• Journal of Chest Surgery
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• v.36 no.3
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• pp.150-156
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• 2003

Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.252-256
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• 2005

Purpose: Thyroglobulin (Tg) is a valuable and sensitive tool as a marker for diagnosis and follow-up for several thyroid disorders, especially, in the follow-up of patients with differentiated thyroid cancer (DTC). Often, clinical decisions rely entirely on the serum Tg concentration. But the Tg assay is one of the most challenging laboratory measurements to perform accurately owing to antithyroglobulin antibody (Anti-Tg). In this study, we have compared the degree of Anti-Tg effects on the measurement of Tg between availale Tg measuring kits. Materials and Methods: Measurement of Tg levels for standard Tg solution was performed with two different kits commercially available (A/B kits) using immunoradiometric assay technique either with absence or presence of three different concentrations of Anti-Tg. Measurement of Tg for patient's serum was also performed with the same kits. Patient's serum samples were prepared with mixtures of a serum containing high Tg levels and a serum containg high Anti-Tg concentrations. Results: In the measurements of standard Tg solution, presence of Anti-Tg resulted in falsely lower Tg level by both A and B kits. Degree of Tg underestimation by h kit was more prominent than B kit. The degree of underestimation by B kit was trivial therefore clinically insignificant, but statistically significant. Addition of Anti-Tg to patient serum resulted in falsely lower Tg levels with only A kit. Conclusion: Tg level could be underestimated in the presence of anti-Tg. Anti-Tg effect on Tg measurement was variable according to assay kit used. Therefore, accuracy test must be performed for individual Tg-assay kit.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.45-55
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• 1998

Purpose: To make objective standards of small intestinal mucosal changes in cow's milk-sensitive enteropathy (CMSE) we analyzed histological changes of endoscopic duodenal mucosa biopsy specimens from normal children and patients of CMSE. Methods: We review the medical records of patients who had been admitted and diagnosed as CMSE by means of gastrofiberscopic duodenal mucosal biopsy following cow's milk challenge and withdrawal. Thirteen babies with CMSE, ranging from 14 days to 56 days of age, were studied. Five non-CMSE patients were used as control, ranging from 22 days to 72 days of age. The morphometric parameters under study were villous height, crypt zone depth, ratio of villous height to crypt zone depth, total mucosal thickness and length of surface epithelium by using H & E stained specimens under the drawing apparatus attached microscope. In addition, the numbers of lymphocytes in the epithelium and eosinophil cells in the lamina propria and epithelium were measured. Results: In the duodenal mucosal biopsy specimens in CMSE we found partial and subtotal villous atrophy with an increased number of interepithelial lymphocytes. The mean villous height($135{\pm}59\;{\mu}m$), ratio of villous height to crypt zone depth ($0.46{\pm}0.28$), total mucosal thickness ($499{\pm}56\;{\mu}m$), length of surface epithelium of small intestinal mucosa ($889{\pm}231\;{\mu}m$) in CMSE was significantly decreased compared with the control (p<0.05). The mean crypt zone depth ($311{\pm}65\;{\mu}m$) was significantly greater than the control ($188{\pm}24\;{\mu}m$)(p<0.05). Infiltration of interepithelial lymphocytes ($34.1{\pm}10.5$) were significantly greater than the control ($13.6{\pm}3.6$)(p<0.05). The number of eosinophil cells in both lamina propria and epithelium was no significant differences between groups (p>0.05). The small intestinal mucosa in treated CMSE showed much improved enteropathy of villous height, crypt zone depth, interepithelial lymphocytes compared with the control as well as untreated CMSE. Conclusion: Quantitation of mucosal dimensions confirmed the presence of CMSE. It seems to be a limitation in the capacity of crypt cells to compensate for the loss of villous epithelium in CMSE. Specimens obtained by gastrofiberscopic duodenal mucosal biopsy were suitable for morphometric diagnosis of CMSE. Improvement of CMSE also can be confirmed histologically after the therapy of protein hydrolysate.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.43-63
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• 2004

Objectives: The purpose of this study was to classify the patterns of health behaviors of some rural residents in Korea by sub-grouping them into populations with similar patterns of diet quality, physical activity, alcohol consumption and cigarette smoking, and then to investigate the relationship between these health behavior patterns and health status or health management of them. Methods: The study subjects were 722 rural residents above 20 years old on a typical rural district in Korea, and the data used in this study was from the survey data for health planning of a health center. Study questionnaire for this survey was developed from modifying the questionnaire for 'National Nutrition and Health Study' conducted in 1998. To classify health behavior patterns, cluster analysis was conducted. And to test the association of health behavior patterns with health status or health management, multiple logistic regression analysis were conducted. Results: The results and their implications of this study were as follows: 1. We identified six health behavior typologies : 67.8% of the sample had a good diet quality but showed sedentary activity level(good diet lifestyle) and 10.9% had heavy smoking behavior(smoking lifestyle). Individuals included in fitness lifestyle cluster(6.2%) had high physical activity level and those in drinking life style(2.6%) had had mainly large amount of alcohol. Zero point six percent of sample were included in hedonic lifestyle cluster, who showed poor health behaviors in all. Those included in passive lifestyle(11.9%) had no active health promoting activities but tended to avoid risk taking health behavior such as cigarette smoking and alcohol drinking. 2. As a result of logistic regression analysis, to compare with the individuals in good diet lifestyle, the prevalence of chronic diseases of those in fitness lifestyle showed higher and that of those in smoking lifestyle, drinking lifestyle, hedonic lifestyle, passive lifestyle showed lower than them, retrospectively. 3. Adjusting with general characteristics and health status, to compare with the individuals in good diet lifestyle, the proportion of those who had good health management practices in fitness lifestyle was higher, and the proportion of those who had health check in past 2 years was lower than them, retrospectively. Conclusions: There were some differences in health behavior patterns between rural population and national population, which influenced significantly on health status and health management practice of them. We suggested that the health promotion program for them be developed with considering these points.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.817-824
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• 2007

Background: There are two choices for heart valve replacement-the use of a tissue valve and the use of a mechanical valve. Using a tissue valve, additional surgery will be problematic due to valve degeneration. If the risk of additional surgery could be reduced, the tissue valve could be more widely used. Therefore, we analyzed the risk factors and mortality of patients undergoing repeated heart valve replacement and primary replacement. Material and Method: We analyzed 25 consecutive patients who underwent repeated heart valve replacement and 158 patients who underwent primary heart valve replacement among 239 patients that underwent heart vale replacement in out hospital from January 1995 to December 2004. Result: There were no differences in age, sex, and preoperative ejection fraction between the repeated valve replacement group of patients and the primary valve replacement group of patients. In the repeated valve replacement group, the previously used artificial valves were 3 mechanical valves and 23 tissue valves. One of these cases had simultaneous replacement of the tricuspid and aortic valve with tissue valves. The mean duration after a previous operation was 92 months for the use of a mechanical valve and 160 months for the use of a tissue valve. The mean cardiopulmonary bypass time and aortic cross clamp time were 152 minutes and 108 minutes, respectively, for the repeated valve replacement group of patients and 130 minutes and 89 minutes, respectively, for the primary valve replacement group of patients. These results were statistically significant. The use of an intra aortic balloon pump (IABP) was required for 2 cases (8%) in the repeated valve replacement group of patients and 6 cases (3.8%) in the primary valve replacement group of patients. An operative death occurred in one case (4%) in the repeated valve replacement group of patients and occurred in nine cases (5.1%) in the primary valve replacement group of patients. Among postoperative complications, the need for mechanical ventilation over 48 hours was different between the two groups. The mean follow up period after surgery was $6.5{\pm}3.2$ years. The 5-year survival of patients in the repeated valve replacement group was 74% and the 5-year survival of patients in the primary valve replacement group was 95%. Conclusion: The risk was slightly increased, but there was little difference in mortality between the repeated and primary heart valve replacement group of patients. Therefore, it is necessary to reconsider the issue of avoiding the use of a tissue valve due to the risk of additional surgery, and it is encouraged to use the tissue valve selectively, which has several advantages over the use of a mechanical valve. In the case of a repeated replacement, however, the mortality rate was high for a patient whose preoperative status was not poor. A proper as sessment of cardiac function and patient status is required after the primary valve replacement. Subsequently, a secondary replacement could then be considered.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.471-478
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• 1997

Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.939-944
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• 1998

Background: The sugical results of the Cox-Maze procedure (CMP) for lone atrial fibrillation(AF) have proven to be exellent. However, those for AF associated with mitral valve(MV) disease have been reported to be a little inferior. Materials and methods: To assess the efficacy and safety of the CMP as a combined procedure with MV operation, we studied retrospectively our experiences. Between April 1994 and October 1997, we experienced 70 (23 males, 47 females) cases of CMP concomitantly with MV operation. Results: The etiologies of MV disease were rheumatic in 67 and degenerative in 3 cases. The mean duration of AF before sugery was 66$\pm$70 months. Fifteen patients had the past medical history of thromboembolic complications, and left atrial thrombi were identified at operation in 24 patients. Twelve cases were reoperations. Aortic cross clamp (ACC) time was mean 151$\pm$44 minutes, and cardiopulmonary bypass (CPB) time was mean 246$\pm$65 minutes. Concomitant procedures were mitral valve replacement (MVR) in 19, MVR and aortic valve replacement (AVR) in 14, MVR and tricupid annuloplasty (TAP) in 8, MVR with AV repair in 3, MV repair in 11, MVR and coronary artery bypass grafting (CABG) in 2, MVR and AVR and CABG in 1, redo-MVR in 10, redo-MVR and redo-AVR in 2 patients. The rate of hospital mortality was 1.4%(1/70). Perioperative recurrence of AF was seen in 44(62.9%), and atrial tachyarrhythmias in 10(14.3%), low cardiac output syndrome in 4(5.7%), postoperative bleeding that required mediastinal exploration in 4(5.7%) patients. Other complications were acute renal failure in 2, aggravation of preoperative hemiplegia in 1, and transient delirium in 1 patient. We followed up all the survivors for 16.4 months(3-44months) on an average. Sinus rhythm has been restored in 65(94.2%) patients. AF has been controlled by operation alone in 73.9% and operation plus medication in 20.3%. Two patients needed permanent pacemaker implantation; one with sick sinus syndrome, and the other with tachycardia- bradycardia syndrome. Only two patients remained in AF. We followed up our patients with transthoracic echocardiography to assess the atrial contractilities and other cardiac functions. Right atrial contractility could be demonstrated in 92% and left atrial contractility in 53%.We compared our non-redo cases with redo cases. Although the duration of AF was significantly longer in redo cases, there was no differences in ACC time, CPB time, postoperative bleeding amount and sinus conversion rate. Conclusions: In conclusion, the CMP concomitant with MV operation demonstrated a high sinus conversion rate under the acceptable operative risk even in case of reoperation.

• The Journal of the Petrological Society of Korea
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• v.8 no.2
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• pp.106-124
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• 1999

In the Cheongju-Minwon area which occupies the middle part of the Ogcheon Metamorphic Belt, three metamorphic events(M1, M2, M3) had occurred. Intermediate P/T type M2 regional metamorphism formed prevailing mineral assemblages in the study area. Low PIT type M3 contact metamorphism occurred due to the intrusion of granites after M2 metamorphism. M1 metamorphism is recognized by inclusions within garnet. During M2 metamorphism, the metamorphic grade increased from the biotite zone in the southeastern part to the garnet zone in the northwestern part of the study area. This result is similar to the metamorphic evolution of the southwestern part of the Ogcheon Metamorphic Belt. Garnets in the garnet zone are classified into two types; Type A garnet has inclusions whose trail is connected to the foliation in the matrix and Type B garnet has inclusion rich core and inclusion poor rim. Type A garnet formed in the mica rich part with crenulation cleavage whereas Type B garnet formed in the quartz rich part with weak crenulation cleavage. In some outcrops, two types garnets are found together. Compared to the rim of Type A garnet, the rim of Type B garnet is lower in grossular and spessartine contents but higher in almandine and pyrope contents. In some Type B garnets, the inclusion poor part is rimmed by muddy colored or protuberant new overgrowth. In the inclusion poor part and new overgrowth, a rapid increase in grossular and decrease in spessartine is observed. However, the compositional patterns of Type A and B are similar; Ca increases and Mn decreases from core to rim. Two types garnets formed mainly due to the difference of bulk chemistry instead of metamorphic and deformational differences. The metamorphic P-T conditions estimated from Type A garnets are 595-690 OC15.7-8.8 kb, which indicates M2 metamorphism is intermediate P/T type metamorphism. On the other hand, a wide range of P-T conditions is calculated from Type B garnets. The P-T conditions from most Type B garnet rims are 617-690 OC16.2-8.9 kb which also indicates an intermediate P/T type metamorphism. However, at the rim part with flat end or weak overgrowth, grossular content is low and 573-624OC14.7-5.8 kb are estimated. The P-T conditions calculated from plagioclase and biotite inclusions in garnet are 460-500 0C/1.9-3.0 kb. The P-T conditions from rim part with weak overgrowth and inclusions within garnet, indicate that low P/T type M1 regional metamorphism might have occurred before intermediate P/T type M2 regional metamorphism. The P-T conditions estimated from samples which had undergone low PIT type M3 metamorphism strongly, are 547-610 0C/2.1-5.0 kb.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.15 no.1
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• pp.59-73
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• 1982

Differences of lipids, especially total lipid composition, fatty acid and sterol composition of the flesh lipids between three species of cephalopods were investigated, since available researches concerning lipids in flesh tissues of the cephalopod are very limited. Extracted total lipid from the flesh tissues were fractionated by silicic acid column chromatography into three lipid classes of neutral lipids, glycolipids and phospholipids. The lipid compositions of total lipid and neutral lipids were estimated by the method of thin layer chromatography and TLC-scanner. The sterol compositions of unsaponifiable matters from total lipid were determined by using thin layer chromatography and gas-liquid chromatography. The fatty acid composition of each lipid class was also determined by gas-liquid chromatography. Total lipid contents of flesh tissues from three species of the cephalopods were 0.5 in Octopus vulgare, 0.8 in Octopus variabilis and $0.6\%$ in Loligo beka based on wet weight, the contents of total fatty acid in total lipid were 19.3, 47.8 and $38.4\%$, and the contents of unsaponifiable matters were 10.9, 18.8 and $41.1\%$, respectively. Total lipid was mainly composed of sterols and polar lipid-pigments as major components in each sample and the proportion of sterols and polar lipid-pigments to total lipid ranged from 27.0 to $35.5\%$ and 38.3 to $63.4\%$, respectively. The other lipid components of total lipid, e.g. triglycerides, free fatty acids, and carbohydrate-esterified sterols were determined as a minor components. The major component fatty acid in total lipid was palmitic acid and additionaly it chiefly consisted of the other unsaturated acids such as oleic, linoleic, octadecatetraenoic and eicosapentaenoic acid as major components of the acid. The compositions of sterol in three species of cephalopod were found to contain mainly cholesterol for its proportion to total sterols was 82.4 to $89.1\%$. However the other sterols such as 22-dehydrocholesterol and 24-methylenecholesterol were determined in addition to cholesterol as a minor components. The result of fractional composition of lipid class in total lipid was that total lipid had large .amount of polar lipid and small amount of nonpolar lipid i, e, neutral lipid in each sample, and the contents of phospholipid were higher than that of glycolipid in polar lipid. Neutral lipid was mainly composed of free sterol as major components in each sample and its proportion of free sterols to total neutral lipid was 50.0 to $70.5\%$. The other lipid components of neutral lipid showing similar in quantity, esterified sterols, free fatty acids and triglycerides were determined as a minor components. The major components fatty acid in neutral lipid were palmitic, oleic and hexadecadienoic acid. Palmitic acid was the most abundant and additionaly oleic, linoleic, octadecatetraenoic and myristic acid were the major component fatty acid in glycolipid. But, especially, glycolipid of Loligo beka contained a higher amount of arachidonic acid which also consists of major component in addition to those of acids. Palmitic acid was the most abundant and additionaly, oleic, linoleic and octadecatetraenoic acid were the major component fatty acids in phospholipid.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.8 no.2
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• pp.47-60
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• 1975

For the calculation of population parameter and estimation of recruitment of a fish population, an application of multiple regression method was used with some statistical inferences. Then, the differences between the calculated values and the true parameters were discussed. In addition, this method criticized by applying it to the statistical data of a population of bigeye tuna, Thunnus obesus of the Indian Ocean. The method was also applied to the available data of a population of Pacific saury, Cololabis saira, to estimate its recuitments. A stock at t year and t+1 year is, $N_{0,\;t+1}=N_{0,\;t}(1-m_t)-C_t+R_{t+1}$ where $N_0$ is the initial number of fish in a given year; C, number o: fish caught; R, number of recruitment; and M, rate of natural mortality. The foregoing equation is $$\phi_{t+1}=\frac{(1-\varrho^{-z}{t+1})Z_t}{(1-\varrho^{-z}t)Z_{t+1}}-\frac{1-\varrho^{-z}t+1}{Z_{t+1}}\phi_t-a'\frac{1-\varrho^{-z}t+1}{Z_{t+1}}C_t+a'\frac{1-\varrho^{-z}t+1}{Z_{t+1}}R_{t+1}......(1)$$ where $\phi$ is CPUE; a', CPUE $(\phi)$ to average stock $(\bar{N})$ in number; Z, total mortality coefficient; and M, natural mortality coefficient. In the equation (1) , the term $(1-\varrho^{-z}t+1)/Z_{t+1}$s almost constant to the variation of effort (X) there fore coefficients $\phi$ and $C_t$, can be calculated, when R is a constant, by applying the method of multiple regression, where $\phi_{t+1}$ is a dependent variable; $\phi_t$ and $C_t$ are independent variables. The values of Mand a' are calculated from the coefficients of $\phi_t$ and $C_t$; and total mortality coefficient (Z), where Z is a'X+M. By substituting M, a', $Z_t$, and $Z_{t+1}$ to the equation (1) recruitment $(R_{t+1})$ can be calculated. In this precess $\phi$ can be substituted by index of stock in number (N'). This operational procedures of the method of multiple regression can be applicable to the data which satisfy the above assumptions, even though the data were collected from any chosen year with similar recruitments, though it were not collected from the consecutive years. Under the condition of varying effort the data with such variation can be treated effectively by this method. The calculated values of M and a' include some deviation from the population parameters. Therefore, the estimated recruitment (R) is a relative value instead of all absolute one. This method of multiple regression is also applicable to the stock density and yield in weight instead of in number. For the data of the bigeye tuna of the Indian Ocean, the values of estimated recruitment (R) calculated from the parameter which is obtained by the present multiple regression method is proportional with an identical fluctuation pattern to the values of those derived from the parameters M and a', which were calculated by Suda (1970) for the same data. Estimated recruitments of Pacific saury of the eastern coast of Korea were calculated by the present multiple regression method. Not only spring recruitment $(1965\~1974)$ but also fall recruitment $(1964\~1973)$ was found to fluctuate in accordance with the fluctuations of stock densities (CPUE) of the same spring and fall, respectively.