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Cryosurgery of Lung with 2.4 mm Cryoprobe: An Experimental in vivo Study of the Cryosurgery in Canine Model (냉동침을 이용한 폐 냉동수술의 동물실험: 냉동수술 방법의 비교 실험)

  • Kim Kwang-Taik;Chung Bong-Kyu;Lee Sung-Ho;Cho Jong-Ho;Son Ho-Sung;Fang Young-Ho;Sun Kyung;Park Sung-Min
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.520-526
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    • 2006
  • Background: The clinical application of cryosurgery the management of lung cancer is limited because the response of lung at low temperature is not well understood. The purpose of this study is to investigate the response of the pulmonary tissue at extreme low temperature. Material and Method: After general anesthesia the lungs of twelve Mongrel dogs were exposed through the fifth intercostal space. Cryosurgical probe (Galil Medical, Israel) with diameter 2.4 mm were placed into the lung 20 mm deep and four thermosensors (T1-4) were inserted at 5 mm intervals from the cryoprobe. The animals were divided into group A (n=8) and group B (n=4). In group A the temperature of the cryoprobe was decreased to $-120^{\circ}C$ and maintained for 20 minutes. After 5 minutes of thawing this freezing cycle was repeated. In group B same freezing temperature was maintained for 40 minutes continuously without thawing. The lungs were removed for microscopic examination on f day after the cryosurgery. In four dogs of the group A the lung was removed 7 days after the cryosurgery to examine the delayed changes of the cryoinjured tissue, Result: In group A the temperatures of T1 and T2 were decreased to the $4.1{\pm}11^{\circ}C\;and\;31{\pm}5^{\circ}C$ respectively in first freezing cycle. During the second freezing period the temperatures of the thermosensors were decreased lower than the temperature during the first freezing time: $T1\;-56.4{\pm}9.7^{\circ}C,\;T2\;-18.4{\pm}14.2^{\circ}C,\;T3\;18.5{\pm}9.4^{\circ}C\;and\;T4\;35.9{\pm}2.9^{\circ}C$. Comparing the temperature-distance graph of the first cycle to that of the second cycle revealed the changes of temperature-distance relationship from curve to linear. In group B the temperatures of thermosensors were decreased and maintained throughout the 40 minutes of freezing. On light microscopy, hemorrhagic infarctions of diameter $18.6{\pm}6.4mm$ were found in group A. The infarction size was $14{\pm}3mm$ in group B. No viable cell was found within the infarction area. Conclusion: The conductivity of the lung is changed during the thawing period resulting further decrease in temperature of the lung tissue during the second freezing cycle and expanding the area of cell destruction.

Change of Regional Myocardial Blood Flow After Transmyocardial Laser Revascularization in Porcine Model of Chronic Myocardial Ischemia (돼지 만성 심근허혈 모델에서 경심근레이저혈류재건술 후 국소 심근 혈류량의 변화)

  • Park, Kay-Hyun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.662-671
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    • 2001
  • Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

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Further Studies on the Specificity of the N- and C-terminal Antigenic Determinant of Hen Egg-white Lysozyme (계난백(鷄卵白) Lysozyme의 N-말단(末端)과 C-말단(末端) 항원결정기(抗原決定基)에 대한 연구(硏究))

  • Ha, Youn-Mun
    • The Journal of the Korean Society for Microbiology
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    • v.12 no.1
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    • pp.19-32
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    • 1977
  • The specificity of the N- and C-terminal antigenic determinant($P_{17}$: sequence $Lys^1-{cys-}^6-Asn^{27},\;{Trp^{12}}_2-Cys^{127}-Leu^{129}$) of hen egg-white lysozyme(HL) was studied in more detail. In a Scatchard plot of the binding of $^{14}C$-acetyl HL with guinea pig purified anti-$P_{17}$ antibody experimental values bent sharply aear r=1. This suggests of two antibody populations with different affinities for HL or possible steric hindrance in the binding of a second HL molecule to the second binding site of the antibody molecule. The antigenic activities of various peptides were tested by measuring their inhibition of the binding of $^{14}C-acetyl-P_{17}$ with the antibody, Only $P_{17}$ and $P_{17}t$(sequence $Lys^1-cys^6-Homoser^{12},\;Trp^{123}-Cys^{127}-Leu^{128})$) were inhibitory, with $K_1$ values of $2.0{\times}10^4$ and $8.1{\times}10^3$, respectively. These results indicate that the direct binding site of $P_{17}$ to anti-$P_{17}$ antibody may be located in the terminal portion of $P_{17}$ (sequence $Lys^1-Cys^6-Homoser^{12},\;Trp^{123}-Cys^{127}-Leu^{129})$) while the rest of $P_{17}$ may be important in maintaining the conformation of this determinant. The single disulphide bond involved in this determinant is essential for manifestation of immunological activity.

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The Diagnostic Value of Interferon-γ Assay in Patients with Active Tuberculosis (활동성 결핵의 진단에서 혈청 인터페론 감마 측정법의 유용성)

  • Park, So Young;Park, Yong Bum;Choi, Jeong Hee;Lee, Jae Young;Kim, Jae-Seok;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.13-19
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    • 2009
  • Background: The interferon-gamma assay is reported to have high sensitivity and specificity for making the diagnosis of latent tuberculosis infection. The clinical usefulness of this essay for detecting active tuberculosis has not fully defined. We evaluated the diagnostic value of the commercial interferon-gamma assay kit (QuantiFERONTB GOLD) for patients with suspected tuberculosis. Methods: From January to August 2007, we recruited 52 patients with suspected tuberculosis infection. We performed chest X-ray, sputum smear, culture, PCR and the QuantiFERON-TB GOLD test. Pleural fluid analysis and pleural biopsy were also done for the patients with pleural effusion. Results: Of the 52 patients we studied, 30 patients had a positive QuantiFERON-TB GOLD test result. 35 patients were finally diagnosed with active tuberculosis: twenty-five with a positive QuantiFERON-TB GOLD test and 10 with a negative QuantiFERON-TB GOLD test. The sensitivity of the QuantiFERON-TB GOLD test was 71.4% and the specificity was 64.7%. The positive predictive value was 0.83 and the negative predictive value was 0.50. There was no significant difference of any of the clinical and laboratory characteristics between the two groups of patients except the C-reactive protein (CRP) level. The CRP level was 29.2${\pm}$27.3 mg/dL in the pulmonary tuberculosis patients with a positive QuantiFERON-TB GOLD test and 72.9${\pm}$67.9 mg/dL in the patients with a negative QuantiFERON-TB GOLD test (p<0.05). Conclusion: The sensitivity and specificity of the QuantiFERON-TB GOLD test were inadequate for making the diagnosis of active tuberculosis. We suggest that the QuantiFERON-TB GOLD test should not be used by itself to exclude the diagnosis of active tuberculosis. The relationship of the QuantiFERON-TB GOLD test and the CRP level in patients with TB would be further investigated.

Knowledge and Attitude on the Restaurant-Related Sanitation of New Restaurateurs (신규 일반음식점 영업자의 위생관리 지식 및 태도)

  • Park, Ki-Hong;Sohn, Seok-Joon
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.21-34
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    • 2006
  • Objectives: The purpose of this study was to investigate the knowledge, attitude and practice toward sanitary administration of the new restaurateurs, to carry out the sanitary management of business for improvement of sanitary level, and to provide basic data which were necessary for sanitary education of the restaurateurs. Methods: The self-recording survey on the attitude and the knowledge toward the sanitation, the sanitary administration, and its education was conducted against new 393 restaurateurs by the administrative division of Gwangju city in charge of the food industry which put in the regular sanitary education annually for the new restaurateurs. Results: In regard to food sanitation, some 87.9% to 94.4% got the right knowledge about the reason and precaution of food poisoning, storage methods of frozen or cold food, and the disposal of product after expiration of validity term. But it was about 56.0% to 63.0% who knew right about the cause and the major precaution of food poisoning, storage temperature in the refrigerator. 30.6% of the subject placed an emphasis on personal sanitation of the workers as the most important thing in the sanitary management. 83.6% replied that it was necessary to improve the sanitary level. Concerning the health examination, 78.3% replied it was needed. 76.4% pointed the need for education, but respondents with higher educational level less emphasized its needs. It was most frequently pointed out by 71.6% restaurateur's poor awareness about it. 36.7% indicated the environmental sanitation like facilities in the restaurants as the first thing to be improved. The rate of personal sanitation was 43.7%. Conclusions: To improve the poor sanitary conditions of the food service business, it was recommended to offer institutional backing and financial aid from administrative office, to encourage restaurateurs to take pride in their job, and to conduct the sanitary education effectively by the technical education institution.

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Mineral Contents in Scalp Hair in Patients with Non-insulin Dependent Diabetes Mellitus (두발중(頭髮中) 일부(一部) 금속(金屬) 농도(濃度)와 인슐린비의존형(非依存形) 당뇨병(糖尿病)과의 관련성(關聯性))

  • Chung, Kyeong-Dong;Kwon, Sam;Kim, Doo-Hee
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.215-223
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    • 1997
  • To estimate association of minerals relating to non-insulin dependent diabetes mellitus(NIDDM) the contents of essential minerals and toxic heavy metals in the scalp hair were measured during the period from March 1993 to June 1993. The cases were selected 69 (32 male, 37 female) from the patients who visited Kyungpook University Hospital during the period from March 1993 to June 1993 and 74 controls (47 male 27 female) from normal population. zinc, copper, manganese, lead, cadmium and aluminum were analyzed by atomic absorption spectrophotometer(IL. 551). The results were summarized as follows. In NIDDM group, mean contents of zinc and copper were $132.99{\pm}19.66$ ppm, $8.58{\pm}5.07$ ppm respectively; where as $152.51{\pm}46.15$ ppm, $12.48{\pm}6.56$ ppm in control group. The mean of above two mineral content showed significant difference statistically (p<0.01). But, in manganese the content of NIDDM group; $0.44{\pm}0.27$ ppm were significantly higher than the control group; $0.34{\pm}0.18$ ppm(p<0.05). A thesis submitted to the Council of the Graduate School of Kyungpook National University in partial fulfillment of the require ements for the degree of Ph.D. in Medical Science in June 1994. The mean contents of toxic metals - lead, cadmium, aluminum - in NIDDM group were $10.04{\pm}4.60$ ppm, $0.57{\pm}0.12$ ppm, $11.31{\pm}3.98$ ppm; whereas $8.10{\pm}2.45$ ppm, $0.41{\pm}0.23$ ppm, $7.61{\pm}4.16$ ppm in control group. The mean of above three mineral showed significant difference statistically(p<0.01). Cadmium, zinc and copper were selected statistically significant variables with presence of the NIDDM by multiple logistic regression analysis; copper, zinc and cadmium may be associated with NIDDM.

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A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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Decreased Attention in Narcolepsy Patients is not Related with Excessive Daytime Sleepiness (기면병 환자의 주의집중 저하와 주간졸음증 간의 상관관계 부재)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Lee, Yu-Jin;Lee, Ju-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.2
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    • pp.122-132
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    • 2005
  • Objectives: The objective of this study is to assess cognitive functions and their relationship with sleep symptoms in young narcoleptic patients. Methods: Eighteen young narcolepsy patients and 18 normal controls (age: 17-35 years old) were recruited. All narcolepsy patients had HLA $DQB_1$ *0602 allele and cataplexy. Several important areas of cognition were assessed by a battery of neuropsychological tests consisting of 13 tests: executive functions (e.g. cognitive set shifting, inhibition, and selective attention) through Wisconsin card sorting test, Trail Making A/B, Stroop test, Ruff test, Digit Symbol, Controlled Oral Word Association and Boston Naming Test; alertness and sustained attention through paced auditory serial addition test; verbal/nonverbal short-term memory and working memory through Digit Span and Spatial Span; visuospatial memory through Rey-Osterrieth complex figure test; verbal learning and memory through California verbal learning test; and fine motor activity through grooved pegboard test. Sleep symptoms in narcolepsy patients were assessed with Epworth sleepiness scale, Ullanlinna narcolepsy scale, multiple sleep latency test, and nocturnal polysomnography. Relationship between cognitive functions and sleep symptoms in narcolepsy patients was also explored. Results: Compared with normal controls, narcolepsy patients showed poor performance in paced auditory serial addition (2.0 s and 2.4 s), digit symbol tests, and spatial span (forward)(t=3.86, p<0.01; t=-2.47, p=0.02; t=-3.95, p<0.01; t=-2.22, p=0.03, respectively). There were no significant between-group differences in other neuropsychological tests. In addition, results of neuropsychological test in narcolepsy patients were not correlated with Epworth sleepiness scale score, Ullanlinna narcolepsy scale score and sleep variables in multiple sleep latency test or nocturnal polysomnography. Conclusion: The current findings suggest that young narcolepsy patients have impaired attention. In addition, impairment of attention in narcolepsy might not be solely due to sleep symptoms such as excessive daytime sleepiness.

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Observations of Oxygen Administration Effects on Visuospatial Cognitive Performance using Time Course Data Analysis of fMRI (뇌기능 자기공명영상의 시계열 신호 분석에 의한 공간인지과제 수행시 산소 공급의 효과 관찰)

  • Sohn Jin-Hun;You Ji-Hye;Eom Jin-Sup;Lee Soo-Yeol;Chung Soon-Cheol
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.1
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    • pp.9-15
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    • 2005
  • Purpose : This study attempted to investigate the effects of supply of highly concentrated $(30\%)$ oxygen on human ability of visuospatial cognition using time course data analysis of functional Magnetic Resonance Imaging (fMRI). Materials and Methods : To select an item set in the visuospatial performance test, two questionnaires with similar difficulty were developed through group testing. A group test was administered to 263 college students. Two types of questionnaire containing 20 questions were developed to measure the ability of visuospatial cognition. Eight college students (right-handed male, average age of 23.5 yrs) were examined for fMRI study. The experiment consisted of two runs of the visuospatial cognition testing, one with $21\%$ level of oxygen and the other with $30\%$ oxygen level. Each run consisted of 4 blocks, each containing control and visuospatial items. Functional brain images were taken from 37 MRI using the single-shot EPI method. Using the subtraction procedure, activated areas in the brain during visuospatial tasks were color-coded by t-score. To investigate the time course data in each activated area from brain images, 4 typical regions (cerebellum, occipital lobe, parietal lobe, and frontal lobe) were selected. Results : The average accuracy was $50.63{\pm}8.63$ and $62.50{\pm}9.64$ for $21\%\;and\;30\%$ oxygen respectively, and a statistically significant difference was found in the accuracy between the two types of oxygen (p<0.05). There were more activation areas observed at the cerebellum, occipital lobe, parietal lobe and frontal lobe with $30\%$ oxygen administration. The rate of increase in the cerebellum, occipital lobe and parietal lobe was $17\%$ and that of the frontal lobe, $50\%$. Especially, there were increase of intensity of BOLD signal at the parietal lobe with $30\%$ oxygen administration. The increase rate of the left parietal lobe was $1.4\%$ and that of the right parietal lobe, $1.7\%$. Conclusion : It is concluded that while performing visuospatial tasks, high concentrations of oxygen administration make oxygen administration sufficient, thus making neural network activate more, and the ability to perform visuospatial tasks increase.

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Early postoperative arrhythmias after open heart surgery of pediatric congenital heart disease (소아 선천성 심장병 개심술 후 발생한 조기 부정맥)

  • Choi, Hee-Joung;Kim, Yeo-Hyang;Cho, Joon-Yong;Hyun, Myung-Chul;Lee, Sang-Bum;Kim, Kyu-Tae
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.532-537
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    • 2010
  • Purpose : Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. Methods : From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. Results : Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times ($P$<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer ($P$<0.05), the mortality rate was not significantly different among the 2 groups. Conclusion : Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.