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Early Changes of Left Ventricular Geometry and Function after Surgical Ventricular Restoration and Mitral Valve Annuloplasty: Magnetic Resonance Imaging (외과적 심실 복원과 승모판 고리성형 후 좌심실 형태와 기능의 초기 변화: 자기공명영상)

  • Choi, Byoung-Wook;Chang, Byung-Chul;Kim, Young-Jin;Hur, Jin;Lee, Hye-Jeong;Kim, Tae-Hoon;Choe, Kyu-Ok
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.1
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    • pp.40-48
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    • 2008
  • Purpose : We sought to determine the early change of ventricular geometry and function after concomitant surgeries of modified Dor procedure and mitral valve annuloplasty by using magnetic resonance imaging. Materials and Methods : We enrolled 21 patients with dilated heart failure who underwent modified Dor procedure (n=8), mitral valve annuloplasty (n=6), or both surgeries (n=7). Cine MRI was used to assess left ventricular dimensions and function before and after surgery. We measured the left ventricular end-diastolic and end-systolic volumes and the dimensions of the left ventricular long-axis and short-axis. Left ventricular stroke volume, ejection fraction, and sphericity index were calculated from these measurements. These parameters were analyzed and compared between three different surgery groups to explain the combined effect of the concomitant surgeries. Results : MRI was performed within average $12\;{\pm}\;15$ days (range 1-58 days) before and $38\;{\pm}\;50$ days (range 7- 231 days) after the surgery. The patients who underwent concomitant surgeries had more profound enlargement of left ventricle and decreased contractility prior to surgery than those in the patients who underwent single surgical procedure. Left ventricular end-diastolic volume and endsystolic volume significantly decreased in all patients regardless of surgery type after surgery. Ejection fraction significantly increased only in the patients who got modified Dor procedure without mitral valve annuloplasty (25.4% to 40.7%). Sphericity index increased in patients with modified Dor procedure but decreased in patients with mitral valve annuloplasty (0.65 to 0.78 vs. 0.75 to 0.65). In the patients who underwent concomitant surgeries showed no significant change in sphericity index after surgery. Conclusion : The early change of the left ventricular geometry and function after the concomitant surgeries with modified Dor procedure and mitral valve annuloplasty in patients with dilated heart failure includes a marked reduction in left ventricular volume and in stroke volume. The shape of the left ventricle does not change because the effect of sphericity index decrease from mitral valve annuloplasty is counteracted by the effect of sphericity index increase from modified Dor procedure. Improvement of left ventricular ejection fraction is not the early change after the concomitant surgeries.

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Clinical characteristics of Epstein-Barr virus infection detected by polymerase chain reaction in children less than 15 years old (15세 이하의 어린이에서 중합효소 연쇄반응으로 검출된 Epstein-Barr 바이러스 감염의 임상적 특성)

  • Na, Jong-In;Kim, Ok Lan;Seoung, Do-kyoung;Yoo, Seung-Taek;Lee, Chang Woo;Choi, Doo-Young;Oh, Yeon-Kyun;Cho, Ji-Hyun;Kim, Jong-Duck
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1191-1197
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    • 2008
  • Purpose : Previously, Epstein-Barr virus (EBV) infection was diagnosed by serological examination; currently, many EBV antigen detection methods have been developed and applied clinically for diagnosing EBV infection. To delineate the clinical characteristics of EBV infection, clinical and laboratory findings were evaluated for patients who tested positive in EBV polymerase chain reaction (PCR). Methods : EBV PCR was conducted in 352 patients admitted to the pediatric ward from January 2004 to December 2006, with more than 2 clinical signs such as fever (${\geq}37.5^{\circ}C$), exudative throat infection, lymphadenopathy, hepatitis of unknown etiology, and splenomegaly. The EBV viral gene was detected by PCR in 115 patients (32%), and the clinical characteristics of these patients were evaluated. Laboratory findings such as leukocytosis, thrombocytopenia, atypical lymphocyte, and alteration in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in peripheral blood were examined. The EBV-specific immunoglobulin M antibody (EBV-IgM Ab) was also tested. Results : Most of the children were younger than 8 years (89%), and the male to female ratio was 1.3:1. Exudative throat infection and fever (${\geq}37.5^{\circ}C$) were observed in all patients. Cervical lymph node enlargement was seen in 36 patients (31 %); leukocytosis ($WBC{\geq}10,000/mm^3$), in 54 patients (47%); and atypical lymphocyte (${\geq}20%$), in 28 patients (24%). EBV-IgM Ab was positive in 33 patients (29%). The younger patients had higher ALT levels and higher incidence of positive EBV-IgM Ab than the older patients. Conclusion : The cumulative number of patients diagnosed to have EBV infection by PCR increased markedly for those under 8 years. ALT was higher and EBV-IgM Ab was detected more in younger patients with EBV infection.

The Study on the Increased Causes of Chloride ($Cl^{-}$) Concentration of the Samyang 3rd Pumping Station in Cheju Island (제주도 삼양 3수원지의 염소이온농도 상승 원인에 관한 연구)

  • 이성복;김구영;한소라;한정상
    • Journal of the Korean Society of Groundwater Environment
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    • v.4 no.2
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    • pp.85-94
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    • 1997
  • The study is aimed to find out the causes of rapidly increasing chloride (Cl$^{-}$) concentration of the Samyang 3rd pumping station originated from coastal springs of Cheju since January 1996. The study results show that it was caused by following complicated natural and anthropogenic effects. Due to severe draught in 1996 with total rainfall of only 41.7% of annual mean of the last 36 years (1991 to 1995), it creates firstly), significant decrease of the spring discharges as well decline of the groundwater level at the site . Sea water level was in general 4.4 cm to 12.4 cm higher than the groundwater level of the site during 2 to 3.8 hours at each high tide. Those higher potential head of sea water motivates the sea water intrusion into the fresh water lens through the permeable clinkers and fracture zones situated beneath the existing grouted zone which was installed to a maximum 10 m below the ground water surface, The repeated expansion and contraction of the fresh water lens occurred by periodic changes of the sea water level at high and low tide accelerates secondly the enlargement of the transition zone between the fresh and sea water at the site. The decrease of recharge amount by rainfall shortage creates thirdly the reverse flow at the interface of sea water and groundwater. The repeated groundwater extraction of 2790${\pm}$450 $m^3$d$^{-1}$ at the time of low tide, when the fresh water lens of the sire is under the contraction stare, makes additional drawdown of the ground water level and induces the upconing of salt water into the fresh water lens. The duration of spring discharge whose Cl concentration is less than 150 mg/1 at the low tide measured at the nearby springs was about two hours with discharge rate of 532 $m^3$d$^{-1}$ and after that Cl$^{-}$ concentration is increased up to more than 1900 mg/ι.eased up to more than 1900 mg/L.

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The Assessment of Scattered Ray According to the Beam Thickness of Z-axis in MDCT(Multi Detector Computed Tomography) (MDCT(다배열검출기 전산화단층촬영장치)에서 Z-축의 빔 두께에 따른 산란선의 평가)

  • Ryu, Gwi-Bok;Kim, Hyun-Soo;Lyu, Kwang-Yeul;Dong, Kyung-Rae;Kweon, Dae-Cheol
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.127-132
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    • 2010
  • The purpose of this study is to measure scattered ray which is occurred except for Z-axis range of the detector in MDCT's iso-center and present the basic data about the standard for reduction of scattered ray. The development of MDCT brings out the enlargement of beam thickness to the patient's Z-axis, which distributes to the increase in exposure dose according to the rise of scattered ray. Also MDCT brings out the increase of scattered ray about 4times more than SDCT. To evaluate scattered ray according to the change of beam thickness on MDCT, we measured scattered ray of MDCT's Z-axis beam thickness by using one 16-slice CTs and two 64-slice CTs. We used the ionization chamber 60ml 2026C as the equipment of measurement. In our results, we found out that the change of scattered ray according to the beam thickness in the same kVp has increase of scattered ray. Secondly we found out the increase of scattered ray according to the increase of kVp. Lastly we found out the decrease of scattered ray according to the increase of the distance from the ionization chamber.

Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI (경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계)

  • Lee, Hyunyong;Kim, Hyeonjin;Im, Inchul;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.231-240
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    • 2014
  • The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

Increased Protein of the Secretory Leukocyte Pretense Inhibitor (SLPI) and the Expression of Growth Factors in NIH3T3 Cells by LPS Stimulation (NIH3T3 세포주에서 LPS자극에 의한 분비백혈구단백분해효소억제제 (SLPI)의 단백질증가와 성장인자들의 발현)

  • Lee, Sang-Hwa;Choi, Baik-Dong;Jeong, Soon-Jeong;Jang, Hyun-Seon;Kim, Byung-Ock;Lim, Do-Seon;Park, Joo-Cheol;Wang, Guan-Lin;Jeong, Moon-Jin
    • Applied Microscopy
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    • v.36 no.3
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    • pp.165-172
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    • 2006
  • Secretory leukocyte protease inhibitor (SLPI) involves tissue protection against the destructive action of neutrophil elastase at the site of inflammation. Several studies on new functions of SLPI have demonstrated that SLPI may play a primary role in innate immunity than protease inhibitor, To identify the function of SLPI by lipopolysaccharide (LPS) stimulation in the embryonic fibroblast (NIH3T3) cells. we studied the expression of SLPI compared to other growth factors involving the LPS treatment. To address this, we performed the reverse transcriptase polymerase chain reaction (RT-PCR) and Western blots for the detection of mRNA and protein expression of the SLPI and some growth factors such as VEGF. bFGF, and PDGF-BB after LPS stimulation. NIH3T3 cells were exposed 100 ng/mL Escherichia coli LPS for 30min, 60min, 90min, 24h, and 48h, respectively. The result of RT-PCR showed that SLPI and VEGF mRNA was expressed strongly in NIH3T3 without related to LPS stimulation. mRNA of bFGF was weakly expressed such as the expression of the control. PDGF mRNA expression gradually increased follows at time course. However, SLPI protein level was increased in lysates and culture medium by LPS stimulation. Phase contrast microscopic and scanning electron microscopic observation showed that the increased cell number and cytoplasmic enlargement of the NIH3T3 cells. Therefore, it suggests that the LPS upregulates SLPI expression in NIH3T3 cells. Moreover, secreted SLPI may stimulate cell proliferation and migration.

A study of Establishment on Radiomap that Utilizes the Mobile device Indoor Positioning DB based on Wi-Fi (Wi-Fi 기반 모바일 디바이스 실내측위 DB를 활용한 라디오맵 구축에 관한 연구)

  • Jeong, In Hun;Kim, Chong Mun;Choi, Yun Soo;Kim, Sang Bong;Lee, Yun
    • Journal of Korean Society for Geospatial Information Science
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    • v.22 no.3
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    • pp.57-69
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    • 2014
  • As of 2013, Korean population density is 505 persons per $1km^2$ and is ranked 3rd place in the most densely populated countries exception of city-states. It shows clearly the population is concentrated in the city area. To fulfil this urban concentration population demand, the enlargement and complexation of buildings, subway and other underground spaces connection tendency has been intensified, and it is need to construct the indoor spatial information DB as well as the accurate indoor surveying DB to promote people's safety and social welfare. In this study, Sadang station and Incheon National Airport were aimed for the construction of Wi-Fi AP location DB and RadioMap DB by collecting the indoor AP raw datas by using mobile device and those collected results were ran through the process of verification, supplementation, and analyzation. To evaluate the performance of constructed DB, 10 points in Incheon Airport- 3rd flr in block A, and 9 points in Sadang station-B1 were selected and calculated the estimated points and ran evaluation experiment using survey positioning error, which is distance between real position and the estimated position. The result shows that Incheon international airport's average and standard deviation was separately 17.81m, 17.79m and Sadang station's average and standard deviation was separately 22.64m, 23.74m. In Sadang station's case, the areas near the exit has low performance of surveying position due to fewer visible AP points than other areas. As total datas were examined except those position, it was verified that the user's location was mapping close position in surveying positioning by using constructed DB. It means that constructed DB contains correct Wi-Fi AP locations and radio wave patterns in object region, so it is considered that the indoor spatial information service based on constructed DB would be available.

The Development of a Model for Selecting Method of Entry for Apartment in Remodeling an Underground Parking Lot (지하주차장 리모델링 공사시 주동진입방법 선정 모델 개발)

  • Song, Nak-Hyun;Jung, In-Su;Lee, Chan-Sik
    • Korean Journal of Construction Engineering and Management
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    • v.10 no.2
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    • pp.65-74
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    • 2009
  • It is expected that the number of apartment complexes in Korea that are over 20 years old will rapidly increase to more than 3,500,000. Consequently, the remodeling of these buildings is being revitalized throughout the country. Among the requirements for such remodeling, the expansion of parking lots has considerable weight. When enlarging a parking lot, the access route from an underground floor to the main building (i.e., the means of entry into the main building) determines the possibility of vertical enlargement for elevators, the size of the parking lot, the construction period, and construction expenses, etc. When enlarging an underground parking lot of an apartment complex, the access between the main building and the parking lot, as well as the inhabitants' requirements for entering the main building, are generally determined based on the designer's experience, rather than on the exact estimation of the peculiarity of the complex. In order to resolve such a problem, when enlarging an underground parking lot, a systematic and rational method is needed for selecting the means of entry into the main building. In this study, a selection model is derived for the method of selecting an access route into the main building when constructing an underground parking lot, in order to provide a reasonable decision-making process. A research method was investigated for determining the access route into the main building when enlarging a parking lot. On the basis of research carried out through in-depth interviews with experts, the characteristics for each means of entry into the main building were analyzed and the factors affecting the selection of the access route were deduced. The affecting factors selected were construction efficiency, convenience efficiency and economic efficiency. Weight values were then estimated for the selected affecting factors by applying the AHP method. Results showed that convenience efficiency, which gained the highest value, is the most important factor in selecting the means of entry into the main building. The most suitable means of entry into the main building was also suggested after estimating the applicability of the site by selecting complexes with remodeling possibility. This study will be applied as a reference for selecting the means of entry into the main building when constructing an underground parking lot particularly for older apartment complexes.

Clinical Features in Primary Mediastinal Tuberculous Lymphadenitis (조직학적으로 증명된 결핵성 림프절염에 대한 임상적 고찰)

  • Ahn, Chul-Min;Yoo, Kwang-Ha;Park, Kwang-Ju;Kim, Hyung-Joong;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.767-774
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    • 1999
  • Background : Tuberculous mediastinal lymphadenitis (TML) is a relatively commonly encountered in Korea. However, there were no datas available on TML without other combined tuberculous infections in Korea. We retrospectively analyzed clinical manifestations, radiologic findings, Chest CT scan findings, the duration of treatment, and follow up Chest CT scan findings of 23 cases who had only TML. Method : 23 cases from 1991 to 1997 with TML confirmed by biopsy and had no other combined tuberculous infections were studied retrospectively. Results : Of the 23 cases, 7 cases were male and 16 female. The male to female ratio was 1 : 2.4. Mean age was 31 years and the most prevalent age group was the 3rd decade(43%). The most common presenting symptoms were fever(39%) followed by no symptom, cough, swallowing difficulty, and chest discomfort. On simple chest X-ray, mediastinal enlargement were noted in 20 cases(90%). The most frequently involved site was the paratracheal node in 11 cases with the right to left side involvement ratio being 4.6 : 1. On chest CT scan, the most commonly enlarged node was the paratracheal node(33%) followed by the subcarinal(20%), hilar(13%), tracheobronchial (8%), subaortic(8%), supraclavicular(8%) and anterior. mediastinal nodes. 6 cases were dropt out due to incomplete follow up. Thirteen cases were treated with HERZ regimen and the mean duration of treatment was 14 months. Three cases were treated with second line drug regimens(Tarivid, Pyrazinamide, Streptomycin plus Ethambutol or Para-aminosalicylic acid) for 18 months. In HERZ groups, one case was recurred after 10 months later and retreatment was done by same HERZ regimen during 12 months. Follow up chest CT scan after completion of treatment were done in 13 cases and that revealed more than a 50% decrease in size in 77% of the cases and no interval change in 23% of the cases. Conclusion : In cases of TML without other combined tuberculous infection, the minimal duration of treatment was required 12 months by HERZ regimen and 18 months by a 2nd line regimen or more. Further studies will be needed to confirm the treatment duration for TML without other combined tuberculous infections.

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Characterization of Cigarette Smoke Extract (CSE)-induced Cell Death in Lung Epithelial Cells (폐상피세포에서 흡연추출물-유도성 세포사에 관한 연구)

  • Choi, Eun Kyung;Kim, Yun Seup;Park, Jae Seuk;Jee, Young Koo;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.43-53
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    • 2005
  • Emphysema is characterized by air space enlargement and alveolar destruction. The mechanism responsible for the development of emphysema was thought to be protease/antiprotease imbalance and oxidative stress. A very recent study shows that alveolar cell apoptosis causes lung destruction and emphysematous changes. Thus, this study was performed to support the evidence for the role of apoptosis in the development of emphysema by characterizing cigarette smoke extract (CSE)-induced apoptosis in A549 (type II pneumocyte) lung epithelial cells. CSE induced apoptosis at low concentration (10% or less) and both apoptosis and necrosis at high concentration (20%). Apoptosis was demonstrated by DNA fragmentation using FACScan for subG1 fraction. Discrimination between apoptosis and necrosis was done by morphologic analysis using fluorescent microscopy with Hoecst 33342/propium iodide double staing and electron microscopy. Cytochrome c release was confirmed by using immunofluorescence with monoclonal anti-cytochrome c antibody. However, CSE-induced cell death did not show the activation of caspase 3 and was not blocked by caspase inhibitors. This suggests that CSE-induced apoptosis might be caspase-independent apoptosis. CSE-induced cell death was near completely blocked by N-acetylcystein and bcl-2 overexpression protected CSE-induced cell death. This results suggests that CSE might induce apoptosis through intracellular oxidative stress. CSE also activated p53 and functional knock-out of p53 using stable overexpression of HPV-E6 protein inhibited CSE-induced cell death. The characterization of CSE-induced cell death in lung epithelial cells could support the role of lung cell apoptosis in the pathogenesis of emphysema.