• Journal of Chest Surgery
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• v.36 no.9
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• pp.651-658
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• 2003

Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52％ of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5％) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1％. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6％; bleeding events, 90.2$\pm$4％; paravalvular leakage 92.3$\pm$4％; and overall valve-related morbidity at 1 year was 76.6$\pm$3％. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8％) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9％, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

• The Korean Journal of Nuclear Medicine
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• v.4 no.2
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• pp.11-27
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• 1970

Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.94-100
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• 2010

Purpose: We can evaluate function of kidney by Glomerular Filtration Rate (GFR) test using $^{99m}Tc$-DTPA which is simple. This test is influenced by several parameter such as net syringe count, kidney depth, corrected kidney count, acquisition time and characters of gamma camera. In this study, we evaluated predose count according to matrix size in the GFR test using $^{99m}Tc$-DTPA. Materials and Methods: Gamma camera of Infinia in GE was used, and LEGP collimator, three types of matrix size ($64{\times}64$, $128{\times}128$, $256{\times}256$) and 1.0 of zoom factor were applied. We increased radioactivity concentration from 222 (6), 296 (8), 370 (10), 444 (12) up to 518 MBq (14 mCi) respectively and acquired images according to matrix size at 30 cm distance from detector. Lastly, we evaluated these values and then substituted them for GFR formula. Results: In $64{\times}64$, $128{\times}128$ and $256{\times}256$ of matrix size, counts per second was 26.8, 34.5, 41.5, 49.1 and 55.3 kcps, 25.3, 33.4, 41.0, 48.4 and 54.3 kcps and 25.5, 33.7, 40.8, 48.1 and 54.7 kcps respectively. Total counts for 5 second were 134, 172, 208, 245 and 276 kcounts from $64{\times}64$, 127, 172, 205, 242, 271 kcounts from $128{\times}128$, and 137, 168, 204, 240 and 273 kcounts from $256{\times}256$, and total counts for 60 seconds were 1,503, 1,866, 2,093, 2,280, 2,321 kcounts, 1,511, 1,994, 2,453, 2,890 and 3,244 kcounts, and 1,524, 2,011, 2,439, 2,869 and 3,268 kcounts respectively. It is different from 0 to 30.02 % of percentage difference in $64{\times}64$ of matrix size. But in $128{\times}128$ and $256{\times}256$, it is showed 0.60 and 0.69 % of maximum value each. GFR of percentage difference in $64{\times}64$ represented 6.77% of 222 MBq (6 mCi), 42.89 % of 518 MBq (14 mCi) at 60 seconds respectively. However it is represented 0.60 and 0.63 % each in $128{\times}128$ and $256{\times}256$. Conclusion: There was no big difference in total counts of percentage difference and GFR values acquiring from $128{\times}128$ and $256{\times}256$ of matrix size. But in $64{\times}64$ of matrix size when the total count exceeded 1,500 kcounts, the overflow phenomenon was appeared differently according to predose radioactivity of concentration and acquisition time. Therefore, we must optimize matrix size and net syringe count considering the total count of predose to get accurate GFR results.

• The Korean Journal of Nuclear Medicine Technology
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• v.24 no.1
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• pp.27-32
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• 2020

Purpose Glomerular Filtration Rate(GFR) is an important indicator for evaluating renal function and monitoring the progress of renal disease. Currently, the method of measuring GFR in clinical trials by using serum creatinine value and ^99mTc-DTPA(diethylenetriamine pentaacetic acid) renal dynamic scan is still useful. After the Gates method of formula was announced, when ^99mTc-DTPA Renal dynamic scan is taken, it is applied the GFR is measured using a gamma camera. The purpose of this paper is to measure the GFR by applying the Gates method of formula. It is according to effect activity and matrix size that is related in the GFR. Materials and Methods Data from 5 adult patients (patient age = 62 ± 5, 3 males, 2 females) who had been examined ^99mTc-DTPA Renal dynamic scan were analyzed. A dynamic image was obtained for 21 minutes after instantaneous injection of ^99mTc-DTPA 15 mCi into the patient's vein. To evaluate the glomerular filtration rate according to changes in activity and matrix size, total counts were measured after setting regions of interest in both kidneys and tissues in 2-3 minutes. The distance from detector to the table was maintained at 30cm, and the capacity of the pre-syringe (PR) was set to 15, 20, 25, 30 mCi, and each the capacity of post-syringe (PO) was 1, 5, 10, 15 mCi is set to evaluate the activity change. And then, each matrix size was changed to 32 × 32, 64 × 64, 128 × 128, 256 × 256, 512 × 512, and 1024 × 1024 to compare and to evaluate the values. Results As the activity increased in matrix size, the difference in GFR gradually decreased from 52.95% at the maximum to 16.67% at the minimum. The GFR value according to the change of matrix size was similar to 2.4%, 0.2%, 0.2% of difference when changing from 128 to 256, 256 to 512, and 512 to 1024, but 54.3% of difference when changing from 32 to 64 and 39.43% of difference when changing from 64 to 128. Finally, based on the presently used protocol, 256 × 256, PR 15 mCi and PO 1 mCi, the GFR value was the largest difference with 82% in PR 15 mCi and PO 1 mCi. conditions, and at the least difference is 0.2% in the conditions of PR 30 mCi and PO 15 mCi. Conclusion Through this paper, it was confirmed that when measuring the GFR using the gate method in the ^99mTc-DTPA renal dynamic scan. The GFR was affected by activity and matrix size changes. Therefore, it is considered that when taking the ^99mTc-DTPA renal dynamic scan, is should be careful by applying appropriate parameters when calculating GFR in the every hospital.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.900-912
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• 1995

Background: Although graded exercise stress tests are widely used for the evaluation of cardiorespiratory performance, normal standards on respiratory gas exchange and ventilatory functions at maximal exercise in Koreans have not been well established. The purpose of this study is to provide reference values on these by sex and age, along with derivation of some of their prediction equations. Method: Symptom-limited maximal exercise test was carried out by Bruce protocol in 1,000 healthy adults consisting of 603 males and 397 females, aged 20~66 years. Among them VC, $FEV_1$ and MVV were also determined in 885 cases. All the subjects were members of a health center, excluding athletes. During the exercise, subjects were allowed to hold on to front hand rail of the treadmill for safety purpose. Results: The $VO_2\;max/m^2$, $VCO_2\;max/m^2$ and $V_E\;max/m^2$ were greater in males than in females and decreased with age. The RR max in men and women was similar but decreased slightly with age. The $V_T$ max was markedly greater in men but showed no significant changes with age in either gender. The mean of $V_T$ max/VC, $V_E$ max/MVV and BR revealed that there were considerable ventilatory reserves at maximal exercise even in older females. The regression equations of the cardinal parameters obtained using exercise time(ET, min), age(A, yr), height(Ht, cm), weight(W, kg), sex(S, 0=male; 1=female), VC(L), $FEV_1$(L) and $V_E$ max(L) as variables are as follows: $VO_2\;max/m^2$(L/min)=1.449+0.073 ET-0.007A+0.010W-0.006Ht-0.209S, $VCO_2\;max/m^2$(L/min)=1.672+0.063ET-0.008A+0.010W-0.005Ht-0.319S, VE max/$m^2$(L/min)=58.161+1.503ET-0.315A-9.871S or VE max/$m^2$(L/min)=47.873+6.548 $FEV_1$-5.715 S, and VT max(L)=1.497+0.223VC-0.493S. Conclusion: Respiratory gas exchange and ventilatory variables at maximal exercise were studied in 1,000 non-athletes by Bruce protocol. During exercise, the subjects were allowed to hold on to hand rail of the treadmill for safety purpose. We feel that our results would provide ideal target values for patients and healthy individuals to be achieved, since our study subjects were members of a health center whose physical fitness levels were presumably higher than ordinary population.

• Parasites, Hosts and Diseases
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• v.21 no.2
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• pp.241-245
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• 1983

PraziquantEI ($Distocide^{\circledR}$), the KcrEan product, was tEstEd for its safety and Efficacy in treatmEnt of Clonorchis sinensiJ infccticn during the period from April to SeptembEr, 1983 in Korea. A total of 55 egg positive cases were selected and treated with the regimen of 25 mg/kg t.i.d. for 1 day (total 75 mg/kg). The follow-up stool examination was done in 47 cases by cellophane thir;k smear and Stoll's egg counting techniques. The 8 uncured cases were treated again with the same regimen. The laboratory tests for blood picture and liver function were done in 27 cases and compared before and after the treatment. The results obtainEd are as follows: 1. After single course treatment, the cure and egg reduction rates were 83.0 and 99.1% respectively. With the second treatment, excellent results of 100% in both rates were obtained. 2. Several kinds of side effects such as dizziness, headache, etc. were complained by 29 cases (61.7 %), however, those were so mild and transient that no special treatment was necessary. 3. No significant change in laboratory findings was recognizable before and after the treatment. From the above results, it is concluded that $Distocide^{\circledR}$ is as effective and safe as $Biltricide^{\circledR}$ and highly recommendable in treatment of C. sinensis infection.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.114-118
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• 1997

Purpose: Functional MR imaging is the method of demonstrating changes in regional cerebral blood flow produced by sensory, motor, and any other tasks. Functional MR of visual cortex is performed as a patient stares a photic stimulation, so adaptable photic stimulation is necessary. The purpose of this study is to evaluate whether the size of photic stimulator can affect the degree of visual cortex activation. Materials and Methods: Functional MR imaging was performed in 5 volunteers with normal visual acuity. Photic stimulator was made by 39 light-emitting diodes on a plate, operating at 8Hz. The sizes of photic stimulator were full field, half field and focal central field. The MR imager was Siemens 1.5-T Magnetom Vision system, using standard head coil. Functional MRI utilized EPI sequence (TR/TE= 1.0/51. Omsec, matrix $No.=98{\times}128$, slice thickness=8mm) with 3sets of 6 imaging during stimulation and 6 imaging during rest, all 36 scannings were obtained. Activation images were obtained using postprocessing software(statistical analysis by Z-score), and these images were combined with T-1 weighted anatomical images. The activated signals were quantified by numbering the activated pixels, and activation a index was obtained by dividing the pixel number of each stimulator size with the sum of the pixel number of 3 study using 3 kinds of stimulators. The correlation between the activation index and the stimulator size was analysed. Results: Mean increase of signal intensities on the activation area using full field photic stimulator was about 9.6%. The activation index was greatest on full field, second on half field and smallest on focal central field in 4. The index of half field was greater than that of full field in 1. The ranges of activation index were full field 43-73%(mean 55%), half field 22-40 %(mean 32%), and focal central field 5-24%(mean 13%). Conclusion: The degree of visual cortex activation increases with the size of photic stimulator.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.365-377
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• 2012

Objectives : This research was conducted to determine the effect of the Visiting Oral Health Care Program by examining the oral health of the elderly women, who are the beneficiaries of this Visiting Oral Care Program. Methods : This research was conducted from November of 2011 to February of 2012, in Chilgok-gun in the Kyeongbuk Province, South Korea. One hundred and twenty five (125) elderly women among the beneficiaries of the Visiting Oral Care Program within the area were randomly selected for the research. The research subjects would regularly visit the area senior citizen center, and they were divided into two groups, with 64 of them belonging to a control group, and the rest (61 people) belonged to a intervention group. The research subjects were examined for their dental health condition, and we investigated the effect of the Visiting Oral Care Program through this research. Results : 1. When they were asked about how many times they wash their dentures, the majority of the control group, 57.4% of them answered that they do it "once" a day. The majority of the intervention group answered "more than 3 times", with 35.2% of group mentioning that they wash their dentures more than 3 times a day(p<.001). 2. When the research subjects were asked to scale their overall quality of life before and after the Visiting Oral Care Program, the control group had rated 49.3 before the Service and 56.8 after the Service (p<.01), and scores for the individual factors to determine the overall quality of life has significantly improved as well (p<.01, p<.01, p<.01, p<.01, p<.01, p<.01, p<.01). 3. The oral hygiene condition after the Visiting Oral Care Program has shown improvement as well. The control group scored 64.2 for the severity of the symptoms of dental plaque before the dental care, and scored 46.8 after the dental care (p<0.1). The control group was diagnosed for the symptoms of coated tongue, and the severity of the symptoms were scaled as 3.7 before the Program and 2.0 after the Program (p<.01). Furthermore, the overall functionality of the oral cavity was improved as well. The control group showed 1.0 time increase in repetitive voluntary swallowing test (p<0.1), increased amount of sublingual saliva from 0.8mm to 1.4mm, and from 1.6mm to 2.0mm in dorsum linguae(p<0.1). Also, the control group showed an improvement in mouth opening as well, increased from 3.9 to 4.0cm after the oral care program (p<.05). When compared the result with the examination after the Visiting Oral Care Program, the two groups showed a significant difference with the control group showing a significant improvement compared to the intervention group(p<.01, p<.01, p<.01, p<.01, p<.05). 4. The correlation between the dental hygiene condition and the functionality of oral was made for the result of examining the beneficiaries for Visiting Oral Care Program. The amount of saliva showed a negative correlation with the severity of dental plaque (p<.05), and a positive correlation with the repetitive voluntary swallowing count (p<0.1). Also, mouth opening showed a positive correlation with repetitive voluntary swallowing count (p<.05). Conclusions : After the Visiting Orall Care Program, the beneficiaries of the program experienced improvement in their quality of life related to oral health, overall oral hygiene and functionality of oral.

• The Journal of the Korean Society for Microbiology
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• v.21 no.3
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• pp.311-329
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• 1986

The experimental exposure of animals to sources of ultraviolet radiation (UVR) which emit their energy primarily in the UVB region (280-320nm) is known to result in a number of well-described changes in the recipient's immune competence. Two such changes include a depressed capacity to effectively respond immunologically to transplants of syngeneic UVR tumors and a markedly reduced responsiveness to known inducers of delayedtype (DTH) and contact hypersensitivity (CH) reactions. The results of experiments that were designed to elucidate the mechanisms responsible for UVR-induced immunomodulation have implicated: 1) an altered pattern of lymphocyte recirculation, 2) suppressor T cells(Ts), 3) deviations in systemic antigen presenting cell (APC) potential. 4) changes in the production of interleukin-1-like molecules, and 5) the functional inactivation of epidermal Langerhans cells in this process. The exposure of skin to UVR, therefore, causes a number of both local and systemic alterations to the normal host immune system. In spite of this seeming complexity and diversity of responses, our recent studies have established that each of the UVR-mediated changes is probably of equal importance to creating the UVR-induced immunocompromised state. Normal animals were exposed to low dose UVR radiation on their dorsal surfaces under conditions where a $3.0\;cm^2$ area of skin was physically protected from the light energy. Contact sensitization of these animals with DNFB, to either the irradiated or protected back skin, resulted in markedly reduced CH responses. This was observed in spite of a normal responsiveness following the skin sensitization to ventral surfaces of the UVR-exposed animals. Systemic treatment of the low dose UVR recipients with the drug indomethacin (1-3 micrograms/day) during the UVR exposures resulted in a complete reversal of the depressions observed following DNFB sensitization to "protected" dorsal skin while the altered responsiveness found in the group exposed to the skin reactive chemical through directly UVR-exposed sites was maintained. These studies implicate the importance of EC as effective APC in the skin and also suggest that some of the systemic influences caused by UVR exposure involve the production of prostaglandins. This concept was further supported by finding that indomethacin treatment was also capable of totally reversing the systemic depressions in CH responsiveness caused by high dose UVR exposure (30K joules/$m^2$) of mice. Attempts to analyze the cellular mechanisms responsible established that the spleens of all animals which demonstrated altered CH responses, regardless of whether sensitization was through a normal or an irradiated skin site, contained suppressor cells. Interestingly, we also found normal levels of T effector cells in the peripheral lymph nodes of the UVR-exposed mice that were contact sensitized through normal skin. No effector cells were found when skin sensitization took place through irradiated skin sites. In spite of such an apparent paradox, insight into the probable mechanisms responsible for these observations was provided by establishing that UVR exposure of skin results in a striking and dose-dependent blockade of the efferent lymphatic vessels in all peripheral lymph nodes. Therefore, the afferent phases of immune responses can apparently take place normally in UVR exposed animals when antigen is applied to normal skin. The final effector responses, however, appear to be inhibited in the UVR-exposed animals by an apparent block of effector cell mobility. This contrasts with findings in the normal animals. Following contact sensitization, normal animals were also found to simultaneously contain both antigen specific suppressor T cells and lymph node effector cells. However, these normal animals were fully capable of mobilizing their effector cells into the systemic circulation, thereby allowing a localization of these cells to peripheral sites of antigen challenge. Our results suggest that UVR is probably not a significant inducer of suppressor T-cell activity to topically applied antigens. Rather, UVR exposure appears to modify the normal relationship which exists between effector and regulatory immune responses in vivo. It does so by either causing a direct reduction in the skin's APC function, a situation which results in an absence of effector cell generation to antigens applied to UVR-exposed skin sites, inhibiting the capacity of effector cells to gain access to skin sites of antigen challenge or by sequestering the lymphocytes with effector cell potential into the draining peripheral lymph nodes. Each of these situations result in a similar effect on the UVR-exposed host, that being a reduced capacity to elicit a CH response. We hypothesize that altered DTH responses, altered alloresponses, and altered graft-versus-host responses, all of which have been observed in UVR exposed animals, may result from similar mechanisms.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.93-100
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• 1988

In clinical practice, creatinine clearance(Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate(GFR) could be obtained from the simple determinations of plasma creatinine(Pcr) and body length(L) : GFR($m{\ell}/min/1.73m^2$=k L(cm)/Pcr(mg/$100m{\ell}$), (k=constant). The subject of this study were ill children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III. from 11 to 15 years old. The results were as following ; 1) Measured creatinine clearance($Ccr_M$, $m{\ell}/min/1.73m^2$) were $109.73{\pm}9.97$ in group I, $108.26{\pm}9.02$ in group II, $96.20{\pm}4.72$ in group III and $105.48{\pm}5.23$ in all age group. 2) Measured k($k_M$) obtained from $Ccr_M=k$ Ht/Pcr were $0.49{\pm}0.03$ in group I, $0.48{\pm}0.02$ in group II, $0.43{\pm}0.02$ in group III, and $0.47{\pm}0.02$ in all age group.(Ht ; height) 3) Linear equations and correlation coefficients between Ht/Pcr(x) and Ccr(y) were y=0.822x-65.63(r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44(r=0.54) in group III and y=0.58x-22.13(r=0.81) in all age group. 4) $Ccr_E$ was again estiamted from linear equations between Ht/Pcr and $Ccr_M$ and $k_E$ was calculated with Ht/Pcr and $Ccr_E$ were $0.48{\pm}0.01$ in group I, $0.49{\pm}0.01$in group II, $0.43{\pm}0.01$ in group III and $0.47{\pm}0.00$ in all age group. 5) Consistant values of $k_E$ and $k_M$ were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k($k_M$) according to the age in easy and rapid way.