• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.52-60
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• 2001

Purpose: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. Materials and Methods: Patients with narrow range of age (21-25. mean $22.8{\pm}1.3$, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed $21.2{\pm}7.3wks$ after trauma. Results: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight hearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). Conclusion: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.372-376
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• 2012

Acute kidney injury (AKI) is a serious problem associated with high morbidity and mortality. Ischemia-reperfusion is an important cause of acute kidney injury. This study was performed to ascertain clinically useful biomarkers for the diagnosis of AKI. In three miniature pigs, AKI were induced by 60 minutes of bilateral renal ischemia by the clamping renal artery. Blood and urine samples were collected from the pigs prior to clamping (baseline) and 0, 1, 3 and 5 days post-clamping. Serum blood urea nitrogen (BUN), creatinine, sodium and uric acid were measured in serum and urine samples. Fractional excretion of sodium ($FE_{Na}$) and fractional excretion of uric acid ($FE_{UA}$) were calculated. Also, interleukin (IL)-6, IL-18, liver type fatty acid binding protein (L-FABP) and glutathione-S-transferase (GST) were detected by Western immunoblotting. Serum BUN and creatinine levels were increased significantly at day 1 post-clamping in all three miniature pigs. However, $FE_{Na}$ and $FE_{UA}$ showed marked individual differences. Western immunoblotting revealed significantly increased levels of IL-6, IL-18, L-FABP and GST in post-ischemic urine, compared to pre-clamping. While more research concerning the variance of $FE_{Na}$ and $FE_{UA}$ is needed, serum BUN, creatinine, IL-6, IL-18, L-FABP and GST may be sensitive urine biomarkers for diagnosis of AKI together with other biomarkers in the porcine ischemia-reperfusion model.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.11
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• pp.897-903
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• 2015

In this paper, the contrast therapy of skin was numerically investigated by solving the conjugate heat transfer problem. A finite volume method based on the SIMPLE algorithm was adopted to solve the axisymmetric incompressible Navier-Stokes equations, coupled with an energy equation. These equations are strongly coupled with the Pennes bio-heat equation in order to consider the effect of blood perfusion rate. We investigated the thermal response of skin at some selected depths for various input temperature profiles of a stimulator for contrast therapy. From the numerical simulations, the regions with cold/hot threshold temperatures were found for five input temperature profiles. It was shown that the temperature varies mildly for different input profiles as the depth increases, owing to the Pennes effect. The input temperatures for effective hot/cold stimulation of dermis layer were found to be $47^{\circ}C$ and $7^{\circ}C$, respectively. The present numerical results will be used for finding an optimal temperature profile of a stimulator for contrast therapy.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.342-348
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• 2004

It is very important for hemodialysis in patients with end stage renal disease to obtain vascular access that resists repeated punctures and maintains adequate blood flow. This study was designed to indentify factors that may influence early patency rate of autogenous arteriovenous fistula. Material and Method: 49 cases in 47 patients who underwent radiocephalic fistula formation in our hospital from June 2002 through May 2003 were reviewed and analyzed. Result: The early patency rate was 79.6%. Age, sex, hypertension, and diabetes mellitus were not significant factors for patency. Body mass index and duration of hypertension and diabetes did not influence the early results either. Cephalic vein diameter measured preoperatively and blood flow at radio-cephalic fistula were significantly positive correlative factors. Groups with the vein diameter less than 2.7mm, or with the blood flow less than 100 mL/min had significantly lower early patency rate than the other groups. Conclusion: To improve early patency rate of radiocephalic fistula, large sized cephalic vein should be selected and if the intraoperative flow at radiocephalic fistula is less than 100 mL/min, another arteriovenous fistula formation should be considered.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.218-224
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• 2004

We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.83-88
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• 2008

Thromboembolic disease associated with assisted reproductive techniques is considered to be extremely rare but most serious complication. The reasons for this are thought to hypercoagulable state characteristic of OHSS due to high serum levels of estrogen, hemoconcentration and reduced circulating blood volume, but is still unclear. The risk is increased those with rare hypercoagulable conditions such as antiphospholipid antibody syndrome, protein C deficiency, protein S deficiency, antithrombin III deficiency, and those with a personal or family history of thromboembolic disease. The majority of thrombosis reported were venous site but arterial thrombosis mostly intracerebral was reported 5 cases in Korea so far. We present a case of basilar a. thrombosis at 11 days after hCG injection. The patient developed the right hemiparesis, and recovered after intraarterial thrombolysis and transluminal angioplasty. Protein S activity was decreased and vWF antigen was increased. Decreased protein S activity was also found in previous reported 4 cases, so we suggest screening test for protein S in OHSS patients.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.49-54
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• 1994

Postoperative brain damage is one of most serious complications of cardiopulmonary bypass (CPB). To prevent brain damage during CPB, adequate cerebral perfusion for cerebral oxygen demand should be maintained. This study monitored jugular venous oxyhemoglobin saturation ($SjO_2$), which reflects the overall balance of cerebral oxygen supply and demand, intermittently in 10 patients undergoing cardiac surgery. At the initiation of CPB, in spite of a significant decrease in mean arterial pressure, $SjO_2$ did not change, and it was stable during the hypothermic period of CPB. But a significan reduction in $SjO_2$ was observed during the rewarming period, and $SjO_2$ had an inverse linear correlation with esophageal temperature. Furthermore, the percent decrease of $SjO_2$ was related to rewarming speed. Therefore, therapeutic approaches for $SjO_2$ desaturation include slower rewarming, increasing cerebral blood flow, decreasing the cerebral metabolic rate for oxygen, increasing oxygen content, and increasing perfusion flow rate.

• Journal of Embryo Transfer
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• v.22 no.2
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• pp.89-95
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• 2007

The present study was conducted to examine some factors affecting in vitro development and fecundity of embryos recloned with somatic cell nuclear transfer (SCNT). Fibroblast cells retrieved from the ear of a 3-week-old, cloned Korean goat (Jinsoonny) were used as karyoplast donors and serum-starvation was conducted in tissue culture medium (TCM)-199 supplemented with 0.5% FBS. Recipient oocytes were surgically collected by flushing the oviducts 35 h after hCG injection following FSH priming. The zonae pellucidae of the oocytes were partially perforated with a laser drill and a donor cell was transferred into an enucleated oocyte. The couplets were electrically fused and activated by ionomycin (5 min) and 6-DMAP (4 h). The reconstructed embryos were cultured in mSOF medium containing 0.8% BSA at $39^{\circ}C$ in an atmosphere of 5% $CO_2$, 5% $%O_2$, 90% $N_2$ for 12 to 15 h. Re-cloned embryos (2- to 4-cell stages) were surgically transferred into the oviducts of the recipients and pregnancy was subsequently diagnosed by progesterone assay and ultrasound on Days 21 and 63 of pregnancy. The fusion rate following 1st fusion pulse was higher (p<0.05) in 2nd cloning (65.9%) compared to 1st cloning (51.0%), but it was not different in the other groups. The rate of cleavage after fusion was significantly higher (p<0.05) in 1st (77.7%) than in 2nd cloning (56.0%). A total of 175 re-cloned embryos were transferred into 28 recipients. On day 21 and 60 after transfer, 11 (39.3%) and 4 recipients (17.4%) were pregnancy, respectively. In comparison of pregnancy rate by estrous synchronization, a total of 66 and 109 re-cloned embryos were transferred into 11 recipients in natural estrus and 17 recipients in induced estrus, respectively. Five (45.4%) and 2 recipients (18.2%) in natural estrus were pregnant on days 21 and 63 while 6 (35.3%) and 2 (11.8%) recipients in induced estrus were pregnant, respectively. These results show that recloning of goat can be achieved by SCNT and estrous synchronization between donor and recipient animals may be one of the major factors affecting success rate.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.817-826
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• 2004

Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26～28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.353-361
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• 1998

Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.