• Journal of Chest Surgery
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• v.32 no.3
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• pp.281-286
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• 1999

Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

• Tuberculosis and Respiratory Diseases
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• v.59 no.2
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• pp.170-178
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• 2005

Background : Idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare but significantly imperative in inducing chronic pulmonary hypertension. Clinically, it is difficult to distinguish between IPAH and CTEPH. However, the treatment of pulmonary hypertension is different depending on the disease. The present study was performed to analyze the similarities and differences in clinical features between IPAH and CTEPH. Methods : During a nine-year period, thirty-three patients with IPAH and twenty-two patients with CTEPH were enrolled. Symptoms, physical findings, chest radiograph, electrocardiograph, pulmonary function test, echocardiograph, perfusion lung scan, right heart catheterization results were analyzed between both the groups. Results : The median age of IPAH group was 33 (6~70) years that was lower than that (52(27~80) years) of CTEPH group. Amongst the IPAH patients, there was female predominance (76 %) and there was no sex difference between the patients with CTEPH. Both the groups exhibited similarity in the results of chest radiograph, electrocardiograph, pulmonary function test, and echocardiograph. In the perfusion lung scan, all IPAH patients exhibited findings with normal (28%) or low probability (72%) of pulmonary embolism and all CTEPH patients exhibited findings with high probability of pulmonary embolism. Conclusion : Although IPAH and CTEPH bear similarities in terms of symptoms, physical signs and general investigation results, there were differences in age distribution, sex predominance and results of perfusion lung scan.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.215-224
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• 1997

Purpose : Stereotactic radiosurgery with external beam irradiation successfully obliterates carefully selected intracranial arteriovenous malformation (AVM) . We Present clinical and radiological long term results after treatment with a single high dose irradiation using a linear accelerator. Materials and Methods : Rrom January 1991 to June 1994, fifteen patients with intracranial AVM were treated in our hospital with the stereotactic radiosurgery using a linear accelerator. The radiation was delivered using a 6 MV linear accelerator. The prescribed doses at the isocenter varied from 1800 to 2500cGy (median : 2000cGy) and were given as a sin91e fraction. The radiation doses at the periphery of the lesion typically corresponded to the 80-90% isodose line. In 14 patients, complete clinical and/or radiological follow-up examination were available. Results : Angiography was available in 13 patients with a follow-up Period from 18 months to 27 months. Of 13 patients, the overall complete obliteration rate was 92.3% (12 patients). This incidence did not correlate with lesion size. Seizure, headache and progressive neurologic deficit were complete recovered. One Patient experienced hemorrhage at 2 months after treatment. One patient developed radiation induced brain edema in the white matter surrounding nidus at 16 months after treatment and showed complete resolution of the edema in MR image obtained at 27 months after treatment. After a follow-up period of up to 6 years, no radiation induced severe late complications occurred. Conclusion : We conclude that stereotactic radiosurgery using a linear accelerator is an effective and safe therapy for symptomatic and surgically inaccessible intracranial AVMs and the results compare favorably to the more expensive and elaborate systems that are currently available for stereotactic radiosurgery.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.6
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• pp.293-301
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• 2006

Purpose: The aim of the study was to evaluate the hemodynamic changes after successful bypass surgery in patients with atherosclerotic stenosis in ICA using $^{99m}Tc-ECD$ SPECT. Materials and Methods: Fourteen patients (M:F=8:6, mean age; $60{\pm}9$ years) who underwent STA-MCA anastomosis for unilateral atherosclerotic cerebrovascular disease were enrolled. $^{99m}Tc-ECD$ basal/acetazolamide perfusion SPECT studies were performed before, 10 days and 6 months after bypass surgery. Perfusion reserve was defined as the % changes after acetazolamide over rest image. Regional cerebral blood flow and perfusion reserve were compared preoperative, early-postoperative and late-postoperative scans. Results: The mean resting perfusion and decrease in perfusion reserve in affected ICA territory on preoperative scan was $52.4{\pm}3.5\;and\;-7.9{\pm}4.7%$, respectively. The resting perfusion was significantly improved after surgery on early-postoperative scan (mean $53.7{\pm}2.7$) and late-postoperative scan (mean $53.3{\pm}2.5$) compared with preoperative images (p<0.05, respectively). Resting perfusion did not showed further improvement on late-postoperative scan compared with early-postoperative scan. The perfusion reserve was $-3.7{\pm}2.6%$ on early-postoperative scan, and $-1.6{\pm}2.3%$ on late-postoperative scan, which was significantly improved after surgery. Additionally, further improvement of perfusion reserved as observed on late-postoperative scan (p<0.05). While, in the unaffected ICA territory, no significant changes in the resting perfusion and perfusion reserve was observed. Conclusion: The improvement of resting perfusion and perfusion reserve in early-postoperative scan reflects the immediate restoration of the cerebral blood flow by bypass surgery. In contrasts, further improvement of perfusion reserve showing on late-postoperative scan may indicate a good collateral development after surgery, which may indicate good surgical outcome after surgery.

• Journal of Veterinary Clinics
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• v.29 no.4
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• pp.301-305
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• 2012

The purpose of the present study was to prove our empirical tendency of relatively high small intestinal diameter (SI) to fifth lumbar vertebral height (L5) ratio, which has been used in dogs. In this study, the ratio of SI/L5 was determined in small breed dogs weighing less than 5 kg. In addition, the effect of large volume of contrast media on the intestinal dilation was determined by performing upper gastrointestinal contrast study. Abdominal radiography and upper gastrointestinal series were performed in twelve healthy dogs weighing less than 5 kg. Small intestinal diameter (SI), fifth lumbar vertebral height (L5), and twelfth rib diameter were measured on abdominal radiographs. The range of values of SI/L5 is from 1.03 to 2.26 in plain radiography, and from 1.55 to 2.5 in contrast studies. Contrast agent significantly increased small intestinal diameter, and could be considered as mildly dilated intestinal model. Therefore, a value of 2.1 for SI/L5 is recommended as the upper limit of the normal range suggesting nonobstructive intestinal dilation.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.391-394
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• 2012

The purpose of the present study was to prove our empirical tendency of relatively high small intestinal diameter (SI) to fifth lumbar vertebral height (L5) ratio, which has been used in dogs. In this study, the ratio of SI/L5 was determined in small breed dogs weighing less than 5 kg. In addition, the effect of large volume of contrast media on the intestinal dilation was determined by performing upper gastrointestinal contrast study. Abdominal radiography and upper gastrointestinal series were performed in twelve healthy dogs weighing less than 5 kg. Small intestinal diameter (SI), fifth lumbar vertebral height (L5), and twelveth rib diameter were measured on abdominal radiographs. The range of values of SI/L5 is from 1.03 to 2.26 in plain radiography, and from 1.55 to 2.5 in contrast studies. Contrast agent significantly increased small intestinal diameter, and could be considered as mildly dilated intestinal model. Therefore, a value of 2.1 for SI/L5 is recommended as the upper limit of the normal range suggesting nonobstructive intestinal dilation.

• The Journal of Korean Medicine
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• v.23 no.3
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• pp.74-84
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• 2002

목적 : 본 실험에서는 gerbil을 이용한 전뇌허혈 동물모델에서 뇌허혈손상 직후 지연성 뇌손상에 대한 대황의 방어효과와 Apoptosis 과정중의 Bax와 Bcl-2 단백질에 대한 조절작용을 관찰하고, TUNEL 염색법을 통하여 대황이 gerbil hippocampus CAl영역의 pyramidal neuron의 세포사에 미치는 영향과 PCl2세포를 이용한 세포배양 모델에서의 대황의 신경방어 효과를 관찰하였다. 방법 : Mongolian gerbil의 총경동맥을 5분간 폐색하여 가역성 전뇌허혈을 유발시킨 후 대황의 전탕액을 하루에 한번 경구 투여하였다. 대황의 신경 보호 효과는 수술 7일 후에 cresyl violet으로 염색하여, 살아있는 신경 세포의 수를 세어 측정하였다. 또, 수술 3일 후에는 면역조직화학적 방범을 통하여 Bax. Bcl-2단백질의 발현과 대황의 신경보호 효과와의 관련성을 알아보았다. 결과： 가역적 전뇌허혈이 일어난 동물군의 경우 hippocampus의 CAl 영역에서 살아있는 신경세포의 수는 $51.0{\pm}2.5개{\;}/mm$에 불과하였으나, 그에 비해 수술 후 7일간 대황을 투여한 동물군은 $106.2{\pm}2.5개{\;}/mm$로 살아 있는 신경세포수가 크게 증가하였다. Apoptosis를 촉진하는 단백질인 Bax의 발현은 3일간 대황을 투여한 동물군의 경우 hippocampus의 CAl 영역에서 현저하게 저해되었고, Apoptosis를 억제하는 Bcl-2 단백질의 발현은 변화가 없었다. TUNEL assay를 통하여 살펴본 결과 대황 투여군의 apoptotic 신경세포사가 감소하였으며 이는 Bax protein의 발현과 유사한 양상을 나타내었다. 결론：대황이 Bax 단백질의 발현을 억제하여 상대적으로 Bax/Bcl-2 자연적 세포사를 억제하여 Mogolian gerbil의 가역성 전뇌허혈 모델에서 신경보호효과를 나타내는 것으로 사료된다.

• Journal of the Korean Geotechnical Society
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• v.36 no.11
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• pp.107-117
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• 2020

Open-ended steel pipe piles have outside frictional force and inside frictional resistance in which blocked soil acts on the inside of the steel pipe during installation. It is expected that the ultimate load will change depending on the inside and outside resistance. And, if the ground on which the piles were constructed is clay soil, it is predicted that it will have effect on the negative skin friction caused by the ground settlement. Therefore, in this study, the behavior according to the inside and outside resistance characteristics of steel pipe piles was analyzed numerically, and the frictional force distribution, axial load and settlements before and after the occurrence of ground settlement were calculated. As a result of the analysis, the inside frictional resistance had less influence than the outside frictional resistance. However, inside frictional resistance is considered to be one of the important factors considering the effect on the overall pile behavior, and both resistance factors need to be considered in the design process.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.225-229
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• 2008

Inferior vena cava filters are increasingly being used as an alternative to anticoagulation therapy for the prevention of pulmonary embolism. However, using an Inferior vena cava filter may result in clinically significant complications. Phlegmasia cerulea dolens is a rare disease that presents with acute complete venous occlusion due to extensive thrombosis in the lower extremity. It is characterized by intense pain, edema, decreased pulses and a cyanotic extremity. We report here on a case of phlegmasia cerulea dolens that was accompanied with disseminated intravascular coagulation (DIC) as a complication of the placement of an inferior vena cava filter in a patient who had been previously diagnosed with pulmonary embolism, and the patient had recently developed a cerebral hemorrhage due to a traffic accident.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.720-723
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• 2001

A case of Marfan’s syndrome with atresia of right coronary artery is reported. A 45-year-old woman, who was diagnosed as Marfan’s syndrome 1 year ago, came to the hospital complaining of acute chest pain. The patient showed arachynodactyly, pectus carinatum, and long and slender extremities. In echocardiography there were severe aortic regurgitation measured grade IV and aortic dilatation of ascending aorta maximally 5.9 cm in diameter. Mitral regurgitation was mild, but there were also moderate left ventricular dilation and moderately decreased ejection fraction of left ventricle. At operation, atresia of right coronary artery was found. We performed Bentall type operation with SJM 27mm valved conduit for left coronary artery, and Piehler’s modification for right coronary artery bypass using 6mm PTFE graft. The atretic portion of right coronary artery from the suspected right coronary ostium to distal coronary flow was about 4 cm in length. The combination of right coronary artery atresia and Marfan’s syndrome is very rare. The author describes the rare case, which is treated with combined technique of Bentall and Piehler modification for reconstruction of coronary circulation.