• Journal of Chest Surgery
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• 제27권4호
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• pp.259-265
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• 1994

Cor triatriatum is a relatively rare cardiac anomaly, whose major feature is a fenestrated membrane separating an upper common pulmonary venous chamber from a lower true left atrial cavity. Interatrial communications may be present between the right atrium and the common pulmonary venous chamber or the true left atrium. From April 1981 to April 1992, 24 patients with cor triatriatum were treated at Seoul National University Hospital. Ages ranged from 1 month to 24 years with mean of 7.4 years. Twenty patients had interatrial communications through a patent foramen ovale, primum or secundum defect of the atrial septum. Four had no interatrial communications. Fourteen patients had associated anomalies; partial anomalous pulmonary venous connection in 3, total anomalous pulmonary venous connection in 2, persistent left superior vena cava in 3, and other anomalies in 6 patients. Surgical corrections were performed through right atriotomy in 18 patients, left atriotomy in 4, and both atriotomy in 2. Three patients [12.5%] died early after operation; two of them were associated with single ventricle. Six out of 21 survivors [28.6%] experienced complications; recurrent pneumonia, pulmonary embolism, ischemic encephalopathy, diaphragmatic palsy and tachyarrhythmias. At the time of follow up, all survivors, except one, were in functional class I. Surgical correction of cor triatriatum restored normal hemodynamic status with relatively low operative mortality, especially in patients not complicated with severe anomalies. This report summarizes the clinical diagnosis, associated anomalies, interatrial communications, surgical approach and late result of 24 patients underwent surgical corrections in our hospital.

• 전기학회논문지
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• 제57권5호
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• pp.902-907
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• 2008

Shape of the pulse waveform is affected by the visco-elasticity characteristics of the arterial wall and the reflection waves generated at the bifurcations of arterial branches. This study was designed to improve the accuracy for the extraction of pulse wave features, then proved the superiority of the developed algorithm by clinical evaluation. Upstroke point of the pulse wave was used as an extraction feature since it is minimally affected by the waveform variation. R-peak of the ECG was used as a reference to decide the minimum level, then intersection of the least squares of regression line was used as an upstroke point. Developed algorithm was compared with the existing minimum value detection algorithm and tangent-intersection algorithm using data obtained from 102 subjects. Developed algorithm showed the least standard deviation of $0.29{\sim}0.44\;m/s$ compared with that of the existing algorithms, $0.91{\sim}3.66\;m/s$. Moreover, the rate of standard deviation of more than 1.00m/s for the PWV values reduced with the range of $29.0{\sim}42.4%$, which proved the superiority of the newly developed algorithm.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.4-9
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• 2013

Leptin, a 16-kDa cytokine, is secreted by adipose tissue in response to the surplus of fat store. Thereby, the brain is informed about the body's energy status. In the hypothalamus, leptin triggers specific neuronal subpopulations (e.g., POMC and NPY neurons) and activates several intracellular signaling events, including the JAK/STAT, MAPK, PI3K, and mTOR pathway, which eventually translates into decreased food intake and increased energy expenditure. Leptin signal is inhibited by a feedback inhibitory pathway mediated by SOCS3. PTP1B involves another inhibitory pathway of leptin. Leptin potently promotes fat mass loss and body weight reduction in lean subjects. However, it is not widely used in the clinical field because of leptin resistance, which is a common feature of obesity characterized by hyperleptinemia and the failure of exogenous leptin administration to provide therapeutic benefit in rodents and humans. The potential mechanisms of leptin resistance include the following: 1) increases in circulating leptin-binding proteins, 2) reduced transport of leptin across the blood-brain barrier, 3) decreased leptin receptor-B (LRB), and/or 4) the provocation of processes that diminish cellular leptin signaling (inflammation, endoplasmic reticulum stress, feedback inhibition, etc.). Thus, interference of the cellular mechanisms that attenuate leptin signaling improves leptin action in cells and animal models, suggesting the potential utility of these processes as points of therapeutic intervention. Various experimental trials and compounds that improve leptin resistance are introduced in this paper.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.112-115
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• 2016

Noonan syndrome is an autosomal dominant, multisystem disorder. Autoimmune thyroiditis with hypothyroidism is an infrequent feature in patients with Noonan syndrome. A 16-year-old boy was admitted because of chest discomfort and dyspnea; an echocardiogram revealed pericardial effusion. Additional investigations led to a diagnosis of severe hypothyroidism due to Hashimoto thyroiditis. The patient was treated with L-thyroxine at 0.15 mg daily. However, during admission, he developed symptoms of cardiac tamponade. Closed pericardiostomy was performed, after which the patient's chest discomfort improved, and his vital signs stabilized. Herein, we report a case of an adolescent with Noonan syndrome, who was diagnosed with Hashimoto thyroiditis with an unusual presentation of cardiac tamponade.

• Journal of Oral Medicine and Pain
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• 제24권3호
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• pp.315-323
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• 1999

The 63 patients(20 males, 43 females) were treated for their trigeminal neuralgia at the Department. of Oral Medicine, Pusan National University Hospital from 1993 to 1998. All the patients were treated for their trigeminal neuralgia by conservative methods such as medication, and Electric Acupuncture Stimulation Therapy The obtained results were as follows: 1. Trigeminal neuralgia was mainly involved in the patients of past forties, women and acute group. 2. 50.8% of patients were related to maxillary branches of trigeminal nerves. The trigger points were on gingivae, cheeks, teeth, lips in order. 3. 55.6% of patients with trigeminal neuralgia had systemic diseases and 39.7% were related to dental practices. 4. Success rate of the treatments was 71.4% and the recurrence rate was 26.3%. 5. The refractory factors in improving symptoms were chronic history, involvement of complex branches, and experience of prosthodontic treatments.

• 대한족부족관절학회지
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• 제17권1호
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• pp.11-16
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• 2013

Freiberg's disease is a osteochondrosis of a metatarsal head that is recognized as primarily a disorder of the second metatarsal. It is seen more often in girls. Pain and limitation of motion of the affected joint is the predominant clincal feature. The radiographic appearance demonstrates from osteosclerosis in the early stage to osteolysis with collapse in the later stage. Conservative therapy may take the form of rest, a stiff shoe, and even a cast support to decrease the stress across the joint. Surgical intervention may also be of benefit. Surgery have been attempted either to modify the diseae process or to salvage the situation once the metatarsophalangeal joint develops degenerative changes. Metatarsophalangeal joint instability is common cause of forefoot pain that can develop in association with a traumatic episode and inflamatory tissue disorders as well as neighboring toe deformities. The second ray is by far the most frequently involved. The diagnosis can be made by clinical observation and physical examination including drawer test. Many surgical procedures have beem recommended when conservative treatment has failed. Procedures described range from soft tissue releases and tendon trasfer to the direct plantar plate repair combined with a Weil osteotomy.

• Archives of Plastic Surgery
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• 제32권1호
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• pp.135-138
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• 2005

Pyoderma gangrenosum(PG) is an uncommon cutaneous vascular disease that typically presents as a painful and destructive ulceration on the anterior surface of the legs. The etiology of PG is currently unknown. But, the association with many immunologic disorders and its clinical response to immunomodulating agents suggest an immune etiology. A common feature of patients with PG is the presence of pathergy(the induction of lesion following injury of the skin). The trauma of surgery can be sufficient to induce pathergy, thus paradoxically limiting the usefulness of surgical treatment of PG. For that reason, medical treatments have been commonly used, while surgical treatments have been regarded not suitable. However, the use of the classic systemic agents is limited by their side effects and contraindications. Moreover, the large, problematic ulcers take too long to heal with medical management only. We present our experience in closing large wounds with the goal of decreasing morbidity, drug side effects and hospital stay by combination of medical and surgical therapy(split thickness skin graft). And authors advocate that surgical management is not a contraindication and may be considered as a selective modality in treatment of PG.

• 비파괴검사학회지
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• 제29권3호
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• pp.214-218
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• 2009

The occlusal force of the tooth leads to loss of tooth tissue owing to attrition and abrasion, and may cause abfraction and pathological change of the dentin. Thus, we developed finite element models, examined them by applying ordinary occlusal force, and analyzed the stress distribution. Specimens used were mandibular first premolars from 15 Korean males and 13 females and were made into finite element models from medical images that were obtained using a Micro-CT. We have found that the irregular feature of the tooth is not only useful to masticating and pronouncing as well known, but it is also suitable for protecting inner tissue by dispersing stress and delivering proper pressure to periodontal tissue to continue a physiological action. Also, image analysis could let us know the factor that is the cause of a disorder due to stress concentration in the cervical line. These results are expected to support the field of dental treatment planning, operating procedure and clinical trial, and the advance of technical expertise to develop implants and dentures.

• Korea-Australia Rheology Journal
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• 제19권2호
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• pp.61-66
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• 2007

The aggregation characteristics of red blood cells (RBCs) are known as important factors in the microvascular flow system, and increased RBC aggregation has been observed in various pathological diseases, such as thrombosis and myocardial infarction. This paper describes a simple microfluidic device for measuring the RBC aggregation by integrating a microfluidic slit rheometry and laser-backscattering technique. While a decreasing-pressure mechanism was applied to the microfluidic rheometry, a syllectogram (the light intensity versus time) showed an initial increase and a peak caused by the high shear stress-induced disaggregation, immediately followed by a decrease in the light intensity due to RBC aggregation. The critical shear stress (CST) corresponding to the peak intensity was examined as a new index of the RBC aggregation characteristics. The CST of RBCs increased with increasing aggregation-dominating protein (fibrinogen) in the blood plasma. The essential feature of this design was the combination of the rheometric-optic characterization of RBC aggregation with a microfluidic chip, which may potentially allow cell aggregation measurements to be easily carried out in a clinical setting.

• Biomolecules & Therapeutics
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• 제20권6호
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• pp.506-512
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• 2012

Although pruritus is the critical symptom of atopic dermatitis that profoundly affect the patients' quality of life, controlling and management of prurirtus still remains as unmet needs mainly due to the distinctive multifactorial pathogenesis of pruritus in atopic dermatitis. Based on the distinct feature of atopic dermatitis that psychological state of patients substantially influence on the intensity of pruritus, various psychotropic drugs have been used in clinic to relieve pruritus of atopic dermatitis patients. Only several psychotropic drugs were reported to show real antipruritic effects in atopic dermatitis patients including naltrexone, doxepin, trimipramine, bupropion, tandospirone, paroxetine and fluvoxamine. However, the precise mechanisms of antipruritic effect of these psychotropic drugs are still unclear. In human skin, serotonin receptors and serotonin transporter protein are expressed on skin cells such as keratinocytes, melanocytes, dermal fibroblasts, mast cells, T cells, natural killer cells, langerhans cells, and sensory nerve endings. It is noteworthy that serotonergic drugs, as well as serotonin itself, showed immune-modulating effect. Fenfluramine, fluoxetine and 2, 5-dimethoxy-4-iodoamphetamine significantly decreased lymphocyte proliferation. It is still questionable whether these serotonergic drugs exert the immunosuppressive effects via serotonin receptor or serotonin transporter. All these clinical and experimental reports suggest the possibility that antipruritic effects of selective serotonin reuptake inhibitors in atopic dermatitis patients might be at least partly due to their suppressive effect on T cells. Further studies should be conducted to elucidate the precise mechanism of neuroimmunological interaction in pruritus of atopic dermatitis.