• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.201-205
• /
• 2009

Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, $54{\sim}77$ years). The average size of the tumors was 48.8mm (range, $36{\sim}111mm$) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A $x^2$-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

• Journal of Chest Surgery
• /
• v.42 no.1
• /
• pp.22-27
• /
• 2009

Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

• Journal of Chest Surgery
• /
• v.40 no.11
• /
• pp.727-732
• /
• 2007

Background: The reciptents of aortic valve replacement or a Bentall operation usually display various degrees of mitral regurgitation. When deciding whether or not to correct the mitral regurgitation, one must consider its severity, underlying causes and operative risk. Recently, the operation method for correcting the concomitant mitral regurgitation has been done through aortic root to reduce the operation time and the cardiac trauma. We report our experiences that transaortic mitral valve commissuroplasty done with aortic valve replacement or a Bentall operation has been a simple, less invasive, effective method in the operative management of mitral valve regurgitation without significant organic changes. Material and Method: Between June 2002 and June 2005, twenty patients under-went mitral valve commissuroplasty via the aortic root with aortic valve replacement (n=14) or a Bentall operation (n=7). The mitral valve regurgitation of the patients didn't exceed a moderate (grade 2) degree and there was no significant organic disease. The preoperative diagnosis of MR was established by TTE and intraoperative TEE, and the patients were followed postoperatively by TTE. The operative technique was a simple anterolateral commissuroplasty of the mitral valve with a single mattress suture via the transaortic annular approach after excision of the aortic valve leaflets. Result: The mean patient age was 56.2 years and 65% (n=13) were male. The preoperative MR was mild (grade 1) in 9 (45%), mild to moderate in 8 (40%), and moderate (grade 2) in 3 (15%) patients. There were no operative mortalities. The MR improved in all patients (p=0.002) and the left ventricular ejection fraction (LV EF) improved in 14 (70%) patients (p=0.005). The mean cross-clamp time for the patients who under- went aortic valve replacement with transaortic mitral repair was $62.1{\pm}13.9 min$ and this was $137.5{\pm}7.2 min$ for the patients who underwent a Bentall operation with transaortic mitral repair. Conclusion: For selected patients without significant mitral organic disease, transaortic mitral valve commissuroplasty combined with aortic valve replacement or a Bentall operation may be a feasible, effective method without adding significant aortic cross clamping time and more cardiotomy.

• Environmental Analysis Health and Toxicology
• /
• v.15 no.4
• /
• pp.131-137
• /
• 2000

The release of hazardous waste materials into the environment poses serious risks in humans and ecosystems. The risk assessment of environmental pollutants including hazardous chemicals requires a comprehensive measurement of hazard and exposure of the chemicals that can be achieved by toxicity evaluation using a biological system such as biomarkers. In this report we have tried to develop a biomarker used to elucidate a molecular basis of, and to monitor abnormal behaviors caused by diazinon in Japanese medaka (Oryzias latipes) as a model organism. First, an attempt was made to clone tyrosine hydroxylase gene from Japanese medaka that would be a candidate for a biomarker for neuronal modulations and behaviors. For monitoring experiments at behavioral and molecular biological levels, the fish were treated under different sublethal conditions of diazinon and their behavioral responses were observed . In this study we have successfully cloned a partial TH gene from the medaka fish through PCR screening of an ovary cDNA library. DNA sequencing analysis revealed that the amplified fragment was 327 bp encoding 109 amino acids. Comparing the DNA sequence of medaka TH with other species, TH gene revealed the DNA sequence was completely identical to that of rat TH. In the RT-PCR, 330 Up of mRNA was consistently amplified in all the treated samples including control There were no significant differences in the TH expression level regardless of treating concentrations (1∼5,000 ppb) and time (0∼48 hr) The reason appeared to be that RT-PCR was not performed using through a quantitative analysis normalized against an actin gene expression. Organ or tissue - specific detection of TH activity and mRNA as biomarkers will be a useful monitoring tool for neurobehavioral changes in fish influenced by toxic chemicals. Furthermore, quantitative analysis of locomotive patterns and its correlation with the neurochemical and molecular data would be highly useful in measuring toxicity and hazard ofvarious environmental pollutants.

• Korean Journal of Psychosomatic Medicine
• /
• v.12 no.1
• /
• pp.15-22
• /
• 2004

Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

• Korean Journal of Psychosomatic Medicine
• /
• v.13 no.2
• /
• pp.95-101
• /
• 2005

Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress res ponses in caregivers of patients with attention deficit hyperactivity disorder. Methods : The subjects were 38 attention deficit hyperactivity disorder patients caregivers(38 women, mean age $37.5{\pm}6.5$). Patients were diagnosed with DSM-IV ADHD criteria. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Results 1) The BDI scores of ADHD patients caregiver group were significantly higher than control group$(16.4{\pm}7.1\;vs.\;10.9{\pm}5.5)(p=0.011)$. 7 of the 38 caregivers(18.4%) and none of control group(0%) had BDI scores over 20 points(p=0.021). Calculated relative risk for ADHD in the presence of caregivers' depression was 1.516 overall(95% confidence interval, 1.234-1.862). 2) In ADHD patient's caregiver group, the scores of Stress Response Inventory were significantly higher than control group$(44.2{\pm}20.2\;vs.\;26.5{\pm}16.8)(p=0.006)$. 3) No significant differences were found in the score of STAI, SIAIS, SIAI-T, TAS between caregiver and control group. Conclusion : This study suggest that ADHD patients' caregivers are likely to have more depressive symptoms and higher stress response level than control group. We propose that physicians should consider integrated approaches for caregiver's psychopathology in the management of ADHD.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.1
• /
• pp.61-71
• /
• 1999

Objective : The purpose of this study was to assess the relationship between the premenstrual changes and stress perception in women with premenstrual changes($PMC^+$)(n=32) and those without premenstrual changes($PMC^-$)(n=62) by using prospective method. Method : The women who were older than 30 years of age and healthy were asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle to assess the changes of psychological and physical symptoms across the menstrual cycle. They also completed 5-point likert scale to assess the perception of stress. Percent changes method was used to assess changes between follicular phase and luteal phase. Results : 1) No significant differences were found in demographic factors(age, education, marriage, employment) and risk factors(onset ages of menarche, regularities of premenstrual changes, duration of menstruation, cycle length, amount of menstruation, dysmenorrhea) between women with and without premenstrual changes. 2) There was a significant difference in mean luteal phase stress score between women with($1.92\pm0.63$) and without premenstrual changes($1.51\pm0.42$)(p<0.05). However no difference was found in mean follicular phase stress score between two groups($PMC^+$ : $1.67\pm0.43$, $PMC^-$ : $1.33\pm0.39$). 3) We divided women having premenstrual changes into two groups, higher stress group(stress score > 1.75(median)) and the lower stress group(stress score <1.75(median)). The higher stress group reported more luteal psychological symptoms than did the lower stress group(df=1, F=13.362, p<0.001). However, the groups did not differ in physical symptoms. Conclusion : In women with premenstrual changes, luteal stress score was higher than follicular stress score and this result suggested tha the perception of stress was related to psychological symptoms but not physical symptoms. These findings suggested that premenstrual change is associated with the stress level, and that it is important to manage the stress which is focused on the management of psychological symptom in the treamtment of prementrual syndrome.

• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.1
• /
• pp.103-115
• /
• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Applied Biological Chemistry
• /
• v.46 no.2
• /
• pp.123-129
• /
• 2003

This study is to investigate consequent nutrient intake status, Influences of body mass index (BMI) and serum lipid composition, and fat distribution on the cocoon hydrolysate, green tea leaves and dietary fiber supplementation. During 2 months of this research (April to May, 2002), 47 women aged 20 yr-30 yr (average age 26.2 yr) were selected as subjects. Nutrient intake was investigated by questionnaire and 24-hr recall method. Antropometric assessments of the subjects were investigated by SBIA method (Segmental bioimpedance assay, Inbody 3.0). The results were as follows: mean body weight was 60.7 kg, mean body height 161.7 cm and mean BMI 23.4. Status of energy intakes significantly decreased (p<0.01) and dietary fiber intakes significantly increased (p<0.001) after supplementation. BMI and WHR (waist-hip ratio) significantly decreased (p<0.01) and body fat significantly decreased after supplementation (p<0.001). Total cholesterol and LDL-cholesterol significantly decreased after supplementation (p<0.05). HDL-cholesterol was negatively correlated with BMI and WHR (p<0.01). LDL/HDL ratio was positively correlated with BMI (p<0.01) and WHR (p<0.05). Above results of this study show that low-molecule peptide, green tea leaves and dietary fiber supplementation-added routine diet improves lessening body fat distribution, total cholesterol, LDL-cholesterol. Especially, decrease of abdominal fat and WHR were notable. That meant decrease of risk factors.

• Journal of Applied Biological Chemistry
• /
• v.61 no.2
• /
• pp.195-204
• /
• 2018

Pesticide residue in the eggs in the market has become a significant problem in Korea. In particular, the detection of fipronil indicated that unregulated pesticide residue can be present in livestock products, including eggs. Institutionally unregulated pesticides are a risk to human health and the ecosystem. In this study, we analyzed the system of agricultural pesticide management in Korea, the European Union, and the United States of America (USA) and discussed the problems of the Korean management system and the possible improvement directions. Based on the analysis, we considered three tasks: registration of pesticides, pesticide residue levels in food, and pesticide residue levels in environmental media. The registration of pesticides was conducted by the Ministry of Agriculture, Food, and Rural Affairs in Korea; the Directorate-General for Health and Food Safety in the European Commission (EC); and the US Environmental Protection Agency (USEPA) in the USA. The work regarding pesticide residue levels in food was conducted by the Ministry of Food and Drug Safety in Korea, the Directorate-General for the Health and Food Safety in the EC, and the USEPA and Food and Drug Administration in the USA. The work regarding pesticide residue levels in environmental media was conducted by the Ministry of Environment in Korea, the Directorate-General for Environment in the EC, and the USEPA in the USA. Therefore, Korea should review the extension of pesticide residue standards in the environmental media for strengthening the system of management of unregulated agricultural pesticides.