Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
Journal of Chest Surgery
/
v.38
no.11
s.256
/
pp.761-772
/
2005
Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objective of this study was to suggest a practical dosing guideline for Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997 to September, 2000. Patients who were at least 6 months post-valve replacement and had nontherapeutic INR value (less than 2.0 or greater than 3.0) were included. The data on 688 patients (1,782 visits) requiring dosing adjustment without any known drug or food interaction with warfarin were analyzed. The amount of adjusted dose and INR changes based on the INR at the time of the event were calculated. Aortic valve replacements (AVR) patients and mitral or double valve replacement (MVR/DVR) patients were evaluated separately. Result: Two methods for the warfarin dosage adjustment were suggested: Guideline I (mg-based total weekly dose (TWD) adjustment), Guideline II (percentage-based TWD adjustment). The effectiveness of Guideline 1 was superior to Guideline II overall in patients with both AVR and MVR/DVR. Conclusion: The guideline suggested in this study could be useful when the dosage adjustment of wafarin is necessary in outpatients with mechanical heart valves.
Kim Joo Young;Kim Il Han;Ha Sung Whan;Park Charn Il
Radiation Oncology Journal
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v.11
no.1
/
pp.69-77
/
1993
Treatment of cerebellar medulloblastoma has been much improved with modern surgical technique for gross total tumor removal and adequate radiation therapy for the whole craniospinal axis. Questions have been arosen about the optimal radiation dose for the preventive treatment of whole cranium and whole spinal axis. Recently, many authors have reported their treatment results as comparable to older data, using lower than conventional dose of 3,600 cGy-4,000 cGy. For 50 patients treated between 1981 and 1990 at the Department of Radiation Therapy of SNUH, retrospective analysis was done for the treatment result, especially the neuraxis control, by radiation dose for the presymptomatic area of the disease. Analysis only by total spinal dose did not give any significant difference. But further analysis by following patient group; 3,600 cGy/150 cGy (n=6), 3,000 cGy/150 cGy (n=10), 2,400 cGy/150 cGy (n=17) and 2,400 cGy/100-120 cGy (n=11) showed significant improvement of neuraxis control by decreasing order (p =0.003). There was no significant difference in overall survival between the groups. For the 19 patients who had been confirmed initially as having no neuraxis disease, TDF 30 was the cur-off value that could prevent neuraxis failure (p =0.004). We couldn't define any TDF value that give reasonable control for the patient group with positive CSF study at initial diagnosis.
Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.
Park, Ik-Soo;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
Tuberculosis and Respiratory Diseases
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v.41
no.6
/
pp.624-631
/
1994
Background: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. Method: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; Results: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic "fungus ball" pattern were observed in 53.8% of the 52cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed fine needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9%(12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. Conclusion: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.
The purpose of this study is to analyze the nutrient intakes and growth development of rural middle school students provided with and without the national school lunch program(NSLP). The subjects consisted of 340 rural middle school students provided with(n=177) and without(n=163) NSLP. Anthropometric measurements were taken for body weight, height, triceps skinfold thickness and percentage of body fat, and nutrient intakes were assessed by food record method. The results of this study were summarized as follows: There was no significant difference in the height, body weight girls provided with (155.8cm 47.2kg) and without (156.0cm, 49.7kg) NSLP. Total energy intakes of boys were 2123kca1 in with NSLP and 1857kca1 in without NSLP. Total energy intakes of girls were 1913kca1 in with NSLP and 1814kca1 in without NSLP. Total daily energy was provided in the ratio of 19.1%, 39.8%, 32.4% and 8.7% by breakfast, lunch, dinner and snacks in the with NSLP and 17.5%, 32.0%, 34.8% and 15.7% in without NSLP, respectively. Phosphorus, vitamin A, vitamin E, ascorbic acid, thiamin, riboflavin, niacin intakes were above the RDA in with NSLP. In without NSLP, phosphorus, vitamin E, thiamin intakes were above the RDA. however, calcium. iron, vitamin A, vitamin B$_{6}$ were less than the RDA. The study showed that total daily energy and nutrient intakes were significantly higher in students provided with than without school-lunch. Thus, the school-lunch program is recommended and necessary to improve the nutritional status of middle school students.
This study was carried out to compare the physicochemical characteristics of Korean traditional wine fermented from foxtail millet and nuruk at different mixing rates. The alcohol contents of fermented wine ranged from 12.70 to 13.38%. Two kinds of commercial nuruks, SH and BS nuruk, were used. The brix degrees of foxtail millet wine fermented by SH and BS nuruks were 21.6 and $22.4^{\circ}Bx$, respectively. The pH, total acidity, and turbidity of the wines fermented by SH and BS nuruks were 3.74 and 3.40, 1.40 and 1.51%, and 0.441 and 0.149, respectively. With an increase in the amount of foxtail millet, brix degree, pH, turbidity, b-value and L-value decreased, and total acidity and a-value increased. Total color difference (${\Delta}Eab$) parameter of the wine fermented by SH nuruk were 8.58, 22.59 and 22.55, while those by BS nuruk were 0.35, 4.08 and 7.16 in 30, 70 and 100% addition rates of foxtail millet, respectively. With an increase in the amount added of foxtail millet, glucose content decreased. The organic acids such as lactic acid and acetic acid were predominantly detected in the fermented wine. Finally, based on sensory evaluations, the wine fermented by BS nuruk showed the best overall quality at the 30% addition rate of foxtail millet.
Inclusion body hepatitis-hydropericardium syndrome (IBH-HPS) is an acute viral disease usually found in broilers aged from 3 to 5 weeks and causes up to 75% mortality. Among the 12 serotypes of fowl adenovirus group 1, serotype-4 (FAdV-4) was identified as a primary agent of IBH-HPS and was usually isolated in IBH-HPS cases in Korea since 2007. To prevent these IBH-HPS outbreaks in Korea, we developed the FAdV-4 inactivated vaccine using Korean isolate (ADL070244) and evaluated the efficacy of this vaccine. For the efficacy test, 2-week-old specific-pathogen-free (SPF) chickens intramuscularly inoculated with 1 or 2 dose of inactivated vaccine were used and challenged with FAdV-4 through either intramuscular or oral route at 2 weeks after vaccination. The vaccine induced good seroconversion which was confirmed by agar gel precipitation (AGP) test. In addition, the vaccine could decrease the FAdV-4 detection rate and histological lesion severity such as lymphocyte infiltration and necrosis in the liver comparing with those of non-vaccination group. Based on the current results, the developed FAdV-4 inactivated vaccine in this study was effective in the terms of reduction of virus detection rate and histological lesions severity. However, it was difficult to confirm the efficacy of the vaccine clearly because of no mortality and clinical signs in the non-vaccinated group after challenge. Therefore, we need further study to develop a standard challenged model system which could clearly evaluate the efficacy of the vaccines for FAdV-4.
In this study, I classify the elements of physiognomic judgment of character with regard to form and meaning from a visual perspective based on physiognomic judgment of character study in 'the cosmic dual forces and the Five Elements theory'. Individual characters for each type are designed using graphic data. Based on that, design system of individual characters for each personality type is investigated using Neural Network system. Faces with O-Haeng (Five Elements) shapes are shown to constitute the system with ${\pm}0.3%$ degree of error tolerance for the non-loaming input data. For the shapes of Chinese characters 'tree, fire, soil, gold and water', their MSE(Mean Square Error) are 0.3, 0.3, 0.2, 0.5, 0.2. It seems to be the best regarding the scoring system which ranges from 0 to 5. Therefore, this system might be regarded to produce the most accurate facial shape of character automatically when we input character's personality we desire to make.
The effects of modified atmosphere(MA) packaging and coating on the quality of mushroom (Agaricus bisporus) were investigated. Whole mushrooms(100 g) were packed with polyvinyl chloride(PVC) film wrap, PD941 and PD961 film bags and were stored in a chamber at $12^{\circ}C$ and 80% RH for 6 days. Gas composition of packages, respiration rate, weight loss, color and maturity index of MA packaged mushrooms were examined. The wrap packaged mushrooms showed different level of internal $CO_2$ concentrations among water washed, chitosan coated and $CaCl_2$ coated subgroups significantly at 5% level. The maximum $CO_2$ concentration of PD941 and PD961 packages for all coated showed $4.1{\sim}4.7%$ and $10.4{\sim}11.7%$, respectively, for the first day. PD961 package showed the lowest $O_2$ concentration compared to other groups. There were no significant respiration rate differences between wrap packed and PD941 packaged. Respiration rate of water washed. chitosan coated and $CaCl_2$ coated in PD961 packaged was 192 mg, 226 mg and 245 mg, respectively. Maturity index of PD961 packaged were not significantly different among the water washed, chitosan and $CaCl_2$ coated packages. Chitosan coating showed a negative effect on color change of mushrooms. The weight loss of 961 packaged was lower $(7.0{\sim}8.0%)$ that those of wrap packaged and PD941 packaged.
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