• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.151-158
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• 1990

We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows : 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology : 14 cases (46%) of bronchogenic ca. 4 cases (14%) of lymphoma, 3 cases (10%) of metastic lung ca. Of bronchogenic ca. small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified ca was 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone. 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.610-617
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• 1995

Sleep apnea occurs in approximately 50% of patients with acromegaly, and sleep apnea is associated with increased cardiovascular diseases and mortality. In view of these findings, sleep apnea may be a factor in the increased incidence of cardiovascular deaths in acromegaly patients. We experienced a case of active acromegaly patient, 54-yr-old man, associated with obstructive sleep apnea syndrome, congestive heart failure with dilated cardiomyopathy and serious cardiac arrhythmias. He was treated for obstructive sleep apnea syndrome, diagnosed by overnight polysomnography, with nasal continuous positive airway pressure(CPAP) for 4 months, which successfully controlled his loud snoring, sleep apnea, nocturnal hypoxemia and apnea-related symptoms. And also he was treated for underlying acromegaly and cardiac complications with bromocriptine and cardiogenic drugs for 4 months, but still had elevated growth hormone(GH) and insulin like growth factor-1(IGF-1) levels and serious cardiac arrhythmias. We describe our experience about the effect of CPAP treatment in an active acromegaly patient associated with obstructive sleep apnea syndrome and cardiac complications with review of literature.

• Applied Microscopy
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• v.23 no.2
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• pp.53-77
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• 1993

In this study, an attempt was made to investigate the probable organelles participating in the secretion of biligrafin. The animals (ICR male mice, 25-30gm) were divided into normal control and 6 biligrafin injected groups to which 30% biligrafin (0.006ml/gm b.w.) were injected at 10, 20, 40, 80, 160 and 320 min prior to the sampling. The mice of each group were perfused through the heart with ice-cold 2.5% glutaraldehyde buffered with 0.1M Na-cacodylate (pH. 7.4) under the Na-pentobarbital (Nembtal 0.0015mg/gm b.w.) anesthesia and liver tissues were taken from each group. Some specimens were immersed 1 hr in the same solution used in the perfusion. After an overnight rinse in 0.1M Na-cacodylate buffer containing 10% DMSO and 7.6% sucrose, $75{\mu}m$ fronzen sections were made for cytochemical study. The sections were incubated in thiamin pyrophosphatase (TPPase) and inosine diphosphatase (ID Pase) media for 70 min at $37^{\circ}C$ respectively and acid phosphatase (AcPase) medium for 40 min at $37^{\circ}C$. They were postfixed in 1 % $OsO_4$ for 1 hr. The other specimens were immersed for 8 hrs in the fixative consisting of 2.5% glutaraldehyde and 3.0% paraformaldehyde buffered with Na-cacodylate (pH. 7.4). All of the osmificated specimens were processed for electron microscopy. In both normal and biligrafin injected groups, endoplasmic reticulum (ER), vacuoles, Golgi apparatus and lysosomes were seen in the vicinity of bile canaliculus. In the biligrafin injected groups, however, the Golgi apparatus appeared to be decreased and ER and vacuoles were dilated and increased. The rough endoplasmic reticulum (RER) having a few attached ribosomes appeared to be the round saccule, especially at 20 min after biligrafin injection. Smooth endoplasmic reticulum (SER) seemed to be formed by the detachment of ribosomes at the cisternal end of RER. The cistern of SER showed saccules which probably budded off to form the vacuole. The vacuoles were devoid of visible centents. This finding seemed to be in agreement with the biochemical property of the bile constituents. The fusion between the vacuoles and bile canaliculus were frequently seen in the groups injected with biligrafin. The lysosome did not show any changes in the biligrafin injected groups. Accumulation of some material and lipid droplets were seen at the 40 and 80 min after biligrafin injection, especially at the latter. At 160 and 320 min after biligrafin injections, however, they were decreased successively while the RER stack, free ribosomes and polysomes were increased. Although the reactive products of TPPase and IDPase were observed in the ER saccules and vesicles of the normal control and biligrafin injected groups, the fusion between the bile canaliculus and saccules or vesicles could easily be seen in the latter. The AcPase activity, however, was observed in the cistern at the maturing face of Golgi apparatus and lysosomes in both normal and biligrafin groups. The results suggest that the biligrafin is excreted via the vesicles, vacuoles or sacoules probably derived from the SER without the participation of Golgi apparatus and lysosomes, and the excess amount of material is stored as inclusions during the repairing of the organelles being overactive.

• Applied Microscopy
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• v.28 no.4
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• pp.603-613
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• 1998

The present study was designed in order to observe relationship between the endoplasmic reticulum and the Golgi complex during spermiogenesis of the long-fingered bat (Miniopterus schreibersi fuliginosus). The testes were obtained from adult bats and treated with the prolonged osmification or fixed with ferrocyanide reduced osmiun. In the Golgi phase, The Golgi complex shows an oval shape, and was composed of a cortex and a medullar enclosing acrosome. The Golgi vacuoles with electron-dense granules of crescent shape were fused with each other. The smooth endoplasrnic reticulum was scattered in all the area of the cytoplasm. In the cap phase, The Golgi complex was crescent in shape, and faced to a nucleus. Large and small vesicles were fused with each other, and then fused with a acrosomal vacuole. The rough endoplasmic reticulum was close to the large Golgi vacuole. In the acrosome phase, The Golgi complex was moved to behind of the acrosome face. Small vesicles were fused with an acrosome, and cisternae of the trans-face of Golgi complex was connected with an acrosome in the early acrosome phase. The smooth endoplasmic reticulum was distributed in the cytoplasm. The annulate lamellar was originated from a radial body-annulate lammellae complex. In the maturation phase, The Golgi complex with dilated cistrern appeared in the cytoplasm, and also, annulate lamellar was observed in the cytoplasm. The connection of the annulate lamellar with the cistern of radial body suggests that an annulate lamellar seems to be closely related to radial body. The smooth endoplasmic reticulum was scattered in the cytoplasm in the early Golgi phase, but annulate lamellar-radial body complex which might be a residual and disappearing form of the smooth endoplasmic reticulum appeared in the acrosome phase. The Golgi complex steadily remained in the late maturation phase when the endoplasmic reticulum began to disappear from the cytoplasm: the Golgi complex was still occurred after acrosome formation. The observations obtained in the present study, which was characterized by the presence of the Golgi complex in the late maturation phase, suggests that the Golgi complex may play an important role also even after the acrosome formation.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.97-102
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• 2007

Background: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported, A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. Material and Method: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. Conclusion: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.719-724
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• 2009

Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.208-213
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• 2007

A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.269-275
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• 2007

Two dogs referred to Veterinary Medical Center, Chungbuk National University diagnosed as multiple extrahepatic portosystemic shunt were reported. The first dog was a 20-month-old, 8 kg, male Cocker spaniel with history of peritoneal effusion, diarrhea, anorexia and stunted growth. The second dog was a 3-year-old, 13.4 kg, male Jindo with a history of severe depression. Hematologic examination of first dog revealed mild microcytosis and nonregenerative anemia. All of 2 cases, serum chemical values showed increase of serum ammonia, ALP, r-GTP and glucose. In survey radiography, microhepatia was apparent. In the color Doppler ultrasonographic examination, the first dog revealed a dilated tortuous vein communicating with caudal vena cava was observed near the left kidney and the second dog revealed numerous shunting vessels ventral to L5 and L6. Transcolonic portal scintigraphy of the first dog confirmed the presence of portosystemic shunt. In intraoperative jejunoportography, the first dog showed single congenital extrahepatic portosystemic shunt and multiple acquired extrahepatic portosystemic shunts. The second dog showed multiple acquired extrahepatic portosystemic shunts. In these dogs, the presence of congenital and acquried portosystemic shunts and histopathologic findings were considered to represent a combination of multiple extrahepatic portosystemic shunts and noncirrhotic portal hypertension or portal vein hypoplasia.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.419-421
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• 2007

A 15 years old castrated male Pug dog was referred with chief complaint of cough, described as a goose honk. He was diagnosed into of tracheal collapse by clinical signs and radiography. He was received by injection- AP with butorphanol (0.15 mg/kg, SID) at BL13, LU01, LU05, LU06, LU07, LU09 and CV22 for 10 days, and he was also received by injection-AP with butorphanol (0.40 mg/kg, SID) at BL13, LU01 and CV22 for 9 days. The patient was given with Sochungryong-Tang (0.5 g/head, TID) for 7 days, and he was additionally given with Sojagangki-Tang (1 ml/kg, TID) for 12 days. Cough was not detected at all, and tracheal diameter was more increased than that of session 1 on radiograph at session 19. Cough was not detected at all and tracheal diameter at follow-up study of three month later was more dilated than that of session 19. In conclusion, the present patient was a case with canine tracheal collapse which showed favorable therapeutic response by injection-AP with butorphanol combined by administration of herbal medicine.

• Parasites, Hosts and Diseases
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• v.25 no.2
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• pp.99-109
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• 1987

The present study was carried out to examine the effect of a calcinogen, aflatoxin B1 on the ultrastructural changes of ciliary epithelial cells in mice infected with Clonerchis sinensis. A total of 93 male albino mice(BALB/c strain) was divided into 3 groups; group I, treated with 1.0 ppm aflatoxin Bl for 12 weeks; group II, given 50 C. sinensis n;etacercariae, and group III, given 50 metacercariae and treated with 1.0 ppm aflatoxin Bl for 12 weeks. Three mice served for untreated-uninfected controls. From 4 weeks after the treatsment and/or in(ection, three mice from each group were sacrificed at 4 week intervals up to the 40th week, and their hepatobiliary tissues were prepared for transmission electron microscopy. The most prominent ultrastructural changes in group I were remarkable enlargement of nuclear size, separation of nucleolus, dispersed chromatin granules in nuclei and increased dense granules along the inner membrane of nuclei. In the cytoplasm there was slight proliferation of mitochondria and endoplasmic reticulum (ER) at earlier stage. At the 12th week separation of fibrillar and granular components of the nucleolus was a characteristic finding. As the time elapsed, epithelial cells showed fiattened-cuboidal form and a tendency of atrophy. Most of the nuclei were elongated and polygonal in shape. In group II the appearance of elaborate interwoven folds of lateral cytoplasm forming a labyrinth of interconnected intercellular space and variety in nuclear shape were the prominent fadings at earlier stage. The cytoplasm showed slight proliferation and dilatation of mitochondria and ER, and a small number of mucin droplets. In the basement membrane scanty fibrous cells were seen. With time, variety in nuclear shape, marked proliferation and dilatation of rough ER and some collagen fibrils were demonstrated. Other features of intracellular organelles and mucin droplets persisted. In group III cuboidal epithelial cells showed their remarkably enlarged and irregular nuclei, increased chromatin granules in the nuclei, separated nucleoli, proliferated and dilated rough ER. With time, sequestered mitochondria showed blob-like evaginations which lacked cristae and dense matrix, and were limited by a single membrane. Since the 20th week, microvilli were relatively scanty and poorly developed. Organelles and inclusions in the cytoplasm of metaplastic cells were poor. Nuclei were variable in shape. The nlost prominent changes at later stage were separation of nuclei from the cytoplasm, and appearance of numerous and irregularly angled electron dense granules in the nuclei.