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Detection and Control of Bacterial Diseases of Cultured Fishes in Korea (양식어류(養殖魚類)의 세균성질병(細菌性疾病)의 진단(診斷)과 대책(對策))

  • Chun, Seh-Kyu
    • Journal of fish pathology
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    • v.1 no.1
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    • pp.5-30
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    • 1988
  • This is a comprehensive study for considering the effective treatment and control program of bacterial disease occurring in common carp, israel carp, color carp, crucian carp, eel and tilapia by clarifying the causes, mechanism of infection and onset and the diagnostic criteria. As a first step, the authors investigated the external views, gross and histopathologic findings of diseased fish using 450 infected fishes obtained from various farmer of Korea. This infection was characterized by hyperemia, hemorrhage and swelling of body surface and fins, congestion of liver, spleen, kidney, inflammation of intestine, hemorrhagic inflammation of various tissues, and necrosis and ulcer of various tissues were accompanied in serious cases. Bacteriologically, Aeromonas hydrophila and Edwardsiella tarda were isoiated from these fishes. Particularly in the regular check on 222 eels, 177 strains were isolated as 29.94% of Aeromonas hydrophila, 48.58% of Edwardsiella tarda and 21.47% of Flexibacter columnaris. Hexibacter columnaris was isolated from corroded gill of eels. The identical disease was occurred by innoculating the isolated Aeromonas hydrophila and Edwardsiella tarda and the identical strains were isolated from infected experimental fishes. The eels which were diagnosed Aeromonas disease from Kwangju, Pusan accompanied hemorrhage, swelling of body surface and fins, inflammation of stomach and intestine containing mucous fluids mixed with the pathogens. Color carp and crucian carp which were innoculated with the isolated 5 strins of Aeromomas hydrorphil died within 3 or 4 days accompanying with the characteristics of Aeromonas disease. Edward disease was characterized by abscesses of body surface, pus formation with concentration on phagocytes. The size of absecsses increased with progression elf disease. There were also various abscesses at internal organ and white nodules appeared in kidney. Histologically, various progressive granuloma were examined without inflammation of intestine. Columnaris disease of eels showed no hemorrhage except slight white body color. In autopsy, most of internal organs appeared normal and there were no septic odors. The only character was corrosion of gills. In order to treat these bacterial diseases, infected fishes must bathe in 20ppm chloramphenicol or kanamycin solution for 1 hour. Besides, medication program in oral ingestion of 75mg/kg chloramphenicol per day continuing for 5 to 7 days. After injecting the formalin treated Aermonas hydrophila antigen into carp, relatively high agglutination titer showed between 3 weeks and 6 weeks. Though this titer decreased from that time, it was continued for 18 weeks. In the case of injecting the formalin treated Edwardsiella tarda antigen into tilapia, the titer also increased. But tilapia which were immersed in the suspension fluid of the formalin treated Edwardsiella tarda showed no increase of the titer.

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Preparation and Characterization of Physicochemical and Sensory Properties of Bread Enriched with Two Types of Wild Grape Extract (제조방법이 다른 두 종류의 머루즙 첨가가 빵의 이화학적 및 관능적 특성에 미치는 영향)

  • Lee, Byung-Yong;Lee, Malp-Eum;O, Jin-Hwan;Kim, Eun-Cho;Surh, Jeong-Hee
    • Korean journal of food and cookery science
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    • v.26 no.5
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    • pp.636-648
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    • 2010
  • Two types of wild grape extracts(WGE) prepared by different methods were added into butter-top bread at different concentrations(0, 5, 10, 15, 20% of water). Then, the resulting breads were analyzed for their physicochemical and sensory properties in order to identify whether or not the WGE-enriched breads were comparable to control bread in terms of qualities and preferences. Wild grape sugar mixture(WGS), which was prepared by osmotic dehydration of wild grape fruits with the same amounts of sugar, presented significantly lower moisture content and titratable acidity as well as higher pH and sugar content compared to wild grape juice(WGJ), which was produced by boiling the fruits in a vacuum jar and squeezing. The pH of the doughs and breads containing WGE tended to decrease with increasing amounts of WGE, and this phenomenon was more appreciable in those containing WGJ than WGS. This was presumably due to the higher contents of tartaric acid in WGJ. For both types of extracts, hardness, gumminess, and chewiness of the doughs decreased with the addition of WGE, nevertheless, which properties were not remained in the resulting breads. This could be partially attributed to the relatively high degree of baking loss and lower pH of the WGE-enriched breads than those of control bread. Contrary to the mechanical analyses, the sensory properties of the breads were dependent on the WGE type. That is, WGJ-enriched bread showed lower consistency and moistness than control bread, which consequently led to relatively lower overall acceptability. However, WGS addition did not adversely affect the sensory properties of the bread. In particular, addition of 5% WGS somewhat improved the physical and sensory qualities of the bread. Thus, WGE-enriched bread could be produced without loss of bread quality when prepared with 5% WGS.

A study on evaluation of the image with washed-out artifact after applying scatter limitation correction algorithm in PET/CT exam (PET/CT 검사에서 냉소 인공물 발생 시 산란 제한 보정 알고리즘 적용에 따른 영상 평가)

  • Ko, Hyun-Soo;Ryu, Jae-kwang
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.55-66
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    • 2018
  • Purpose In PET/CT exam, washed-out artifact could occur due to severe motion of the patient and high specific activity, it results in lowering not only qualitative reading but also quantitative analysis. Scatter limitation correction by GE is an algorism to correct washed-out artifact and recover the images in PET scan. The purpose of this study is to measure the threshold of specific activity which can recovers to original uptake values on the image shown with washed-out artifact from phantom experiment and to compare the quantitative analysis of the clinical patient's data before and after correction. Materials and Methods PET and CT images were acquired in having no misalignment(D0) and in 1, 2, 3, 4 cm distance of misalignment(D1, D2, D3, D4) respectively, with 20 steps of each specific activity from 20 to 20,000 kBq/ml on $^{68}Ge$ cylinder phantom. Also, we measured the distance of misalignment of foley catheter line between CT and PET images, the specific activity which makes washed-out artifact, $SUV_{mean}$ of muscle in artifact slice and $SUV_{max}$ of lesion in artifact slice and $SUV_{max}$ of the other lesion out of artifact slice before and after correction respectively from 34 patients who underwent $^{18}F-FDG$ Fusion Whole Body PET/CT exam. SPSS 21 was used to analyze the difference in the SUV between before and after scatter limitation correction by paired t-test. Results In phantom experiment, $SUV_{mean}$ of $^{68}Ge$ cylinder decreased as specific activity of $^{18}F$ increased. $SUV_{mean}$ more and more decreased as the distance of misalignment between CT and PET more increased. On the other hand, the effect of correction increased as the distance more increased. From phantom experiments, there was no washed-out artifact below 50 kBq/ml and $SUV_{mean}$ was same from origin. On D0 and D1, $SUV_{mean}$ recovered to origin(0.95) below 120 kBq/ml when applying scatter limitation correction. On D2 and D3, $SUV_{mean}$ recovered to origin below 100 kBq/ml. On D4, $SUV_{mean}$ recovered to origin below 80 kBq/ml. From 34 clinical patient's data, the average distance of misalignment was 2.02 cm and the average specific activity which makes washed-out artifact was 490.15 kBq/ml. The average $SUV_{mean}$ of muscles and the average $SUV_{max}$ of lesions in artifact slice before and after the correction show a significant difference according to a paired t-test respectively(t=-13.805, p=0.000)(t=-2.851, p=0.012), but the average $SUV_{max}$ of lesions out of artifact slice show a no significant difference (t=-1.173, p=0.250). Conclusion Scatter limitation correction algorism by GE PET/CT scanner helps to correct washed-out artifact from motion of a patient or high specific activity and to recover the PET images. When we read the image occurred with washed-out artifact by measuring the distance of misalignment between CT and PET image, specific activity after applying scatter limitation algorism, we can analyze the images more accurately without repeating scan.

Preparation of Pure CO2 Standard Gas from Calcium Carbonate for Stable Isotope Analysis (탄산칼슘을 이용한 이산화탄소 안정동위원소 표준시료 제작에 대한 연구)

  • Park, Mi-Kyung;Park, Sunyoung;Kang, Dong-Jin;Li, Shanlan;Kim, Jae-Yeon;Jo, Chun Ok;Kim, Jooil;Kim, Kyung-Ryul
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.18 no.1
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    • pp.40-46
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    • 2013
  • The isotope ratios of $^{13}C/^{12}C$ and $^{18}O/^{16}O$ for a sample in a mass spectrometer are measured relative to those of a pure $CO_2$ reference gas (i.e., laboratory working standard). Thus, the calibration of a laboratory working standard gas to the international isotope scales (Pee Dee Belemnite (PDB) for ${\delta}^{13}C$ and Vienna Standard Mean Ocean Water (V-SMOW) for ${\delta}^{18}O$) is essential for comparisons between data sets obtained by other groups on other mass spectrometers. However, one often finds difficulties in getting well-calibrated standard gases, because of their production time and high price. Additional difficulty is that fractionation processes can occur inside the gas cylinder most likely due to pressure drop in long-term use. Therefore, studies on laboratory production of pure $CO_2$ isotope standard gas from stable solid calcium carbonate standard materials, have been performed. For this study, we propose a method to extract pure $CO_2$ gas without isotope fractionation from a solid calcium carbonate material. The method is similar to that suggested by Coplen et al., (1983), but is better optimized particularly to make a large amount of pure $CO_2$ gas from calcium carbonate material. The $CaCO_3$ releases $CO_2$ in reaction with 100% pure phosphoric acid at $25^{\circ}C$ in a custom designed, evacuated reaction vessel. Here we introduce optimal procedure, reaction conditions, and samples/reactants size for calcium carbonate-phosphoric acid reaction and also provide the details for extracting, purifying and collecting $CO_2$ gas out of the reaction vessel. The measurements for ${\delta}^{18}O$ and ${\delta}^{13}C$ of $CO_2$ were performed at Seoul National University using a stable isotope ratio mass spectrometer (VG Isotech, SIRA Series II) operated in dual-inlet mode. The entire analysis precisions for ${\delta}^{18}O$ and ${\delta}^{13}C$ were evaluated based on the standard deviations of multiple measurements on 15 separate samples of purified $CO_2$. The pure $CO_2$ samples were taken from 100-mg aliquots of a solid calcium carbonate (Solenhofen-ori $CaCO_3$) during 8-day experimental period. The multiple measurements yielded the $1{\sigma}$ precisions of ${\pm}0.01$‰ for ${\delta}^{13}C$ and ${\pm}0.05$‰ for ${\delta}^{18}O$, comparable to the internal instrumental precisions of SIRA. Therefore, we conclude the method proposed in this study can serve as a way to produce an accurate secondary and/or laboratory $CO_2$ standard gas. We hope this study helps resolve difficulties in placing a laboratory working standard onto the international isotope scales and does make accurate comparisons with other data sets from other groups.

Current Status of Children Born from Renal Transplanted Mother (신이식을 받은 산모로부터 출생한 소아의 성장상태)

  • Ki Mina;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil;Moon Jang Il;Kim Soon Il;Kim Yu Seun;Park Kiil;Park Young Won
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.77-83
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    • 2000
  • Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children. Patients and Methods: We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed. Results: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{\pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{\pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52\%$, HTN during pregnancy, $48\%$; preeclampsia, $41\%$; urinary tract infection, $48\%$; oligohydramnios $4\%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52\%$, LBW(<2500g) in $62\%$, VLBW(<1500g) in $7\%$ and $48\%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{\pm}3.0\;wk$; a mean birthweight, $2.23{\pm}0.6\;kg$; a mean birth-height, $45.1{\pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{\pm}0.91$ and mean weight SDS was $0.62{\pm}1.34$. Only one child($4\%$) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate(1), tuberous sclerosis(1), essential hematuria(1), and one child expired due to sepsis. Conclusion: This study showed similar incidence of premaure birth($57\%$) and low birth weight infants($62\%$), but lower incidence of spontaneous abortion($5.6\%$) was observed and compared to other studies. Postnatal growth in majority of children($96\%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.

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Effects of Dietary Salt Restriction on the Development of Renal Failure in the Excision Remnant Kidney Model (식이 sodium 제한 및 식이 sodium 제한에 따른 항고혈압제의 투여가 만성신부전증의 진행에 미치는 영향에 관한 실험적 연구)

  • Kim Kee-Hyuk;Kim Sang-Yun;Kang Yong-Joo;Maeng Won-Jae;Kim Kyo-Sun
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.170-179
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    • 1999
  • Purpose: To evaluate whether or not sodium restriction had its own beneficial effect and increased the efficiency of the anti-hypertensive drugs on the progression of renal failure. Methods: We studied using the excision remnant kidney model. Treatment groups were as follows: 5/6 nephrectomy and a 0.49% (normal-high) sodium diet (NN); 5/6 nephrectomy and a 0.25% (normal-low) sodium diet (LN); 5/6 nephrectomy, a 0.49% sodium diet and enalapril (NNE); 5/6 nephrectomy, a 0.49% sodium diet and nicardipine (NNN); 5/6 nephrectomy, a 0.25% sodium diet and enalapril (LNE); 5/6 nephrectomy, a 0.25% sodium diet and nicardipine (LNN). Both diets were isocaloric and had the same content of protein, phosphorus and calcium. Proteinuria, remnant kidney weight, mesangial expansion scores, and glomerular volume were assessed. Results: Blood pressure tended to be lower in LN compared to NN (P<0.05). NN developed progressive hypertension. LNE, LU, NNE, and NNN reduced blood pressure. LNE, LNN, NNE, NNN, and LN had significantly less proteinuria than NN at 16 weeks (P<0.05). At 24 weeks, LN developed proteinuria (82 mg/day), which were lessened in LNE (54 mg/day) and not lessened in LNN (76 mg/day). Mesangial expansion scores were significantly less in LN rats compared to those in NN rats. Glomerular volumes at 24 weeks in LN rats were significantly less compared to those at 16 weeks in NN rats. Mesangial expansion scores and glomerular volumes at 4, weeks, 12 weeks, and 24 weeks were not different among LN, LNE, and LNN groups. Conclusion: Dietary salt restriction lessens renal damage, at least in part, by inhibiting compensatory renal growth and reducing blood pressure. Enalapril was particularly successful in reducing proteinuria and glomerular injury when combined with dietary salt restriction.

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Dietary Effects of an Animal Fat with High Free- Fatty Acid Content on Feed Utilization and Meat Quality in Broilers (고산가 동물성 지방의 첨가가 육계의 사료이용성과 육질에 미치는 영향)

  • 오미향;지규만;최인숙
    • Korean Journal of Poultry Science
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    • v.12 no.1
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    • pp.7-16
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    • 1985
  • Present experiment was undertaken to compare the effects of two dietary fats whose free fatty acid content was quite different on performances and on meat quality of broilers. Yellow grease or animal fat (trade name) containing 15 or 38.6% free fatty acid, respectively, was added to the broiler starter and finisher diets at levels of 3.0 and 5,0%, respectively. A total of 108, day old, male Maniker(Chunho) broiler chicks was alloted to 3 dietary treatments with 3 replications per treatment and 12 chicks per replication Though control diet was not supplemented with fat, the three dietary groups were made isocaloric and isonitrogenous. All the chicks were ad libitum fed the test diets for 8 weeks. Feed intake and body weight were measured every other week. Shank color was measured at the end of feeding trial by Roche Color Fan. To evaluate meat quality, 7 chicks of mean body weight were selected from each treatment group after the trial. Measurements were made for abdominal fat content, organoleptic scores for thigh and breast, and for contents of total lipids, free fatty acids, iodine values and peroxide values of the breasts. During the period from 0 to 4 weeks of age, the broilers fed the diets added with fats performed the same as those fed the control diet. However, the body weight gam (25%), feed intake (10.8%) and feed efficiency (11.3%) of chicks fed the fat-supplemented diets, during the finisher period (5-8 weeks), appeared significantly improved compared to those of control group (p<0.05). During overall period of 8 weeks, body weight gain, feed intake, and feed efficiency of chicks fed the diets added with fats were, on the average, 16.2. 8.8 and 6.8%, respectively, better than, those of control Monwhile the performance between the chicks fed diets added with the two different fat sources appeared to be of the same tendency. Though the shank pigmentation was not statistically different among the treatments, the chicks fed the fat-supple ented diets tended to have slightly less pigments than the control. Organoleptic scores of thigh or breast of chicks fed the animal fat diet were of the same range as those of the other two groups. The contents of total lipids, free fatty acids, iodine values and peroxide values of breasts from broilers fed the various diets appeared to be in the same ranges among the treatments. The values for control, yellow grease and animal fat groups were 7.77, 6.66 and 6.32% for total lipids, 9.23, 9.7 and 9.31mg oleic acid/g fat for free fatty acids, 65.36, 63.89 and 59.25g/ 100g fat for iodine values, and 9.62, 10.46 and 8.79 meq/kg fat for peroxide values, respect vely. Changes of free fatty acids contents of breast during a storage for 10 da s at 4$^{\circ}C$ were also not different among the dietary groups. From the observations n. this experiment, it seems possible to conclude that the animal fat containing 38.6% free fatty acid can be used as efficiently as yellow grease in broiler diets without any adverse effects on meat quality.

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A Study on the Observation of Soil Moisture Conditions and its Applied Possibility in Agriculture Using Land Surface Temperature and NDVI from Landsat-8 OLI/TIRS Satellite Image (Landsat-8 OLI/TIRS 위성영상의 지표온도와 식생지수를 이용한 토양의 수분 상태 관측 및 농업분야에의 응용 가능성 연구)

  • Chae, Sung-Ho;Park, Sung-Hwan;Lee, Moung-Jin
    • Korean Journal of Remote Sensing
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    • v.33 no.6_1
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    • pp.931-946
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    • 2017
  • The purpose of this study is to observe and analyze soil moisture conditions with high resolution and to evaluate its application feasibility to agriculture. For this purpose, we used three Landsat-8 OLI (Operational Land Imager)/TIRS (Thermal Infrared Sensor) optical and thermal infrared satellite images taken from May to June 2015, 2016, and 2017, including the rural areas of Jeollabuk-do, where 46% of agricultural areas are located. The soil moisture conditions at each date in the study area can be effectively obtained through the SPI (Standardized Precipitation Index)3 drought index, and each image has near normal, moderately wet, and moderately dry soil moisture conditions. The temperature vegetation dryness index (TVDI) was calculated to observe the soil moisture status from the Landsat-8 OLI/TIRS images with different soil moisture conditions and to compare and analyze the soil moisture conditions obtained from the SPI3 drought index. TVDI is estimated from the relationship between LST (Land Surface Temperature) and NDVI (Normalized Difference Vegetation Index) calculated from Landsat-8 OLI/TIRS satellite images. The maximum/minimum values of LST according to NDVI are extracted from the distribution of pixels in the feature space of LST-NDVI, and the Dry/Wet edges of LST according to NDVI can be determined by linear regression analysis. The TVDI value is obtained by calculating the ratio of the LST value between the two edges. We classified the relative soil moisture conditions from the TVDI values into five stages: very wet, wet, normal, dry, and very dry and compared to the soil moisture conditions obtained from SPI3. Due to the rice-planing season from May to June, 62% of the whole images were classified as wet and very wet due to paddy field areas which are the largest proportions in the image. Also, the pixels classified as normal were analyzed because of the influence of the field area in the image. The TVDI classification results for the whole image roughly corresponded to the SPI3 soil moisture condition, but they did not correspond to the subdivision results which are very dry, wet, and very wet. In addition, after extracting and classifying agricultural areas of paddy field and field, the paddy field area did not correspond to the SPI3 drought index in the very dry, normal and very wet classification results, and the field area did not correspond to the SPI3 drought index in the normal classification. This is considered to be a problem in Dry/Wet edge estimation due to outlier such as extremely dry bare soil and very wet paddy field area, water, cloud and mountain topography effects (shadow). However, in the agricultural area, especially the field area, in May to June, it was possible to effectively observe the soil moisture conditions as a subdivision. It is expected that the application of this method will be possible by observing the temporal and spatial changes of the soil moisture status in the agricultural area using the optical satellite with high spatial resolution and forecasting the agricultural production.

The Characteristics and Fates of Pulmonary Tuberculosis Patients Seen at Medical Department of A Medium Sized General Hospital (부산에 한 중형 종합 병원 내과에서의 폐결핵 환자의 양상과 귀결)

  • Kim, Young-Hyo;Park, Ki-Chan;Bae, Seong;Lee, Sang-Hun;Chun, Myung-Ho;Lee, Sang-Ki;Jun, Kwang-Su;Lee, Chan-Se
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.417-424
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    • 1992
  • Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

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Early Results of Heart Transplantaion: A Review of 20 Patients (심장이식술 20례의 조기성적)

  • Park, Chong-Bin;Song, Hyun;Song, Meong-Gun;Kim, Jae-Joong;Lee, Jay-Won;Seo, Dong-Man;Sohn, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.164-171
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    • 1997
  • Heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal hear failure. The first successful heart transplantation in humans was done in 1967 and the first case in Korea was performed in november, 1992. Since the first case in 1992, more than 50 cases have been performed in Korea. A total of 20 patients underwent orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The purpose of this study is to evaluate the early results and the follow-up course of 20 cases of heart transplantation done in Asan Medical Center. The average age of 20 patients was 39.9$\pm$11.8 years old(20~58). The mean follow-up duration was 14.4$\pm$11.2 months(1~41). All patients are alive till now. The blood type was identical in 14 and compatible in 6 patients. ihe original heart disease was dilated cardiomyopathy in 16, valvular heart disease in 2, ischemic cardiomyopathy in 1, and giant cell myocarditis in 1 patient. HLA cross matching for recipient and donor was done in 18 cases and the results were negative for T-cell and B-cell in 16 patients, pos tive for warm B-cell in 2 patients. Among 6 loci of A, B, and DR, one locus was matched in 8 cases, 2 loci in 5 cases, and 3 loci matched in 1 case. The number of acute allograft rejection averaged 2.8$\pm$0.5 (0~6) per case and the number of acute allograft rejection requiring treatment averaged 1.0$\pm$0.9 (1~3) per case. The time interval from operation to the first acute rejection requiring treatment was 35.5$\pm$20.4 days (5~60). Acute humoral rejection was suspected strongly in 1 case and was successfully treated. The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 17.5$\pm$6.8 (9~32)% to 58.9$\pm$2.0 (55~62)% after heart transplantation. Temporary pacing was needed in 5 patients over 24 hours but normal sinus rhythm appeared within 7 days in all cases. One patient has been taken permanent pacemaker implantation due to complete AV block appearing 140 days after heart transplantaion. One patient had cyclosporine-associated n urotoxicity during the immediate postoperative period and was recovered after 27 hours. The heart transplantation of Asan Medical Center is on a developing stage but the early result is comparable to that of well established centers in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in patients with terminal heart failure.

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