• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

• Journal of Fisheries and Marine Sciences Education
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• v.4 no.1
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• pp.30-46
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• 1992

Korea's first exploratory tuna fishing was done with a used longliner in 1957. Then the commercial fishing has been made steady headway since the 1960's and grown up to one of major tuna fishing countries in 1970's. The tuna fishing aimed primarily at acquiring foreign currency, then tuna was exported directly from the overseas fishing base. Tuna, however, has been gradually favored by Koreans as high-proteined foods according to the growth of GNP since the 1970's. In 1980, the canned tuna began to be produced and sold at home. And so the demand of raw tuna for cannaries has steeply increased not only for home but also for abroad, and stimulated the development of tuna purse seine fishery. The author carried out a study on the development of tuna purse seine fishery in Korea and countries concerned-the United States and Japan-because it is recognized to be significant for the further development of this fishery. Just as purse seining was originated in the United States, so tuna purse seining was also pioneered by Californian fishermen in the west coastal waters of the United States (Eastern Pacific Ocean). They started to produce the canned tuna in the early 1900's, and the demand for raw tuna began to be increased rapidly. In those days, tuna was mostly caught by pole-and-line, but the catch amount was far away from the demand. To satisfy this demand, they began to try out fishing tuna by the use of purse seine which had been born in the eastern waters in the 1820's and applied to catch white fishes in the western waters of the United States in those days. Even though their trial was technically successful through severe trial and error, a new problem was raised on the management of tuna resource and the preservation of porpoise which was occassionally caught with tuna. Then the Inter-American Tropical Tuna Commission (IATTC) was established by countries neighboring to the United States in 1950 and they set up the Commission's Yellowfin Regulatory Area (CYRA) and regulated the annual quota for yellowfin. Then, American owners tried to send their seiners to the Western African waters to expand the fishing ground in 1967 and to the Centeral-Western Pacfic in 1974, and the fishing ground was widely expanded. The number of the United States' purse seiners amounted to about 150 in 1980, but the enthusiasm was gradually cooled thereafter and the number of seiner was decreased to 67 in 1986. The landing of tuna by purse seiners in the United States after 1980 maintains 200 thousands M/T or so with a little increase despite the decreasing of domestic seiners. This shows that the landing by foreign seiners are increasing, compared with the landing by domestic seiners are decreasing. In Japan, even though purse seining was introduced in 1880, they had fished tuna by longline and pole-and -line until the tuna purse seining was introduced from the United States again. In the 1960's, Japanese tuna seiners made the exploratory fishing in the South-western Pacific and West African waters with a limited success. In 1971, the government-funded research center "JARMRAC" conducted the exploratory fishing which extended to the Central American waters, the Asia-Pacific Region and the South-western Pacific. It had also much difficulties, till they improved the fishing gear adaptable to the new fishing condition in the South-western Pacific. Japanese government has begun to licence 32 single seiners and 7 group seiners since 1980 and their standard has lasted up to now. The catch in the Pacific Islands Region amounted to 160 thousands M/T in 1986. Korea's tuna purse seine fishery was originated in 1971 by Jedong Industrial Co., Ltd. with three used tuna purse seiners purchased from the United States, and they began to fish in the Eastern Pacific, but failed owing to the superannuation of vessel and the infancy of fishing technique. The second challenge was done by Dongwon Industrial Co., Ltd. in 1979, with one used seiner purchased from the United States, and started to fish in the Eastern Pacific. Even though the first trial was almost unsuccessful but they could obtain the noticeable success by removing the vessel to the South-western Pacific in 1980. This success stimulated the Korean entherprisers to take part in this fishery, and the number of Korean tuna purse seiners has been increased rapidly in accordance with the increased demand for raw tuna. The number of vessels actually at work amounted to 36 in 1990 and they operate in the South-western Pacific. The annual catch of tuna by purse seiners amounted to 170 thousands M/T in 1990 and ranked to one of the major tuna purse seining countries in the world.

• Journal of Chest Surgery
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• v.35 no.6
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• pp.420-429
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• 2002

Moderate hypothermic cardiopulmonary bypass (CPB) has commonly been used in cardiac surgery. Several cardiac centers recently practice normothermic CPB in cardiac surgery, However, the clinical effect and safety of normothermic CPB on cerebral metabolism are not established and not fully understood. This study was prospectively designed to evaluate the clinical influence of normothermic CPB on brain metabolism and to compare it with that of moderate hypothermic CPB. Material and Method: Thirty-six adult patients scheduled for elective cardiac surgery were randomized to receive normothermic (nasopharyngeal temperature ＞34.5 $^{\circ}C$, n=18) or hypothermic (nasopharyngeal temperature 29~3$0^{\circ}C$, n=18) CPB with nonpulsatile pump. Middle cerebral artery blood flow velocity (VMCA), cerebral arteriovenous oxygen content difference (CAVO$_{2}$), cerebral oxygen extraction (COE), modified cerebral metabolic rate for oxygen (MCMRO$_{2}$), cerebral oxygen transport (TEO$_{2}$), cerebral venous desaturation (oxygen saturation in internal jugular bulb blood$\leq$50 %), and arterial and internal jugular bulb blood gas analysis were measured during six phases of the operation： Pre-CPB (control), CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ in the hypothermic group), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ in the both groups), CPB-off and Post-CPB (skin closure after CPB-off). Postoperaitve neuropsychologic complications were observed in all patients. All variables were compared between the two groups. Result： VMCA at Rewarm-2 was higher in the hypothermic group (153.11$\pm$8.98%) than in the normothermic group (131.18$\pm$6.94%) (p＜0.05). CAVO$_{2}$ (3.47$\pm$0.21 vs 4.28$\pm$0.29 mL/dL, p＜0.05), COE (0.30$\pm$0.02 vs 0.39$\pm$0.02, p＜0.05) and MCMRO$_{2}$ (4.71 $\pm$0.42 vs 5.36$\pm$0.45, p<0.05) at CPB-10 min were lower in the hypothermic group than in the normothermic group. The hypothermic group had higher TEO$_{2}$ than the normothermic group at CPB-10 (1,527.60$\pm$25.84 vs 1,368.74$\pm$20.03, p＜0.05), Rewarm-2 (1,757.50$\pm$32.30 vs 1,478.60$\pm$27.41, p＜0.05) and Post-CPB (1,734.37$\pm$41.45 vs 1,597.68$\pm$27.50, p＜0.05). Internal jugular bulb oxygen tension (40.96$\pm$1.16 vs 34.79$\pm$2.18 mmHg, p＜0.05), saturation (72.63$\pm$2.68 vs 64.76$\pm$2.49 %, p＜0.05) and content (8.08$\pm$0.34 vs 6.78$\pm$0.43 mL/dL, p<0.05) at CPB-10 were higher in the hypothermic group than in the normothermic group. The hypothermic group had less incidence of postoperative neurologic complication (delirium) than the normothermic group (2 vs 4 patients, p＜0.05). Lasting periods of postoperative delirium were shorter in the hypothermic group than in the normothermic group (60 vs 160 hrs, p<0.01). Conclusion: These results indicate that normothermic CPB should not be routinely applied in all cardiac surgery, especially advanced age or the clinical situations that require prolonged operative time. Moderate hypothermic CPB may have beneficial influences relatively on brain metabolism and postoperative neuropsychologic outcomes when compared with normothermic CPB.