• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.11-18
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• 2007

Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.767-773
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• 2007

Purpose : Obesity has become a pandemic and especially the prevalence of childhood obesity has increased remarkably over the past years. Childhood obesity is often accompanied by the expected morbidities such as hyperlipidemia, fatty liver and glucose intolerance. We evaluated the pattern of alteration in the body mass index (BMI), serum adiponectin concentration, insulin resistance (HOMA-IR), and complication rates after one year follow-up. Methods : Forty two obese children (age: 8-15 years, 95th percentile of BMI for age and sex) were examined twice annually on June, 2004 and July, 2005. The body mass index (BMI) and sexual maturityrating (SMR) were determined annually by the same examiner and serum fasting glucose, liver enzyme, lipid profiles, adiponectin, insulin and HOMA-IR were measured and annual results were compared. Upper abdominal sonography was performed to detect fatty liver. Results : BMI ($25.3{\pm}2.9kg/m^2$ vs. $26.0{\pm}2.9kg/m^2$) and HOMA-IR ($3.6{\pm}1.8$ vs. $4.7{\pm}1.9$) have increased significantly after one-year follow-up. The serum adiponectin concentration ($17.2{\pm}5.2g/mL$ vs. $12.6{\pm}5.2g/mL$) has decreased after one year. The prevalence of hyperlipidemia and fatty liver were not changed significantly but that of hyperinsulinemia increased after one-year. HOMA-IR showed a positive correlation with BMI and SMR, but was negatively correlated with serum adiponectin concentration. Conclusion : Obese children in our study showed significant increment of insulin resistance during one year. These results suggest that well-organized and continuous obesity control is required especially for obese adolescent to prevent complication of obesity.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.331-338
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• 1996

Background : Lung cancer continues to be the leading cause of cancer death in the United States and it's incidence has been rapidly increasing in Korea, too. The overall cure rate for non-small cell lung cancer(NSCLC) is approximately 10%, and the cure is generally achieved by surgery. Unfortunately, however, less than 15% of all patients and less than 25% of those who present with localized disease are candidates for curative surgical resection. So preoperative staging evaluation followed by curative resection has a major role in determining the long tenn prognosis of NSCLC patients. Therefore, we have conducted this study to compare pre-operative and post-operative staging and the long-tenn relapse-free survival rates in NSCLC patients according to its stage. Methods : We analyzed the medical records of 217 NSCLC patients who were operated on for curative resection in Seoul National University Hospital, retrospectively. Among them, 170 patients who were completely resected were selected to determine the long term relapse-free survival rates. Results : Among 217 NSCLC patients, men were 157 and women were 30. The median age was 58 and the difference between men and women was not found. The discrepancy rate between preoperative and postoperative staging was 40.1%. Its major cause was due to the difference of nodal staging. The 3-year relapse-free survival rates were 73%, 53% and 48% in stage I, II and IIIa, respectively. There was no difference of relapse-free duration in recurred patients according to the stage or histologic types. Conclusion : The postoperative pathologic staging determines the long tenn prognosis of patients with NSCLC after surgery, but current preoperative clinical staging can not predict the postoperative pathologic staging correctly. So the improved modality of staging system is required to predict the pathologic staging more correctly.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.132-136
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• 2003

Purpose : To evaluate the usefulness of breath-hold T2-weighted MR imaging in patients with myocardial infarction. Materials and Methods : We investigated 11 patients with myocardial infarction who shown delayed enhancement on MR imaging. Infarcted myocardium on T2-weighted MR imaging was classified as high, iso, and low signal area comparing with normal myocardium. The intensity and transmural extent of infracted myocardium was also analyzed. On the basis of clinical information, the stage of infracted myocardium on T2-weighted MR imaging was assessed. Results : It was observed high signal area in 12 segments of 5 patients, low in 12 segments of 6 patients on T2-weighted MR imaging. The high signal intensity of infarcted myocardium was shown as $175{\pm}9\%$ comparing with that of the normal myocardium, low signal intensity as $73{\pm}5\%\;(p\;<\;0.05)$. In the evaluation of transmural extent, the high signal areas on T2-weighted MR imaging were larger than infarct area on delayed enhancement imaging $(100\%\;vs.49\%{\pm}17\%)$, whereas low signal areas on T2-weighted MR imaging correlated. High signal area was visualized on T2-weighted MR imaging within 11 days, whereas low-signal area was seen after 7 months. Conclusion : Breath-hold T2-weighted MR imaging is useful in the evaluation of stage as well as edema and fibrous scar in patients with myocardial infarction.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.1
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• pp.65-72
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• 2010

Objective: To compare the respective pregnancy outcomes of cycles undergoing elective two cleavage-stage embryos transfer (2ET) and three cleavage-stage embryos transfer (3ET) in fresh in vitro fertilization and embryo transfer (IVF-ET) program. Methods: We conducted a retrospective matched case control study that included 100 women with 2ET and 100 women with 3ET from January 2007 to June 2009. Subjects were matched for reproductive profiles and cycle characteristics. All of transferred embryos in both groups had good qualities. Pregnancy rates (PR), implantation rate, and multiple PR were compared. Results: Demographics, stimulation parameters and embryological data were comparable in both groups. Main pregnancy outcomes with 2ET and 3ET groups were not statistically different; implantation rate (41.0% vs. 35.3%), positive pregnancy rate (58.0% vs. 60.0%), clinical PR (55.0% vs. 59.0%), ongoing PR (51.0% vs. 55.0%), respectively. However, the 3ET group showed significantly higher multiple pregnancy and triplet pregnancy rates (30.9% vs. 50.8%, p=0.031; 1.8% vs. 11.9%, p=0.036, respectively). Conclusion: In women with favorable conditions and good quality embryos undergoing IVF, 2ET can get pregnancy outcomes comparable to those of 3ET and reduce multiple pregnancy (especially, triplet pregnancy).

• Journal of the Society of Cosmetic Scientists of Korea
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• v.30 no.2
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• pp.159-165
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• 2004

This study described about method that forms liquid crystal gel (LCG) by main ingredient with hydrogenated lechin (HL) in O/W emulsion system. Result of stability test is as following with most suitable LCG's composition. Composition of LCG is as following, to form liquid crystal, an emulsifier used 4.0wt% of cetostearyl alcohol (CA) by 4.0wt% of HL as a booster. Moisturizers contained 2wt% of glycerin and 3.0wt% of 1,3-butylene glycol (1,3-BG). Suitable emollients used 3.0wt% of cyclomethicone, 3.0wt% of isononyl isononanoate (ININ), 3.0wt% of cerpric/carprylic triglycerides (CCTG), 3.0wt% of macademia nut oil (MNO) in liquid crystal gel formation. On optimum conditions of LCG formation, the pHs were formed all well under acidity or alkalinity conditions (pH=4.0-11.0). Considering safety of skin, pH was the most suitable 6.0${\pm}$1.0 ranges. The stable hardness of LCG formation appeared best in 32 dyne/$\textrm{cm}^2$. Particle of LCG is forming size of 1-20$\mu\textrm{m}$ range, and confirmed that the most excellent LCG is formed in 1-6$\mu\textrm{m}$ range. According to result that observe shape of LCG with optical or polarization microscope, LCG could was formed, and confirmed that is forming multi -layer lamellar type structure around the LCG. Moisturizing effect measured clinical test about 20 volunteers. As a result, moisturizing effect of LCG compares to placebo cream was increased 36.6%. This could predicted that polyol group is appeared the actual state because is adsorbed much to round liquid crystal droplets to multi-lamellar layer's hydrophilic group. It could predicted that polyol group is vast quantity present phase that appear mixed because is adsorbed to round liquid crystal to multi-lamellar layer's hydrophilic group. This LCG formation theory may contribute greatly in cosmetics and pharmacy industry development.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.59-66
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• 2007

Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

• Journal of Gastric Cancer
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• v.7 no.3
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• pp.152-159
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• 2007

Purpose: Recently, the use of laparoscopic assisted gastrectomy for early gastric cancer has been on the increase and the procedure has been quickly adopted by clincians. However, there are few reports regarding the safety and risk of this type of surgery. The aim of this study is to evaluate the morbidity and to verify the safety of laparoscopic assisted gastrectomy for early gastric cancer. Materials and Methods: A total of 376 patients that had undergone laparoscopic assisted gastrectomy for early gastric cancer between April 2004 and December 2006 were reviewed retrospectively. The clinicopathological characteristics, operative complications, and factors related to complications were evaluated. Results: The overall operative morbidity and mortality rates were 10.6% and 0%, intraoperative morbidity was 1.1% (4 of 376 patients) and post operative morbidity was 9.6% (36 of 376 patients). Most complications required no surgery except for an intestinal obstruction in two cases. Multivariate analysis of risk factors related to operative morbidity determined that age was an independent factor associated with morbidity (P=0.021). Conclusion: The complication rate of laparoscopic assisted gastrectomy is low and most complications can be managed by conservative methods rather than with surgery. There were no specific predicting factors for complications except old age. Laparoscopy is a technically feasible and acceptable surgical modality for early gastric cancer.

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.245-253
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• 2003

Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.416-422
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• 2004

Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.