• Journal of Korean Medicine for Obesity Research
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• v.2 no.1
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• pp.83-87
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• 2002

Increasing body weight is closely associated with increasing risk for glucose intolerance and type II diabetes. Especially, abdominal distribution of weight and visceral obesity also seriously increase the morbidity and mortality. Dietary program including very-low-calorie diet(VLCD) is regarded as most effective in the control of obesity and diabetes, which mainly due to calorie restriction rather than weight loss itself. We are reporting a case of diabetes with obesity whose fast glucose was over 220 mg/dl and BMI was $25.1kg/m^2$(fat rate 32.8%, WHR 0.9). She was prescribed VLCD and oriental medical diet program. After 10 days of hospitalization, her glucose level dropped dramatically with 3kg loss of body weight She has further lost her weight until about 53kg, but the glucose level ceased to go down probably due to loosened calorie restriction.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.393-398
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• 2023

Patients transported from fire sites may exhibit various injury patterns. Major trauma, skin burn, inhalation burn, and carbon monoxide poisoning are typical injuries. However, most physicians may be unfamiliar that cyanide poisoning can frequently occur due to combustion. Cyanide poisoning is highly significant owing to high mortality and the existence of antidotes. I present a 35-year-old man who was transported from a burning building and suffered severe metabolic acidosis despite no major bleeding as well as mild carbon monoxide poisoning. I suspected cyanide poisoning and administered the antidote; subsequently, the patient showed improvement. The next day, sudden airway obstruction developed, and emergency endotracheal intubation was performed. The inhalation damage was detected only in the lower airway tract and not in the upper airway. Physicians should be aware of cyanide poisoning and inhalation burn to avoid missing treatment opportunities.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1049-1055
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• 1998

Background: Coronary artery bypass surgery is an important treatment for ischemic heart disease. Recently operative mortality and morbidity has decreased, however further improvement is necessary. Materials and methods: This study was designed to evaluate the risk of operative mortality and morbidity by retrospective method. From 1992 to 1997, eighty six patients underwent coronary artery bypass surgery. There were 61 males and 25 females aged 36~74 years(mean, 58.6). Fourteen patients(16%) had previous PTCA or stent insertion, 41 patients(48%) had unstable angina, and 45 patients(52%) had three vessel disease. Patients with low LV ejection fraction(<35%) were 7 cases and urgent or emergent operation were 10 cases. There were 6 cases of combined surgery which were mitral valve replacement(2 cases), aortic valve replacement(2 cases), ASD repair(1 case), and VSD repair(1 case). Average number of distal anastomosis was 3.5 per patient and average aortic cross clamp time was 115±38.3min. Preoperative risk factors were defined as follows: female, old age(>70 years), low body surface area(<1.5M2), PTCA or stent insertion history, hypercholesterolemia, smoking, hypertension, DM, COPD, urgent or emergent operation, left main disease, low LV ejection fraction(<35%), and combined surgery. Results: Operative mortality was 7cases(8%). As a postoperative morbidity, perioperative myocardial infarction was 6 cases, cerebrovascular accident 6 cases, reoperation for bleeding 5 cases, acute renal failure 4 cases, gastrointestinal complication 3 cases, and mediastinitis 3 cases. In the evaluation of operative risk factors, low body surface area, DM and low LV ejection fraction were found to be predictive risk factors of postoperative morbidity(p<0.05), and low ejection fraction was especially a risk factor of hospital mortality(p<0.05). Conclusions: In this study, low body surface area, DM and low LV ejection fraction were risk factors of postoperative morbidity and low ejection fraction was a risk factor of hospital mortality.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.419-425
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• 2015

Objective : Acute vertebrobasilar artery occlusion (AVBAO) is a devastating disease with a high mortality rate. One of the most important factors affecting favorable clinical outcome is early recanalization. Mechanical thrombectomy is an emerging treatment strategy for achieving a high recanalization rates. However, thrombectomy alone can be insufficient to complete recanalization, especially for acute stroke involving large artery atheromatous disease. The purpose of this study is to investigate the safety and efficacy of mechanical thrombectomy in AVBAO. Methods : Fourteen consecutive patients with AVBAO were treated with mechanical thrombectomy. Additional multimodal treatments were intra-arterial (IA) thrombolysis, balloon angioplasty, or permanent stent placement. Recanalization by thrombectomy alone and multimodal treatments were assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcome was determined using the National Institutes of Health Stroke Scale (NIHSS) at 7 days and the modified Rankin Scale (mRS) at 3 months. Results : Thrombectomy alone and multimodal treatments were performed in 10 patients (71.4%) and 4 patients (28.6%), respectively. Successful recanalization (TICI 2b-3) was achieved in 11 (78.6%). Among these 11 patients, 3 (27.3%) underwent multimodal treatment due to underlying atherosclerotic stenosis. Ten (71.4%) of the 14 showed NIHSS score improvement of >10. Overall mortality was 3 (21.4%) of 14. Conclusion : We suggest that mechanical thrombectomy is safe and effective for improving recanalization rates in AVBAO, with low complication rates. Also, in carefully selected patients after the failure of recanalization by thrombectomy alone, additional multimodal treatment such as IA thrombolysis, balloons, or stents can be needed to achieve successful recanalization.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.310-321
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• 1991

Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

• Asian-Australasian Journal of Animal Sciences
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• v.4 no.4
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• pp.333-339
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• 1991

Eighty-two ewes of Balochi breed, two to four years of age were used in a completely randomized design to study the effect of winter supplementation on their performance in Kalat area of Balochistan and randomly divided into two groups of 40 and 42 animals. Two treatments (T1 and T2) studied were : 250 gm/animal/day of a 50 : 50 mixture of cottonseed cake and barley grain fed from Oct. 20 to Dec. 18, 1988 plus grazing and 500 gm/animal/day of the same feed mixture fed from Oct. 9 to Dec. 18, 1988 in addition to grazing. Lucerne hay and wheat straw in a 50 : 50 ratio were provided to all the ewes for a period of one month from Jan. 6, 1989 @ 320 gm/animal/day to sustain them in severe winter. Same feeding levels to the same ewe groups were again fed from Mar. 1 to May 27, 1989. Three breeding rams stayed with the flock from Nov. 1 to Dec. 13, 1988. Lambing took place from Apr. 2 to May 12, 1989. Conception, lambing and mortality percentage was found different (P<.05) between T1 and T2 (12.5 vs 14.8 kg). The ewes on T2 maintained higher body weights throughout winter than the ewes on T1. The results are suggestive of improvement in conception rate with winter supplementation (flushing) and decrease in ewe mortality. Late-gestation and early-lactation supplemental feeding of ewes results in increases in weaning weights of their lambs.

• Asian-Australasian Journal of Animal Sciences
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• v.6 no.1
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• pp.115-122
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• 1993

A study was conducted to compare the effect of feeding commercial formula ration and corn-soybean meal based rations on growth performance, feed conversion ratio, mortality percentage, dressing percentage, carcass composition and economics of raising broiler chicks at commercial farms. 3000 day old broiler chicks were randomly divided into 4 groups with 3 replicates of 250 birds in each. Four iso-nitrogenous and isocaloric rations (A, B, C and D) were prepared and randomly allotted to each group. Ration A was a commercial broiler ration whereas ration B had the same formula with the exception that all the animal protein sources were replaced with soybean meal (SBM). Ration C was based on only corn and SBM. Ration D contained corn, SBM and 25% fullfat soybean (FFSB). The birds were given the experimental rations starter from day 1 to 28 and finisher from 29 to 49. The results indicated that the birds fed on corn-soybean meal based rations gained significantly figher weights showed better feed conversion ratio, gave higher dressing percentage with better carcass composition, lower mortality and higher net profits as compared to those fed on commercial ration. The replacement of animal protein sources in commercial ration with SBM (ration B) although did not show any significant differences in the performance of birds as compared to ration A, a little improvement was visible indicating that SBM can be used as a good substitute of animal protein sources. Similarly the replacement of SBM with FFSB up to a level of 25% did not affect the broiler performance as compared to only SBM.

• Korean Journal of Poultry Science
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• v.43 no.3
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• pp.169-176
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• 2016

An experiment was conducted to evaluate the growth performance and meat quality traits of broilers fed a diet supplemented with dry-ground curry leaves (Murraya koenigii). A total of 750 one-day-old broiler chicks (Cobbs 500) were arranged in the experiment with a completely randomized design and allotted to one of five treatments, with $T_1-Control$ and $T_2-T_5$ curry leaves powder levels (i.e., 0.3%, 0.6%, 0.9% and 1.2%, respectively). The initial body weights, final body weights and daily feed intake were measured over an experimental period of 32 days. At the conclusion of the experiment, the carcass weights and meat quality parameters were measured. The birds fed diets supplemented with curry leaves powder had a higher weight gain (P<0.05; ADG), improved feed conversion ratio (P<0.05; FCR) and lower mortality (P<0.05) rates compared to the birds in the control group. Nonetheless, there was no difference (P>0.05) in feed intake among the dietary treatments. Similarly, supplementation of curry leaves powder had no effect (P>0.05) on the proportions of the carcass, leg meat and drumstick. No differences were (P>0.05) observed in cooking loss or the pH of meat from broilers fed the curry leaves supplemented diet. However, curry leaf supplementation affected (P<0.05) the meat water holding capacity. A sensory evaluation showed higher levels of taste and tenderness in meat from broilers fed with curry leaves powder. In conclusion, our results suggested that curry leaves powder improved the growth performance of broilers, with a lower incidence of mortality and improvement of some meat qualities.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.267-273
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• 2009

Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.32-41
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• 1992

From August 1982 to December 1991, 58 consecutive infants with tetralogy of Fallot underwent primary repair. Age ranged from 22 days to twelve months [n=58, 8.7$\pm$2.7 months] and body weight from 3.1 to 13 kilograms [n=58, 7.8$\pm$1.7 kilograms]. Qne infant had absence of the pulmonary valve; one had Ebstein`s anomaly and one had supramitral ring. Thirty-two patients [56%] experienced anoxic spell. Preoperative pulmonary artery indices were measured in 38 cases, ranging 126-552mm2/M2BSA[n=38, 251$\pm$79mm2/M2BSA]. All infants required a right ventricular outflow tract patch; in 41, the patch extended across the pulmonary valve annulus, in 13 of them, monocusps were constructed. All had patch closure of ventricular septal defect. Two infants had REV operation for avoiding injury to the canal branch of the right coronary artery which cross the right ventricular out flow tract. Post repair PRV/LV were measured at operating room in 40 cases, which revealed mean value of 0.49$\pm$0.12 [range: 0.25-0.74]. The hospital mortality was 10.3% [6 patients], and causes of deaths were right heart failure due to sustained right ventricular hypertension[4] and right ventricular outflow tract obstruction, intractablesuraventricular tachyarrhythmia[1], hypoxia[1] due to residual right to left shunt across the atrial septal defect in patient associated with Ebstein`s anomaly. All infants were doing well at follow-up from 1 to 101 months[20.6 months /patient, 1, 072 patient-month] Serial postoperative echocardiograms revealed no residual ventricular septal defects and estimated RVOT gradients between 0 and 40 mmHg except 3 cases [50, 50, 60 mmHg]. There were no late deaths and late ventricular arrhythmias or congestive heart failure. Redo operations were done in 2 cases because of residual right ventricular outflow tract obstruction. This experience with infants with tetralogy of Fallot suggests that, if mortality is tolerable, eletive repair of tetralogy of Fallot could be reasonably undertaken during the first year of life, and even better results could be anticipated along with improvement of methods of myocardial protection and postoperative care.