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Aortic and Mitral Valve Replacement with Reconstruction of the Intervalvular Fibrous Skeleton in Prosthetic Valve Endocarditis (인공판막 심내막염에서 판막간 섬유체 재건을 이용한 대동맥판 및 승모판 치환술)

  • Baek, Man-Jong;Kim, Wook-Sung;Oh, Sam-Se;Jeon, Yang-Bin;Ryu, Jae-Wook;Kong, Joon-Hyuk;Lim, Cheong;Kim, Soo-Cheol;Kim, Woong-Han;Na, Chan-Young;Lee, Seong-Ki;Lee, Chang-Ha;Lee, Young-Tak;Yoon, Youg-Woong;Park, Young-Kwang;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.561-565
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    • 2001
  • Patients who have complex endocarditis with involvement of both the aortic and mitral valves and intervalvular fibrous skeleton are among the most difficult to treat and still have the highest surgical mortality and morbidity rates. We report one case of aortic and mitral valve replacement with reconstruction of the fibrous skeleton performed in a 55-year-old female patient who had an aortic annular abscess and both the aortic and mitral prosthetic valve endocarditis with destruction of the fibrous skeleton. Previously, she had undergone redo double valve replacement\`, Transesophageal echocardiogram showed the paravalvular defect at the noncoronary aortic sinus and abnormal sinus tract along the fibrous skeleton. Emergent operation was performed due to positive blood cultures of staphylococcus epidermidis and persistent sepsis despite appropriate antibiotic therapy. After aortotomy extended to the roof of left atrium, both prosthetic valves and destroyed fibrous skeleton were completely resected and the aortic annular abscess was debrided and closed with a bovine pericardial patch. Reconstructions of both aortic and mitral annuli and the fibrous skeleton were done by using two separate bovine pericardial patches in triangular shape and mechanical valves were implanted. Postoperatively, adequate antibiotic therapies were continued and the patient was discharged at the postoperative 72 days without evidence of recurrence of endocarditis. Transthoracic echocardiogram of the postoperative 8 months shows no paravalvular leakage or recurrence of endocarditis and the patient has been followed up with no symptom.

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Incidence of Immunoglobulin G Subclass Deficiencies in Patients with Bronchiectasis and the Clinical Characteristics of Patients with Immunoglobulin G Subclass Deficiency and Bronchiectasis (기관지확장증 환자에서 면역글로불린 G 아강 결핍증의 빈도 및 특성)

  • Kim, Chang Hwan;Kim, Dong-Gyu;Park, Sung Hoon;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Sin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol-Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.295-299
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    • 2009
  • Background: There are various etiologies causing bronchiectasis, but the cases without definite causes account for a quite high proportion. It is also uncertain that immunoglobulin G subclass deficiency (IgGSD) is associated with bronchiectasis. Therefore, we tried to measure the frequency of IgGSD in patients with bronchiectasis of unclear etiology, and to observe the clinical features of those patients with bronchiectasis and IgGSD. Methods: For the outpatients of a university hospital who were diagnosed as bronchiectasis by chest CT, we produced comprehensive history taking and physical examinations, and finally selected 31 patients with bronchiectasis of unclear etiology. Results: Two patients had total immunoglobulin G deficiency. The frequency of IgGSD was comparatively high (n=14). When we compared IgGSD group to normal immunoglobulin G subclass group, there were no significant differences in sex, age, and the frequency of sinusitis, bronchial asthma, and the abnormal lung function. Conclusion: In cases of bronchiectasis without definite causes, it can be considered to measure the level of immunoglobulin G subclass. It is also probably worthwhile to further evaluate the relationship between IgGSD and bronchiectasis.

Identification of DNA Methylation Markers for NSCLC Using Hpall-Mspl Methylation Microarray (Hpall-Mspl Methylation Microarray를 이용한 비소세포폐암의 DNA Methylation Marker 발굴)

  • Kwon, Mi Hye;Lee, Go Eun;Kwon, Sun Jung;Choi, Eugene;Na, Moon Jun;Cho, Hyun Min;Kim, Young Jin;Sul, Hye Jung;Cho, Young Jun;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.495-503
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    • 2008
  • Background: Epigenetic alterations in certain genes are now known as at least important as genetic mutation in pathogenesis of cancer. Especially abnormal hypermethylation in or near promoter region of tumor suppressor genes (TSGs) are known to result in gene silencing and loss of gene function eventually. The authors tried to search for new lung cancer-specific TSGs which have CpG islands and HpaII sites, and are thought to be involved in carcinogenesis by epigenetic mechanism. Methods: Tumor tissue and corresponding adjacent normal tissue were obtained from 10 patients who diagnosed with non small cell lung cancer (NSCLC) and underwent surgery in Konyang university hospital in 2005. Methylation profiles of promoter region of 21 genes in tumor tissue & non-tumor tissue were examined with HpaII-MspI methylation microarray (Methyl-Scan DNA chip$^{(R)}$, Genomic tree, Inc, South Korea). The rates of hypermethylation were compared in tumor and non-tumor group, and as a normal control, we obtained lung tissue from two young patients with pneumothorax during bullectomies, methylation profiles were examined in the same way. Results: Among the 21 genes, 10 genes were commonly methylated in tumor, non-tumor, and control group. The 6 genes of APC, AR, RAR-b, HTR1B, EPHA3, and CFTR, among the rest of 11 genes were not methylated in control, and more frequently hypermethylated in tumor tissue than non-tumor tissue. Conclusion: In the present study, HTR1B, EPHA3, and CFTR are suggested as possible novel TSGs of NSCLC by epigenetic mechanism.

Investigating Research on the Degree of Frequency and Importance of Tasks for Framing the EMTs Occupational Description (응급구조사 직무기술서 작성에 따른 일의 요소별 빈도 및 중요도 조사 연구)

  • Kim, Tae Min;Kim, Hyo Sik;Yoou, Soon Kyu
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.199-212
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    • 2001
  • This research, aiming at analyzing the Emergency Medical Technicians' duties prior to establishing a baseline for question development in the national exams to qualify for the EMTs, investigated the importance and frequency per unit specified in the description with the EMTs to be subjects working on the task spot by means of questionnaires. The EMT duties were classified into 9 items like 1) the notification and response, 2) the scene size-up, 3) the patient assessment, 4) the emergency care, 5) the patient transport, 6) the duties at hospital clinics, 7) the operational management, 8) the receiving and responding to a call, 9) the self-development, and put the functional tasks into 52 items, describing the task elements into 177 items, and then questioned 112 EMTs working on the spot from July 21 through August 30, 2000, which showed the following results. 1) The distribution of subjects' career showed the highest rate with 33.9% for those who careered "less than a year", only 13.4% for those with more than 4 years and the highest rate with 43.8% for those who aged at 20-25. And 70.5% of all those who were questioned was the junior college graduates, 58.9% for those working at fire station and 29.5% working at hospital clinics. 2) Looking at the distribution of frequency and importance for each task element, questioning 'the patients main symptoms', 'accidental type', 'place of the patients identification' showed the highest rate in both frequency and importance in the field of "notification and response". 3) In the "scene size-up", identifying the patients showed the highest rate of frequency and importance, compared to other field of tasks, among which "identifying the patients' state" showed the highest rate of frequency (2.66) and importance (2.81). 4) In the "patient assessment", "identifying the patients" showed the high rate of frequency and importance in most elements of task, especially the importance showed the highest rate with 2.83 for the task of airway management and the cervical immobilization during "the primary assessment", and the frequency showed the highest rate for questioning the past case of the task of grasping the patients' history. 5) In the "emergency care", "the management of the heart attacked patients" and "the advanced cardiac life support" showed a high rate in the importance, whereas the frequency showed a very low rate. The high rate of frequency during the emergent task was the management of "musculoskeletal system injury patients" and of "the gastro-intestinal and urinary genital system injury patient support." In care of the patients with heart attack, the management of the airway showed the highest rate with 2.95, whereas the management of alcoholic abused patients and of dying patients, showed comparatively lower rate of assessment in the importance. The frequency of tasks showed the highest rate with 2.69 in the control of bleeding and the lowest with 0.47 in the management of abnormal delivery of child. 6) As to the patient transport, "the emergency transport" showed the highest rate with 2.74 and the unemergent transport with 2.55 in the importance, and the task importance at hospital showed the highest rate with 2.89 in managing the cardio-pulmonary resuscitation and with 2.60 in identifying the patient state. 7) Of all the tasks related with "operational task", the high importance was to "educate for the management of the first responder", but the frequency of tasks mostly showed a low rate and "receiving and responding to a call" showed relatively a high rate of importance and frequency. And related with "the self-development", "the health care management" and "the stress control" on working spot showed a high rate, but the frequency mostly showed a low rate.

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ROOT RESORPTION OF PRIMARY TEETH WITHOUT PERMANENT SUCCESSORS (계승영구치가 선천적 결손된 유치의 치근 흡수)

  • Lee, Jung-Eun;Lee, Jae-Ho;Choi, Hyung-Jun;Kim, Seong-Oh;Song, Je-Seon;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.625-630
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    • 2009
  • Root resorption of primary teeth usually occurs as the succeeding permanent teeth erupt, which induces differentiation of the hemopoietic cells into osteoclasts. Their root resorption pattern reflects the eruption path of the succeeding permanent teeth, and eventually the primary teeth shed as their succeeding permanent teeth erupt. Even when a permanent tooth germ is congenitally missing, root resorption of the corresponding primary tooth may still occur due to various factors, such as inflammation, traumatic occlusal force, and weakness of periodontium etc. Such congenital missing of permanent teeth is a commonly observed phenomenon in human be ing, and it often accompanies delayed retention of primary teeth. The etiologic factors for congenital missing in elude not only systemic diseases, but also local factors and human evolution process. In the radiographs of the cases in this report, the primary teeth without succeeding permanent teeth show pathologic root resorption. Root resorption progressed about 1/2~3/4 of the roots, and the surfaces of the resorption area were irregular. Considering high susceptibility of the periodontal ligament of primary teeth to root resorption, pathologic root resorption of primary teeth with delayed retention can be explained by the increased masticatory muscle force and abnormal occlusion developed during the mixed dentition. When the primary teeth without succeeding permanent teeth are lost, decision for space maintenance is required and long-term treatment plan for further prosthetic or orthodontic treatment should be establsihed.

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DEVELOPMENT OF ALLOTRANSPLANTED TOOTH GERMS AT VARIOUS DEVELOPMENTAL STAGE INTO THE WHITE RAT'S EXTRACTION SOCKET (흰쥐의 발치와에 이식한 단계별 치아싹의 발육 과정)

  • Jung, Hwi-Hoon;Jung, Han-Sung;Kim, Seoung-Oh;Choi, Hyung-Jun;Lee, Jae-Ho;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.205-215
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    • 2008
  • The purpose of this study is to evaluate at which stage of tooth germ would develop into normal calcification and hence to increase the success rate of transplantation. Therefore, tooth germs on the 15th, 17th embryonic day and the 3rd day of birth were separated for allotransplantation into maxilla of adult rat of 11 weeks. Calcification processes were analyzed radiographically and histopathologically at 4 weeks and 8 weeks after allotransplantation. The results are as follows: 1. Allotransplanted tooth germ at 4 weeks and 8 weeks showed delayed calcification compared to that of normal odontogenesis. 2. At 4 weeks, abnormal calcified tissue, such as odontoma and ankylosis of osteodentin with surrounding alveolar bone were observed. 3. At 8 weeks, allotransplanted tooth germs of the 15th and 17th embryonic day showed calcification and osteodentin surrounded by periodontal ligament. 4. At 8 weeks, allotransplanted tooth germs of the 3rd day of birth showed calcification composed of cementum and osteodentin. In this study, we observed small sized and amorphous calcified tissue from allotropic allotransplantation of tooth germs. Since these calcified tissue were underdeveloped and shaped irregularly, for calcification into normal tooth form, further study needs consideration about the reduction of surgical trauma, developmental stage of transplanted tooth germ, blood supply from recipient site, fixation method in transplanted site and period of transplantation.

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Comparison of Perception Differences About Nuclear Energy in 4 East Asian Country Students: Aiming at $10^{th}$ Grade Students who Participated in Scientific Camps, from Four East Asian Countries: Korea, Japan, Taiwan, and Singapore (동아시아 4개국 학생들의 핵에너지에 대한 인식 비교: 과학캠프에 참가한 한국, 일본, 대만, 싱가포르 10학년 학생들을 대상으로)

  • Lee, Hyeong-Jae;Park, Sang-Tae
    • Journal of The Korean Association For Science Education
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    • v.32 no.4
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    • pp.775-788
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    • 2012
  • This study was done at a scientific camp sponsored by Nara Women's University Secondary School, Japan. In this school, $10^{th}$ grade students from 4 East Asian countries: Korea, Japan, Taiwan, and Singapore, participated. We made a research on students' perceptions about nuclear energy. Sample populations include 77 students in total, with 12 Korean, 46 Japanese, 9 Taiwanese and 10 Singaporean students. Overall perceptions comparison about nuclear energy shows average values from the order of highest Korea, Taiwan, Singapore, and to lowest, Japan. We implemented a T-test to identify perception differences about nuclear energy, with one group that include 3 countries (Korea, Taiwan and Singapore) and another group that includes all the Japanese students. T-test results of perceptions about nuclear energy shows students from the 3 countries of Korea, Taiwan and Singapore having higher average than Japanese students. (p<.05). Korean average scores regarding overall perceptions about nuclear energy show as the highest in all 4 East Asian countries and also highest in all subcategories. On the contrary in Japan, they have lower and negative perceptions of nuclear energy. In spite of these facts, perceptions of Japanese students about nuclear energy seem lowest and negative mainly because of the recent Fukushima nuclear power plant disaster, caused by the tsunami and its subsequent damages and fears of radiation leaks, etc. This shows that negative information about future disasters and its resulting damages like the Chernobyl nuclear accident could influence more on people's risk perception than general information like nuclear energy-related technologies or the news that the plant is operating normally, etc. Even if the possibility of this kind of accident is very low, just one accident could bring abnormal risks to technology itself. This strong signal makes negative image and strengthens its perceptions to the people. This could bring a stigma about nuclear energy. This study shows that Government's policy about the highest priority for nuclear energy safety is most important. As long as such perception and decision are fixed, we found that it might not be easy to get changed again because they were already fortified and maintained.

A Study on the Serologic Parameters in Petients with Anemia of Chronic Renal Failure-According to Erythropoietin Treatment (만성 신부전환자의 빈혈에 있어서 Erythropoietin 치료에 따른 혈청지표의 양상)

  • Lim, Jong-Sik;Kang, Ho-Jung;Park, Jong-Won;Do, Joon-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.82-93
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    • 1994
  • Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was $28.8{\pm}2.0pg$, and MCV was $92.4{\pm}4.7fl$. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were $657.4{\pm}292.0ng/ml$ in men and $511.5{\pm}370g$ in women. Mean valuses of serum iron were $145.5{\pm}63.7{\mu}g/dl$. Mean values of transferrin saturation was $61.6{\pm}28.4%$. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT) hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386)(p<0.05). In conclusion, erythropoietin treatment cna reduce requirement of blood transfusion and transfusion related side effects such as iron overload, hemosiderosis and hemochromatosis.

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Which types of the strategies diffused to the public through company's announcement do contribute to the long-term performance? (공시된 경영전략의 유형별 장기실적 기여도 분석)

  • Kang, Won
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.4 no.4
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    • pp.45-70
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    • 2009
  • This article investigates which types of the strategies announced by the listed firms contribute to enhancing the long-term performance of the companies. Since 2002, Korean Exchange adopted the "faire disclosure policy" which mandates that all publicly traded companies must disclose material information to all investors at the same time. Thanks to the policy, Korean investors can, now, easily access the board's decision on management strategies on the same day the decision is made. If the companies trustfully carry out their announced strategies, we can decide which types of strategies actually enhance or deteriorate the long-term performance, simply by comparing the announced strategies and the firm's performance. The sample companies are confined to 60 firms that became listed in the KOSDAQ market through back-door listing from 2003 to 2005. Using only the newly listed companies, we can avoid the interference on the long-term performance of the strategies pursued before the event date. This often holds true, for many companies radically modify their strategies after the listing. Furthermore, the back-door listing companies serve our purpose better than IPO companies do, because the former tend to have a variety of announcement within a given period of time beginning the listing date. Using these sample companies, this article analyzes the effect on one year buy-and-hold returns and abnormal buy-and-hold returns after the listing of the various types of strategies announced during the same period of time. The results show that those evidences of restructuring such as 'reduction of capital' and 'resignation of incumbent board members', actually contribute to the increase in adjusted long-term stock returns. Those strategies which can be view as evidence of new investment such as 'increase in tangible assets', 'acquisition of other companies', do also helps the stockholders better off. On the contrary, 'increase in bank loans', 'changes of CEO' and 'merger' deteriorate the equity value. The last findings let us to presume that the back-door listing companies appear to use the bank loans for value-reducing activities; the change in CEO is not a sign of restructuring, but rather a sign of failure of the restructuring; another merger carried out after back-door listing itself is also value-reducing activity. This article's findings on reduction of capital, merger and bank loans oppose the results of the former empirical studies which analyze only the short-term effect on stock price. Therefore, more long-term performance studies on public disclosures are in order.

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Fruiting body development and genetic analysis of somatic hybrids by protoplast fusion in edible fungi (식용버섯의 원형질체 융합체의 자실체 발생 및 유전분석)

  • Yoo, Young Bok;Kong, Won Sik;Oh, Se Jong;Jhune, Chang Sung;Shin, Pyung Gyun;Kim, Beom Gi;Kim, Gyu Hyun;Park, Minsun;Min, Byung Re
    • Journal of Mushroom
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    • v.2 no.3
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    • pp.115-126
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    • 2004
  • Somatic hybrids of inter-compatible and inter-incompatible strains were obtained by protoplast fusion. The fusion products between compatible strains, Pleurotus ostreatus and P. florida, formed heterokaryons, while fusants between incompatible strains such as P. cornucopiae + P. florida, P. ostreatus + Ganoderma applanatum, P. florida + Ganoderma lucidum, and P. ostreatus + Flammulina velutipes formed synkaryons that retained genes from both parents. The heterokaryons showed the same level of basidioma development. In contrast, the synkaryons showed unique characteristics including clamp connection formation at mitosis, either partner basidioma development, and abnormal segregation and recombination compared with inter-compatible strains. Synkaryons can be classified into homokaryoyic and heterokaryotic type. A comparison of somatic hybrids with compatible and incompatible strains was made using random amplified polymorphic DNA (RAPD) analysis. The heterokaryons between compatible species showed the same level of variability and contained both parental RAPD bands. In contrast, most of the synkaryons between incompatible species showed similarity to those of either parental bands and non-parental RAPD bands. Synkaryons can be classified into microgenome insertion type and macrogenome insertion type. A tetrapolar mating system was found among monospore isolates in somatic hybrids and wild type P. ostreatus. Homokaryons from each somatic hybrid combination were paired with tester homokaryons of the initial wild type of P. ostreatus. The changed mating types were identified in progenies. The pattern of mating type switching in somatic hybrids depends on compatibility of fusion partner. There are several factors related to the mechanism of clamp connection formation and fruiting body development of synkaryons. Of these,the major factor may be associated with self-fertility and mating type switching such as homokaryotic fruiting of wild type P. ostreatus. This review will discuss these aspects.

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