• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.785-794
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• 1998

Background: Chemical pleurodesis is a widely used method for the control of symptomatic and recurrent malignant pleural effusions. Talc has been accepted to be the most effective sclerosing agent for chemical pleurodesis. This study was undertaken to evaluate the usefulness of talc pleurodesis via video-assisted thoracoscopic surgery (VATS) in treatment of malignant pleural effusions. Methods : A retrospective analysis of the medical records and radiographic findings was performed. The success of the procedure was defined as daily pleural fluid drainage below 100ml within 1 week after pleurodesis and complete expansion of the lung on simple chest radiograph. Recurrence was defined as reaccumulation of pleural fluid on follow-up chest radiographs, and complete response as no fluid accumulation on follow-up chest radiographs. Results: Between October 1994 and August 1996, talc pleurodesis via VATS was performed in 35 patients. Duration of follow-up ranged from 5 days to 828 days(median 79days). The initial success rate of procedure was 88.6%(31 of 35 cases). Complete responses were observed in 92.8% at 30 days, 75.7% at 90 days and 64.9% at 180 days. Postoperative complications were fever (54.3%), subcutaneous emphysema(11.4%), reexpansion pulmonary edema(2.9%) and respiratory failure(5.7%). But procedure related mortality or respiratory failure was not found. Conclusion: Talc pleurodesis via VATS is a safe and effective method for the control of symptomatic malignant pleural effusions.

• 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.

• Journal of Haehwa Medicine
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• v.9 no.1
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• pp.387-397
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• 2000

Background : Intravascular Laser Irrardiation of Blood(ILIB) is used in disorder of cerebral and peripheral blood circulation, dysfunction of brain, atherosclerosis etc., but there are little study about ILIB in oriental medicine. We wished to assess the efficacy of ILIB for the treatment of cerebral infarction. Method : The study group comprised 40 patients who arrived at hospital during 48 hours after attack. All patient were divided into two group. The control group was treated with Uhuangcheongsimhuan(牛黃淸心丸), Seonghyangjeonggisan(星香正氣散), acupuncture therapy only, while the ILIB group was treated with above therapy plus 5 days of irradiation of He-Ne Laser(1.8~2.5mW, 50min. per day). In rat model of middle cerebral artery(MCA) occlusion, the control group was not treated, while the ILIB group was treated with irradiation of He-Ne Laser(1.8~2.5mW, 24sec.). Result : 1. Symptom improve scores did not showed significant difference between control and ILIB group. 2. Vasoreactivity of carotid siphon did not showed significant difference between control and ILIB group. 3. Vasoreactivity of radial artery did not showed significant difference between control and ILIB group. 4. PT a-PTT did not showed significant changes between before and after treatment in both group. Fibrinogen significantly increased after treatment in ILIB group(p<0.05)), but it was in normal degree. 5. ILIB showed a significant decrease of brain ischemic area and edema in rat model of middle cerebral artery(MCA) occlusion. Conclusion : These findings suggest that additional treatment of ILIB is not more useful than traditional therapy only in acute cerebral infarction. But ILIB showed potential effect in rat model of MCA occlusion. So further investigation will be necessary.

• Journal of Haehwa Medicine
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• v.9 no.1
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• pp.547-594
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• 2000

I. Introduction The essence of Oriental medicine consists of ancient books, experienced doctors and succeeded skills of common society. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. $\ll$DangDaeMyeongIImJeungJeongHwa(當代名醫臨證精華)$\gg$ written by SaWoogWang(史宇廣) and DanSeoGeon(單書健) has many medical experience of famous doctors. So it has important historical value. Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. So I studied ${\ll}BiJeungJuJip{\gg}$. II. Final Decision Following decisions of Chinese doctors of 20th century are as follows ; 1. JuYangChun(朱良春) emphasized on IkSinJangDok(益腎壯督) to treat BiJeong. And he devided WanBi(頑痺) as PungHanSeup(風寒濕), DamEo(痰瘀), YeolDok(熱毒), SinHeo(腎虛). He used insects for medicine. 2. ChoSuDoek(焦樹德) introduced past prescription. He used ChiBiTang(治痺湯) to treat HaengBi(行痺), TongBi(痛痺), ChakBi(着痺). He insisted that Han(寒; coldness) and Seup(濕; dampness) be Eum(陰) and Pung(風; wind) can change his character to be Eum. After all BiJeung is usually EumJeung. So he used GaeJi(桂枝) and BuJa(附子). By the way he used ChungYeolSanBiTang(淸熱散痺湯) for YeolBi, BoSinGeoHanChiWangTang SaBok(王士福) emphasized on the importance of medicine. He introduced many treatments like CheongYeol(情熱) for YeolBi and YiO(二烏) for HanBi. And he divided BiJeung period for three steps. At 1st step, we must use GeoSa(祛邪), at 2nd step, we must use BuJeong(扶正) and at 3rd step, we must use BoHyeol(補血), he insisted. And he introduced many herbs to treat BiJeung. 4. JeongGwangJeok(丁光迪) said that GaeJi(桂枝), MaHwang(麻黃), OYak(烏蘖) and BuJa(附子) are very important for TongRak(通絡). And pain usually results from Han(寒), so he liked to use hot-character herbs. 5. MaGi(馬志) insisted that BiJeung usually result from ChilJeong(七情). And he liked to use insects for treatment of BiJeung. 6. WeolSeokMu(越錫武) introduced 8 kinds of treatments and divided BiJeung period. Also he divided BeJeung for PungBi(風痺), HanBi(寒痺) and SeupBi(濕痺). 7. SeoGeaHam(徐季含) observed many patients and concluded that 86.7% of BiJeung is HeuJeung(虛症). 8. YuJiMyeong(劉志明) said that YeolBi is important and CheongYeol is also important. So he emphasized on DangGyuiJeomTongTang(當歸拈痛湯) and SeonBiTang(宣痺湯). 9. WangLiChu(汪履秋) studied cause of WanBi. Internal cause is GiHyeolHeo(氣血虛) and GanSinHeo(肝腎虛) and external cause is SaGi(邪氣) he insisted. 10. WangSaSang(王士相) said that YeolBi can be SeupYeolBi or EumHeuYeolBi(陰虛熱痺) and HanSeupBi(寒濕痺) is rare. He use WooBangJaSan(牛蒡子散) and BangPungHwan(防風丸) for SeupYeolBi, DangGyuiSaYeokTang(當歸四逆湯) for HanSeupBi. 11. JinTaekGang(陳澤江) treated YeolBi with BaekHoGaGyeJiTang(自虎加桂枝湯) and SaMyoSan(四妙散). If they don't have effect, he tried to cure BiJeung step by step. And he used e term of GeunBi(筋痺) and BangGiMogwaEIInTang(防己木瓜薏苡仁湯) was good for GeunBi. 12. MaSeoJeong(麻瑞亭) said that PungSeupYeokJeul(風濕歷節) is BiJeung and it is related to GanBinSin(肝脾腎; liver, Spleen, Kindey). And he emphasized on balance WiGi(衛氣) and YoungHeul(營血). 13. SaJeJu(史濟桂) said that GeunGolBi(筋骨痺) is similar to arthritis and sometimes called ChakBi. And SinBi(腎痺) is terminal stage of ChakBi, he said. He also used insects for treatment. 14. JeongJeNam(丁濟南) tried to cure SLE and used GyeJi, CheonCho(川椒), SinGeunCho(伸筋草), SunRyeongBi(仙靈脾), HyconSam(玄蔘) and GamCho(甘草). 15. JinGYungHwa(陳景和) emphasized on diagnosis of tongue. If the color of tongue is blue, it usually has EoHyeol(瘀血), for example. And he also used insects. 16. JuSongI(朱松毅) tried to devide YeolBi with OnByeong(溫病), Wi(衛), Gi(氣) and Hyeol(血). 17. RuDaBong(蔞多峰) said that JyeongHeo(正虛), OiSa(外邪) and EoHyeol are closely related. And he explained BiJeung by deviding the body into the part, for example head, neck, shoulder, waist, upper limb and lower limb. 18. YuMuBo(劉茂甫) defined PungHanSyubBi as chronic stage and YeolBi as acute stage.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.132-136
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• 2003

Purpose : To evaluate the usefulness of breath-hold T2-weighted MR imaging in patients with myocardial infarction. Materials and Methods : We investigated 11 patients with myocardial infarction who shown delayed enhancement on MR imaging. Infarcted myocardium on T2-weighted MR imaging was classified as high, iso, and low signal area comparing with normal myocardium. The intensity and transmural extent of infracted myocardium was also analyzed. On the basis of clinical information, the stage of infracted myocardium on T2-weighted MR imaging was assessed. Results : It was observed high signal area in 12 segments of 5 patients, low in 12 segments of 6 patients on T2-weighted MR imaging. The high signal intensity of infarcted myocardium was shown as $175{\pm}9\%$ comparing with that of the normal myocardium, low signal intensity as $73{\pm}5\%\;(p\;<\;0.05)$. In the evaluation of transmural extent, the high signal areas on T2-weighted MR imaging were larger than infarct area on delayed enhancement imaging $(100\%\;vs.49\%{\pm}17\%)$, whereas low signal areas on T2-weighted MR imaging correlated. High signal area was visualized on T2-weighted MR imaging within 11 days, whereas low-signal area was seen after 7 months. Conclusion : Breath-hold T2-weighted MR imaging is useful in the evaluation of stage as well as edema and fibrous scar in patients with myocardial infarction.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.138-146
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• 1996

Background : Known as a kind of complication or a specific form of pulmonary tuberculosis, endobronchial tuberculosis caused several kinds of problems in diagnosis and managements. But the frequency of this disease are is widely variable, generally reported from as low as 10 - 20 % to as high as 40 - 50 %. We prospectively performed bronchoscopy in patients diagnosed as pulmonary tuberculosis to evaluate the frequency of endobronchial tuberculosis and its related findings. Method : From March, 1995 to February, 1996, we prospectively performed bronchoscopy in patients newly diagnosed as pulmonary tuberculosis and evaluated the frequency of endobronchial tuberculosis, its clinical features and laboratory findings including raiologic, microbiologic and physiologic aspects. Results : Number of patients diagnosed as pulmonary tuberculosis was 103 and 55 patients(53.4%) were found to have endobronchial tuberculosis. But the frequency were 43.8% in male and 76.7% in female, respectively. Frequently noted symptoms were nonspecific including cough, sputum, fever, weight loss in the order of frequency but cough was more frequent than in pulmonary tuberculosis. Physical examination showed rale, decreased breathing sound and wheezing and wheezing was more frequent than in pulmonary tuberculosis. All 7 subtypes were noted bronchoscopically and edema-hyperemia (stenotic without fibrosis) type was most frequently(32.7%) noted, and followed by chronic nonspecific bronchitis type, stenotic with fibrosis type and actively caseating type in the order of frequency. The relationship between subtypes of endobronchial tuberculosis and radiologic findings was insignificant. Right lung was involved more frequently than left lung and left upper lobe was most commonly involved site, and followed by right upper lobe and trachea. Acid-fast bacilli(AFB) positivity in sputum and / or bronchial washing fluid was 73% and suggested high risk of infectivity. Conclusion : The frequency of endobronchial tuberculosis in patients with pulmonary tuberculosis was higher than known and also suggested bronchoscopic examination to detect endobronchial involvement should be recommanded and careful management is also needed to prevent complications.

• Food Science and Preservation
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• v.22 no.5
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• pp.735-743
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• 2015

This study investigated the anti-inflammatory activity of barley leaf extract in lipopolysaccharide (LPS)-stimulated RAW264.7 cells and hairless mice. Pre-treatment with barley leaf extract significantly inhibited the protein expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-II (COX-II) in a dose-dependent manner in LPS-stimulated RAW264.7 cells. Barley leaf extract also significantly inhibited the secretion of inflammatory cytokines, such as tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-$1{\beta}$), and interleukin-6 (IL-6). Moreover, phosphorylation of mitogen-activated protein kinases (MAPKs) and nuclear translocation of nuclear factor-kappa B (NF-${\kappa}B$) were strongly suppressed by barley leaf extract in LPS-stimulated cells. In hairless mice, barley extract significantly decreased the pathological phenotypes of contact dermatitis, such as erythema, edema, and scabs. These results indicate that barley leaf extract has an anti-inflammatory effect and therefore a possible role in the treatment of inflammatory diseases or in functional cosmetics.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.877-883
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• 1998

Background: Cardiopulmonary bypass(CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. Material and Method: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava(MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm(GA), 1 for renal cell carcinoma(RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients(MOVC 4, GA 1, RC 1). Result: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26$^{\circ}C$ on average in MOVC, and 19$^{\circ}C$ in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients(malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. Conclusion: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.391-400
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• 2004

Xenotransplantation in discordant species results in immediate and irreversible hyperacute rejection due to natural antibodies, IgM. With this, antibody depletion is one option to reduce hyperacute rejection, we investigated the effect of PCPP (postcentrifugal plasmapheresis) on the depletion of natural antibodies and the effect of antibody titer on xenograft survival. Material and Method: Outbred swines (n=4) weighing 10∼20 kg were used as donors and mongrel dogs (n=4) weighing 25∼30 kg were used as recipients. Recipient canines underwent plasmapheresis (COBE TPE Laboratories, Lakewood. CO, USA). Pre-transplantation PCPP was peformed on day －2 and day 0. There were three groups (Group 0: no PCPP, Group 1: 1 pla sma-volume (PV) at day －2 and 2 PV at day 0, Group 2: 2 PV at day －2 and 2 PV at day 0). A swine heart was heterotopically transplanted into a recipient's abdominal infrarenal aorta and inferior vena cava. Mean percent depletion of total IgM and IgG in plasma of the recipients was calculated. Serum albumin, electrolyte, complement activity and coagulation factors were measured. Histopathologic examination of heart specimens was performed. Result: Mean percent depletion of IgM and IgG were 95.7$\pm$1.2%, 80.5$\pm$2.4% in the group 2 at the end of PCPP. The percent depletion of serum albumin concentration was decreased from 2.8 to 1.4 g/㎗ in the group 1 and 3.0 to 1.5 g/㎗ in the group 2. Complement hemolytic activity was decreased in group 1 and 2, but returned to normal level within 24 hours. Complement hemolytic activity was reduced to 10% of pre-PCPP level in group 2. Serum fibrinogen decreased to 20% or less and was recovered within 24 hours in group 2. Antithrombin III decreased but less than fibrinogen. PT and aPTT were sometimes but not always prolonged during plasmapheresis. After plasmapheresis, PT and aPTT were prolonged beyond the measurable level. D-dimer was not found during PCPP, but appeared and maintained from 10 minutes after trasplantation. Graft Survival time was 5 min in group 0, and it was 90$\pm$0 min in the group 2. Histopathologic changes were more typically characterized by edema, hemorrhages, thrombosis in all groups at the end of experiment. Conclusion: PCPP effectively removed immuoglobulins and reduced the titer of natural antibodies, as a result, significantly prololonged swine heart xenograft survival.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.416-422
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• 2004

Acute renal failure (ARF) is a common postoperative complication after the cardiac surgery. Postoperative ARF have various causes, and are combined with other complications rather than being the only a complication. It deteriorates the general condition of the patient, and makes it difficult to manage the combined complications by disturbing the adequate medication and fluid therapy. We have planned this study to evaluate the effects of postoperative ARF after the on-pump coronary artery bypass surgery (CABG) on the recovery of patients and identify the risk factors. Method and Material: We reviewed the medical records of patients who underwent CABG with cardiopulmonary bypass by a single surgeon from Jan. 2000 to Dec. 2002, We checked the preoperative factors; sex, age, history of previous serum creationism over 2.0 mg/㎗, preoperatively last checked serum creatinine, diabetes, hypertension, left ventricular ejection fraction, intraoperative factors; whether the operation is an emergent case or not, cardiopulmonary bypass time, aortic cross clamp time, the number of distal anastomosis, postoperative factors: IABP. Then we have studied the relations of these factors and the cases of postoperative peak serum creatinine over 2.0 mg/㎗. Result: There were 19 cases with postoperative peak serum creatinine over 2.0 mg/㎗ in a total 97 cases. Dialysis were done in 3 cases for ARF with pulmonary edema and severely reduced urine output. There were 8 cases (42.1%) with combined complications among the 19 patients. This finding showed a significant difference from the 5 cases (6,4%) in the patients whose creatinine level have not increased over 2.0 mg/㎗. The mortalities are different as 1.3% to 10.5%. The risk factors that are related with postoperative serum creatinine increment over 2.0 mg/㎗ are diabetes, the history of previous serum creatinine over 2.0 mg/㎗ and left ventricular ejection fraction. Conclusion: Postoperative ARF after the on-pump CABG is related with preoperative diabetes, the history of previous serum creatinine over 2,0 mg/㎗ and left ventricular ejection fraction. Postoperative ARF could De the reason for increased rate of complications and mortality after on-pump CABG. Therefore, in the patients with these risk factors, the efforts to prevent postoperative ARF like off-pump CABG should be considered.