• Journal of Chest Surgery
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• v.37 no.2
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• pp.113-118
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• 2004

The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. Material and Method: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37$^{\circ}C$ (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. Result: In the group that was rapidly thawed, the expression of TUNEL (＋) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. Conclusion: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopresewed arterial allografts. The expression of TUNEL (＋) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.844-848
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• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.190-198
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• 2001

Purpose : It was reported that Captopril (angiotensin converting enzyme inhibitor) had an effect to reduce the pneumonitis and pulmonary fibrosis induced by radiation in rat. We peformed this study to investigate the radioprotective effect and mechanism of Captopril. Methods and Materials : The comparison was made between the radiation only group and the combined Captopril and radiation group by examining histopathologic findings and immunohistochemical stains $(TNF\alpha\;and\;TGF\beta1)$ at 2 and 8 weeks after irradiation. Each group has 8 to 10 rats (Sprague-Dawley). 12.5 Gy of X-ray was irradiated to the left hemithorax in a single fraction. Captopril (50 mg/kg/d) mixed with water was given per oral and continuously from 1 week prior to irradiation up to 8th week of the experiment. Result : In the combined Captopril and radiation group, the histopathologic changes which were hemorrhage into alveolar space, changes of alveolar epithelium, bronchial epithelium and blood vessels, and perivascular edema were less severe than in the radisation only group at 2 weeks. At 8 weeks, the alveolar epithelial changes and perivascular edema were less prominant in the combined Captopril and radiation group. At 2 weeks, the $TNF\alpha$ expression of the combined Captopril and radiation group was markedly decreased at the alveolar epithelium (p<0.01), lymphoid tissue (p=0.06) and the macrophage of alveolar space (p<0.01) compared with the radiation only group. Furthermore the $TGF\beta1$ expression was significantly prominant at the alveolar epithelium (p<0.02) and the macrophage in alveolar space (p<0.02). At 8 weeks, the expression of $TNF\alpha\;and\;TGF\beta1$ of most sites, except $TGF\beta1$ of the macrophage of alveolar space (p=0.09), showed no significant difference between 2 groups. Conclusion : This study revealed that early lung damage induced by irradiation was reduced with the addition of Captopril in the latent and early pneumonitis phase. The expression of $TNF\alpha\;and\;TGF\beta1$ at 2 weeks and $TGF\beta1$ at 8 weeks was further decreased in the combined Captopril and radiation group than the radiation only group. From these results, it may be concluded that the proinflammatoy cytokine $(TNF\alpha)$ and fibrogenic cytokine $(TGF\beta1)$ probably play the role of the radioprotective mechanism in Captopril.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.1-9
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• 2001

Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.58-72
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• 1985

A histopathological study was carried out on the duodenum of mice and rats experimentally infected by F. seoulensis. Each mouse was infected with 500 metacercariae and killed after 1, 2, 3 days, 1 and 2 weeks from infection. Each rat was given 1, 000 metacercariae and was examined after 1, 2 and 4 weeks from infection. The duodenal tissue sections of mice and rats were stained with hematoxylin eosin, and PAS stained for the rats of 1 week group. The pathological findings are summarized as below. 1. There were no differences in mucosal findings between the mice and the rats, and between the location of duodenum, 1 and 5 em distal to the pylorus. 2. Each worm embraced a villus exclusively with its foliate fore body which was inserted into the intervillous spaces. The fluke pinched villous epithelia using its oral and ventral suckers. The tribocytic organ destroyed the villous epithelia deeply up to the stroma after 3 days from infection. 3. Apparent villous changes were observed in the mice after 3 days from infection. Villous changes were shortening, widening, blunting or fusion. The villous stroma showed edema, microscopic hemorrhage, capillary congestion, dilatation of lymphatics and inflammatory cell infiltration. The cells were lymphocytes, plasma cells, eosinophils and giant cells. Rarely submucosal and trans:nural inflammation was encountered.

• Journal of Yeungnam Medical Science
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• v.3 no.1
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• pp.261-267
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• 1986

Development of supervoltage treatment machine may minimize skin reaction by skin-sparing effect, but skin damage is still one of "the dose limiting factor" in radiation therapy. In spite of these importance, systemic histopathologic studies of skin in similar conditions which used in clinical treatment has not been performed so far. 60mice were irradiated with conventional fraction ($200{\times}5/wk$) and whole abdominal field ($2{\times}3cm$, from symphysis pubis to xyphoid process). Used machine was 250KV, 24mA, orthovoltage x-ray machine. Histopathological changes of acute skin reaction at the level of total irradiation dose were analyzed and the possible mechanism of later chronic changes were investigated. Obtained results are as follows: 1. In 1,000 rad irradiated group, only mild epidermal edema is noted. 2. In 2,000 rad irradiated group, slightly decreased number and size of hair follicles and appendages, dermal edema and scanty infiltration of inflammatory cells are visible. 3. In 3,000 rad irradiated group, marked increased capillary congestion and prominant infiltration of inflammatory cells are observed. 4. In 4,000 rad irradiated group, vascular wall thickening with proliferation of endothelial cells are prominant. Dermal thinning and hyalinization are newly developed. 5. In 5,000 rad irradiated group, complete desquamation of epidermis is not seen, despite of acceleration of all above mentioned changes.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.118-125
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• 1996

Scrub typhus의 발현증상에는 저알부민혈증, 단백뇨, 전신 부종 등을 들 수 있다. 그러나, 저알부민혈증에 비해 단백뇨와 부종 등은 심하지 않은 경우가 많다. 본 연구에서는 저알부민혈증이 장내에서의 단백질 소실에 의한 것인지를 확인하고자 하였다. Scrub typhus가 의심되는 25명의 환자를 대상으로 (1) 저알부민혈증의 원인 장내 단백질 소실에 의한 것인지 여부와 (2) $^{99m}Tc$-HSA 신티그램의 진단적 유용성을 알아보고자 하였다. 신티그램은 혈청학적 검사상 Scrub typhus로 확인된 18명의 환자에서 (13예는 항생제 치료 개시후 1일에서 8일 사이에, 5예는 치료 전에 시행하였으며, 11예에서는 대변에서 alpha-1- antitrypsin (${\alpha}AT$)배설 여부를 확인하였다. 촬영방법은 $^{99m}Tc$-HSA 30mCi를 정맥 주사한 후, 2, 4, 6, 24시간에 복부 전면상을 얻었다. 판정은 소장과 대장의 주행 위치에서의 혈관외 방사능 소견을 장내 단백질 소실로 간주하였다. 13예에서 양성으로 판정하였는데, 이중 8예는 대변에서의 ${\alpha}AT$치도 높게 나왔다. 신티그램상 음성을 보인 5예중 2예에서는 대변중 ${\alpha}AT$치가 매우 높게 나왔는데 그 이유는 신티그램 검사는 치료 도중에 하였고, 대변 검사는 치료 전에 하였기 때문인 것으로 간주하였다. 결론적으로 전체 18예중 15예에서 신티그램이나 대변검사로 Scrub typhus로 진단하였다. 한편, 13예 (72%)에서 저알부민혈증을 보였는데 이중 4예는 장내단백질 소실과 단백뇨를, 5예는 장내단백질 소실만을, 3예에서는 단백뇨만을 보였고, 1예는 아무 소견이 없었다. 요약하면, 장내단백질 소실 소견은 Scrub typhus환자의 83%에서 보여, 혈중 알부민치가 저하되는 원인으로 추정된다. 따라서 $^{99m}Tc$-HSA 신티그램은 장내단백질 소실의 진단에 매우 유용한 검사방법이다. 또한, 검사방법이 다소 어렵지만 대변에서의 ${\alpha}AT$측정도 동위원소 검사상 음성 소견을 보이는 환자에게는 어느 정도 진단에 도움을 주리라 보여진다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.32-32
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• 1991

성대의 점막하 조직의 부종을 특징으로 하는 폴립양 성대는 음성의 남용 및 상기도에 대한 다양한 자극 요인들에 의하여 발생된다고 보고되어 있으며, 현재까지 부종의 기전 및 병태에 대하여도 혈괴의 유리화 현상(hyalinization), 또는 단순한 혈관의 투과력 증대 등의 논란이 많은 실정에 있어 치료방법 역시 학자에 따라 견해를 달리하고 있다. 이에 저자들은 폴립양 성대의 치료에 도움을 얻고자 최근 5년간 본 교실에서 경험한 폴립양 성대 34례(남자 18예, 여자 16예, 평균연령 53.7세)에 대한 임상 소견 및 저자들의 치료 성적을 분석 검토하여 다음과 같은 결과를 얻었다. 1. 측별로는 총 34예중 양측 23예(67.6%), 편측 11예(32.4%)이었다. 2. 동반질환으로 성대에 타 질환이 있었던 예가 9예(후두용 5예, 과각화증 3예, 성대마비 1예 ; 26.5%), 수면무호흡증 5예(14.7 %)이었으며 전신질환이 있었던 예가 4예(기관지 천식 2예, 폐결핵 2예 ; 11.8%)이었다. 3. 유발요인으로는 음성남용 7예(20.6%), 상기도감염 3예(8.8%), 흡연 26 예 (76.5%)이었다. 4. 공기역학검사 및 청각심리검사가 가능하였던 14예에서 최대발성지속시간이 정상이하이었던 예가 10예(71.4%), 발성율이 정상이상이었던 예가 9예 (64.3%)이었으며, 애성의 특징도 조호성(rough)이 10예(71.4%)로 가장 많았다. 5. 총 34예를 sucking technique를 적용하여 수술적 치료를 하였는데 음성이 호전된 경우는 32예(정상 15예, 호전 17예 : 94.1%)이었으며 호전되는데 걸린 평균 기간은 2.8개월이었다. 이상의 성적으로 보아 폴립양 성대는 국소 또는 전신적으로 동반질환이 많고 흡연 등의 만성 자극 요인이 있으며 술후 음성 호전에 걸리는 기간이 길어 보다 복합적인 측면에서 치료에 임하여야 할 것으로 사료된다. with such configuration.trap with 2.88[eV] deep of injected space charge from the chathode in the crystaline regions. The origin of ${\alpha}$$_2$ peak was regarded as the detrapping process of ions trapped with 0.9[eV] deep originated from impurity-ion remained in the specimen during production process of the material, in the crystalline regions. The origin of ${\beta}$ peak was concluded to be due to the depolarization process of "C=0"dipole with the activation energy of 0.75[eV] in the amorphous regions. The origin of ${\gamma}$ peak was responsible to the process combined with the depolarization of "CH$_3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를

• Journal of Chest Surgery
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• v.36 no.7
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• pp.527-530
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• 2003

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.240-245
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• 2010

Neurofibromatosis type 1, an autosomal dominant disorder with prevalence of 1 per 3000 people, has clinical features of cafe au lait spots in skin, multiple neurofibroma and dysplasia in skeletal, endocrinal, and blood vessel systems. Actual intraoral neurofibromas are known to occur in 25% of patients. A 9 year-old girl diagnosed with type 1 neurofibromatosis visited our hospital with chief complaint of gingival swelling. Gingival enlargement in lower anterior region existed and cafe au lait spots were confirmed in patient' skin. Enlarged gingival tissue were excised under local anesthesia. Neurofibroma was confirmed with biopsy. Clinical examination after months showed fine recovery without any evidence of recurrence. Due to its possibility of recurrence, periodic follow-up will be needed.