• Journal of Chest Surgery
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• v.31 no.6
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• pp.598-603
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• 1998

Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.871-875
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• 2002

Despite early aggressive treatment, post myocardial infarction(MI) ventricular septal defect(VSD) revealed high surgical mortality. We reviewed the 10-year experiences of surgically treated post-MI VSD in Yonsei University. Material and Method: From Jan. 1991 to May 2001, 17 patients underwent surgical repair of post-MI VSD. Ages ranged between 47 and 77 years(mean age＝63.2$\pm$9.1). There were 10 males and 7 females. VSD was located at anterior in 16 patients and at posterior in one. IABP was inserted preoperatively in 12 patients due to cardiogenic shock. Mean interval from MI to occurrence of VSD was 5.6 days. Among patients undergoing early surgical correction(n＝13), mean interval from occurrence of VSD to operation was 2.5 days. In 11 patients, concomitant CABG was performed during repair of VSD. Result: Four patients died within 30 days after the operation(30 day mortality＝23.5%). Among 12 patients with preoperative cardiogenic shock, 4 patients died within 30 days(30-day mortality＝33.3%). During mean follow up period of 52 months, one patient died of unknown cause and 10-year survival of discharged patients was 66.7%. All follow-up patients were in NYHA functional class I or II when their last OPD visit. Conclusion: In the treatment of post-MI VSD, aggressive medical treatment with early surgical correction seems to be very important in terms early and long-term survival of patients.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.1-12
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• 1999

Bacterial infection of the pulp results in the development of a periapical lesion with the concomitant resorption of periapical bone. The cytokines are believed to play an important role in this matter. The purpose of this study was to find the relationship among the presence of black pigmented bacteria, the levels of cytokines(TNF-${\alpha}$, -${\beta}$, IL-$1{\beta}$, and TGF-${\beta}1$), and the amount of bone resorption in periapical and pulpal diseases. For the purpose, the patients were grouped into chronic apical pathosis, acute apical pathosis, acute pulpitis, and a healthy control group. Root canal samples were taken from periapical tissue exudates during routine endodontic treatment, and the venous blood was taken from each patients. The samples were processed to measure local and systemic levels of the cytokines using enzyme linked immunosorbent assay(ELISA). Bacterial content of Porphyromonas endodontalis, Porphyromonas gingivalis, and Prevotella nigrescens were measured by indirect immunofluorescence method and the size of the periapical lesions were measured from the radiographs. The following results were obtained: 1. The levels of bone resorptive cytokines(TNF-${\alpha}$, TNF-${\beta}$, and IL-$1{\beta}$) in exudates from acute and chronic apical pathoses were significantly higher than those from acute pulpitis and the normal pulps(p<0.05). 2. IL-$1{\beta}$ were the highest among the bone resorptive cytokines in apical pathoses. However, no statistical difference between acute and chronic lesions were found(p>0.05). 3. The levels of TGF-${\beta}1$ in exudates from acute pulpitis and chronic apical pathoses were significantly higher than those from acute apical pathoses and the normal pulps(p<0.05). However, there were no significant correlations among the levels of bone resorptive cytokines. 4. The levels of TNF-${\beta}$ in serum were significantly higher than those from the exudates while serum TGF-${\beta}1$ concentrations were significantly lower(p<0.05). 5. Exudates from the canals in which the P. nigrescens were detected showed significantly higher levels of IL-$1{\beta}$ than those from the canals without the microorganism(p<0.05). 6. There were no significant correlations among the levels of the cytokines, the amount of bone destruction, and the presence of acute and chronic symptoms(p>0.05).

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.9
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• pp.1249-1255
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• 2011

This study examined the effect of CLA, flaxseed oil and fish oil and their combination forms on crude fat of liver and fatty acid profiles of liver, breast and thigh meat in broiler chicks. A total of 72, 1-day-old Cobb broilers were assigned to 6 groups, and fed an experimental diet supplemented with 5 different fat sources; conjugated linoleic acid (2% CLA), flaxseed oil (2% FXO), fish oil (2% FHO), CLA and flaxseed oil combination (1:1; 2% CXO), and CLA and fish oil combination (1:1; 2% CHO). Eight birds per treatment were processed, and liver, breast and thigh samples were investigated at 21 d of age. As a result of this study, most fatty acids of liver, breast and thigh meat were influenced by fat sources supplemented in the diet (p<0.05). CLA addition resulted in an increase of crude fat and saturated fatty acid (SFA) content but a concomitant decrease in n-3 to n-6 fatty acid ratio was observed in liver (p<0.05). Moreover, the same trends of SFA and n-3 to n-6 fatty acid ratio were also observed in breast and thigh meats of birds fed CLA alone. In the CXO-fed group or CHO-fed group, n-3 and n-3 to n-6 fatty acid ratio in both breast and thigh meat increased compared with CLA group, while SFA content decreased (p<0.05). FHO fed-groups had the lowest proportion of n-6 fatty acid in both breast and thigh meats compared to other fat source treatments (p<0.05). In conclusion, the increased levels of crude fat and SFA in liver and meats obtained by feeding CLA could be reduced by its combination with FXO or FHO. In addition, the combination of CLA and FXO or FHO fed to broiler chicks could increase the n-3 to n-6 fatty acid ratio of their meat along with the deposition of CLA.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.222-230
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• 1990

Protamine, a polycationic peptide extracted from fish, has been widely used for the reversal of anticoagulant action of heparin. However it may cause untoward circulatory side effects including hypotension and bradyarrhythmia. Nowadays, histamine and prostacyclin are regarded as one of the causative agents in the underlying mechanism of hemodynamic changes. To certify the possible role of histamine and prostacyclin, we observed simultaneous changes of the hemodynamic status, plasma concentration of thromboxane B, and circulating platelet count before and after intravenous injection of protamine. Experimental dogs, weighing 12-14kg, were divided into 2 groups; group A animals [n=10], were pretreated with indomethacin[2.5mg/kg] and group B animals[n=10] were pretreated with chlorpheniramine[0.5mg/kg] Heparin[3mg/kg] and protamine [3mg/kg] were administered sequentially in both groups. The results were as follows ; 1. The mean systemic arterial pressure was maintained well in groups A, whereas in group B it decreased from 165\ulcorner18mmHg to 138\ulcorner30mmHg[p<0.01] and 151\ulcorner21 mmHg[p<0.05] at 1 minute and 2 minutes after protamine injection. The mean pulmonary arterial pressure was not changed significantly in group A, whereas in group B it increased from 852 mmHg to 11\ulcorner3 mmHg[p<0.05], 11\ulcorner3 mmHg[p<0.05] and 10\ulcorner3 mmHg[p<0.05] at 1 minute, 3 minutes and 5 minutes after protamine injection. 2 The thromboxane B2 was not changed significantly in group A, whereas in group B it increased from 399\ulcorner401 \ulcornerg/ml to 744\ulcorner615 \ulcornerg/ml[p<0.05] and 814\ulcorner1070 \ulcornerg/ml [p<0.0 5] at 1 minute and 3 minutes after protamine injection without concomitant changes of pulmonary vascular resistance and pulmonary capillary wedge pressure. 3. The number of circulating platelet was not changed in group A, whereas in group B it decreased from 207100\ulcorner103600/\ulcornerl to 159700\ulcorner90900/\ulcornerl [p<0.05] at 1 minute after protamine injection, Although thromboxane B2 and platelet count were changed significantly after protamine injection, they did not cause the remarkable hemodynamic changes. Considering the above results, hemodynamic changes may be caused mainly by prostacyclin rather than thromboxane or platelet. Therefore, the pretreatment with cyclooxygenase inhibitor would be beneficial to prevent circulatory adverse effects of protamine for the patients undergoing cardiac surgery.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.123-134
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• 1991

Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1031-1036
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• 1998

Background: Medtronic-Hall mechanical valve is a world widely using prosthesis. But, in Korea, the clinical result from Medtronic-Hall valve replacement is not frequenthy available. Materials and methods: From March 1986 to May 1990, 50 patients underwent valve replacement surgery with Medtronic-Hall valve at Pusan National University Hospital. Seventeen were male and thirty three were female and ra nging in age from 16 to 70 years of age(mean=35 years). Results: The causes of valvular lesion were rheumatic in 43 patients, bicuspid aortic valve in 3 patients, degenerative lesion in three patients and bacterial endocarditis in one patient. The operative procedures were mitral valve replacement(MVR) in 38, aortic valve replacement(AVR) in 5 and double valve replacement(DVR) in 7. The most commonly used valve size was 21mm in AVR, 29mm in MVR. Concomitant surgical procedures were performed in 15 patients; left atrial thrombectomy in 9, left atrial auricle obliteration in 6 and tricuspid annuloplasty in 5(Kay: 2, DeVega: 3). New York Heart Association functional class was mostly Class Ⅲ or Ⅳ(91.5%) preoperatively and ClassⅠor Ⅱ(87.2%) after operation. The findings of postoperative echocardiogram of LAD, LVESD, LVEDD were reduced compared with preoperative period and ejection fraction was increased compared with preoperative period. Postoperative complications were massive bleeding in three, low cardiac output syndrome in two, thromboembolism in one and fulminant hepatitis in one patient. There were three hospital deaths and their causes were low cardiac output syndrome in two and rupture of left ventricle in one patient. The 5 year survival rate was 93.65±0.71% and 10 year actuarial survival rate was 88.27±6.42%. Conclusions: Medtronic-Hall mechanical valve has low valve related complication rate. It's durability and hemodynamic performance is comparable to other mechanical valves.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.6 no.1
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• pp.100-108
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• 1995

The purpose of the present study was to examine whether Interpersonal Cognitive Problem Solving(ICPS) skill training would enhance interpersonal solving skills and behavioral adjustment of mildly mentally retarded adolescents in the junior and high school. The program used in the present study was shortened and adapted for mildly retarded adolescents from Shure and Spivack(1982) program which was developed to improve the adjustment of children in the intermediate grades 5-6. The subjects were 22 mildly retarded adolescents, and they were assigned to either the experimental(11) or the control group(11). The experimental group were given ICPS training 4 times a week over a period of 8 weeks with a total of 32 sessions in all. The results showed a significant improvement of alternative thinking and consequential thinking in the experimental group compared with the control group. With regard to behavioral ratings by the parents and teachers, there were no significant differences between the groups. The results indicated that the training was effective in increasing the ability to generate alternative solutions and to predict consequences, but the significant improvement of interpersonal cognitive problem solving skills did not lead to noticeable improvement in behavioral adjustment. It was suggested that a longer training period for over-learning, concomitant parent education program, and more behaviorally oriented social skill training combined with the cognitive approach would yield significant training effects, maintenance and transfer.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.137-142
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• 2005

Purpose: The purpose of this study is to evaluate the results of arthroscopic anterior cruciate ligament(ACL) repair with minimal incision and to review prognostic factors according to ACL tear patterns and the presence of associated injury Materials and Methods: Thirty eight patients (thirty nine knees) with acute ACL tear were given arthroscopic ACL repair between January 2001 and December 2002 and were followed up at least over six months. Intraoperative findings such as ACL tear pattern and the presence of synovial or concomitant medial collateral ligament injuries were recorded. Each knee was then postoperatively re-evaluated with aid of KT-1000 arthrometer and Lachman test and Lysholm score. Results: Postoperative limitation of motion was significant when combined typed ACL tear was present with concurrent medial collateral ligament(MCL) injury. In contrast, in the case where there were sole proximal ACL tear or no evidence of synovial injury, the limitation of motion was not significant. Anterior laxity was significantly associated with the presence of combined typed ACL tear or concurrent synovial injury, but was not significant when there were sole proximal ACL tear. Conclusion: In the case where there is sole proximal ACL tear without concurrent synovial injury, arthroscopic ACL repair can be considered as a treatment modality for the treatment of acute ACL injury.

• Proceedings of the Zoological Society Korea Conference
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• 1998.10b
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• pp.113-113
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• 1998

In Saccharomyces cerevisiae UV irradiation and a variety of chemical DNA -damaging agents induce the transcription of specific genes, including several involved in DNA repair. One of the best characterized of DNA -damage inducible genes is PHRI, which encodes the apoenzyme for DNA photolyase. Basal-level and damage-induced expression of PHRI require an upstream activation sequence, UASPHRI. Here we report the identification of the UlvIE6 gene of S. cerevisiae as a regulator of UASPHRl activity. Surprisingly, the effect of deletion of UME6 is growth phase dependent. In wild-type cells PHRI is induced in late exponential phase, concomitant with the initiation of glycogen accumulation that precedes the diauxic shift. Deletion of UNIE6 abolishes this induction, decreases the steady-state concentration of photolyase molecules and PHRI mRNA, and increases the UV sensitivity of a rad2 mutant. The results suggest that UM E6 contributes to the regulated expression of a subset of damage-responsive genes in yeast. Furthermore, the upstream repression sequence, URSPHRI, is required for repression and damage-induced expression of PHRl. Here we show identification of YER169W and YDR096W as putative regulators acting through $URS_{PHRI}$. These open reading frames were designated as RPHI (YERl69W) and RPH2 (YDR096W) indicating regulator of PHRI. Simultaneous disruption of both genes showed a synergistic effect, producing a four-fold increase in basal level expression and a similar decrease m the induction ratio following treatment of methyl methanesulfonate(MMS). Mutation of the sequence ($AG_4$) bound by Rphlp rendered the promoter of PHRI insensitive to changes in RPHI or RPH2 status. The data suggest that RPHI and RPH2 act as damage-responsive negative regulators of PHRI. Surprisingly, the sequence bound by Rphlp in vitro is found to be $AG_4$ which is identical to the consensus binding site for the regulators Msn2p and Msn4p involved in stress-induced expression. Deletion of MSN2 and MSN4 has little effect on the induction$.$ ratio following DNA damage. However, all deletions led to a significant decrease in basal-level and induced expression of PHRI. These results imply that MSN2 and MSN4 are positive regulators of P HRI but are not required for DNA damage repression. [Supported by grant from NIH]om NIH]