Chung, Wou Young;Byun, Min Kwang;Park, Moo Suk;Hahn, Chang Hoon;Kang, Shin Myung;Lee, Do Yon;Kim, Young Sam;Kim, Se Kyu;Kim, Sung Kyu;Chang, Joon
Tuberculosis and Respiratory Diseases
/
v.60
no.1
/
pp.65-71
/
2006
Background : Hemoptysis, when massive and untreated, has a mortality rate of over 50 percents, is considered as one of most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) has become an established procedure in the management of massive and recurrent hemoptysis, and its efficacy is widely documented thereafter by number of articles. However, the long-term success rate of BAE is known to be unfavorable. Risk factors influencing that control failure are inevitably needed. Materials and methods : Seventy-five patients underwent bronchial artery embolization due to massive hemoptysis in Severance Hospital from Jan. 2000 to Jan. 2005. Nine patients' data were not available and could not be contacted with. Finally 66 patients' (48 males, 18 females) medical records were analyzed retrospectively during a mean follow up period of 20.4 months (ranging from 1 month to 54 months). Results : Among 66 patients whose data were available, 23(34.9%) patients had recurrent major hemoptysis. Patients' age, sex, underlying disease, previous intervention history, and number of feeding vessels had no statistical validity as risk factors of recurred major hemoptysis. But bilaterality of lesion, amount of hemoptysis, and pleural thickening were revealed as meaningful factors for predicting relapse (p = 0.008, 0.018, and 0.001, respectively). Conclusion : According to our series, patients presenting with larger amount of hemoptysis, pleural thickening of chest radiography and bilateral lesion are associated with increased risk of major hemoptysis in patients treated with BAE.
Background: Left ventricular dysfunction is one of the important prognostic factors of early mortality and long-term survival after valve operation. We studied the intermediate term results of mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction. Material and Method: Forty four patients who underwent mitral valve reconstruction with a left ventricular ejection fraction (EF) of <45% or less (20∼45%) from April 1995 through July 2001 were reviewed retrospectively. Ages ranged from 10 to 67 years (46∼14 years) and 32 patients were in NYHA class III-IV. The mitral valve diseases were regurgitation (MR) in 28 patients, stenosis(MS) in 10, and mixed lesion in 5. The etiologies of mitral valve disease were rheumatic in 20 patients, degenerative in 14, ischemic in 5, annular dilatation in 2, congenital in 2, and endocarditis in 1. Operatively, all patients had annuloplasty and/or various valvuloplasty techniques, and a total of 52 procedures were concomitantly performed. Total cardiopulmonary bypass and aortic crossclamp time were 160$\pm$57 minutes and 112$\pm$45 minutes respectively. Result: Two operative deaths occurred as a result of left ventricular failure (4.5%). After the mean follow-up of 39 months (range, 10∼83 months), there was no late death. Transthoracic echocardiography revealed no or grade I of MR in 29 patients (72.5%) and no or mild MS in 35 patients (87.5%). The actuarial survival at 5 years was 100%. Four patients required mitral valve replacement due to progressive mitral valvular disease. The actuarial freedom from valve-related reoperation at 5 years was 84$\pm$9%. Conclusion: This study suggests that mitral valve reconstruction in patients with moderate to severe left ventricular dysfunction offers good early and intermediate survival and acceptable freedom from valve-related reoperation, and it is the strategy for effective management for these patients.
After allergic contact dermatitis elicitated by Dinitrochlorobenzene(DNCB) treatment, ICR female mice administered Yunkyopaedocksangamibang(YPGM) extract were observed to investigate the effect of YPGM on allergic contact dermatitis. This study investigated that contact hypersensitivity assay, abdominal skin morphologic changes including mast cells. At contact hypersensitivity assay, the right ear swelling in YPGM group were probability decreased than DNCB group. At observation of abdominal skin morphologic change, the infiltration of lymphocyte, lymphocyte insertion to epithelium, enlarged capillary, angiogenesis, and damages of epithelium as cytoplasmic vacuolation and enlarge of inter cellular space in YPGM were diminished than DNCB group. The number of mast cell was increased both DNCB and YPGM group. The shape of mast cell in DNCB group was mainly appeared degranulated type, but granulated type in YPGM group. The number of serotonin positive cell was increased both DNCB and YPGM group. The shape of serotonin positive cell in DNCB group was mainly appeared degranulated type, but granulated type in YPGM group. As results indicated that the YPGM extract administration work on the mitigation of skin damages in mouse with allergic contact dermatitis.
Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.
From September 1992 to May 1996, 38 patients ranging in age from 23 to 78, were operated for aortic dissection at Asan medical center There were 21 men and 17 women. The underlying aortic pathology were acute aortic dissection in 23, chronic aortic dissection in 15. Eight patients had Martian syndrome. In 34 cases of DeBakey type I, II patients, femoral artery and vein and/or right atrial auricle were used as cannulation site. With deep hypothermic c rculatory arrest (esophageal temperature 12 $\pm$ 2.5$^{\circ}C$) and retrograde cerebral perfusion of cold oxygenated blood through SVC, we replaced the ascending aorta and the part of arch if necessary. The mean duration of the total circulatory arrest time was 25 $\pm$ 1.7 mintstuts. In 4 cases of DeBakey type III patients, we replaced descending thoracic aorta or thoracoabdomlnal aorta without shunt or bypass under normothermia with an average 30: 1.5 minutesaortic cross clamp time. One death(2.6%) occurred on the twenty-second postoperative day owing to asphyxia related to ulcer bleeding. Postoperative complications were myocardial infarction with transient left peroneal palsy in 1 case, transient lower extremity weakness in 1 case and prolonged ventilatory support in 1 case. Two patients required reoperation due to retrograde extended dissection and aortic insufuciency. There was no late death with an average 25 months follow-up period.
Kim, Ae-Jung;Park, Shin-Young;Choi, Jin-Won;Park, Sang-Hyun;Ha, Sang-Do
Korean Journal of Food Science and Technology
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v.38
no.1
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pp.121-127
/
2006
Microbial and nutritional characteristics of Kwangchun shrimp Jeotgal (salt-fermented shrimp) were assessed. Total mesophilic bacteria, coliforms, and S. aureus counts in Kwangchun shrimp Jeotgal were 3.48-5.42, 2.22-2.95, and 0.58-2.51 $log_{10}CFU/g$, respectively. Yeast and mold were detected only in Ohjeot (1.99 $log_{10}CFU/g$) and Yookjeot (1.47 $log_{10}CFU/g$). B. cereus, L. monocytogenes, Vibrio spp. and E. coli were not detected in Kwangchun shrimp Jeotgal, which contained abundant macrominerals (Ca, Mg, Na, K), with Na showing highest content. Palmitic acid content was higher than those of other saturated fatty acids. Eicosapentaenoic acid and docosahexaenoic acid contents were higher than those of other poly unsaturated fatty acids. Results showed Kwangchun shrimp Jeotgal is safe microbiologically with abundant nutritional components.
Inflammation is the most common condition in the human body. Tissue damage triggers inflammation, together with vasodilation and increased blood flow at the inflamed site, resulting in edema. Inflammatory responses are also triggered by lipopolysaccharide (LPS), a Toll-like receptor Enterococcus faecalis, a gram-positive organism, has been reported to possess immunomodulatory and preventive activities; however, its use may present risks of sepsis and other systemic infections. Heat-killed Enterococcus faecalis (EF-2001) has been reported to induce antitumor activity, but its effects on inflammation are not known. In the present study, we investigated the effect of EF-2001 on LPS-induced macrophage inflammatory responses. EF-2001 treatment reduced nitric oxide (NO) production, indicating suppression of inflammatory reactions. EF-2001 showed no cytotoxicity in macrophages. Further investigation of the anti-inflammatory mechanism of EF-2001 indicated that EF-2001 reduced the LPS-induced expression of inducible nitric oxide synthase and cyclooxygenase-2. EF-2001 also reduced f the LPS induction of several inflammatory molecules involved in the nuclear factor-${\kappa}B$ ($NF-{\kappa}B$) and mitogen-activated protein kinase pathways, including ERK, JNK, and p38 phosphorylation, in a concentration-dependent manner. Additionally, EF-2001 inhibited Akt phosphorylation and increased the expression of the inhibitory ${\kappa}B$ ($I{\kappa}B$) protein, an inhibitor of $NF-{\kappa}B$. EF-2001 also inhibited the nuclear translocation of p65. These results suggest that EF-2001 has anti-inflammatory properties and may be useful for treating inflammatory diseases.
Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.
Purpose: Flash 3D (pixon(R) method; 3D OSEM) was developed as a software program to shorten exam time and improve image quality through reconstruction, it is an image processing method that usefully be applied to nuclear medicine tomography. If perfoming brain diamox perfusion scan by reconstructing subtracted images by Flash 3D with shortened image acquisition time, there was a problem that SNR of subtracted image is lower than basal image. To increase SNR of subtracted image, we use LEAP collimators, and we emphasized on sensitivity of vessel dilatation than resolution of brain vessel. In this study, our purpose is to confirm possibility of application of LEAP collimators at brain diamox perfusion tomography, identify proper reconstruction factors by using Flash 3D. Materials and methods: (1) The evaluation of phantom: We used Hoffman 3D Brain Phantom with $^{99m}Tc$. We obtained images by LEAP and LEHR collimators (diamox image) and after 6 hours (the half life of $^{99m}Tc$: 6 hours), we use obtained second image (basal image) by same method. Also, we acquired SNR and ratio of white matters/gray matters of each basal image and subtracted image. (2) The evaluation of patient's image: We quantitatively analyzed patients who were examined by LEAP collimators then was classified as a normal group and who were examined by LEHR collimators then was classified as a normal group from 2008. 05 to 2009. 01. We evaluate the results from phantom by substituting factors. We used one-day protocol and injected $^{99m}Tc$-ECD 925 MBq at both basal image acquisition and diamox image acquisition. Results: (1) The evaluation of phantom: After measuring counts from each detector, at basal image 41~46 kcount, stress image 79~90 kcount, subtraction image 40~47 kcount were detected. LEAP was about 102~113 kcount at basal image, 188~210 kcount at stress image and 94~103 at subtraction image kcount were detected. The SNR of LEHR subtraction image was decreased than LEHR basal image about 37%, the SNR of LEAP subtraction image was decreased than LEAP basal image about 17%. The ratio of gray matter versus white matter is 2.2:1 at LEHR basal image and 1.9:1 at subtraction, and at LEAP basal image was 2.4:1 and subtraction image was 2:1. (2) The evaluation of patient's image: the counts acquired by LEHR collimators are about 40~60 kcounts at basal image, and 80~100 kcount at stress image. It was proper to set FWHM as 7 mm at basal and stress image and 11mm at subtraction image. LEAP was about 80~100 kcount at basal image and 180~200 kcount at stress image. LEAP images could reduce blurring by setting FWHM as 5 mm at basal and stress images and 7 mm at subtraction image. At basal and stress image, LEHR image was superior than LEAP image. But in case of subtraction image like a phantom experiment, it showed rough image because SNR of LEHR image was decreased. On the other hand, in case of subtraction LEAP image was better than LEHR image in SNR and sensitivity. In all LEHR and LEAP collimator images, proper subset and iteration frequency was 8 times. Conclusions: We could archive more clear and high SNR subtraction image by using proper filter with LEAP collimator. In case of applying one day protocol and reconstructing by Flash 3D, we could consider application of LEAP collimator to acquire better subtraction image.
Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.
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