the formation of the anionic chlororocomplex of metal ion. The addition of methanol in the medium contributes markedly to the distribution data. In order to apply this work for the treatment of polluted sea water with toxic heavy metal ions, removal experiment of the metal ions from the synthetic sample solution was investigated.

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Tidal-Flat Sedimentation in a Semienclosed Bay with Erosional Shorelines: Hampyong Bay, West Coast of Korea (해안침식이 우세한 반폐쇄적 조간대의 퇴적작용: 한국 서해안의 함평만)

  • Chang, Jin-Ho;Kim, Yeo-Sang;Cho, Yeong-Gil
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.4 no.2
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    • pp.117-126
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    • 1999
  • Hampyong Bay is a semienclosed and macrotidal bay which opens to the eastern Yellow Sea through a narrow inlet in the southwestern coast of Korea. In order to understand the tidal-flat sedimentation in the semienclosed setting, morphology, sediments, accumulation rate and sea cliff erosion were investigated in the tidal flat of Hampyong Bay. The tidal flat of Hampyong Bay lacks intertidal drainage systems, and generally shows the concave-upward profile whose relief is designated by marked morphological features such as high-tide beaches, intertidal sand shoals and tidal creeks. Surfacial sediments of the tidal flat mainly consist of mud, sandy mud, gravelly mud, gravelly sand and muddy gravel, thus showing the textural characteristics of multimodal grain-size distribution, poorly sorting and positive skewness. The sediments generally coarsen landward due to the increase in coarse fraction content. Sedimentary structures are deeply bioturbated, but parallel lamination and lenticular bedding are locally found in the mudflat near mean low water line. Annual accumulation rates across the tidal flat (along Line SM) average -5.2 cm/yr with a range of -45.8~+4.2 cm/yr, indicating that the tidal flat is erosional. In general, erosion rates of upper and lower tidal flat are higher than those of middle tidal flat. Seasonally, the erosion rates are much higher during spring and winter when dominant wind direction corresponds to the long axis of Hampyong Bay. Sea cliffs are eroded at a rate of 1.4 m/yr. The biggest sea cliff erosion generally occurs 1~2 months later after tidal flats were extensively eroded. Such erosions of tidal Oats and sea cliffs in the semienclosed bay setting are interpreted to be due to wind waves coupled with local sea-level rise.

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The Influence of Nutrients Addition on Phytoplankton Communities Between Spring and Summer Season in Gwangyang Bay, Korea (광양만에서 춘계와 하계 영양염류 첨가가 식물플랑크톤군집의 성장에 미치는 영향)

  • Bae, Si Woo;Kim, Dongseon;choi, Hyun-Woo;Kim, Young Ok;Moon, Chang Ho;Baek, Seung Ho
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.1
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    • pp.53-65
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    • 2014
  • In order to estimate the effect of nutrients addition for phytoplankton growth and community compositons in spring and summer season, we investigated the abiotic and biotic factors of surface and bottom waters at 20 stations of inner and offshore areas in Gwangyang Bay, Korea. Nutrient additional experiments were also conducted to identify any additional nutrient effects on phytoplankton assemblage using the surface water for the assay. Bacillariophyceae occupied more than 90% of total phytoplankton assembleges. Of these, diatom Eucampia zodiacus and Skeletonema costatum-like species was mainly dominated in spring and summer, respectively. Here, we can offer the season why the two diatom population densities were maintained at high levels in both seasons. First, light transparency of spring season in the euphotic zone was greatly improved in the bay. This improvement is one of important factor as tigger of increase in E. zodiacus population. Second, low salinity and high nutrient sources supplied by Seomjin River discharge are a main cue for strong bottom-up effects on S. costatum-like species during the summer rainy season. Based on the algal bio-assays, although maximum growth rate of phytoplankton communities at inner bay (St.8) were similar to those of outer bay (St.20), half-saturation constant ($K_s$) for phosphate at outer bay was slightly lower than those of inner bay. This implied that adapted cells in low nutrient condition of outer bay may have enough grown even the low phosphate and they also have a competitive advantage against other algal species under low nutrient condition. In particular, efficiency of N (+) addition in summer season was higher compared to control and P added experiments. In the bay, silicon was not a major limiting factor for phytoplankton growth, whereas nitrogen (N) was considered as a limiting factor during spring and summer. Therefore, a sufficient silicate supply form water mixing Si recycled from diatom decomposition and river water is favorable form maintaining diatom ecosystems in Gwangyang Bay.

Application of WEP Model to the Cheonggecheon Watershed (청계천 유역에 대한 WEP 모형의 적용)

  • Noh, Seong Jin;Kim, Hyeon Jun;Cheong, Il Moon;Jang, Cheol Hee;Kim, Dong Pil
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.148-152
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    • 2004
  • 본 연구에서는 물순환의 재생이나 보전에 필수적인 유역 물순환의 정량화와 유역변화의 영향예측을 위해 개발된 WEP (Water and Energy Transfer Process) 모형의 국내 유역에 내한 적용성을 검토하고, 청계천 유역의 물순환 양상을 모의하였다. WEP 모형은 복잡한 토지이용이 이루어지고 있는 도시하천 유역에 내한 물순환의 정량화를 목적으로 일본의 토목연구소 (PWRI; Public Works Research Institute), 과학기술진흥사업단, Jia 박사 등에 의해 공동으로 개발되었으며 지표면 및 비포화 토양층의 물${\cdot}$열 플럭스 계산, 하도흐름의 추적계산 및 지하수 유동계산, 격자내 토지이용의 불균질성 반영 등이 가능한 물리적인 기반의 공간 분포형 모형 (Physically Based Spatially Distributed)이다. 모형을 적용한 청계천 유역 (유로연장 13.75 km, 유역 면적 $50.96km^2$)은 전체 토지이용중 도시지역이 $75.9\%$를 차지하고, 유역내 인구가 120만명에 이르는 도시유역으로 높은 불투수 면적비율, 인공계 물순환 요소의 영향 등의 도시 유역 특성이 물순환의 구조 전반에 미치는 영향에 대한 연구가 부족하였다. WEP 모형 적용 결과, 모의 기간 동안의 하천 유출량은 실측치에 근사한 값을 나타내었으며 유역의 물순환 양상을 모의할 수 있었다. 청계천 유역은 전형적인 도시 유역의 특성을 보여주었는데, 강우시의 직접유출이 크고, 강우의 유출에 대한 반응이 빠르며, 증발산의 경우는 산림지역보다 도시지역이 상대적으로 적은 것으로 분석되었다. 이번 연구를 통하여 WEP 모형이 유역 물순환 해석에 적절한 모형임을 확인할 수 있었으면, 향후 청계천 유역의 물리적 특성에 대한 매개변수와 인공계 물순환 자료의 보완을 통해 보다 향상된 모의가 가능할 것으로 판단된다. 하였던 Cd과 Mg이 Ca 및 Ca과 vitamin D의 동시(同時) 급여(給與)로 감소(減少)하였고 Cu는 전체적(金體的)으로 변화(變化)가 없었으며 Zn은 Cd 급여(給與)로 감소(減少)하였으나 Ca과 vitamin D의 급여(給與)에 의하여 증가(增加)하였고 Ca은 Ca과 viamin D의 급여(給輿)로 유의(有意)하게 증가(增加)하였다. 신장(腎臟)중의 무기질(無機質) 함량(含量)은 Cd급여(給輿)로 Cu, Mg은 감소(滅少)하였으나 Ca, Zn은 변화(變化)가 없었고 Ca 및 Ca과 Vitamin D의 급여(給與)로 Cd, CU, Zn은 증가(增加)하였다.ce area)는 수술 전100.8$\pm$25.6 mm/$m^{2}$에서 79.3$\pm$ 15.8 mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carriage

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Present State and Conservation Counterplan for the Wetlands of the Tributaries around Namgang-River (남강 주변 습지의 보전 현황과 보전 대책)

  • Ha, Hye-Jeong;Oh, Kyung-Hwan
    • Journal of Wetlands Research
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    • v.12 no.3
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    • pp.21-37
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    • 2010
  • The abiotic factors and the vegetation naturalness of the 13 tributary wetlands around Namgang-River were assessed to investigate the present state and to present the conservation counter plan for the wetland ecosystem of the tributaries. Assessment indices for the abiotic factors were estimated based on the dominant land use types of the riparian zone, ecological function of the upper levee, levee slope structure, artificiality and utilization intensity of the waterfront, artificiality of the revetment structure, diversity of the substrate, and severance of the transverse. The assessment index of Omi-cheon is the highest among 13 tributaries. The second was Banseong-cheon and third was Hyangyang-cheon, followed by Nabul-cheon and Yeongcheon-gang and Sugok-cheon, Jungchon- cheon, and Daegok-cheon in their order and Munsan-cheon got the lowest assessment index. Assessment indices for the vegetation naturalness were estimated based on the vegetation diversity, exotic species dominance, annual herb dominance, naturalness and peculiarity of the vegetation, and species diversity. The assessment index of Omi-cheon is the highest among 13 tributaries. The second was Sugok-cheon and third was Banseong-cheon, followed by Yeongcheon-gang, Jungchon- cheon, Jinae-cheon, Nabul-cheon, and Jisu-cheon in their order, and Yonga-cheon got the lowest assessment index. The grades of the stream naturalness were estimated based on the the naturalness indices for the abiotic factors and the vegetation naturalness. The grades of Omi-cheon is the highest among 13 tributaries as the grade I. Those of Banseong-cheon, Sugok-cheon, Yeongcheon-gang, Nabul-cheon and Jungchon-cheon, Hyangyang-cheon, Jinae-cheon, Jisu-cheon, Daegok-cheone, and Munsan-cheon and Doksan-cheon were grade II in their order, and Yonga-cheon got the lowest as the grade III. It was suggested that restoration of the simple and flat substrate, create the natural vegetation on the levee slope constructed with concrete or stone wall, and rehabilitation of the eco-bridge were demanded to improve the grades of the stream naturalness through the restoration of the tributaries for the diverse aquatic wildlife, high vegetation diversity and species diversity with the vegetation consisted of perennial herbs and trees.