• Journal of Chest Surgery
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• v.50 no.5
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• pp.363-370
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• 2017

Background: Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients. Methods: This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients. We also analyzed the risk factors for hospital mortality in the entire ECLS population using univariate and multivariate analyses to investigate the effects of transport. Results: All 44 patients were safely transported without adverse events. The average travel distance was 178.7 km, with an average travel time of 74.0 minutes. Early survival of the transported group seemed to be better than that of the in-house group, but the difference was not statistically significant (70.5% vs. 56.6%, p=0.096). The incidence of complications was similar between the 2 groups, except for critical limb ischemia, which was significantly more common in the transported group than in the in-house group (25.0% vs. 8.1%, p=0.017). After adjusting for confounders, being part of the transported group was not a predictor of early death (adjusted odds ratio, 0.689; p=0.397). Conclusion: Transportation of patients on ECLS is relatively safe, and the clinical outcomes of transported patients are comparable to those of in-house ECLS patients. Although matched studies are required, our study demonstrates that transporting patients on ECLS did not increase their risk of hospital mortality after adjustment for other factors.

• 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.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.387-391
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• 2007

An oxygenator is a very important artificial organ and widely used for patients with lung failure or during open heart surgery. Although an oxygenator has been widely studied worldwide to enhance its efficiency, studies on oxygenators, in particular when using a pulsatile blood flow, are domestically limited. Therefore, a new oxygenator was developed in the lab and animal experimental results are described in the paper. The oxygenator is composed of polycarbonate housing and polypropylene hollow fibers. It has a total length of 400 mm and a surface area of $1.7 m^2$. The animal experiment lasted for 4 hours. The blood flow rate was set to 2 L/min and a pulsatile blood pump, T-PLS (Twin-Pulse Life Support), was used. Samples were drawn at the oxygenator's inlet and outlet. The total hemoglobin (Hb), saturation oxygen ($sO_2$), and partial oxygen pressure ($pO_2$), partial $CO_2$ pressure ($pCO_2$), and plasma bicarbonate ion concentration ($HCO_3^-$) were measured. The oxygen and carbon dioxide transfer rates were also calculated based on the experimental data in order to estimate the oxygenator's gas transfer efficiency. The oxygen and carbon dioxide transfer rates were $16.4{\pm}1.58$ and $165.7{\pm}10.96 mL/min$, respectively. The results showed a higher carbon dioxide transfer rate was achieved with the oxygenator. Also, the mean inlet and outlet blood pressures were 162.79 and 137.92 mmHg, respectively. The oxygenator has a low pressure drop between its inlet and outlet. The aim of own preliminary study was to make a new oxygenator and review its performance when applying a pulsatile blood pump thus, confirming the possibility of a new oxygenator suitable for pulsatile flow.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2915-2921
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• 2015

Background: Some recent clinical trials have been conducted to evaluate a combination of EGFR- TKI with chemotherapy for advanced NSCLC patients as second-line therapy, but the results on the efficacy of such trials are inconsistent. The aim of this meta-analysis was to evaluate the efficacy and safety of combination of EGFR-TKI and chemotherapy for patients with advanced NSCLC who failed first-line treatment. Materials and Methods: We searched relative trials from PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, Cochrane Library and Clinical Trials.gov. Outcomes analyzed were overall response rate (ORR), progression- free survival (PFS), overall survival (OS) and major toxicity. Results: Seven trails eventually were included in this meta-analysis, covering 1,168 patients. The results showed that the combined regimen arm had a significant higher ORR (RR 1.76 [1.16, 2.66], p=0.007) and longer PFS (HR 0.75 [0.66-0.85], p<0.00001), but failed to show effects on OS (HR 0.88 [0.68-1.15], p=0.36). In terms of subgroup results, continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance confered no improvement in ORR (RR 0.95 [0.68, 1.33], p=0.75) and PFS (HR 0.89[0.69, 1.15], p=0.38), and OS was even shorter (HR1.52 [1.05-2.21], p=0.03). However, combination therapy with EGFR-TKI and chemotherapy after failure of first-line chemotherapy significantly improved the ORR (RR 2.06 [1.42, 2.99], p=0.0002), PFS (HR 0.71 [0.61, 0.82], p<0.00001) and OS (HR 0.74 [0.62-0.88], p=0.0008), clinical benefit being restricted to combining EGFR-TKI with pemetrexed, but not docetaxel. Grade 3-4 toxicity was found at significantly higher incidence in the combined regimen arm. Conclusions: Continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance should be avoided. Combination therapy of EGFR-TKI and pemetrexed for advanced NSCLC should be further investigated for prognostic and predictive factors to find the group with the highest benefit of the combination strategy.

• Tuberculosis and Respiratory Diseases
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• v.51 no.2
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• pp.155-160
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• 2001

Cryoglobulinemia is the presence of globulins in the serum that precipitate on exposure to cold temperatures(cryoglobulins). Pulmonary complications of cryoglobulinemia include interstial infiltration, impaired gas exchange, small airway disease and pleurisy. Only one other acute respiratory distress syndrome(ARDS) case has been described in patients with cryoglobulinemia. A 55-years old man was admitted with dyspnea. He had been diagnosed as being a hepatitis B virus antigen carrier 15 years ago. On the first admission, chest radiography showed a bilateral pleural effusion and a patchy infiltration on both lungs. On protein- and immuno-electrophoresis, cryoglobulinemia was confirmed. The patient was treated with corticosteroid and plasmapheresis. Forty-five days after the diagnosis, the patient complained of progressive dyspnea and showed a diffuse bilateral pulmonary infiltration on chest radiography. Despite intensive care with mechanical ventilation, the patient died as consequence of hypoxemia and multiple systemic organ failure. On a pathologic examination of the postmortem lung biopsy, multiple necrotizing vasculitis and increased infiltration of the lymphocytes and monocytes were observed. In conclusion, ARDS developed as a result of pulmonary hemorrhage due to cryoglobulinemia-associated vasculitis.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.729-734
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• 1999

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

• Korean Journal of Veterinary Service
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• v.42 no.4
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• pp.201-216
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• 2019

Porcine reproductive and respiratory syndrome (PRRS) is characterized by reproductive failure in sows and respiratory distress in all age pigs. Porcine respiratory disease complex (PRDC) is a disease caused by opportunistic bacterial infection secondary to a weakened immune system by a preceding respiratory infection. In this study, we tried to compare the immune responses in PRRS and PRDC groups to clearly characterize the disease severity. Eighty-five pigs were infected with various Korean field PRRS virus strains. Infected animals were classified into PRRS (n=32) and PRDC (n=53) groups based on lung lesions such as interstitial pneumonia, suppurative pneumonia, and pleuropneumonia. The immune cell population of bronchoalveolar lavage cells (BALc) was evaluated on 14 and 28 days post infection (dpi) and PMBC cytokine expression was measured on 0, 3, 7, 14 dpi to investigate early inflammatory reactions. Pulmonary lesion severity was negatively correlated with alveolar macrophage (AM) in both PRRS and PRDC groups on 14 and 28 dpi. AM in BALc was less populated in PRDC group on 28 dpi compared to PRRS group. AM in BALc was significantly less populated in PRDC group on 28 dpi compared to 14 dpi. In addition, cytotoxic T lymphocyte (CTL) in BALc was higher populated in PRDC group on 14 dpi and 28 dpi compared to PRRS group. In the case of PBMC cytokine TNF-α, IFN-α, IL-1β, IFN-γ, FoxP3, and IL-2, the PRRS group showed higher expression than the PRDC group on 7 dpi, 14 dpi, 7 dpi, 14 dpi, 14 dpi, and 14 dpi, respectively. On the other hand, in the case of IFN-β, IL-6, IL-8, IL-4, and IL-17, the PRDC group showed higher PBMC cytokine expression at 14 dpi, 7 dpi, 14 dpi, 3 dpi, and 3 dpi, respectively, than the PRRS group. Based on these results, our study could characterize differential immune responses in pigs with PRRS or PRDC.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6135-6140
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• 2013

Background: Breast cancer is a common malignant tumor which affects health of women and multidrug resistance (MDR) is one of the main factors leading to failure of chemotherapy. This study was conducted to establish paclitaxel-resistant breast cancer cell line and nude mice models to explore underlying mechanisms of MDR. Methods: The breast cancer drug-sensitive cell line MCF-7 (MCF-7/S) was exposed in stepwise escalating paclitaxel (TAX) to induce a resistant cell line MCF-7/TAX. Cell sensitivity to drugs and growth curves were measured by MTT assay. Changes of cell morphology and ultrastructure were examined by optical and electron microscopy. The cell cycle distribution was determined by flow cytometry. Furthermore, expression of proteins related to breast cancer occurrence and MDR was tested by immunocytochemistry. In Vivo, nude mice were injected with MCF-7/S and MCF-7/TAX cells and weights and tumor sizes were observed after paclitaxel treatment. In addition, proteins involved breast cancer and MDR were detected by immunohistochemistry. Results: Compared to MCF-7/S, MCF-7/TAX cells had a higher resistance to paclitaxel, cross-resistance and prolonged doubling time. Moreover, MCF-7/TAX showed obvious alterations of ultrastructure. Estrogen receptor (ER) expression was low in drug resistant cells and tumors while expression of human epidermal growth factor receptor 2 (HER2) and Ki-67 was up-regulated. P-glycoprotein (P-gp), lung resistance-related protein (LRP) and glutathione-S-transferase-${\pi}$ (GST-${\pi}$) involved in the MDR phenotype of resistant cells and tumors were all overexpressed. Conclusion: The underlying MDR mechanism of breast cancer may involve increased expression of P-gp, LRP and GST-${\pi}$.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.77-86
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• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.10-15
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• 2001

Purpose : This is a retrospective study to evaluate the results of radiation therapy in nasopharyngeal carcinoma. Materials and Methods : From September 1989 to October 1996, 19 patients with nasopharyngeal carcinoma completed planned radiation therapy course. Stages were 1 in 2 patients, II in 6, III in 2 IV in 9 patients, respectively. Pathology was squamous cell carcinoma in 5 patients, undifferentiated cell carcinoma in 14 patients. Fourteen patients were treated with radiation therapy only. Five patients received chemotherapy. The follow-up period ranged from 5 months to 115 months with a median of 33 months. Follow-up was possible in all patients. Results : Responses to radiation therapy were complete response in 15 patients, partial response in 2, and no response in 2, respectively. Patterns of failure were as follows : locoregional recurrence in 6 patients and distant metastasis in 4 patients. The sites of distant metastasis were bone, liver and lung. Five year survival rate was $47.8\%$ and five year disease free survival rate was $48.1\%$. Stage, T-stage, N-stage, central nervous system involvement, pathology type, performance status, response, radiation dose, chemotherapy were not significant prognostic factors. Conclusion : 5-year survival rate was $47.8\%$ and 5-year disease free survival rate was $48.1\%$. The advances in radiation therapy techniques and chemotherapy are needed.