• Journal of Chest Surgery
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• v.40 no.9
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• pp.593-599
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• 2007

Background: The correlation between levels of brain natriuretic peptide (BNP) and the effect of pulmonary resection on the right ventricle of the heart is not yet widely known. This study aims to assess the relationship between the change in hemodynamic values of the right ventricle and increased BNP levels as a compensatory mechanism for right heart failure following pulmonary resection and to evaluate the role of the BNP level as an index of right heart failure after pulmonary resection. Material and Method: In 12 non small cell lung cancer patients that had received a lobectomy or pnemonectomy, the level of NT-proBNP was measured using the immunochemical method (Elecsys $1010^{(R)}$, Roche, Germany) which was compared with hemodynamic variables determined through the use of a Swan-Garz catheter prior to and following the surgery. Echocardiography was performed prior to and following the surgery, to measure changes in right ventricular and left ventricular pressures. For statistical analysis, the Wilcoxon rank sum test and linear regression analysis were conducted using SPSSWIN (version, 11.5). Result: The level of postoperative NT-proBNP (pg/mL) significantly increased for 6 hours, then for 1 day, 2 days, 3 days and 7 days after the surgery (p=0.003, 0.002, 0.002, 0.006, 0.004). Of the hemodynamic variables measured using the Swan-Ganz catheter, the mean pulmonary artery pressure after the surgery when compared with the pressure prior to surgery significantly increased at 0 hours, 6 hours, then 1 day, 2 days, and 3 days after the surgery (p=0.002, 0,002, 0.006, 0.007, 0.008). The right ventricular pressure significantly increased at 0 hours, 6 hours, then 1 day, and 3 days after the surgery (p=0.000, 0.009, 0.044, 0.032). The pulmonary vascular resistance index [pulmonary vascular resistance index=(mean pulmonary artery pressure-mean pulmonary capillary wedge pressure)/cardiac output index] significantly increased at 6 hours, then 2 days after the surgery (p=0.008, 0.028). When a regression analysis was conducted for changes in the mean pulmonary artery pressure and NT-proBNP levels after the surgery, significance was evident after 6 hours (r=0.602, p=0.038) and there was no significance thereafter. Echocardiography displayed no significant changes after the surgery. Conclusion: There was a significant correlation between changes in the mean pulmonary artery pressure and the NT-proBNP level 6 hours after a pulmonary resection. Therefore, it can be concluded that changes in NT-proBNP level after a pulmonary resection can serve as an index that reflects early hemodynamic changes in the right ventricle after a pulmonary resection.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.2
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• pp.102-108
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• 2016

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome is one of mitochondrial encephalopathy. As the early clinical manifestations can be variable, it is important to suspect the disease, especially in patients with multiple organ dysfunctions. A boy was diagnosed with epilepsy when he was 9 years old. Two years later, severe headache and blurred vision developed suddenly. On examination, left homonymous hemianopsia was detected with corresponding cerebral parenchymal lesions in right temporo-occipito-parietal areas. MELAS syndrome was confirmed by genetic test, which showed m.3243 A>G mitochondrial DNA mutation. Multivitamins including coenzyme Q10 were added to anticonvulsant. He experienced 4 more events of stroke-like episodes over 5 years, but he is able to perform normal daily activities. A 13-year-old boy was brought to the hospital due to suddenly developed respiratory arrest and asystole associated with pneumonia. Past medical history revealed that he had multiple medical problems such as epilepsy, failure-to-thrive, optic atrophy, and deafness. He has been on valproic acid as an anticonvulsant which was prescribed from local clinic. He recovered after the resuscitation, but his cognition and motor function were severely damaged. He became bed-ridden. He was diagnosed with MELAS syndrome by brain MRI, muscle biopsy, and clinical features. Genetic test did not reveal any mitochondrial gene mutation. Four years later, he expired due to suddenly developed severe metabolic acidosis combined with hyperglycemic hyperosmolar nonketotic coma. The clinical features of MELAS syndrome are variable. Early diagnosis before the presentation to the grave clinical course may be important for the better clinical outcome.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.123-135
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• 2005

Objectives:EEG coherence could imply the connectivity between two different areas of the brain, which is known to be important in the pathophysiology of bipolar I disorder(BPD I) and schizophrenia. The authors investigated EEG coherence in patients with BPD I and schizophrenia to examine the connectivity of the neural circuit. Methods:EEGs were recorded in 15 schizophrenia and 14 bipolar disorder patients, and 14 age-matched normal control subjects from 16 electrodes with linked-ear reference. Spectral parameters and coherence were calculated for the alpha bandwidth(8-13Hz) by a multi-channel autoregressive model using 20 artifact-free 2-seconds epochs and the differences were compared among three groups by two different statistical methods;F-test and Kruskal-Wallis test. Furthermore, when there were significant differences among three groups, Scheffe's multiple comparison tests were provided and Jonckheere-Terpstra tests for the ordered alternative were given. Results:In the intra-hemispheric comparison, left frontal coherence was increased in order of control, BPD I and schizophrenia. In the inter-hemispheric comparison, 1) inter-prefrontal coherence in BPD I was signifi- cantly higher than in normal controls, and 2) inter-prefrontal coherence in schizophrenia was significantly lower than in controls. Conclusion:These results suggest that 1) both schizophrenia and BPD I are diseases having the abnormality of neural circuit connectivity in both frontal and prefrontal lobes, and 2) the abnormality is more severe in schizophrenia than in BPD I. Furthermore, the data support that a common pathogenetic process may reside in both schizophrenia and BPD I.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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• pp.95-109
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• 2017

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.717-720
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• 2005

Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1004-1008
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• 1998

We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.

• The Korean Journal of Zoology
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• v.31 no.4
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• pp.334-343
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• 1988

Five types of synaPses were differentiated in the antennal lobe or Pieris rapoe. aev are in general axo-dendritic synapses and have symmetrical contacts. The type I synapses contain the uniformly round vesicles of medium size, and consist of the 11% of all synapses in the antennal lobe. The type synapses are filled with the small flat and densely arranged (19%). The type III synapses possess medium-sized round vesicles and dense core ones(24%). The type IV synapses are characterized by such three kinds of vesicles as small round, small flat and dense core vesicles(33%). The type V synapses exhibit the presence of medium-sized round, large round and dense core vesicles(13%). The removal of the left antenna on its proximal portion caused the type IV boutons of the above ave types in ipsilateral antennal lobe to turn into dark or semidark degenerative changes. Therefore, it was concluded that many of the antennal receptor cells projected into the brain terminate in the antennal lobe to form type IV synapses together with the dendrites. 배추회나비 뇌의 촉각엽에 있는 신경세포들은 5가지의 신경연접을 형성하는 것으로 관찰되었다. 이 신경연접들은 모두 축색과 수상돌기간의 연접으로 대칭연접이었다. 제1형 신경연접은 축색종말내에 중등도크기의 단형 연접소포를 가지고 있었고, 촉각엽에 있는 5가지의 신경연접중 11%의 출현빈도수로 관찰되었다. 제2형 신경연접의 축색종말에는 장형과 도형의 2가지 연접소포가 포함되어 있었는데, 모두 소형이었으며 이같은 연접소포들이 축색 종말내에서 조밀하게 관찰되었다. 제2형 신경연접의 출현 빈도수는 19%이었다. 제3형 신경연접은 축색 종말내에 중등도크기의 도형 연접소포와 DENSE CORE VESICLE을 포함하고 있었고 그 출현빈도수는 24%이었다. 제4형 신경연접은 축색총말내에 소형의 도형, 소형의 장형 연접소포 및 DENSE CORE VESICLE의 3가지 연접소포를 가지고 있었고 출현빈도수는 촉각엽에서 가장 큰 33%이었다. 제5형 신경연접은 축색종말내에 중등도크기의 원형, 대형의 원형연접소포 및 DENSE CORE VESICLE을 포함하였고 13%의 출현빈도수로 관찰되었다. 배추횐나비의 촉각에 있는 지각신경세포가 뇌의 촉각엽으로 뻗어 들어가 위의 5가지 신경연접중 어느 형을 형성하는지를 관찰하기 위하여 좌측 촉각의 기부를 제거하여 지각신경세포를 절단하였는데 그 결과, 좌측 촉각엽에서 제4형의 신경연접이 퇴행성 변화를 나타내었다. 그러므로 촉각의 지각신경세포는 뇌의 같은 족 촉각엽에 뻗어와 제4형 신경연접을 형성한다고 결론되었다.

• Korean Journal of Soil Science and Fertilizer
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• v.25 no.4
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• pp.401-406
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• 1992

Antifungal substances against three plant pathogenic fungi, Phytophthora capsici, Phytophthora nicotianae var. parasitica and Rhizoctionaia solani were fractionated cultures of Streptomyces sp. A-2 strain isolated in Korean soils. Characterizations of active substances related with antagonistic effects were follows : 1. The excellent media which showed the transfer efficiency of antagonistic substances from Streptomyces sp. A-2 strain G.Y.B and B.H.I. among four that are glucose yeast broth (G.Y.B), $M\ddot{u}eller$, brain heart infusion(B.H.I.) and Czapek media. Active substances which were transfered into ethylacetate or left in residual aqueous phase did not lose antagonistic activity in spite of autoclavation. This indicated that bonds of these compounds were rigid enough to keep activity under such conditions. 2. Antagonistic substances were extracted according to adjustment of pH 3 or pH12 to 5 day-old B.H.I. broth cultures of Streptomyces sp. A-2 strain. Comparative analysis fluorescent bands on HPTLC to antagonsitic spectra against three phytopathogenic fungi indicated that major substances with antagonistic activity were extracted regardless of different pH adjustment to broth cultures. Since UV spectrum of these fractions scanned from 500nm to 200nm was similiar to that of polyene macrolide, major substances related with antagonistic activities were assumed to be polyene derivatives antibiotics.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.315-321
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• 1997

A clinical analysis was performed on 326 cases of the non-penetrating rib fractures experienced in the department of thoracic and cardiovascular surgery, Chosun University Hospital and 102 cases of the non-penetrating rib fractures those has been admitted and treated in the department of thoracic and cardiovascular surgery, Jeonnam Hwasoon lung-ang Hospital during a period from Jan. 1994 to Dec. 1995. 1. Sex ratio was 3.4:1 in urban and 3.6:1 in rural communities with male predominance. 2. Most· common cause were traffic accident in both communities. 3. Hemothorax, pneumothorax and hemopneumothorax which needed thoracostomy were observed iii 146 cases(44.7%) in the urban and 12 cases(11.7%) in the rural communities. 4. Left thorax was the spell site of rib fractures in both communiti s. 5. Rib fracture was prevalent from 3rd to 6th rib in both communities. 6. Open thoracotomy was performed in 37 cases(11.3%) in urban and 3 cases(2.9%) in rural communities. 7. Overall mortality was 4.29%(14 cases) in urban area and, 1.96%(2 cases) in rural communities, and cause of death were hypovolemic shock, brain edema, sepsis, respiratory failure, asphyxia, and cardiogenic shock.

• Science of Emotion and Sensibility
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• v.12 no.4
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• pp.425-432
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• 2009

The purposes of the study were to examine cerebellar areas and lateralization responsible for visuospatial and verbal tasks using functional Magnetic Resonance Imaging(fMRI). Eight healthy male college students($21.5\;{\pm}\;2.3$ years) and eight male college students($23.3\;{\pm}\;0.5$ years) participated in this fMRI study of visuospatial and verbal tasks, respectively. Functional brain images were taken from 3T MRI using the single-shot EPI method. All functional images were aligned with anatomical images using affine transformation routines built into SPM99. The experiment consisted of four blocks. Each block included a control task(1 minute) and a cognitive task(1 minute). A run was 8 minutes long. Using the subtraction procedure, activated areas in the cerebellum during the visuospatial and verbal tasks were color-coded by t-score. A cerebellar lateralization index was calculated for both cognition tasks using number of activated voxels. The activated cerebellar regions during the both cognition tasks of this study agree with previous results. Since the number of activated voxels of the left and right cerebellar hemisphere was almost same, there was no cerebellar lateralization for both cognition tasks.