• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.278-282
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• 2002

A 68-year-old woman was admitted after suffering facial edema with neck vein engorgement for approximately 2 months. A chest X-ray showed a mild widening of the superior mediastinum and a luminal obliteration of the superior vena cava(SVC) was noted on a computed tomograph. Venography showed that both subclavian veins were obstructed at the level of the proximal clavicle with a nonvisualization of the SVC. The SVC, both the innominate and the left internal jugular veins were completely obstructed with extensive cord-like fibrotic changes despite the absence of mediastinal involvement. The microscopic features showed a chronic granulomatous inflammation with a fibrosis minimally invading the mediastinal fat, which is consistent with fibrosing mediastinitis.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.2
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• pp.197-202
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• 2015

Numerous challenges in treating permanent dentition are encountered, especially in treating immature teeth with pulp necrosis. Historically, calcium hydroxide application during long periods of time was used to induce the formation of a calcific barrier across the open apex. In 2004, a new treatment modality for the management of the open apex was introduced. This treatment was named as 'revascularization' and gained acceptance among dentists. The protocol was different from the traditional apexification techniques in that the canal was irrigated and disinfected with a combination of three antibiotics (ciprofloxacin, metronidazole and minocycline). At the next appointment, bleeding was induced and the canal was sealed with MTA. Successful regenerative endodontic treatment of necrotic immature permanent teeth can provide continued root development, increased thickness in the dentinal walls and apical closure. These developments of a functional pulp-dentin complex have a promising impact on retaining the natural teeth, the goal of the dental health care.

• Restorative Dentistry and Endodontics
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• v.36 no.5
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• pp.397-408
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• 2011

Objectives: This study investigated changes in gene expressions concerning of differentiation, proliferation, mineralization and inflammation using Human-8 expression bead arrays when white Mineral Trioxide Aggregate and calcium hydroxide-containing cement were applied in vitro to human dental pulp cells (HDPCs). Materials and Methods: wMTA (white ProRoot MTA, Dentsply) and Dycal (Dentsply Caulk) in a Teflon tube (inner diameter 10 mm, height 1 mm) were applied to HDPCs. Empty tube-applied HDPCs were used as negative control. Total RNA was extracted at 3, 6, 9 and 24 hr after wMTA and Dycal application. The results of microarray were confirmed by reverse transcriptase polymerase chain reaction. Results: Out of the 24,546 genes, 43 genes (e.g., BMP2, FOSB, THBS1, EDN1, IL11, COL10A1, TUFT1, HMOX1) were up-regulated greater than two-fold and 25 genes (e.g., SMAD6, TIMP2, DCN, SOCS2, CEBPD, KIAA1199) were down-regulated below 50% by wMTA. Two hundred thirty nine genes (e.g., BMP2, BMP6, SMAD6, IL11, FOS, VEGFA, PlGF, HMOX1, SOCS2, CEBPD, KIAA1199) were up-regulated greater than two-fold and 358 genes (e.g., EDN1, FGF) were down-regulated below 50% by Dycal. Conclusions: Both wMTA and Dycal induced changes in gene expressions related with differentiation and proliferation of pulp cells. wMTA induced changes in gene expressions related with mineralization, and Dycal induced those related with angiogenesis. The genes related with inflammation were more expressed by Dycal than by wMTA. It was confirmed that both wMTA and Dycal were able to induce gene expression changes concerned with the pulp repair in different ways.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.307-312
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• 2004

With the development of cardiac surgical technique, we need more prosthetic materials for repairing the intra- and extracardiac defects. Although bovine pericardial bioprosthesis treated with glutaraldehyde (GA) solution is one of the most popular materials, it has a drawback of later calcific degeneration. The purpose of this study is to investigate the effectiveness of several materials and methods in reducing the calcific degeneration of bovine pericardium. Material and Method: Forty square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4 g/L MgCl$_2$ㆍ6$H_2O$ as a control group (group 1). Other 40 pieces pre-treated with 1 % SDS(group 2) and 40 pieces post-treated with 8% glutamate (group 3) and 2% chitosan (group 4) were also fixed in the same GA solution. Other 40 pieces pre-treated with 1% SDS and post-treated with 8% glutamate and 40 pieces post-treated with 2% chitosan were also fixed in the same GA solution (group 5, 6). The pericardial pieces were implanted into the belly of 40 Fisher 344 rats subdermally and were extracted 1 month, 2 months, 3 months, and 6 months after the implantation. With an atomic absorption spectrophotometry, we measured the calcium amount deposited and examined the tissue with microscope. Result: The calcium deposition in 1 month was less in group 2, 5, 6 than that in group 1 (p＜0.05). It was most prominent in group 5 (p＜0.01). This finding continued in 2 month. In 3 month, the calcium deposition was less in group 3 and 4 as well as group 2, 5, and 6 than in group 1. In 6 month, the calcium deposition in group 2, 3, 4, 5, and 6 was less than that in group 1 and the difference was more than that of 1, 2, and 6 month. The microscopic calcium deposition was also less in group 2 and 5. Calcium deposition developed in the whole layer of pericardium, beginning with the surrounding the collagen fiber and progressing inwardly. Conclusion: Pre-treatment with SDS, post-treatment with glutamate or chitosan, and SDS pre-treatment and post-treatment with glutamate or chitosan were effective in reducing the calcium deposition in bovine pericardium. Moreover, the combined method of SDS pre-treatment and glutamate post-treatment was more effective than other methods.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.1
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• pp.79-84
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• 2004

Pilomatricoma is a benign soft tissue tumor of hair follicle origin. They occur most commonly in the head and neck region and are usually found in girls during the first two decades of life. Although malignant transformation has been described, it is exceedingly rare. The clinical presentation is typically that of an asymptomatic, superfical, solitary, firm mass that is often accompanied by a reddish-blue discoloration of the overlying skin. Histopathologically pilomatricoma are seen as epithelial islands embedded in a cellular stroma. The epithelial component consist of two main cell types : basaloid cells and ghost cells. Intracellular and stromal calcification is reported in many cases. Diagnosis is usually suspected based on palpation of a superficial, rock-hard mass and confirmed by histopathologic examination. Surgical excision is both curative and the treatment of choice. Recurrence is rare. In this case, the radiographs showed a dense calcification, measuring about 1cm diameter. So simple excision was peformed intraorally, and resultantly the lesion was proved to be a pilomatricoma by histological examination.

• Proceedings of the Korean Society of Veterinary Pathology Conference
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• 2002.11a
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• pp.150-150
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• 2002

40두 규모의 농장에서 사육된 홀스타인 종, 4개월령의 수컷 송아지에서 거세 후 고열, 식욕부진, 기침 등의 증상과 함께 전신 체표 림프절의 종대가 관찰되어 백혈병으로 잠정진단 하고 도태를 권유하였으나 축주가 치료를 원해 항생제와 해열제 및 기타 대증요법을 실시한 후 치료반응이 없어 폐사하여 부검을 실시하였다. 혈액 검사상 이상핵과 다형핵을 가진 다수의 림프구 및 백혈구, 호중구, 림프구 및 단핵구의 증가가 관찰되었다. 또한 백혈병 바이러스에 대한 분리 및 PCR 검사는 음성이었다. 부검 소견으로 체표 림프절, 슬관절 부위 및 비장과 간의 종대가 관찰되었으며 비장 중심에 12x11 cm의 종괴와 폐의 전엽부 유착 및 폐문, 종격동 림프절의 심한 종대가 관찰되었다. 견갑전 림프절을 비롯하여 대퇴골 전, 서혜, 폐문, 이하림프절 등 전신 림프절의 종대 및 소성의 연한 황색의 매끄러운 절단면을 보였다. 전지 관절의 종대와 관절강 내부는 증가된 농성 활액을 보였으며 고관절 강 내에 농성 활액의 증가와 공기 노출 후 젤리양 응고를 보였다. 심장은 장액성 위축과 함께 섬외막성 점상출혈이 나타났다. 병리조직학적 소견으로 비장은 지주 주변에 미성숙형의 세포들의 침윤이 보이며 유사분열상이 다수 관찰되었고 백색 수질에도 유사분열상의 증가와 함께 림프아구성 세포들이 다수 나타났다. 이들 주요한 비정상 세포들은 다형성의 큰 핵을 가진 다양한 림프아구의 형태를 지녔으며 핵내 공포가 인정되었다. 비장의 종괴 주변에는 증식된 섬유조직으로 둘러싸여 있었으며 미세농양 형성되어 있고, 일부 석회화가 진행된 부위도 있었다. 간소엽성 중심성 울혈과 가벼운 간세포내 지방침윤, 혈관 내 림프아구 형태의 세포와 소수의 호중구가 관찰되었다. 간삼조 주변에는 가볍거나 중등도의 단핵세포의 침윤이 미만성으로 관찰되었다. 폐에서는 중등도의 기관지 폐렴과 함께 일부는 무기폐가 관찰되었으며 폐포강과 세기관지내에는 염증성 삼출물이 다량 들어 있었다. 다병소성 미세농양과 함께 괴사가 있었고 실질의 섬유화가 진행되어 있었다. 또한 중등도의 간질성 신장염과 림프절은 지주 주변에 간극 내 비정상 림프구 세포의 형태는 비장의 그것과 유사하였으며 적수와 백수의 구이 힘들며 림프소절이 증가되어 있었다. 한 시야에서 유사분열상이 6-8 개로 그 지수가 매우 높으며 이와 더불어 큰 림프구가 전반에 걸쳐 침윤되어 있었다. 주변부 동(sinus)에는 많은 물질들이 침윤되어 있으며 렴프소절내 미만성의 성상현상이 관찰되었다. 회장은 파이어판내 심한 림프구 소실이 나타났다. 이상의 소견을 바탕으로 본 증례는 산재성 송아지 백혈병으로 진단되었다

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.180-192
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• 2007

Background: As determined from the recent investigations of discordant cardiac xenotransplantation, hyperacute rejection occurs mainly at the endothelial cells in donor microvascular systems, but this does not occur at cardiac valve leaflets or at medium-to-large caliber vessels. On the basis of this background, this study was performed to look into the biocompatibility for transplantation of a middle or large diameter xenogenic blood vessel by conducting xenogenic arterial transplantation with the carotid artery in a pig-to-goat model. Material and Method: The experimental group was composed of 10 pairs of pig-to-goat combinations. They were divided into each period of 1 week, and 1, 3, 6 and 12 months. Four carotid artery grafts obtained through collection of the bilateral carotid arteries from two pigs were preserved at $-70^{\circ}C$ without other treatment, and then they were transplanted into the bilateral carotid arteries of two goats. Doppler ultrasonography was done on a periodic basis after transplantation to evaluate the patency of the grafted blood vessel. At the ends of a predetermined period, the grafts were explanted from the goats and they underwent gross examination. Hematoxylin-eosin and Masson's trichrome staining were conducted. In addition, in order to examine the immunological rejection of the grafted xenogenic blood vessel, immunohistochemical staining was conducted with T-lymphocyte indicator and von Willebrand factor. Result: Two goats at the each one-week period and the one-year period died during the experimental period because of a reason unrelated to the experimental procedure, and the remaining 8 goats survived until the end of each experiment period. On Doppler ultrasonography, unilateral carotid artery occlusion was found in a goat, whose period was specified as 3 months, among the 8 survived goats. However, the vascular patency was maintained well and there was no graft that formed aneurysms in the other goats. On gross examination, the region of vascular anastomosis was preserved well, and calcification of the grafted blood vessel was not shown. Histologically, the endothelial cells of the graft disappeared one week after transplantation, and then there was progressive spread of the recipients' endothelial cells from the anastomotic site. The reendothelialization occurred over the whole graft at one month after transplantation. The neointimal thickening and adventitial inflammation became severe by 3 months after transplantation, but this lessened at 6 months and 12 months, respectively. The rate of CD3 positive cells was very low among the infiltrated inflammatory cells. Conclusion: The fresh-frozen xenogenic artery kept its patency without being greatly influenced by xenogenic immune reaction.

• Journal of Chest Surgery
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• v.33 no.11
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• pp.886-893
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• 2000

배경: 흉복부 대동맥류는 질환 자체가 광범위하고 수술 중 척수를 포함한 각종 장기의 보호 및 허혈 방지라는 면에서 아직도 수술 합병증이 높은 질환이다. 본 연구에서는 그 동안의 임상경험을 바탕으로 치료성적, 합병증 발생, 사망률 등을 검토하였다. 대상 및 방법: 1990년 1월부터 1999년 12월까지 흉복부동맥류로 수술을 시행한 38명의 환자를 대상으로 의무 기록 검토을 통한 후향적 분석을 시행하였다. 결과: 남자가 22명, 여자가 16명, 평륜 연령은 46.2$\pm$12.3세였고, 크로포드 진단분류 상 1형 이 13례(34.2%), 2형이 19례(50%), 3형이 4례(11%), 4형이 2례(4.8%)였다. 만성 대동맥박리증에 관련된 경우가 29례(76.3%)로 가장 많았고, Marfan 증후군이 동반된 경우가 9례(23.7%)에서 있었다. 원위부 대동맥 관류를 35례에서 시행하였으며, 고동맥-고정맥 심폐바이패스를 31례에서, 좌심방-고동맥 바이패스를 4례에서 시행하였다. 심폐바이패스를 이용한 31례중 4례에서 초저체온하 완전순환정지를 이용하였다. 대동맥 차단 중 복강내 주요 대동맥 분지로의 선택적 관류를 시행하였다. 대동맥류의 최대직경은 평균 8.2$\pm$2.4cm이었고, 동맥류가 파열된 경우는 11례(28.9%)에서 있었다. 전례에서 인조혈관을 이용한 대동맥의 치환술을 시행하였다. 단계적으로 흉복부 대동맥을 겸자하면서 인공혈관을 문합하였고, Adamkiewicz 동맥으로 생각되는 부위의 늑간 동맥을 문합해주었는데, 8번째부터 12번째 흉추 사이의 늑간 동맥 중 역류혈류가 나타나고 상대적으로 내경이 큰 것들을 문합해 주었다. 술 후 조기사망은 3례에서 있었으며, 사인은 심폐기 이탈 실패 (2례), 저혈압 및 산증(1례) 등이었다. 조기 합병증으로는 애성 5례, 출혈 5례, 창상간염 3례, 장기간의 인공호흡기보조가 3례 등이 있었다. 치명적인 조기 합병증인 하지마비는 2례(5.3%)에서 발생하였고, 이 중 1례는 대동맥의 심한 석회화로 늑간동맥을 문합해 주지 못했던 경우였다. 35명의 환자에서 평균 추적기간은 103.1$\pm$6.1 개월, 2년 생존율은 93.8%, 5년 생존율은 86.1%, 8년 생존율은 80.7%였다. 추척기간 동안 4례의 만기사망이 관찰되었고, 사인은 2례에서는 갑작스런 의식소실이 발생하여 규명하기 어려웠으며, 대동맥-식도루 발생에 의한 경우가 1례, 경동맥류 파열에 의한 경우가 1례 등이었다. 만기 합병증으로는 복부 대동맥류(2례), 상행 대동맥 및 대동맥 근부 확장(1례), 대동맥-늑막루(1례), 창상 부위 탈장(1례), 역행성 사정(1례) 등이 있었다. 결론: 저자들은 흉복부대동맥류의 수술에 있어 심폐우 회술 혹은 좌심방-고동맥 바이패스를 통한 원위부 관류 및 저체온법, 수술 시 척수의 혈류공급과 관련된 늑간동맥의 연결 등으로 주요 신경합병증의 발생을 줄이고 좋은 성적을 거두고 있다고 판단하였으며 향후 임상 경험 축적과 함께 보다 정련된 위험인자의 분석이 필요하다고 본다.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.11-19
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• 2010

Background: The commercially used vascular xenografts have some problems such as calcification, fibrosis and tissue degeneration that are associated with inflammatory and immunologic reactions. We compared two methods of xenograft preservation (fresh cryopreservation versus acellularized cryopreservation) of goat aorta. Material and Method: Aortic valved xenografts were harvested from adult pigs, and these were preserved using fresh cryopreservation (FC group, n=4) or acellularized crypreservation (AC group, n=4). These xenografts were implanted into adult goats. There were 2 short-term survivors (less than 100 days) and 2 long-term survivors in each group. These xenografts were explanted and they underwent microscopic examination. Result: The goats survived 31, 40, 107 and 411 days in the FC group and the other goats survived 5, 40, 363 and 636 days in the AC group. All the short-term survivors in each group expired because of rupture at the proximal anastomosis site. Marked neutrophil infiltration was observed in the FC group FC and lymphocytes were observed in the AC group. There were no differences in the occurrence of calcification, fibrosis and thrombosis among the groups. Conclusion: Some goats survived more than 100 days after the xenograft implantation irrespective of the methods of preservation. Because severe tissue degeneration developed in both groups, we think these methods are not appropriate for xenograft preservation of aorta. It was worth a preliminary trial for improving the preservation method or to modify the processing of xenografts.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.390-394
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• 2008

We report here on two eases of a 48-year old woman and a 46-year-old man who both presented with broneholithiasis and obstructive pneumonitis. Removal of the broncholithiasis failed with bronchofibroscopy, and so right middle lobectomy of the lung were done in the 2 patients. The histopathologic diagnosis was thoracic actinomycosis associated with broncholithiasis. Thoracic actinomycosis associated with broncholithiasis is a very rare condition, so we report here on these two cases of thoracic actinomycosis associated with broncholithiasis.