• Journal of Chest Surgery
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• v.32 no.4
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• pp.368-372
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• 1999

Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.466-473
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• 2000

Background : Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. Method : Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. Results : The forces vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$ and maximal voluntary ventilation (MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity (DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption ($VO_2$max), carbon dioxide production ($VCO_2$), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. Conclusion : Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.754-758
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• 2006

Background: Surgical role for acute coronary syndrome has been reduced in recent years due to development of drug eluting stent. We evaluated the surgical results of acute coronary syndrome in our hospital. Material and Method: Between January 2001 and August 2005, 416 patients underwent coronary artery bypass grafting (CABG) under diagnosis of non-ST-elevation acute coronary syndrome (NSTE ACS). Mean age was $61.8{\pm}9.0$ years and 276 (66.3%) patients were male. 324 (77.9%) patients had triple vessel disease and 92 (22.1%) had left main disease at angiographic study. 236 (56.7%) patients had hypertension and 174 (41.8%) had diabetes mellitus. Conventional on-pump CABG was performed in 194 patients (46.6%) and off-pump CABG in 222 (53.4%). Total arterial revascularization with no touch technique was done in 97 patients (23.3%). The number of total distal anastomosis was 1,306 and the number per patient was $3.21{\pm}1.71$. Result: Surgical mortality rate was 1.0% (4 patients) and postoperative complication rate was 15.6% (65 patients). Graft patency was checked at mean $3.7{\pm}7.6$ months (from 1 to 37 months) postoperatively with multi-directional computed tomography in 152 patients. Left internal mammary artery was patent in 95.3%, right internal mammary artery in 98.1%, radial artery in 92.2% and saphenous vein in 89.0%. Conclusion: The surgical treatment of NSTE ACS showed relatively low mortality rate and good graft patency rate. Further study is needed to compare the long term results with drug eluting stent.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.55-60
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• 2008

Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age $60.0{\pm}9.6$ years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r=-0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=$99{\pm}23\;pg/mL$ vs. $296{\pm}74\;pg/mL$, p<0.05) and presence (mean BNP=$212{\pm}29\;pg/mL$ vs. $408{\pm}23\;pg/mL$, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receiving CABG.

• Applied Microscopy
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• v.37 no.1
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• pp.23-33
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• 2007

The lacrimal gland are compound tubule-acinar glands. The main lacrimal function is the production of the aqueous layer, the thickest and major constituent of the precorneal tear film. The lacrimal gland also has an important function in the defense system of the ocular surface, forming a part of the conjunctival-associated hymphoid tissue. The ultrastructural characteristics of the lacrimal gland of the rabbit were described. The lacrimal tissues of rabbits were processed through the conventional techniques for transmission electron microscopy. The secretory portions consisted of three cell types: 1. Serous cells with electron dense secretory granules. 2. Seromucous cells containing variable moderately electron dense secretory granules with flocculent material. 3. Mucous rolls containing mucous secretory granules. The serous cells were situated at the basal portion of acini, and they contained electron dense granules of variable densities and sizes. The seromucous cells contained a few protein secretory granules and more mucous secretory granules. The mucous cells contained even fewer protein secretory granules and exclusively mucous secretory granules. The epithelium of the intralobular ducts showed secretory granules, junctional complexes, and large basolateral intercellular spaces with lateral folds. These study might be helpful in determining inter-relationships, similarities and differences among the orbital glands of various physiological or pathological conditions.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1218-1222
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• 1996

The reported incidence of postcardiotomy cardiogenic shock not responding to conventional therapy is still 0.1 to 0.8%. For this group of patients, more aggressive form of circulatory support must be employed. Centrifugal pumps are a ventricular assist device most commonly used on this purpose, due to low cost and easy availability. Currently, however, clinical experience of centrifugal pumps as a ventricular assist device is rarely reported in Korea. From January 1992 to January 1996, 2986 patients underwent cardiac operations on cardiopulmonary bypass at Seoul National University Hospital. Refractory postcardiotomy cardiac failure requring ventricular support with a Biomedicus centrifugal pump developed in ten of these patients. There were eight men and two women, ranged in age from nine years to 77 years with a mean of 50$\pm$20 years. The primary surgical procedures consisted of isolated coronary revascularization in four patients, combined coronary revascularization and aortic valve replacement in two, aortic dissection repair in two, pulmonary embolectomy in one, and heart transplantation in one. Of the ten patients, five had left ventricular assistance, one had right ventricular assistance, and four had biventricular assistance. Duration of ventricular assistance ranged from 24 to 175 hours, with a mean of 76$\pm$51 hours. Seven patients were weaned from ventricular assistance, and four of them discharged. The causes of death for nonsurvivors were progressive cardiac failure in two patients and multiorgan failure, intractable ventricular fibrillation, irreversible brain injury, and mechanical problem, respectively, in the other four. Survival was not predicted by time on cardiopulmonary bypass, aortic cross-clamp time, or duration of ventricular support. Major complications included bleeding(7), renal failure(6), infection(3) and neurologic complication(2). These results indicate that a centrifugal pump can provide reasonably satisfactory short-term circulatory support.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.51-56
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• 2009

Purpose: Recently, most hospitals are introducing the PACS system and use of the system continues to expand. But small-scaled PACS called MicroPACS has already been in use through open source programs. The aim of this study is to prove utility of operating a MicroPACS, as a substitute back-up device for conventional storage media like CDs and DVDs, in addition to the full-PACS already in use. This study contains the way of setting up a MicroPACS with open source programs and assessment of its storage capability, stability, compatibility and performance of operations such as "retrieve", "query". Materials and Methods: 1. To start with, we searched open source software to correspond with the following standards to establish MicroPACS, (1) It must be available in Windows Operating System. (2) It must be free ware. (3) It must be compatible with PET/CT scanner. (4) It must be easy to use. (5) It must not be limited of storage capacity. (6) It must have DICOM supporting. 2. (1) To evaluate availability of data storage, we compared the time spent to back up data in the open source software with the optical discs (CDs and DVD-RAMs), and we also compared the time needed to retrieve data with the system and with optical discs respectively. (2) To estimate work efficiency, we measured the time spent to find data in CDs, DVD-RAMs and MicroPACS. 7 technologists participated in this study. 3. In order to evaluate stability of the software, we examined whether there is a data loss during the system is maintained for a year. Comparison object; How many errors occurred in randomly selected data of 500 CDs. Result: 1. We chose the Conquest DICOM Server among 11 open source software used MySQL as a database management system. 2. (1) Comparison of back up and retrieval time (min) showed the result of the following: DVD-RAM (5.13,2.26)/Conquest DICOM Server (1.49,1.19) by GE DSTE (p<0.001), CD (6.12,3.61)/Conquest (0.82,2.23) by GE DLS (p<0.001), CD (5.88,3.25)/Conquest (1.05,2.06) by SIEMENS. (2) The wasted time (sec) to find some data is as follows: CD ($156{\pm}46$), DVD-RAM ($115{\pm}21$) and Conquest DICOM Server ($13{\pm}6$). 3. There was no data loss (0%) for a year and it was stored 12741 PET/CT studies in 1.81 TB memory. In case of CDs, On the other hand, 14 errors among 500 CDs (2.8%) is generated. Conclusions: We found that MicroPACS could be set up with the open source software and its performance was excellent. The system built with open source proved more efficient and more robust than back-up process using CDs or DVD-RAMs. We believe that the operation of the MicroPACS would be effective data storage device as long as its operators develop and systematize it.

• Journal of the Korean Dietetic Association
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• v.11 no.2
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• pp.216-222
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• 2005

In Korea, there are many kinds of functional foods to manage diabetes, however, they have not been evaluated or investigated systematically. The purpose of this study was to investigate the status of recognition and intake of functional foods among diabetic patients. The study subjects were 307 patients(male 135, female 172), who diagnosed with type 2 diabetes at Seoul National University of Bundang Hospital. Questionnaire survey was done from July to October, 2004 for the characteristics of patients and factors related to the use of functional foods. The mean age of the subjects was 64$\pm$10.2 years, and the mean duration of disease was 9.5$\pm$8.90 years. Approximately 49.8% of the subjects had experience to use functional foods at least once in past. Total number of functional foods used were 56 types. Red ginseng was used most frequently(27.9%), then followed by Silkworm powder(13.6%), Vitamin supplements(10.4%), Mulberry tree(7.1%), Cordyceps sinensis(6.8%) and Ginseng(4.2%). Functional foods were introduced by their friends.relatives(38.4%), family(29.1%), internet(13.9%), and the mass media(10.6%). Among respondents, 94.7% took functional foods with conventional diet therapies(diet, exercise and medication). The purpose of functional food use was to control blood glucose level(49.0%), to relieve fatigue and improve stamina(19.9%), to treat and prevent a disease(17.2%) and to help blood circulation(7.9%). Upon the question of further recommendation of functional foods to others, 74.8% of the subjects answered negative response. However, 12.6% of the subjects showed the further intention of using new product. Therefore, to guide the appropriate use of functional foods for diabetic patients, diabetic educator should provide the knowledge of the efficacy of functional foods and the desirable guidelines.

• Journal of the Institute of Electronics Engineers of Korea SP
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• v.47 no.4
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• pp.105-111
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• 2010

This paper proposes the recursive algorithm for passive proximity detection system based on signal strength. The system is designed to be used in the smart medicine chest in order to provide location-based service for the senior personnel. Due to the system profile, single receiver and uni-direction communication are applied over the signal attenuation model for the determination of user existence within certain proximity. The performance of conventional methods is subjective to the sight between the transmitter and receiver unless the direction of target is known. To appreciate the temporal and spatial locality of human subjects, the authors present exponential moving average (EMA) to compensate the unexpected position error from the direction and/or environment. By using optimal parameter, the experiments with EMA algorithm demonstrates 32.26% (maximum 40.80%) reduction in average of the error probability with 50% of consecutive sight in time.

• Annals of Clinical Neurophysiology
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• v.10 no.2
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• pp.83-97
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• 2008

Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.