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Mitral valve Replacement (승모판막 치환술)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.137-145
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    • 1997
  • From July 1983 to December 1993, total 112 consecutive mitral valve replacements in 107 patients were performed in patient with mitral valvular abnormalities. To estimate the risk factor related to operative death, all patient's perioperative data were reviewed retrospectively. Except 20 patients received concomitant aortic valve replacement and 2 patients had incomplete data, 85 patients were included in this study. Mean age were $37.3\pm$ 13.1 years ranging from 13 to 72 years. Thirty-seven patients were male and fourty-eight patients were female. Mean follow-up durations were $51.1\pm33.8$ months ranging from 6 months t 11 years. Patients in this study showed improvement in mean NYHA functional clssification, from $3.02\pm0.73$ to 1 $78\pm0.55,$ and also in cardiothoracic ratio, from 0.61 $\pm0.09$ to $0.58\pm0.08$ at 6 months follow-up after operation. Operative complications were detected in 23 patients(27.1 %) and common postoperative complications were rhythm disturbance in 7 cases, pulmonary complications in 6 cases and low cardiac output syndrome in 6 cases. Early mortality was 10.6%(n=9) and the most common cause of death was a congestive heart failure due to low cardiac output syndrome. Main cause of our higher operative mortality than other study was that operative mortality in the initial period of our mitral surgery was high(5 operative deaths among 19 mitral valve replacement from July 1983 to December 1985). Actuarial survival was 80.8% at 5 years, 71.8% at 11 years including operative deaths. Actuarial freedom from anticoagulant-related bleeding was 85.3% at 5 years, 78.3% at 11 years. 95.1% at 5 years and 88.8% at 11 years among the patient in this study were free from thromboembolism, and 97.5% at 5 years and 75.1% at 11 years were free from reoperation. Preoperative cardiothoracic ratio and patient's age were statistically significant operative risk factors.

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Comparison of Olfactory Sensibility With/Without Consideration of Individual Olfactory Threshold (피험자의 후각 역치 고려 유무에 따른 후각 감성 비교)

  • Seo, Han-Seok;Jeon, Kwang-Jin;Kwon, Jin-Hwan;Hwang, In-Kyeong;Kang, Jin-Kyu;Min, Byung-Chan
    • Science of Emotion and Sensibility
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    • v.10 no.2
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    • pp.199-208
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    • 2007
  • The olfactory function of subjects could be different due to various factors such as aging, and such discrepancies influence on the olfactory sensibility. Therefore, the objectives of this study was to investigate changes of olfactory sensibility characteristics and structure in relation to the consideration of olfactory threshold of subject. Stimulants of this study were five standard odor samples of T&T olfactometer, and thirty undergraduates over than 19 years old were tested twice during this study In experiment 1, subjects were given to odor samples which were controlled on the basis of individual olfactory threshold. Whereas, subjects were provided with uncontrolled odor samples which had the same concentration(+1) in experiment 2. Olfactory sensibility characteristics were significantly different with presentation types of odor samples, and these gaps were more higher on condition that the preference of odor sample was not distinct. Moreover, such differences affected the olfactory sensibility structure, and 'esthetic sense', 'intensity', and 'activity' were common factors, but 'friendship' of experiment 1 and 'weight' of experiment 2 were unique factors. In conclusion, the olfactory sensibility characteristics and structure could be different with consideration of olfactory threshold of subject. Overall, this study suggest that the olfactory function and the presentation method of odor sample be regarded as principal consideration factors in the olfactory sensibility evaluation.

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The Change of $SaO_2$, PFT and ABGA During the Bronchofiberscopy (기관지 내시경 검사에 따른 산소 포화도, 폐기능 및 동맥혈 가스의 변화)

  • Kim, Jong-Seon;Shin, Jeon-Eun;Kim, Tae-Hee;Chang, Jung-Hyun;Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.574-582
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    • 1998
  • Background: Bronchofiberscopy is a procedure with a chance of airway irritation and it may cause pathophysiologic changes of respiratory system. So we tried to evaluate the influence of bronchofibercopy on $O_2$ saturation, ABGA and PIT by patient's basal status and procedure type. Method: $O_2$ saturation was measured every 1 minute from the left index finger tip with percutaneous oximetry. ABGA was done before and right after the bronchofiberscopy and PIT was done before and within 10 minutes after the bronchofiberscopy. Results: The mean time for bronchofiberscopy procedure was 14.5mim and $SaO_2$ maximally fall to 89.0 below 8% of the baseline after mean time of 8.4min, which was recovered at the end of the procedure. $SaO_2$ change amount was 8.4 % on Non-$O_2$ supply group, which was lower compared to 6.4 % of the $O_2$-supply group without statistically significance. Biopsy Group and BAL group showed more $SaO_2$ fall than washing only group. The level of $PaO_2$ and FEV1 of the patient didn't influence significantly on $SaO_2$ fall during the procedure. ABGA taken before and after the bronchofiberscopy showed mild fall of $PaO_2$ and mild rise of $PaCO_2$. Whereas PFT showed decrease of FEV1(P<0.05) and increase of RV without changes in airway resistance and pulmonary diffusion capacity. Comparing before and after the bronchofiberscopy, the washing group showed no significant changes on PIT, while the biopsy group and the BAL group showed increase of RV & decrease of $FEV_1$ after the bronchofiberscopy. BAL group showed more changing tendency rather than biopsy group although not statistically significant. Conclusion: Bronchofiberscopy is considered as a relatively safe procedure, but it would be better to be done with $O_2$ supply especially in the patient with low $PaO_2$ and in the case of biopsy and BAL.

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Evaluation of the Cell-Mediated Immunity in Treatment Failure Pulmonary Tuberculosis (치료실패 폐결핵 환자의 세포성면역반응에 관한 연구)

  • Park, Jeong-Kyu;Park, Jang-Seo;Kim, Hwa-Jung;Jo, Eun-Gyeong;Min, Dul-Lel;Lim, Jae-Hyun;Suhr, Ji-Won;Paik, Tae-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.13-25
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    • 1999
  • Background: Ineffective cell-mediated immune response in human tuberculosis is associated with a depressed Thl cytokine response and reduced production of IFN-$\gamma$. Most persons infected with Mycobacterium tuberculosis are healthy tuberculin reactors with protective immunity, but a minority with ineffective immunity develop extensive pulmonary tuberculosis. The cell-mediated immune response is an important aspect of host resistance to mycobacterial infection and is believed to be tightly regulated by a balance between Th1 cytokines including IFN-$\gamma$, IL-12, IL-18, regulated on activation, normal T cell expressed and secreted (RANTES) and Th2 counterparts such as IL-4, monocyte chemoattractant protein-l (MCP-l). Methods: Proliferation and mRNA expression of IFN-$\gamma$, RANTES and MCP-l by RT-PCR in peripheral blood mononuclear cells (PBMCs) in response to in vitro stimulation with mycobacterial antigens were compared in pulmonary tuberculosis patients with cured and treatment failure and in tuberculin-positive and tuberculin-negative healthy subjects. Results: Defective proliferative responsiveness to aqueous TSP antigen was involved with treatment failure tuberculosis patients. Aqueous TSP antigen-induced IFN-$\gamma$ and RANTES mRNA expression was decreased in treatment failure tuberculosis patients compared with healthy tuberculin reactors and cured tuberculosis patients (23.1 % versus 90.0% for IFN-$\gamma$ and 46.2% versus 70.0% versus 46.2% for RANTES). The frequency of MCP-l mRNA expression to aqueous TSP antigen in treatment failure tuberculosis patients was greater than in healthy tuberculin reactors and cured tuberculosis patients (76.9% versus 40.0%). Conclusion: The increasing expression of MCP-1 mRNA in response to aqueous TSP antigen might be predicted to favor Th1 responses and restricted Th1 responses in treatment failure of pulmonary tuberculosis.

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Usefulness of $^{18}F$-Fluoride PET/CT in Bone Metastasis of Prostate Cancer (전립선암 환자의 뼈 전이에 대한 $^{18}F$-Fluoride PET/CT의 유용성)

  • Park, Min-Soo;Kim, Jung-Yul;Park, Hoon-Hee;Kang, Chun-Goo;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.24-30
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    • 2009
  • Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

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Effect of $Al^{3+}$ on Labeling Efficiency and Biodistribution of $^{99m}Tc$-MDP ($Al^{3+}$ 존재가 $^{99m}Tc$-MDP의 표지효율과 생체내 분포에 미치는 영향)

  • Chang, Young-Soo;Jeong, Jae-Min;Kim, Young-Ju;Kwark, Cheol-Eun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.361-366
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    • 1996
  • This study was to determine the effect of $Al^{3+}$ in $^{99m}Tc$ eluate from $^{99}Mo-^{99m}Tc$ generator on labeling efficiency and biodistribution of $^{99m}Tc$-MDP. The chromatographic analysis of $^{99m}Tc$-MDP preparations containing $Al^{3+}(0-62.5{\mu}g/ml)$ showed decreased labeling efficiency $^{99m}Tc$ pertechnetate and hydrolyzed reduced $^{99m}Tc$ fraction increased with increasing concentrations of aluminum. However, the chromatography system could not discern between hydrolyzed reduced $^{99m}Tc$ and $^{99m}Tc$ labeled colloid. $^{99m}Tc$-MDP preparations containing aluminum were relatively stable. Chromatographic analysis also confirmed that no significant differences were observed in the radiochemical purity of the filtered and the unfiltered $^{99m}Tc$-MDP preparations containing aluminum by $0.22{\mu}m$ syringe filter. In biodistribution data of ICR-mice, blood and heart uptake were increasing with increasing concentrations of aluminum, because of decreasing labeling efficiency of $^{99m}Tc$-MDP and increasing of $^{99m}Tc$ pertechnetate. However, liver and bone uptake were not significantly increased. In rat images no difference were observed at $5{\mu}g/ml\;Al^{3+}$ compare with at $0{\mu}g/ml\;Al^{3+}$, but at $10{\mu}g/ml\;Al^{3+}$ lumbar uptake was increased. As a practical conclusion, a concentration below $10{\mu}g/ml\;Al^{3+}$($10{\mu}g/ml\;Al^{3+}$ is the maximum allowed in pertechnetate eluate from $^{99}Mo-^{99m}Tc$ generator by USP.) in $^{99m}Tc$-MDP radiopharmaceutical result in low labeling efficiency. Radiochemical purity 90% of $^{99m}Tc$-MDP is the minimum allowed by USP. Therefore, when soft tissue uptake is observed in $^{99m}Tc$-MDP bone scan and labeling efficiency is above 90%, we can expect that $Al^{3+}$ in pertechnetated eluate is not the cause of soft tissue uptake.

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Assessment of Metabolic Impairment in Alzheimer's Disease with [$^{18}F$]FDG PET: Validity and Role of Simplified Tissue Radioactivity Ratio Analysis (알쯔하이머병에서 양전자방출단층촬영을 이용한 국소뇌포도당대사의 변화에 관한 연구)

  • Kim, Sang-Eun;Na Duk-Lyul;Lee, Jeong-Rim;Choi, Yong;Lee, Kyung-Han;Choe Yearn-Seong;Kim, Doh-Kwan;Kim, Byung-Tae;Lee, Kwang-Ho;Kim, Seung-Tai P.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.299-314
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    • 1996
  • The purpose of the present study was to validate the use of tissue radioactivity ratios instead of regional metabolic rates for the assessment of regional metabolic changes in Alzheimer's disease(AD) with [$^{18}F$]FDG PET and to examine the correlation of ratio indices with the severity of cognitive impairment in AD. Thirty-seven AD Patients(age $68{\pm}9 yrs$, $mean{\pm}s.d.$; 36 probable and 1 definite AD), 28 patients with dementia of non-Alzheimer type(age $66{\pm}7 yrs$), and 17 healthy controls(age $66{\pm}4 yrs$) underwent [$^{18}F$]FDG PET imaging. Two simplified radioactivity ratio indices were calculated from 37-66 min image: region-to-cerebellar radioactivity ratio(RCR) and a composite radioactivity ratio(a ratio of radioactivity in the most typically affected regions over the least typically affected regions: CRR). Local cerebral metabolic rate for glucose(LCMRglu) was also measured using a three-compartment, five-parameter tracer kinetic model. The ratio indices were significantly lower in AD patients than in controls(RCR in temporoparietal cortex, $0.949{\pm}0.136$ vs. $1.238{\pm}0.129$, p=0.0004; RCR in frontal cortex, $1.027{\pm}0.128$ vs. $1.361{\pm}0.151$, p<0.0001; CRR, $0.886{\pm}0.096$ vs. $1.032{\pm}0.042$. p=0.0024). On the RCR analysis, 86% of AD patients showed a pattern of bilateral temporoparietal hypometabolism with or without frontal involvement; hypometabolism was unilateral in 11% of the patients. When bilateral temporoparietal hypometabolism was considered to be suggestive of AD, the sensitivity and specificity of the RCR analysis for the differential diagnosis of AD were 86% and 73%, respectively. The RCR was correlated significantly with the macroparameter K [$K_1k_3/(k_2+k_3)$] (r=0.775, p<0.0001) and LCMRglu(r=0.633, p=0.0002) measured using the kinetic model. In patients with AD, both average RCR of cortical association areas and CRR were correlated with Mini-Mental Status Examination(r=0.565, p=0.0145; r=0.642, p=0.0031, respectively), Clinical Dementia Rating(r=-0.576, p=0.0124; r=-0.591, p=0.0077), and total score of Mattis Dementia Rating Scale (r=0.574, p=0.0648; r=0.737, p=0.0096). There were also significant correlations between memory and language impairments and corresponding regional RCRs. The results suggest that the [$^{18}F$]FDG PET ratio indices, RCR and CRR, reflect global and regional metabolic rates and correlate with the severity of cognitive impairment in AD. The simplified ratio analysis may be clinically useful for the differential diagnosis and serial monitoring of the disease.

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Effect of Small Black Soybean Powder on Blood Glucose and Insulin Sensitivity in Streptozotocin-Induced Diabetic Rats (Streptozotocin-유도 당뇨모델을 이용한 쥐눈이콩 분말의 혈당강하 및 인슐린 감수성의 효과)

  • Lee, Dae-Hoon;Kwak, Dong-Hoon;Kim, Sung-Min;Ju, Eun-Jin;Choi, Han-Gil;Kim, Ok-Hee;Hwang, Jin-Bong;Bae, Nahm-Gung;Jung, Kyu-Yong;Han, Jin-Chul;Park, Hum-Dai;Choo, Young-Kug
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.10
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    • pp.1618-1625
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    • 2004
  • Beans are acknowledged to be food resources, which have more abundant proteins and fats. The constituent parts of beans (i.e. aspartic aid, glycine, arginine) are effective against diabetes, and dietary fiber contained in the beans has an important property to maintain insulin sensitivity. Based on these, using streptozotocin (STZ)-induced diabetic rats, this study examined how the rat-eye soybean, which is principal products of the Imsil province, is effective to attenuate and/or prevent the development of diabetes mellitus. We divided rats into the non-diabetic and diabetic group, and diabetic group was further subdivided into six experimental groups [DC, diabetic control; DI, diabetes with insulin treatment (4∼6 IU/rat); DB, diabetes with black bean; DY, diabetes with yellow soybean; DS, diabetes with rat-eye soybean; DSS, diabetes with vinegar-fermented rat-eye soybean. All bean treatment (1.5 mg/l g body weight).]. Food efficiency ratio (FER), body weight and insulin sensitivity in diabetic rats were significantly reduced compared to those in normal control animals. These reductions were obviously attenuated by administration of a variety of beans used in this study (20∼30%), and the recovery effects were comparable to the results obtained by insulin treatment. Taken together, this study suggests that all beans used may have an essential property to improve and/or attenuate the development of diabetes mellitus in rats.

Chitosan and Acetylchitosan from Squid Pen and Their Characteristics (오징어 연골을 이용한 Chitosan 및 Acetylchitosan의 제조와 특성)

  • CHOI Hyeon-Mee;HWANG Sun-Young;PARK Seong-Min;LEE Keun-Tai
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.34 no.5
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    • pp.563-569
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    • 2001
  • In order to utilize the processing wastes of squid, chitosan was prepared by intermittent deacetylation treaoent of $\beta-chitin$ contained richly in the pen of squid. Acetylchitosan also was synthesized from squid pen chitosan with anhydrous acetic acid and their characteristics were investigated. The amounts of nitrogen and ash of squid pen chitosan were $5.80.2\% and 0.2\pm0.03\%$ respectively, the yield of squid pen chitosan was $25\pm3\%$, the degree of deacetylation was $92\%$, and the molecular weight was $1.15\times10^6$, Acetyl contents of N-acetylchitosan powder, acetylchitosan bead, N-ACF-1 (N-acetylchitosan film-1) and N-ACF-2 (N-acetylchitosan film-2) were $55.9\%, 63.2\%, 56\% and 58.7\%$ respectively. Two major peaks, amide I ($1,653 cm^{-1}$) and II ($1,558 cm^{-1}$) bent, on FT-IR spectra of the N-acetylchitosan from squid pen were almost similar to these of $\beta-chitin$, While there was a broad single peak at $1,601 cm^{-1}$assigned to be an amide I bend in squid pen chitosan. The CP/MAS NMR spectra of $\beta-chitin$, squid pen chitosan and N-acetylchitosan from squid pen showed a relative broad and single peak at 74 ppm assigned to fifth carbon (C-5) and third carbon (C-3). In case of $\beta-chitin$ and N-acetylchitosan from squid pen, single peak at 74 ppm was showed as the same of $\beta-chitin$ type.

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The Difference between Clinical Manifestations and Feeding or Delivery Methods in Healthy Full-term Neonates and Those with Nosocomial Rotaviral Infection (수유 및 분만방법에 따른 신생아실 로타바이러스 원내감염의 증상 차이)

  • Lee, So Young;Kim, Hyun Ji;Kim, Mi Young;Kim, Won Duck;Lee, Dong Seok;Kim, Doo Kwun;Choi, Sung Min
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.454-458
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    • 2003
  • Purpose : Rotavirus is the main cause of infantile diarrheal disease worldwide. The purpose of this study is to assess the difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomially-acquired rotaviral infection. Methods : The study was conducted on 348 babies who were delivered in Dongguk University Kyongju Hospital from Jan 1 to June 30 in 2001. Stool specimens were collected from clinically symptomatic neonates. We studied the rate of positive stool rotazyme ELISA tests and positive symptoms. We compared the frequency of clinical manifestations according to the feeding methods [breast feeding(BF) or formula feeding(FF)] and the delivery methods[normal vaginal delivery(NVD) or Cesarean section(C/sec)]. Results : Rotavirus was detected in 152 of 348 babies. The rate of positive rotazyme ELISA test was 43.7% in healthy full-term symptomatic neonates. The most common symptom of rotaviral enteritis was mild fever; the others were watery diarrhea, abdominal distension, vomiting, delayed weight gain, irritability, poor oral intake and dehydration. Compared with FF neonates, BF neonates have lower frequency of symptoms, especially watery diarrhea, delayed weight gain and poor oral intake. The symptomatic frequency was higher in FF and NVD neonates than BF and C/sec. Conclusion : The symptoms of rotaviral enteritis were less frequent in BF or C/sec delivered neonates. BF appeared to alleviate the rotaviral enteritis but further studies are needed. The cause of the lower frequency of symptoms in C/sec delivered neonates was unknown.