• Journal of Preventive Medicine and Public Health
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• v.23 no.1 s.29
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• pp.87-97
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• 1990

We followed up all the infants born to the married women under 50 years of age residing in Gunwee county, Kyungpook Province, between 1 April 1985 and 31 March 1987, and those born to the married women under 50 years residing in Hapchun County, Kyungnam Province, between 1 March 1987 and 28 February 1988, to their first birthday. Likewise, we followed up the infants born to the women who visited the MCH Center of South District Health Center in Taegu City for delivery between 1 April 1985 and 31 March 1987 to the 27th day after birth and obtained the infant mortality rate and the neonatal mortality rate, respectively. There were 17 infant deaths among 1,359 live births in Gunwee and Hapchun Counties and the infant mortality rate was 12.5 per 1,000 live births. Out of 17 infant deaths, 82.4 percent were neontal death and 17.6 percent were postnonatal deaths. Out of the 6,001 live births born to the women visited the MCH Center, 4,834 infants (80.6%) were followed up to the 27th day after birth. Of these 4,834 infants, 36 infants died before the 28th day after birth and thus the neonatal mortality rate was 7.4 per 1,000 live births. Comparison of the maternal characteristics and the birth weight between infants who were followed up and those who were lost to follow-up showed no significant differences. Assuming that the neonatal and postneounatal mortality ratio had been 6:4, the infant mortality rate for the infants born at the MCH Center would have been 12.3 per 1,000 live births. Taking such findings into consideration as the infant mortality rate observed in Gunwee and Hapchun Counties, the neonatal mortality rate at the MCH Center, the causes of infant deaths, and the low birth weight incidence rate, a conservative estimate of infant mortality rate of Korea would be between 12 and 15 per 1,000 live births in $1985{\sim}1988$.

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.15-26
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• 1998

p53 is the most frequently mutated gene in female breast cancer tissues and the prognosis of breast cancer could be changed by mutation of the gene. This study was performed to examine risk factors for breast cancer subtypes classified by p53 mutation and to investigate the roles of p53 gene mutation in carcinogenesis of breast cancer. The study subjects were 81 breast cancer patients and 121 controls who were matched to cases 1:1 or 1:2 age, residence, education level and menopausal status. All the subjects were interviewed by a well-trained nurse with standardized questionnaire on reproductive factors, and wire asked to fill the self-administrative food frequency questionnaire. p53 gene mutation in the cancer tissue was screened using polymerase chain reaction (PCR)-single strand conformational polymorphism (SSCP) method. Mutation type was identified by direct sequencing of the exon of which mobility shift was observed in SSCP analysis. Mutations were detected in p53 gene of 25 breast cancer tissues. By direct sequencing, base substitutions were found in 20 cancer tissues (10 transition and 10 transversion), and frame shift mutations in 5 (4 insertions and 1 deletion). For the whole cases and controls, risk of breast cancer incidence decreased when the parity increased, and increased when intake amount of total calory, fat, or protein increased. Eat and protein were statistically significant risk factors for breast cancer with p53 mutation. For breast cancer without p53 mutation, protein intake was the only significant dietary factor. These results suggest that causes of p53 positive breast lancer would be different from those of p53 negative cancer, and that dietary factors or related hormonal factors induce mutation of p53, which may be the first step of breast cancer development or a promoter following some unidentified genetic mutations.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.269-276
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• 1988

Eight patients with intracranial tumors or arteriovenous malformation (AVM)s which were less than 3 cm in diameter were treated by a technique of stereotactic radiotherapy during the 4months period from July 1988 through October 1988 at the Division of Radiation Therapy, Kang-Nam St. Mary's Hospital, Catholic University Medical College. The patients were diagnosed as AVMs in 3 cases, acoustic neurinoma, craniopharyngiom (recurrent), hemangioblastoma, pineocytoma, and pituitary microadenoma in each case. There are several important factors in this procedure, such as localization system, portal, field size, radiation dose, and perioperative supportive care. It is suggested that stereotactic radiotherapy may be peformed safely with a radiation dose of 12-30 Gy. So this nonivasive procedure can be used to treat unresectable intracranial tumors or AVMs. Of these, clinical symptoms had been regressed in AVMs in 2 cases at 3 months and 2 months after Stereotactic radiotherapy, one of whom was confirmed slightly regressed on the follow-up angiogram. And also craniopharyngioma and pineocytoma was minimally regressed on 3 month follow-up CT.

• Parasites, Hosts and Diseases
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• v.23 no.1
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• pp.123-139
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• 1985

The present survey was undertaken to observe the geographical distibution of matacercaria among the sweetfish, Plecoglossus altivelis, the most important second intermediate host of Metagonimus yokegawai, which were collected during the period from 1983 to 1984 in south-eastern coastal areas of Korea. The results obtained were summarized as follow: 1. A total of 668 sweetfish collected from 70 chins (=streams) in the above coastal arcus was examined for the metacercariae, and 432 (64.7%) among them were infected with metacercariae of M. yokogawai. The mean number of metacercariae in a fish was in the range from 0 to 29,604 and the mean number of the metacercariae in a fish was 640.3. 2. It was observed that the mean infection rate showed 46.45 in Gangweon-Do (=province) . The infection rates varied from stream to stress showing 100% in Namdae stream(Gangnun-city) , Obsib stream (Samchok-gun) and Dongmak, 95.0% in Hosan stream, 90.0% in Gungchin stream, and Namdae stream (Yangyang-fp) ,80.0% in Hwasang stream,50.0% in Daebong stream,45.0% in Yonghwa stream, 30.0% in sangchsn stream and Sachsn stream, 20.0% in Munam stream and Okgyoe stream, 15.0% in Imweon stream, 10.0% in Namchsn stream. And no metacercarial infections in their fish host were found in the areas of Mulchi stream, Sangun stream, Gosamun stream, Jonchon stream and Gagok stream. 3. It was observed that the mean infection rate showed 50.9% in Kyangsangbuk-Do (=province). The infection rates also varied from stream to stream showing 100% in Songchon stream, Osib stream (Yongdok-gun) and Daejong stream,60.0% in Pyanghae stream and Gunmu stream,50.0% in Buhwung stream and stream, 25.0% in Nagok stream, 20.0% in Oangbi stream, 10.0% in Namhodong stream. And no metacercarial infections in their fish host were found in the areas of Namdae stream (Uljinup) and Chaksan stream. 4. It was observed that the mean infection rate showed 67.6% in Kyangsangnam-Do(=province). The infection rates varied from stream to stream showing 100% in Taehwa river, Hwiya river, Inchfn stream, Miryang river, Nam river, Hwagae stream, Koha stream, Sosang stream, and Tongchon stream,90.9% in Yancho stream,90.0% in Hoihwa stream,80.0% in Chindong stream, 66. YoA in Chingyo stream, 40.0% in Hoyam river. And no metacercarial infections in their fish host were found in the areas of Chinjon stream, Sanchan stream and Jukch6n stream. 5. It was observed that the mean infection rate showed 94.6"A in 0h511anam-Do(=province). The infection rates varied from stream to stream showing 100% in DongchEn stream, Isachon stream, Somjin river(GoksEng-gun) , Ssmjin river(Kurye-gun) , S6si stream, Gokchsn stream, Kohung stream, Kwansan stream, Youi stream, stream, Unj6n stream and Apnae stream, 92.3% in Tamjin river, 90.9% in Okkok stream, 84.6% in Songgen stream. And no metacercarial infections in their fish host were found in the area of Ypmgpl stream. 6. On the other hand, the infection rate showed 100% in Inchsn river of Chollabuk Do (=province) (=province) and Kangsn stream of Cheju-Do(=province) .

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.38-43
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• 2005

Matrix metalloproteinase-2 (MMP-2) is a class of proteolytic enzymes that digest collagen type IV and other components of the basement membrane. It plays a key role in the local invasion and the formation of distant metastases by various malignant tumors. The aim of this study was to evaluate the activity of MMP-2 and its significance as a prognostic marker in resected stage I non-small cell lung cancer (NSCLC). Material and Method: In this study we obtained fresh-frozen samples of tumor and non-tumor tissues from 34 patients with stage I NSCLC who underwent resection without preoperative radiotherapy or chemotherapy. After the extraction of total protein from tissue samples, MMP-2 activities were assessed by gelatin-substrate-zymography. The activities were divided into the higher or lower groups. Result: The MMP-2 activities were higher in tumor tissues than in non-tumor tissues. The MMP-2 activity of non-tumor tissues in recurrent group was higher than in non-recurrent group (p<0.01). Also the patients with higher MMP-2 activity of non-tumor tissues showed poor 5 year survival (p<0.01). Conclusion: This result indicates that the higher level of MMP-2 activity in the non-tumor tissue is associated with the recurrence and survival after the resection of stage I NSCLC. Therefore, MMP-2 activity in the non-tumor tissue could be used as a potential prognostic marker for the resected stage I-NSCLC.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.611-618
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• 2006

Background: There have been controversies whether mitral valvular surgery is necessary in the patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting. The purpose of this study is to evaluate the long term clinical results of patients with moderate ischemic mitral regurgitation. Material and Method: Between January 1992 and February 2005, 44 patients with moderate ischemic mitral regurgitation underwent coronary artery bypass grafting. Concomitant mitral valvular procedure was performed in 20 patients (group 1) and isolated coronary artery bypass grafting was performed in 24 patients (group 2). There were no significant difference between groups except cardiopulmonary bypass time (p<0.01). Postoperative follow up duration was $30.1{\pm}29.6$ months and last follow up echocardiographic examination was performed at $21.2{\pm}28.0$ months. Result: There was no difference in operative mortality between groups (group 1 vs group 2, 15.0% vs 8.3%, p=0.493). Grade of mitral regurgitation ${(0.81{\pm}0.91\;vs\;1.50{\pm}0.05,\;p=0.046)}$ and reduction in regurgitation grade ${(1.75{\pm}0.93\;vs\;0.70{\pm}1.26,\;p=0.009)}$ were different between two groups. But there were no significant differences in left ventricular ejection fraction ${(34.1{\pm}11.4%\;vs\;41.6{\pm}12.9%)}$, left ventricular end systolic volume ${(118.2{\pm}63.9\;ml%\;vs\;85.6{\pm}281\;ml)}$, New York Heart Association functional class ${(2.1{\pm}0.2\;vs\;2.4{\pm}1.2)}$ and 5 year survival rate ${(85{\pm}8%\;vs\;82{\pm}8%)}$. There was no risk factor for operative mortality and the only risk factor for late death was preoperative atrial fibrillation (p=0.042). There was no significant correlation between mitral valvular surgery and late death. Conclusion: Concomitant mitral valvular procedure in patients with moderate ischemic mitral regurgitation undergoing coronary artery bypass grafting had no significant positive effect on survival and ventricular function compared with isolated coronary artery bypass grafting. Prospective randomized study may be needed to evaluate the necessity of concomitant mitral procedure and to find more effective method for the improvement of ventricular function.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.626-632
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• 2006

Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.383-394
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• 1979

Treatment of valvular heart disease with valve replacement has been one of the most popular procedures in cardiac surgery recently. Although, first effort was directed toward the prosthetic valve, it soon became popular that bioprosthesis, the valvular xenograft, was prefered in the majority cases. Valvular xenograft has some superiority to the artificial prosthetic valve in some points of thromboembolism and hemolytic anemia, and it also has some inferiority of durability, immunologic reaction and resistance to Infection. Tremendous efforts were made to cover the inferiority with several methods of collection, preservation, and valve mounting of the porcine valve or pericardium of the calf, and also with surgical technique of the valvular xenograft replacement. Auther has collected 320 porcine aortic valves immediately after slaughter, and aortic cusps were coapted with cotton balls in the Valsalva sinuses to protect valve deformity after immersion in the Hanks' solution, and oxidation, cross-linking and reduction procedures were completed after the proposal of Carpentier in 1972. Well preserved aortic valves were suture mounted in the hand-made tissue valve frame of 19, 21, and 23 mm J.d., and also in the prosthetic vascular segment of 19 mm Ld. with 4-0 nylon sutures after careful trimming of the aortic valves. Completed valves were evaluated with bacteriologic culture, pressure tolerance test with tolerane gauge, valve durability test in the saline glycerine mixed solution with tolerance test machine in the speed of 300 rpm, and again with pathologic changes to obtain following results: 1. Bacteriologic culture of the valve tissue in five different preservation method for two weeks revealed excellent and satisfactory result in view of sterilization including 0.65% glutaraldehyde preservation group for one week bacteriologic culture except one tissue with Citobacter freundii in 75% ethanol preserved group. 2. Pressure tolerance test was done with an apparatus composed of V-connected manometer and pressure applicator. Tolerable limit of pressure was recorded when central leaking jet of saline was observed. Average pressure tolerated in each group was 168 mmHg in glutaraldehyde, 128 mmHg in formaldehyde, 92 mmHg in Dakin's solution, 48 mmHg in ethylene oxide gas, and 26 mmHg in ethanol preserved group in relation to the control group of Ringer's 90 mmHg respectively. 3. Prolonged durability test was performed in the group of frame mounted xenograft tissue valve with 300 up-and-down motion tolerance test machine/min. There were no specific valve deformity or wearing in both 19, 21, and 23 mm valves at the end of 3 months (actually 15 months), and another 3 months durability test revealed minimal valve leakage during pressure tolerance test due to contraction deformity of the non-coronary cusp at the end of 6 months (actually 30 months) in the largest 23 mm group. 4. Histopathologic observation was focussed in three view points, endothelial cell lining, collagen and elastic fiber destructions in each preservation methods and long durable valvular tolerance test group. Endothel ial cell lining and collagen fiber were well preserved in the glutaraldehyde and formaldehyde treated group with minimal destruction of elastic fiber. In long durable tolerance test group revealed complete destruction of the endothelial cell lining with minimal destruction of the collagen and elastic fiber in 3 month and 6 month group in relation to the time and severity. In conclusion, porcine xenograft treated after the proposal of Carpentier in 1972 and preserved in the glutaraldehyde solution was the best method of collection, preservation and valve mounting. Pressure tolerance and valve motion tolerance test, also, revealed most satisfactory results in the glutaraldehyde preserved group.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.739-744
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• 1999

Background: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. Material and Method: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). Result: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was $1.5\pm$0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4$\pm$1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5$\pm$1.2. Conclusion: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.135-140
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• 2009

Background: Chronic rejection after a cardiac allograft usually occurs about six months after the operation. Vasculopathy due to chronic rejection causes atherosclerosis in the coronary artery of the transplanted heart and then this causes myocardial injury. We intended to discover and document those findings that occur in a transplanted ascending aorta. Material and Method: In rats weighting $200{\sim}300gm$ (Spraque-Dawley rat), we carried out heterotopic heart allo-transplantation with the modified Ono-Lindsey method and then the rats were administrated cyclosporine (10mg/kg/day). After three months survival, we acquired biopsy materials from the native ascending aorta and the allo-transplanted ascending aorta and we compared them. We classified each severity of 1) intimal thickening, 2) medial hyperplasia, 3) medial calcification, 4) medial inflammation and 5) chondroid metaplasia, which are specific biopsy findings for chronic rejection after a cardiac allograft. Each severity was classified, according to the opinion of one pathologist, in the native ascending aorta biopsies (n=9) and the allo-transplanted ascending aorta biopsies (n=13). The data of the control group and the study group were statistically analyzed with using the Mann-Whitney test (SPSS version 12.0 window). Result: The important changes of the allo-transplanted aorta were intimal thickening (p<0.0001), medial calcification (p=0.045), medial inflammation (p<0.0001) and chondroid metaplasia (p=0.045), but not medial hyperplasia (p=0.36). Conclusion: Cardiac allograft vasculopathy was seen in the transplanted ascending aorta, the same as was seen in the coronary artery, after allograft cardiac transplantation. We have reached the conclusion that chronic rejection also progresses in the aorta.