• Parasites, Hosts and Diseases
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• v.30 no.1
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• pp.33-42
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• 1992

Naegleria fowleri, a free-living amoeba commonly found in moist soil and fresh water, enters the body via the nasal mucosa and migrates along the olfactory nerve to t he brain, where it causes acute amoebic meningoencephalitis. In the present study 7 clones secreting monoclonal antibodies (McAbs) against N. fowleri were produced and the effector function of them was investigated. Their isotopes were IgGl (Nf 1, Nf 154), 19G3 (Nf 137) and 19A (Nf 1, Nf 2, Nf 256, Nf 279). Five McAbs (McAb Nf 2, Nf 279, Nf 27, Nf 154, Nf 137) were specific for N. fowleri by ELISA and recognized the antigenic determinants located on the trophoBoite surface by IFAT and immunoperoxidase stain. These aye McAbs had capacity to agglutinate N. fowleri trophozoites and inhibited the growth of the amoeba in culture medium. McAb Nf 2 inhibited proliferation of trophozoites in vitro significantly. Also the cytotoxicity of JV. fowleri against CHO cell was reduced in the presence of McAb Nf 2 and McAb Nf 154. From these results McAb Nf 2 was confirmed to weaken the virulence of the amoeba among 7 screened McAbs.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.532-537
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• 2010

Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.387-391
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• 2002

Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.542-547
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• 2002

Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.289-297
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• 2006

Background: Surgery for Stanford type A aortic dissection shows a high operative mortality rate and frequent postoperative brain injury. This study was designed to find out the risk factors leading to operative mortality and brain injury after surgical repair in patients with type A aortic dissection. Material and Method: One hundred and eleven patients with type A aortic dissection who underwent surgical repair between February, 1995 and January 2005 were reviewed retrospectively. There were 99 acute dissections and 12 chronic dissections. Univariate and multivariate analysis were performed to identify risk factors of operative mortality and brain injury. Resuit: Hospital mortality occurred in 6 patients (5.4%). Permanent neurologic deficit occurred in 8 patients (7.2%) and transient neurologic deficit in 4 (3.6%). Overall 1, 5, 7 year survival rate was 94.4, 86.3, and 81.5%, respectively. Univariate analysis revealed 4 risk factors to be statistically significant as predictors of mortality: previous chronic type III dissection, emergency operation, intimal tear in aortic arch, and deep hypothemic circulatory arrest (DHCA) for more than 45 minutes. Multivariate analysis revealed previous chronic type III aortic dissection (odds ratio (OR) 52.2), and DHCA for more than 45 minutes (OR 12.0) as risk factors of operative mortality. Pathological obesity (OR 12.9) and total arch replacement (OR 8.5) were statistically significant risk factors of brain injury in multivariate analysis. Conclusion: The result of surgical repair for Stanford type A aortic dissection was good when we took into account the mortality rate, the incidence of neurologic injury, and the long-term survival rate. Surgery of type A aortic dissection in patients with a history of chronic type III dissection may increase the risk of operative mortality. Special care should be taken and efforts to reduce the hypothermic circulatory arrest time should alway: be kept in mind. Surgeons who are planning to operate on patients with pathological obesity, or total arch replacement should be seriously consider for there is a higher risk of brain injury.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.495-502
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• 2010

Purpose : Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm. The objective of this study was to analyze the incidence rate, causative pathogens and clinical features of neonatal sepsis in one neonatal intensive care unit (NICU) for 6 years. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics including sex, gestational age, birth weight, Apgar score, length of hospitalization, length of total parenteral nutrition, presence of central venous catheter, underlying diseases, laboratory findings, microorganisms isolated from blood culture, complications and mortality in 175 patients between January 2003 and December 2008. Results : 1) Sepsis was present in 175 of 3,747 infants for 6 years. There were more gram-positive organisms. 2) The gram-negatives were more prevalent in preterm. There were no significant differences of other clinical features between two groups. 3) Underlying diseases were found in 73.7%, and the most common disease was cardiovascular disease. The most common organisms of gram-positives and gram-negatives were methicillin resistant Staphylococcus aureus (MRSA) and Serratia marcescens. 4) There was statistically significant difference on platelet counts between two groups (P<0.05). 5) Complications were found in 18.3% and septic shock was the most common. MRSA was the most common pathogen in sepsis with complication. 6) The mortality rate was 7.4%. 7) There were differences in monthly blood stream infection/1,000 patient-days. Conclusion : The studies about the factors that can influence neonatal sepsis will contribute to decrease the infection rates in NICUs.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.321-328
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• 2003

Background: The St. Jude Medical prosthesis is one of the popularly used artificial prosthesis, therefore the National Medical Center reports the long-term clinical results of patients who underwent prosthetic valve replacement with St. Jude medical valve for 18 years. Material and Method: Between January, 1984 and June, 2002, a series of 163 consecutive patients who had Implanted St. Jude prosthesis at the National Medical Center were reviewed. Mean age was 42.9$\pm$15.1 years and male to female ratio was 69:94. The operative procedure comprised of 87 MVR, 30 AVR, 45 DVR, and 1 TVR. The reoperative procedure comprised of 21 MVR, 2 AVR, and 14 DVR. Follow-up rate was 96.9%, and cumulative follow-up was 823.8 patient-years. Result: Early mortality rate was 7.9% (13 patients), late mortality rate was 8.7% (13 patients) and late mortality due to valve related complication was 47% (7 patients). Actual survival rate at 10 and 18 years were 91.7$\pm$2.1% and 91.0$\pm$1.9%. Linearized Incidence was as follows: thromboembolism, 1.09%/ patient-year; anticoagulant related hemorrhage, 0.36%/patient-year; valve thrombosis, 0.24%/patient-year; paravalvular leakage, 0.12%/patient-year; and prosthetic bacterial endocarditis, 0.12%/patient-year linearized incidence of over all valve related complication was 1.94%/patient-year. Freedom from valve related complication at 10 and 18 years were 89.1$\pm$3.3% and 88.4$\pm$3.9%. Freedom from valve related death at 10 and 18 years were 95.1$\pm$1.2% and 95.1$\pm$1.0%. Valve related complication was related the age of patient, especially anticoagulant related hemorrhage was more common in patients over 60 years of age. Valve related complication, death were higher in DVR than AVR or MVR, and valve related death was higher in reoperation. There was no relationship between valve related complication or death and implant valve of size. Conclusion: The long-term clinical results of patients implanted with St. Jude Mechanical prosthesis was quite satisfactory with a low incidence of valve related complication and mortality.

• Proceedings of the Korea Contents Association Conference
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• 2014.11a
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• pp.61-62
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• 2014

말라리아는 인체에 감염되는 열원충의 종류에 따라 크게 열대열 원충, 삼일열 원충, 사일열 원충, 난형열 원충으로 구분된다. 말라리아는 감염 후 치료시기를 놓칠 경우 사망에 이를 수 있는 위험한 질병이므로 초기 진단을 위한 Rapid Diagnostic Test(RDT) 키트가 중요하다. 기존의 진단키트의 경우, 열대열 말라리아와 삼일열 말라리아를 동시에 검출하여 치료법이 다름에도 불구하고 구분하여 진단하기가 어렵다. 이러한 이유로 본 연구에서는 열대열 말라리아에 특이적인 RDT키트 개발을 위해, PlasmoDB에서 열대열 말라리아 항원 단백질을 얻고 BLAST를 이용하여 열대열 말라리아에 특이적인 항원 단백질 후보군을 얻었다. 이후 감염단계에 따라 우선순위를 정하고 SPpred에서 제공하는 protein solubility prediction을 통해 실험적으로 단백질 발현 가능 여부를 확인한 결과, 최종적으로 histidine-rich protein II, histidine-rich protein III, glycophorin binding protein를 선정하였다. 이들 단백질을 이용한 열대열 말라리아 진단키트 제작은 열대열 말라리아 특이적 진단을 효과적으로 할 수 있다.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
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• 2011.06a
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• pp.388-389
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• 2011

Work at height by Rope access, including the marine plants are used in many industries, worldwide these workers are demanding IRATA certification due to danger of work. Also, the largest cause of death in National Industrial Accident is crash but nevertheless the training for worker at height is not carry out almost. In the here, introduce the kind of IRATA qualifications, training and membership, etc. and propose how could apply to korea it.

• Journal of Korea Ship Safrty Technology Authority
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• s.36
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• pp.28-42
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• 2014

본 연구는 예인선 해양사고로 인한 사망사건 중 예인삭 절단사건이 큰 비중을 차지하고 있어 인명사고 예방이 시급한 가운데 예인 로프의 아이스플라이스에 대한 기준이 현재 국내에 마련되어 있지 않아 본선의 임의대로 제작?사용하는 실정이다. 이에 우리 공단에서 수검 중인 예인선을 대상으로 예인선에서 주로 사용하는 예인삭의 종류와 구조, 재질 등에 대한 국내 사용실태를 조사하고, 조사를 바탕으로 선정된 로프의 인장강도 시험을 통하여 스플라이스 횟수에 따른 유의성 평가를 시행하며, 국내 외 유사 기준 및 표준을 조사 분석하여 최종적으로 국내에서 적용할 수 있는 예인삭 아이스플라이스 기준을 제시하였다.