• Journal of Chest Surgery
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• v.29 no.8
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• pp.889-896
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• 1996

Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial by- pass operation has been advocated by some authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A Univer- sity Hospital between March 1990 and August 1995 was analyzed. The patients were 92 males and 9 females ranging fro 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular trauma in 3 cases and pseudoaneurysm in 3 cases. - The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were posterior tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases. The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which Included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with inverted Y-gr ft In 3 cases, femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliad bypass in 1 case Over all postoperative patency rates were 83.6 oyo at 1 year, 75.5% at 3 years and limb salvage rate was 86.8 oyo . Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the order of multiple organ failure, acute renal failure, and sepsis.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.161-169
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• 2009

Purpose : This study was performed to report the diagnosis and treatment of nephrotic syndrome manifesting in the first year of life. Methods : We retrospectively reviewed the clinical data with chart review in 7 patients who were diagnosed as nephrotic syndrome manifesting in the first year of life from 1996 to 2007. Results : Three patients had congenital nephrotic syndrome, the other 4 patients had infantile nephrotic syndrome. Their ages ranged from birth to 11 months and male to female ratio was 1 to 6. Renal biopsies were done in 6 patients. One patient had Finnish type congenital nephrotic syndrome, 2 patients had diffuse mesangial sclerosis, 2 patients had focal segmental glomerulosclerosis and 1 patient had minimal change disease. Genetic analyses of NPHS2, PLCE1, and WT1 were done in 4 patients and 2 of them had WT1 mutation. Among 3 patients with congenital nephrotic syndrome, 1 patient was diagnosed as congenital nephrotic syndrome of Finnish type and the other 2 patients were diagnosed as Denys-Drash syndrome. All of the patients with congenital nephrotic syndrome died due to sepsis. Among 4 patients with infantile nephrotic syndrome, 2 patients died and 1 had remission, another patient progressed to end stage renal disease. Conclusion : Most of nephrotic syndrome manifesting in the first year was hereditary renal disease. Patients with nephrotic syndrome manifesting in the 3 month of life had poorer prognosis and needed more aggressive management including early dialysis and renal transplantation might be considered compared with infantile nephrotic syndrome. Further genotype-phenotype correlation studies are needed.

• Research in Plant Disease
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• v.21 no.4
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• pp.290-296
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• 2015

This study was conducted to establish an efficient screening system for resistant tomato to bacterial wilt caused by Ralstonia solanacearum. Under several conditions such as inoculation methods, growth stages of tomato seedlings, inoculum concentrations, and incubating temperatures after inoculation, development of bacterial wilt on nine resistant or susceptible cultivars of tomato was investigated. To inoculate by drenching the non-cut roots with the bacterial suspension was better to distinguish resistance and susceptibility of tomato cultivars than by drenching the cut roots using scalpel. And 'Hawaii7996' a resistant tomato to R. solanacearum showed high resistance at all the tested conditions including growth stages (3-, 6-, 8-, 10-leaf stages), inoculum concentrations ($OD_{600}=0.1-0.4$) and incubation temperatures (25, 30, $35^{\circ}C$). On the other hands, susceptible cultivars represented disease index of 3.7 and 3.9 at 6- and 8-leaf stages, respectively. At 3- and 10-leaf stages, the cultivars demonstrated lower disease severity of 2.1 and 0.5, respectively, than at 6- and 8-leaf stages. When the inoculated seedlings were incubated in growth chambers of 25, 30 and $35^{\circ}C$, disease severity of susceptible cultivars was significantly greater at 30 and $35^{\circ}C$ than at $25^{\circ}C$. In addition, the level of resistance of the tomato cultivars was not significantly affected by inoculum concentrations of $OD_{600}=0.1-0.4$. On the basis of the results, we suggest an efficient screening method to measure resistance level of tomato cultivars to bacterial wilt. The eight-leaf stage seedlings transplanted 7 days before inoculation, are inoculated with R. solanacearum by drenching the non-cut roots with a bacterial suspensions ($OD_{600}=0.4$) to give inoculum volume of 50 ml/soil l. The inoculated plants are incubated in a growth room at $30^{\circ}C$ for 12-13 days with 12-hour light a day.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.23-28
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• 2005

Ross procedure is ideal aortic valve replacement method with several merits of hemodynamic superiority and durability without the need of anticoagulation. Based upon this presumption, we studied its procedure performed in our hospital and tried to get the mid-term results Material and Method: From Jan 1999 to Oct 2001, 22 patients underwent the Ross procedure. The mean age of experimented (including 17 men and 5 women) was $30.9{\pm}8.1(17\~44)$. The diagnosis before the surgery had shown 20 as accompanied with AR and the rest 2 as with ASR. The follow-up period ranged from 0.6 to 40.6 months, mean of $38.9{\pm}1.6\;months,\;and\;follow-up\;rate\;was\;100{\%}$. Result. There was no operative death and two late deaths, one of whom was cardiac originated and the other, non-cardiac relate The survival rate was $94.1{\pm}5.7{\%}$(40.6 months). Postoperatively there were 2 exploration for bleeding, 3 low cardiac output patients. The pulmonary autograft technique was root replacement in 14 and inclusion technique in 8. Pulmonary homografts were used at the pulmonary position in all cases. There was no patient with significant aortic regurgitation. Conclusion: These showed that the mortality and morbidity of the Ross procedure were acceptable and postoperative AR was not significant. However, further long-term follow-up will be necessary for the improvement of the function of pulmonary autograft and homograft.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.541-549
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• 2008

Background: Vasoconstrictor-induced reduction in arterial graft diameter can cause significant flow deprivation. The aim of this study was to evaluate the effect of vasodilator pretreatment on vasoconstrictor-induced blood vessel spasm in vitro. Material and Method: Rabbit brachial arteries (BA) and celiac arteries (CA) were cut into rings $(3{\sim}4mm)$ and suspended with a force displacement transducer (TSD $125C^{(R)}$, Biopac Inc. USA) in a tissue bath filled with 5 mL modified Krebs solution bubbled with 5% $CO_2$ and 95% $O_2\;at\;38^{\circ}C$. The rings were contracted with vasoconstrictors, and the developed tension changes were considered control values. The rings were then pre- treated with $30{\mu}M$ nitroglycerin, nicardipine, verapamil, and papaverine, respectively, for 40 minutes and rinsed with the physiologic buffered salt solution three times every 15 min. The vasoconstrictor-induced tension changes after the previous procedure were considered experimental values. Data are expressed as the percentage tension induced by vasoconstrictors before and after pretreatment with vasodilators. Result: Nicardipine depressed vasoconstriction induced by norepinephrine, angiotensin II (All), and U46619 in both the BA and the CA more significantly than did nitroglycerin (p<0.01) and verapamil (p<0.05). Verapamil depressed vasoconstriction induced by 5-hydroxytryptamine (5HT), All, and U46619 in the BA and by 5HT in the CA more significantly than did nitroglycerin (p<0.01). Conclusion: These findings suggest that both nicardipine and verapamil effectively depressed vasoconstrictor action. Nicardipine is thought to be more effective than verapamil for the prevention of vasoconstrictor action.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.20-24
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• 2010

Purpose: To evaluate the long term outcomes of the ACL reconstruction from the standpoint of osteoarthritis. Materials and Methods: We evaluated 31 patients who underwent ACL reconstruction from April 1986 to April 1999 and could be followed-up more than 7 years. Mean follow-up period was 10.1 years (7~22 years). In terms of the graft, 11 cases were treated with the ACL reconstruction using a autologous hamstring tendon graft, 20 cases were treated with using a autologous bone patellar tendon bone graft. For femoral tunnel, 11 cases were placed through transtibial tunnel, 20 cases were placed through anteromedial portal using mini-open arthrotomy. Functional and radiographic evaluation was performed. Results: Mean Lysholm score was $89.2{\pm}11.7$ points. Patients had KT-2000 side-to-side differences were $2.1{\pm}1.9\;mm$. IKDC ligament evaluation showed 38.7% type A, 48.3% type B, 6.5% type C and 6.5% type D. Femoral tunnel were placed at 11 or 1 o'clock position in transtibial technique and placed 10 to 10:30 or 2 to 2:30 o'clock position in technique using anteromedial portal. Radiographic analysis for degenerative arthritis revealed that in group using anteromedial tunnel, 50.0% were excellent, 25.0% were good. In group using transtibial tunnel 18.2% were excellent, 18.2% were good. Conclusion: More than 87.1% of cases, long term result of the ACL reconstruction showed good and excellent result in IKDC score. Especially, the group using tunnel through anteromedial portal showed good results for degenerative arthritis.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.695-702
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• 2008

Background: The choice between a bioprosthetic and a mechanical valve is an important decision in cardiac valve surgery, and the durability of the tissue valve is a major decision factor. We retrospectively evaluated the midterm results of bioprosthetic valve replacement in the mitral position. Material and Method: The subjects were all patients who had undergone mitral bioprosthesis replacement between July 1989 and August 200.7. Among the 216 patients, there were 236 surgical cases. The mean age was $63{\pm}15$ years, and the male to female ratio was 1 : 3. We retrospectively analyzed hospital and outpatient records such that the total follow-up duration amounted to 760.2 patient-years, and the mean follow-up duration was $41.9{\pm}40.7$ months (range $0{\sim}212$ months). Result: Early death occurred in 18 patients (8.3%), and 13 of these underwent concomitant cardiac procedures. The survival rate after 5 years was $79.9{\pm}3.5%$, and the survival rate after 8 years was $65.5{\pm}5.5%$, while freedom from structural valve deterioration (SVD) was $96.2{\pm}2.2%$ at 5 years and $85.9{\pm}5.3%$ at 8 years. Freedom from reoperation was $90.6{\pm}1.7%$ at 5 years and $90.4{\pm}4.2%$ at 8 years, while freedom from reoperation for SVD was $98.1{\pm}1.2%$ at 5 years and $92.3{\pm}4.1%$ at 8 years. On multivariate analysis of preoperative risk factors, small valve size (between 25mm and 27mm) was a significant risk factor for reoperation, and low LV ejection fraction (<40%) was a significant risk factor for SVD and mortality. Conclusion: Survival and freedom from reoperation for SVD in mitral bioprosthesis replacement had acceptable midterm results, but freedom from SVD Was relatively low. In particular, since SVD increased sharply at the eighth postoperative year, frequent follow-up and echocardiograms around that time will be helpful for the early detection of SVD. It will be necessary to conduct further studies involving long-term follow-up and more patients.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.347-356
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• 1999

Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.19-24
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• 2014

The purpose of the present study was to determine the priming effects of progesterone that affect the emergence of LH surge mode secretion by three different progesterone levels. In previous studies, we have shown that LH surge occurred in follicular levels of progesterone, whereas there was no surge mode secretion of LH and FSH in either the subluteal or luteal levels of progesterone. In this study, the hypothesis was that the priming effects of progesterone on the timing of the LH surge induced by exogenous estradiol are same between subluteal and luteal levels of progesterone. Long-term ovariectomized Shiba goats that had received implants of estradiol capsules (Day 0) and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels. On Day 7, all devices of progesterone packets were removed but estradiol capsules were maintained during the experiment, and blood samples were collected at 1 hr interval for 12 h from the time of progesterone removals to determine peripheral changes of estradiol and progesterone concentration. Then all animals were infused estradiol on the Day 7 after 13 h from the removals of progesterone devices with a peristaltic pump into jugular vein at a rate of 3 ${\mu}g/h$ for 36 h. For analysis of peripheral LH and estradiol concentration, blood samples were collected via another jugular vein at 2 h intervals for 52 h (from 4 h before the start of estradiol infusion to 48 h after the start of estradiol infusion). In all animals of the three groups treated with estradiol infusion, an LH surge was expressed but the peak time of LH surge was different. This time interval from estradiol infusion until the peak of LH surge was gradually and significantly extended by the different levels of progesterone treated before estradiol infusions in the three groups.

• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.25-30
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• 2014

This study tested the hypothesis that the priming effects of progesterone on the timing of the LH surge induced by exogenous estradiol are more potentiated the negative feedback actions of progesterone on LH secretion by the existence of estradiol. In previous studies, the time interval from estradiol infusion until the peak of LH surge was gradually and significantly extended by the different levels of progesterone treated before estradiol infusions. Longterm ovariectomized Shiba goats that had received implants of estradiol capsules (Day 0) and three different progesterone silastic packet inducing follicular, subluteal and luteal levels of progesterone were divided into three groups such as non-P, low-P and high-P group. Blood samples were collected daily throughout the experiment for the analysis of gonadal steroid hormone levels. On Day 7, all devices of progesterone and estradiol packets were removed but estradiol capsules were maintained during the experiment, and blood samples were collected at 1 hr interval for 12 h from the time of progesterone removals to determine peripheral changes of estradiol and progesterone concentration. Then all animals were infused estradiol on the Day 7 after 13 h from the removals of progesterone devices with a peristaltic pump into jugular vein at a rate of 3-6 ${\mu}g/h$ for 36 h. For analysis of peripheral LH and estradiol concentration, blood samples were collected via another jugular vein at 2 h intervals for 52 h (from 4 h before the start of estradiol infusion to 48 h after the start of estradiol infusion). In all animals of the three groups treated with estradiol infusion, an LH surge was expressed but the peak time of LH surge was different. This time interval was not extended by the different levels of progesterone treated before estradiol infusions and the difference was not significant during this interval between the Low P and the High P groups. Progesterone pretreatment may contribute to regulating the neural system that is responded by estradiol, and estradiol existence potentiates the negative feedback effect of progesterone on GnRH/LH surge-generating system.