• The Journal of Internal Korean Medicine
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• v.15 no.1
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• pp.22-44
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• 1994

Clinical observations were done on 67 cases with Diabetes Mellitus in CVA patients who were confirmed by CT scan and observed for over 1 week, admitted to the Dept. of Internal Medicine in Oriental Medical Hospital of Dongguk University from January 1992 to December 1993. The results were as follows; 1. 86 patients (15.3%) with Diabetes Mellitus were found in 561 CVA patients, the 6th decade of age was 40.2%, the ratio of male to female was 0.72:1. 2. The local distribution of CVA was similar to common CVA, and occlusive CVD was 83.6%, cerebral hemorrhage was 16.4% in this study. 3. The association between blood glucose and years were not significant. The largest ratio of fasting blood glucose were 140-199 mg/dl (44.6%) in admission, below 139 mg/dl (51.8%) in discharge in case of occlusive CVD. In cerebral hemorrhage, that were 140-199 mg/dl(45.5%) in dmission, below 139 mg/dl (45.5%) in discharge. The largest ratio of pp2hrs blood glucose were 200-299mg/dl in admission and discharge both occlusive CVD and cerebral hemorrhage. 4. The total sensitivity of urine glucose was 71.6%, and sensitivity of urine glucose in cerebral hemorrhage (81.8%) was more higher than that of occlusive CVD (69.6%). 5. Below 4 years had the highest prevalence(44.8%) in duration of diabetes mellitus. Patients usually used oral hypoglycemic agents(41.8%), insulin injection(23.9%) treatment and non-therapeutic was 17.9% in this study. 6. Predisposing factors and symptoms in admissin were similar to common CVA. The conscious disturbance on attacck was 41.1% in occlusive CVD, and that was 63.7% in cerebral hemorrhage. 7. The most common ratio of the season's attack was spring (44.8%), 8. The frequency of post history was as follows, hypertension (44.8%), heart disease (10.4%), and they were in below 199 mg/dl (83.3%) of fasting blood glucose. 9. The family history of CVA was 46.3%, and they was higher than nondiabetic patients. 10. The recurrence rate of CVA was 28.4%, and that of occlusive CVD(28.6%) was higer than cerebral hemorrhage's (18.2%). 11. The smoker was 52.2%, the drinker was 38.9%. 12. The complications was occured in 10 cases (14.9%) after admission, and they frequently occured than common CVA. 13. In admission, the ratio of systolic blood pressure in over l60mmHg was 42.9%, that of diastolic blood pressure in over l00mmHg was 12.5% in occlusive CVD. In cerebral hemorrhage, the ratio of systolic blood pressure in over l60mmHg was 54.5%, that of diastolic blood pressure in over l00mmHg was 27.3%. 14. The average beginned time of physical theraphy was, generally lated, 8.3 days in occlusive CVD, 11.2 days in cerebral hemorrhage. Average admitted period was longer than common CVA, and was 29.2 days in occlusive CVD, 11.2 days in cerebral hemorrhage. 15. The degree of recovery were 82.1% in occlusive CVD, 72.7% in cerebral hemorrhage. 16. The herb medications were various Sunghyanggeonggisans, Sopungtang, Ganghwalyupungtang, Yanggyuksan etc. were used most frequently, and Yukmijihwangtang, Gamidaebotang, Mangeumtang etc. were used as discharge.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.193-199
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• 2007

Background: Reoperation is usually required for a right ventricle to pulmonary artery conduit obstruction caused by valve degeneration, conduit peel formation or somatic growth of the patient. An autologous tissue reconstruction (peel operation), where a prosthetic roof is placed over the fibrotic tissue bed of the explanted conduit, has been used to manage conduit obstructions at our institute since May 2002. Herein, the early and midterm results are evaluated. Material and Method: Between May 2002 and July 2006, 9 patients underwent obstructed extracardiac conduit replacement with an autologous tissue reconstruction, at a mean of 5.1 years after a Rastelli operation. The mean age at reoperation was $7.5{\pm}2.4$ years, ranging from 2.9 to 10.1 years. The diagnoses included 6 pulmonary atresia with VSD, 2 truncus arteriosus and 1 transposition of the great arteries. The preoperative mean systolic gradient was $88.3{\pm}22.2mmHg$, ranging from 58 to 125 mmHg. The explanted conduits were all Polystan valved pulmonary conduit (Polystan, Denmark). A bioprosthetic valve was inserted in 8 patients, and a monocusp ventricular outflow patch (MVOP) was used in 1 patient. The anterior wall was constructed with a Gore-Tex patch (n=7), MVOP (n=1) and bovine pericardium (n=1). Pulmonary artery angioplasty was required in 5 patients and anterior aortopexy in 2. The mean cardiopulmonary bypass time . was 154 minutes, ranging from 133 to 181 minutes; an aortic crossclamp was not performed in all patients. The mean follow-up duration was 20 months, ranging from 1 to 51 months. All patients were evaluated for their right ventricular outflow pathway using a 3-D CT scan. Resuit: There was no operative mortality or late death. The mean pressure gradient, assessed by echocardiography through the right ventricular outflow tract, was 20.4 mmHg, ranging from 0 to 29.6 mmMg, at discharge and 26 mmHg, ranging from 13 to 36 mmHg, at the latest follow-up (n=7, follow-up duration >1 year). There were no pseudoaneurysms, strictures or thrombotic occlusions. Conclusion: A peel operation was concluded to be a safe and effective re-operative option for an obstructed extracardiac conduit following a Rastelli operation.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.1-33
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• 1997

The objective of this study was to analyze the in vitro and in vivo corrosion products of low and high copper amalgams. The four different types of amalgam alloy used in this study were Fine cut, Caulk spherical, Dispersalloy, and Tytin. After each amalgam alloy and Hg were triturated according to the directions of the manufacturer by means of the mechanical amalgamator(Amalgam mixer. Shinhung Co. Korea), the triturated mass was inserted into a cylindrical metal mold which was 12mm in diameter and 10mm in height. The mass was condensed by 150Kg/cm compressive force. The specimen was removed from the mold and aged at room temperature for about seven days. The standard surface preparation was routinely carried out by emery paper polishing under running water. In vitro amalgam specimens were potentiostatically polarized ten times in a normal saline solution at $37^{\circ}C$(potentiostat : HA-301. Hukuto Denko Corp. Japan). Each specimen was subjected to anodic polarization scan within the potential range -1700mV to+400mV(SCE). After corrosion tests, anodic polarization curves and corrosion potentials were obtained. The amount of component elements dissolved from amalgams into solution was measured three times by ICP AES(Inductive Coupled Plasma Atomic Emission Spectrometry: Plasma 40. Perkim Elmer Co. U.S.A.). The four different types of amalgam were filled in occlusal and buccal class I cavities of four human 3rd molars. After about five years the restorations were carefully removed after tooth extraction to preserve the structural details including the deteriorated margins. The occlusal surface, amalgam-tooth interface and the fractured surface of in vivo amalgam corrosion products were analyzed. In vivo and in vitro amalgam specimens were examined and analyzed metallographically by SEM(Scanning Electron Microscope: JSM 840. Jeol Co. Japan) and EDAX(Energy Dispersive Micro X-ray Analyser: JSM 840. Jeol Co. Japan). 1. The following results are obtained from in vitro corrosion tests. 1) Corrosion potentials of all amalgams became more noble after ten times passing through the in vitro corrosion test compared to first time. 2) After times through the test, released Cu concentration in saline solution was almost equal but highest in Fine cut. Ag and Hg ion concentration was highest in Caulk spherical and Sn was highest in Dispersalloy. 3) Analyses of surface corrosion products in vitro reveal the following results. a)The corroded surface of Caulk spherical has Na-Sn-Cl containing clusters of $5{\mu}m$ needle-like crystals and oval shapes of Sn-Cl phase, polyhedral Sn oxide phase. b)In Fine cut, there appeared to be a large Sn containing phase, surrounded by many Cu-Sn phases of $1{\mu}m$ granular shapes. c)Dispersalloy was covered by a thick reticular layer which contained Zn-Cl phase. d)In Tytin, a very thin, corroded layer had formed with irregularly growing Sn-Cl phases that looked like a stack of plates. 2. The following results are obtained by an analysis of in vivo amalgam corrosion products. 1) Occlusal surfaces of all amalgams were covered by thick amorphous layers containing Ca-P elements which were abraded by occlusal force. 2) In tooth-amalgam interface, Ca-P containing products were examined in all amalgams but were most clearly seen in low copper amalgams. 3) Sn oxide appeared as a polyhedral shape in internal space in Caulk spherical and Fine cut. 4) Apical pyramidal shaped Sn oxide and curved plate-like Sn-Cl phases resulted in Dispersalloy. 5) In Tytin, Sn oxide and Sn hydroxide were not seen but polyhedral Ag-Hg phase crystal appeared in internal space which assumed a ${\beta}_l$ phase.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.212-222
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• 2004

The application of acidulated phosphate fluoride gel(APF) and fluoride varnishes are the most common topical fluoride therapy. The purpose of this in vitro study was to compare the remineralization effects of two topical fluoride agents, APF gel and fluoride varnish with microtomograph and 3D image analyzer without sample preparation and chemical fixation. For the purpose of the study, the artificial caries lesion was caused on the caries-free permanent pre molar and 48 specimens were divided into three groups each containing 16 specimens No application was performed on group 1, which acted as control group. Group 2 was treated with APF gel and was removed after a minute. Group 3 was treated with the topical application of fluoride varnish and removed after 45 minutes. Each specimen was placed into a closed container with 50ml of a artificial saliva during three months and the 3D images of the remineralization area were taken using the SkyScan each month. Using the density-measuring program in V $works^{TM}$, the density value of the remineralization area was measured. The following results were obtained: 1. All groups demonstrated an increase in the density of artificial caries lesion with time. 2. The density was significantly higher in APF gel and fluoride varnish group than control group at 1 month, 2 months, 3 months after the treatment(P<0.05). 3. The difference of the density between that "prior to treatment" and that "1 month after treatment" in Group 2 and Group 3 was significantly higher than that of Group 1 and, the difference of the density between that "1 month after treatmen" and that "2 month after treatment" in Group 3 was significantly higher than that of Group 1 and 2(P<0.05). 4. The fluoride varnish was more effective after 2 and 3 months and continuous than the APF gel.

• Journal of Radiation Protection and Research
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• v.38 no.4
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• pp.214-227
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• 2013

Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1263-1270
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• 1997

Background : Differentiation of malignity and benignity is crucial for management of solitary pulmonary nodule(SPN). Clinical parameters such as patient's age, nodule size, smoking history, doubling time, typical calcification in X-ray and CT findings have been reported as helpful in this purpose. However, in most cases, these parameters are not conclusive. Glucose metabolism is increased in cancer tissues including lung cancer tissues. After uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose(FDG), the glucose analogue, by cancer cell, FDG is trapped in the cell without further metabolism after phosphorylation. Thus, hypermetabolic focus in FDG-positron emission tomography (PET) imaging suggest malignancy. We evaluated the diagnostic efficacy of FDG-PET imaging in distinguishing malignant and benign SPN. Methods : We evaluated 28 patients with SPN from Jan. 1995 to Jan. 1997. CT scan of chest and whole-body FDG-PET imaging were performed in all patients. Histologic diagnosis was confirmed by transthoracic fine needle aspiration and biopsy, bronchoscopic biopsy and open thoracotomy. Results : Of the 28 SPN's, 22 nodules were malignant and 6 nodules were benign. FDG-PET imaging diagnosed all malignant nodules correctly as positive, and diagnosed 4 of 6 benign nodules correctly as negative. One tuberculous granuloma and one aspergilloma showed hypennetabolic focus and were diagnosed falsely positve with FDG-PET imaging. In the diagnosis of SPN with FDG-PET, sensitivity and specificity were 100% and 66.7%, positive predictive value and negative predictive value were 92% and 100%. Conclusion : FDG-PET imaging is highly useful noninvasive diagnostic tool in distinguishing between malignant SPN and benign SPN.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.528-531
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• 2004

Purpose: PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal charge using microPET scanner. Materials and Methods: Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCl. A burr hole was made at 1cm right lateral to the bregma. Collagenase type IV 10 ${\mu}l$ was injected using 30 G needle for 5 minutes to establish the infarction model. $^{18}F$-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, $^{18}F$-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Results: Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. Conclusion: We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using $^{18}F$-FDG microPET scanner.

• Restorative Dentistry and Endodontics
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• v.35 no.2
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• pp.88-95
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• 2010

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in simulated root canals. For the preparation of thirty two curved root canals, Mtwo instruments using "single length"technique, and Profile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were prepared by reaching an apical canal size of #30. Pre- and post-instrumentation digital images were recorded and an assessment of canal shape was determined using a computer image analysis program SigmaScan Pro (Systat Software Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of the dimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and then data were statistically analyzed using one-way ANOVA and Duncan's test. The results were as below; 1. The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instruments (p < 0.05). 2. The deformation and fracture of all instruments used for this study were not experienced. 3. In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowest changes of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p < 0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls of canals at all measuring points (p < 0.05). 4. In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changse of the dimension of outer walls of canals except at the measuring point of the 1 mm (p < 0.05). However, Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of 3 and 4 mm and ProTaper Universal and K3 showed the largest changes of the dimension of outer walls of canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05). 5. In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centering ratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm. Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universal may efficiently flare the canal orifice and form a better taper, and in the apical part of the canal, files which have a better centering ability such as Profile may maintain the original canal curvature and reduce the shaping time.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.567-573
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• 2017

The purpose of this study was to evaluate whether or not there was artifact when the upper limb could not be lifted to the top of the head during multi-detector computed tomography(MDCT) scans of the chest and abdomen. Contrast radiography of the human and chest phantom was performed with 128channal MDCT. Under the same conditions(120 kVp, 110 mAs, standard algorithm)both hands lifted up and put down each time in the human experiment. In the chest phantom experiment, the radiography was carried out when the upper limb phantom was adjusted at a certain distance(0, 3, 7 cm) from the chest phantom. Subsequently, the values of Noise, CT number, SNR, and CNR were measured in the field of concern. The noise value of fat, rib, and muscle increased when the arm was lifted in humans(0.79, 47.8, 27%). Furthermore, when the upper limb was lowered, the noise value of muscle and lung increased in the phantom(31.2, 9.4%). In addition, the noise value of the muscles and lung decreased by 5, 25.12% and 5.6, 15.35% as the upper limb moved about 0,3,7cm away from the chest. When the chest and abdominal radiography were performed, in the case of the presence of other parts outside the inspection area, the probability of artifact was minimal while the distance was more than 3cm away from the upper limb to the chest and abdomen.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.213-225
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• 1989

An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.