• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.374-382
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• 1999

Background: The aim of this study was to investigate etiologic factor, treatment, prognosis of spontaneous pneumothorax (SP). Material and Methods: The medical records of 225 cases of SP experienced at Kyungpook University Hospital from Jan. 1996 to Dec. 1997 were retrospectively analyzed. Results: The patients were 128 primary SP and 97 secondary SP. The mean age was $30{\pm}15.5$ years in primary SP and $51{\pm}7.4$ years in secondary SP. The ratio of male to female was 8:1 in primary SP and 5.5:1 in secondary SP. Smoker was more common in seconday SP (71.1 %) than primary SP (34.4%). About 70% of patients with primary and secondary SP was underweighted. The previous history of SP was present in 28.9% and 25.8% of primary and secondary SP, respectively. The main underlying lung diseases in secondary SP were inactive tuberculosis (68%), active tuberculosis (12.4%) and COPD (11.3%). Tube thoracostomy was performed in 96.8% and 97.9% of primary and secondary SP, respectively. The duration of chest tube insertion was longer in seconday SP ($18.2{\pm}19.59$ days) than primary SP ($7.5{\pm}6.57$ days). The open thoracotomy were performed in 22.7% and 10.3% of primary and secondary SP, respectively. The most com- mon indication of open thoracotomy was recurrence in primary SP and persistent air leak in secondary SP. During following-up of $17{\pm}7.8$ months, the recurrence rate in patients with conservative treatment was 16.5% and 11.8% of primary and secondary SP, respectively. The recurrence was most common within 1 month after discharge. Conclusion: Greater attention and research about SP are necessary for more efficient patient care.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.207-216
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• 2000

Background : The occurrence of lung complications after allogenic bone marrow transplantation(BMT) has been reported as 40-60 percent. The risk factors for lung complications are whole body irradiation, high dose chemotherapy, graft versus host disease, old age and CMV infection. The prevalence of graft versus host disease is less in Korea than in Western countries, but frequency of CMV infection is higher. Therefore, the pattern of lung complications may be different in Korea from those in Western countries. Methods : A retrospective cohort study was performed on one hundred consecutive adult patients who underwent allogenic bone marrow transplantation from December, 1993 to May, 1999 at Asan Medical Center. Lung complications were divided into two groups by the time of development, within 30days (pre-engraftment) and beyond 30 days (post-engraftment), and then subdivided into infectious and non-infectious complication. Infectious complications were defined as having the organism in blood, BAL fluid, pleural fluid or sputum, or compatible clinical findings in patients, which improved with antibiotics or an anti-fungal therapy. Result: 1) Eighty three episodes of lung complications had occurred in 54 patients. 2) Within thirty days after BMT, non-infectious complications were more common than infections, but this pattern was reversed after 30 days. After one year post-BMT, there was no infectious complication except in cases of recurrence of underlying disease or development of chronic GVHD. 3) Among the non-infectious complications, pleural effusion (27 episodes) was most common, followed by pulmonary edema (8 episodes), bronchiolitis obliterans(2 episodes), diffuse alveolar hemorrhage (1 episode) and bronchiloitis obliterans with organizing pneumonia (1 episode). 4) The infectious complications were pneumonia (bacterial: 9 episodes, viral: 4 episodes, fungal : 5 episodes, pneumocystis carinii : 1 episode), pulmonary tuberculosis(3 episodes) and tuberculous pleurisy (3 episodes). 5) Lung complications were more frequent in CMV positive patients and in patients with delayed recovery of neutrophil count. 6) The mortality was higher in the patients with lung complications. Conclusion : Lung complications developed in 54% after allogenic BMT and were associated with higher mortality.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.89-109
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• 1999

Vascular spasm which has been reported to occur in 25% of clinical cases continues to be a problem in microvascular surgery; When prolonged and not corrected, it can lead to low flow, thrombosis, and replant or free flap failure. Ischemia, intimal damage, acidosis and hypovolemia have been implicated as contributors to the vascular spasm. Although much work has been done on the etiology and prevention of vasospasm, a spasmolytic agent capable of firmly protecting against or reversing vasospasm has not been found. Therefore vascular freezing was introduced as a new safe method that immediately and permanently relieves the vasospasm and can be applied to microsurgical transfers. Cryosurgery can be defined as the deliberate destruction of diseased tissue or relief the vascular spasm in microvascular surgery by freezing in a controlled manner. 96 Sprague Dawley rats each weighing within 250g were used and divided into 2 group, experimental 1 and 2 group. In the experimental 1 group, right epigastric vessels (artery and vein) were freezed with a cryoprobe using $N_2O$ gas for 1 min. In the experimental 2 group, after freezing for 1 min, thawing for 30 secs and repeat freezing for 30 secs. Left side was chosen as control group in both group. We sacrified the experimental animals by 1 day, 3 days, 1 week, 2 weeks, 4 weeks & 5 months and observed the sequential change that occur during regeneration of epigastric vessels using a histologic, histomorphometric, immunohistochemical and SEM study after the vascular freezing. The results were as follows1. In epigastric arteries, internal diameters had statistically significant enlargement in 1 day, 3 days of Exp-1 group and 1 day, 3 days, 1 week & 2 weeks of Exp-2 group. Wall thickness had statistically significant thinning in 2 weeks of Exp-2 group. 2. In epigastric veins, internal diameters had enlargement of statistical significance in 1 day of Exp-1 and Exp-2 group. 3. The positive PCNA reactions in smooth muscle appeared in 1 week and increased until 2 weeks, decreased in 4 weeks. There was no statistical significance between Exp-1 and Exp-2 group. 4. The positive ${\alpha}$-SMA reaction in smooth muscles showed weak responses until 1 week and slowly increased in 2 weeks and showed almost control level in 4 weeks. 5. The positive S-100 reactions in the perivascular nerve bundles showed markedly decrease in 1 day, 3 days and increased after 1 week and showed almost control level in 4 weeks. Exp-1 group had stronger response than Exp-2 group. 6. In SEM, we observed defoliation of endothelial cell and flattening of vessel wall. Exp-2 group is more destroyed and healing was slower than Exp-1 group. To sum up, relief of vasospasm (vasodilatation) by freezing with cryoprobe was originated from the damage of smooth muscle layer and perivascular nerve bundle and the enlargement of internal diameter in vessels was similar to expeimental groups, but Exp-2 group had slower healing course and therefore vessel freezing in microsurgery can be clinically used, but repeat freezing time needs to be studied further.

• Journal of Haehwa Medicine
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• v.7 no.2
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• pp.609-620
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• 1999

Over the period between January 1997 and December 1998, herbal medicine was more than three times administered to the patients coming to Na dong gyu's Oriental Medical Clinic on account of the symptom of growth deficiency. According to radiological opinions about the patients providing cooperation for measuring their height and weight as well as their bone age every three months, it was found that the growth plates were not closed. A research was conducted for 200 children randomly selected of patients in prepuberty (they grew by less than 5cm a year before treatment at a age of 12years for female children and 14years for male children). As a result, the following conclusion was drawn: 1. The randomly selected subjects were made up of 116 male and 84 female children in terms of gender. The age direstribution was most 10 to 12 years in 86 children(34.00%), followed by 8-10 years(27.50%) and 12 to 14 years(19.50%). 2. Considering the distribution of sick children's parental height, the fathers of 141 children(70.50%) measured less than 170cm high, the subaverage height, while the mothers of 172 children(86%) measured less than 160cm high, the subaverage height. It was shown that sick childen's height was genetically influenced by their parents. 3. Children patients's weight at a time of birth was most 3.1-3.5kg for 85 children(44%) and less than 2.5kg which came under the range of growth dificiency for 19 children(9.5%). 4. The highest proportian of the children patients with growth dificiency(56.33%) had the symptom of digestive disorders, of which 77 children patients(18.78%) had anorexia, 16.59% of children patients had the high level of respiratory disorders. Both the digestive disorder and the respiratory disorder put together, they had the high rate of 72.92%. Therefore, this indicates that both the digestive disorder and the respiratory disorder have a great effect on children's growth dificiency. 10.74% of chilren patients were shown to have allergic disorders, which indicates that they also exert an effect on growth deficiency. Specifically, 7.07% of the children patients had the high level of obesity, which shows that an excessive uptake of nutrition may rather induce children to have growth dificiency though an appropriate amount of nutritional uptake is necessary. 5. Comparing their bone age and their chronological age, 58 children patients(29.00%) showed that they were the same at the highest percent. 79 children patients(39.50%) showed that thier bone age was lower than their chronological age. And 63 children patients(31.50%) showed that their bone age was higher than their chronological age. 6. As regards the prescription administered to children patients for treating their growth dificiency, Growth tang A related to the kidney, the congenital factor, of the causes for growth dificiency in traditional Oriental Medicine was administered to 108 children patients(54%), whereas the Growth tang B related to the spleen, the acquired factor, was administered to 92 children patients(46%). 7. 116 male children patients with growth dificiency had the average value of growth for one year before treatment, 4.39cm, while 84 female children patients had the average value of growth for one year before treatment, 4.24cm. A total of 200 children had the average value of growth for one year before treatment, 4.33cm. The annual average value of growth in growth curve surveyed by the Korea Pediatrics Society was 5.79cm. Compared to this value, the one year average value of growth for 108 male and female children patients taking Growth tang A was shown be 8.44cm, which indicates a greater growth by 4.12cm(95.37%) in comparison with the average value of growth before treatment, 4.32cm, and a greater growth by 2.65cm(45.77%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Also, the average value of growth before treatment for 92 male and female children patients taking Growth tang B was shown to be 8.47cm, which indicates a greater increase by 4.15cm(96.06%) compared to 4.32cm, the average value of growth before treatment and a greater increase by 2.67cm(46.29%) in comparison with 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society. Considering the average value of growth for male and female children patients taking Growth tang A and B, it was shown to be 8.46cm, which indicates a greater increase by 4.14cm(95.81%) compared to 4.32cm, the average value of growth before treatment, and a greater increase by 2.67cm(46.11%) compared to 5.79cm, the average value of growth in growth curve surveyed by the Korea Pediatrics Society.

• Progress in Medical Physics
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• v.13 no.3
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• pp.120-128
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• 2002

To investigate differences between the metabolic ratios of normal controls and brain tumors such as astrocytomas and glioblastoma multiforme (GM) by proton MR spectroscopy (MRS) at 37 high field system. Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16$\pm$0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of glioblastoma multiforme was significantly higher than that of astrocytomas (P=0.001). Lactate was observed in all tumor cases. The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.9.2-9
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• 1978

Monaural and binaural hearing aid performance under quiet and noisy conditions were compared in regard to (1) the degree of hearing impairment, (2) the symmetry of pure tone audiogram, (3) the automatic gain control of the hearing aid. (4) hearing impairement with recruitment and, word discrimination ability. Performance using binaural hearing aids was consistently superior to that using monaural hearing aids. The results were as follows. 1. Speech detection thresholds were enhanced by a mean of 4.25dB when tested with danavox 747 PP stereo type hearing aid and by a mean of 4.12 dB when tested hearing aids connected seperately to the right and left ears. 2. Binaurally tested speech reception thresholds were superior to monaurally tested thresholds by a mean of 3.56dB when tested in quiet and by a mean of 5.56dB when tested in noise. 3. Binaurally tested word discrimination scores were also superior by a mean of 17.09% in quiet and by a mean 19.63% in noise. 4. Both SRT and word discrimination scores were performed best by subjects with moderately-severe impairement. The performance by one mildly impaired subject was the poorest of all performances. The levels of performance order were; moderately-severe loss, severe loss. moderate loss and mild loss. 5. The data obtained using AGC aids when compaired with that of linear amplification show that when AGC aids were worn in both ears. the results were very poor but when one AGC aid was worn in one ear and linear amplification in the other. the results were good. 6. The advantages of binaural hearing aids were obvious even in cases 1) with great diferences in hearing thresholds between right and left ears, 2) when the subject was unable to discriminate words without vision and. 3) when the subject had extreme recruitme t phenomenon.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.81-94
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• 2003

Objectives：Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods：Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test：One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task：mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results：Word/Nonword Reading Test：the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task：the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion：The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1263-1270
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• 1997

Background : Differentiation of malignity and benignity is crucial for management of solitary pulmonary nodule(SPN). Clinical parameters such as patient's age, nodule size, smoking history, doubling time, typical calcification in X-ray and CT findings have been reported as helpful in this purpose. However, in most cases, these parameters are not conclusive. Glucose metabolism is increased in cancer tissues including lung cancer tissues. After uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose(FDG), the glucose analogue, by cancer cell, FDG is trapped in the cell without further metabolism after phosphorylation. Thus, hypermetabolic focus in FDG-positron emission tomography (PET) imaging suggest malignancy. We evaluated the diagnostic efficacy of FDG-PET imaging in distinguishing malignant and benign SPN. Methods : We evaluated 28 patients with SPN from Jan. 1995 to Jan. 1997. CT scan of chest and whole-body FDG-PET imaging were performed in all patients. Histologic diagnosis was confirmed by transthoracic fine needle aspiration and biopsy, bronchoscopic biopsy and open thoracotomy. Results : Of the 28 SPN's, 22 nodules were malignant and 6 nodules were benign. FDG-PET imaging diagnosed all malignant nodules correctly as positive, and diagnosed 4 of 6 benign nodules correctly as negative. One tuberculous granuloma and one aspergilloma showed hypennetabolic focus and were diagnosed falsely positve with FDG-PET imaging. In the diagnosis of SPN with FDG-PET, sensitivity and specificity were 100% and 66.7%, positive predictive value and negative predictive value were 92% and 100%. Conclusion : FDG-PET imaging is highly useful noninvasive diagnostic tool in distinguishing between malignant SPN and benign SPN.

• Tuberculosis and Respiratory Diseases
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• v.50 no.1
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• pp.29-41
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• 2001

Background : The appearance of multiple-drug-resistant Mycobacterium tuberculosis strains has been seriously compromising successful control of tuberculosis. Rifampin-resistance, caused by mutations in the rpoB gene, can be indicative of multiple-drug-resistance, and its detection is of great importance. The present study aimed to develop an oligonucleotide chip for accurate and convenient screening of drug-resistance. Methods : In order to detect point mutations in the rpoB gene, an oligonucleotide chip was prepared by immobilizing specific probe DNA to a microscopic slide glass by a chemical reaction. The probe DNA that was selected from the 81 bp core region of the rpoB gene was designed to have mutation sites at the center. A total of 17 mutant probes related to rifampin-resistance including 8 rifabutin-sensitive mutant probes were used in this study. For accurate determination, wild type probes were prepared for each mutation position with an equal length, which enabled a direct comparison of the hybridization intensities between the mutant and wild type. Results : Mycobacterial genomic DNA from clinical samples was tested with the oligonucleotide chip and the results were compared with those of the drug-susceptibility test in addition to sequencing and INNO-LiPA Rif. TB kit test in some cases. Out of 15 samples, the oligonucleotide chip results of 13 samples showed good agreement with the rifabutin-sensitivity results. The two samples with conflicting result also showed a discrepancy between the other tests, suggesting such possibilities as existence of mixed strains and difference in drug-sensitivity. Further verification of these samples in addition to more case studies are required before the final evaluation of the oligonucleotide chip can be made. Conlcusion : An oligonucleotide chip was developed for the detection of rpoB gene mutations related to drugsusceptibility. The results to date show the potential for using the oligonucleotide chip for accurate and convenient screening of drug-resistance to provide useful information in antituberculosis drug therapy.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.341-350
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• 1998

Background: Airway hyperreponsiveness is a cardinal feature of asthma. It consists of both an increased sensitivity of the airways, as indicated by a smaller concentration of a constrictor agonist needed to initiate the brochoconstrictor response and an increased reactivity, increments in response induced subsequent doses of constrictor, as manifested by slopes of the dose-response curve. The purpose of this study is to observe the relationship between bronchial sensitivity and reactivity in asthmatic subjects. Method: Inhalation dose-response curves using methacholine were plotted in 56 asthmatic subjects. They were divided into three groups(mild, moderate and severe) according to clinical severity of bronchial asthma. PC20 were determined from the dose-response curve as the provocative concentration of the agonist causing a 20% fall in FEVl. PC40 were presumed or determined from the dose response curve, using the PC20 and the one more dose after PC20. Reactivity was calculated from the dose-response curve regression line, connecting PC20 with PC40. Results: PC20 were 1.83mg/ml in mild group, 0.96mg/ml in moderate, and 0.34mg/ml in severe. PC40 were 7.l7mg/ml in mild group, 2.34mg/ml in moderate, and 0.75mg/ml in severe. Reactivity were $24.7{\pm}17.06$ in mild group, $46.1{\pm}22.l0$ in moderate, and $59.0{\pm}5.82$ in severe. There was significant negative correlation between PC20 and reactivity (r= -0.70, P<0.01). Conclusion: Accordingly, there was significant negative correlation between bronchial sensitivity and brochial reactivity in asthmatic subjects. However, in some cases, there were wide variations in terms of the reactivity among the subjects who have similar sensitivity. So both should be assessed when the bronchial response tor bronchoconstrictor agonists is measured.