• Journal of Chest Surgery
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• v.29 no.10
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• pp.1095-1101
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• 1996

From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.69-74
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• 1996

Background: The diagnosis of pulmonary embolism (PE) based on clinical findings is often elusive and therefore requires confirmative diagnostic method. Pulmonary angiography, though the gold standard for the diagnosis of pulmonary embolism, is an invasive method and requires trained personnel and special equipment. Lung V/Q scan, on the other hand, is a noninvasive method but the diagnostic specificity and sensitivity arc not satisfactory in case that the results are either intermediate or low probability scan. Plasma D-dimer is generated when a thrombus is fibrinolysed by plasmin and is known to be increased in various thrombotic disorders. The aim of this study was to investigate the value of the determination of plasma D-dimer level in the diagnosis of pulmonary embolism. Methods: Pulmonary angiography was performed in 17 patients who were clinically suspected to have pulmonary embolism. 9 patients(PE, $56{\pm}13.4$ yrs, M:F=8:1) were diagnosed to have pulmonary embolism by pulmonary angiography. The control group were the 8 patients with negative pulmonary angiography and 13 orthopedic patients with no evidence of pulmonary embolism on scintigraphic and impedance plethysmographic studies(n=21) (non-PE, $54.5{\pm}11.1$ yrs, M:F=11:10). Plasma D-dimer was measured by latex agglutination method in study subjects and the results were analyzed according to the presence or absence of pulmonary embolism. Results: 1) The increased level of plasma D-dimer was more frequently observed in the patients with pulmonary embolism than in the controls(>0.5 mg/L, 8 in PE, 10 in non-PE; <0.5 mg/L, 1 in PE, 11 in non-PE, p=0.049). 2) The diagnostic value of plasma D-dimer level higher than 0.5 mg/L were as follows: sensitivity 88.9%(8/9), specificity 52.4%(11/21), positive predictive value 44.4%(8/18), and negative predictive value 91.7%(11/12). Conclusion: Plasma D-dimer determination showed high sensitivity and negative predictive value in the diagnosis of pulmonary embolism and is therefore thought to be useful in excluding the possibility of pulmonary embolism.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.27-34
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• 2008

Purpose: Many recent studies have reported on the feasibility and usefulness of laparoscopy assisted distal gastrectomy (LADG) for treating early gastric cancer. On the other hand, there has been few reports about laparoscopy assisted total gastrectomy (LATG) because upper located gastric cancer is relatively rare and the surgical technique is more difficult than that for LADG, We now present our procedure and results of performing LATG for the gastric cancer located in the upper or middle portion of the stomach. Materials and Methods: From Jan 2005 to Sep 2007, 96 patients underwent LATG by four surgeons at the Asan Medical Center, Seoul, Korea. Among them, 48 consecutive patients who were operated on by asingle surgeon were analyzed with respect to the clinicopathological features, the surgical results and the postoperative courses with using the prospectively collected laparoscopy surgery data. Results: There was no conversion to open surgery during LATG. For all the reconstructions, Roux-en Y esophago-jejunostomy and D1+beta lymphadenectomy were the standard procedures. The mean operation time was $212{\pm}67$ minutes. The mean total number of retrieved lymph nodes was $28.9{\pm}10.54$ (range: $12{\sim}64$) and all the patients had a clear proximal resection margin in their final pathologic reports. The mean time to passing gas, first oral feeding and discharge from the hospital was 2.98, 3.67 and 7.08 days, respectively. There were 5 surgical complications and 2 non-surgical complications for 5 (10.4%) patients, and there was no mortality. None of the patients needed operation because of complications and they recovered with conservative treatments. The mean operation time remained constant after 20 cases and so a learning curve was present. The morbidity rate was not different between the two periods, but the postoperative course was significantly better after the learning curve. Analysis of the factors contributing to the postoperative morbidity, with using logistic regression analysis, showed that the 8MI is the only contributing factor forpostoperative complications (P=0.029, HR=2.513, 95% CI=1.097-5.755). Conclusions: LATG with regional lymph node dissection for upper and middle early gastric cancer is considered to be a safe, feasible method that showed an excellent postoperative course and acceptable morbidity. BMI should be considered in the patient selection at the beginning period because of the impact of the BMI on the postoperative morbidity.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.4
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• pp.723-729
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• 2004

To develop foods using dried persimmon, hot-water extracts of dried persimmons were added into strong wheat flour in the ratio of 10, 20, 30, and 40% and the quality characteristics of baked products were investigated. The proximate compositions of dried persimmons hot-water extracts were 70.37% of moisture, 1.72% of crude protein, 0.18% of crude lipids, 1.99% of crude ash and 4.37% of crude fiber, respectively. With increasing the addition of dried persimmons hot-water extracts, moisture content of the added breads was increased to 47.20% from 41.12% of non-added bread and water activity to 0.576 from 0.495. Water binding capacity of the added dried persimmons hot-water extracts rasied weight of the bread but decreased specific volume. In the hunter's color values the more dried persimmons hot-water extracts was added, the lower L vaules we, and the higher a and b values we. In the texture property, the addition of dried persimmons hot-water extracts increased hardness, gumminess and chewiness, while decreased adhesiveness and fracturability. Judging from texture, taste and overall acceptability of the product, recommended substitution level for hot-water extracts of dried persimmons in bread was 30% or less.

• Journal of Aquaculture
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• v.21 no.2
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• pp.82-88
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• 2008

A 12-week feeding trial was conducted to investigate the effects of dietary supplementation of probiotics as a feed additive for juvenile Korean rockfish Sebastes schlegeli. Four experimental diets supplemented with no probiotic(Control), Bacillus polyfermenticus(BP), Bacillus licheniformis(BL) or Bacillus polyfermenticus plus Saccharomyces cerevisiae(BP+SC) at $1.0{\times}10^7$ CFU/kg diet as a dry-mater(DM) basis were prepared by mixing with a basal diet. After 12 weeks of the feeding trial, fish fed BP+SC diet showed significantly higher weight gain(WG), feed efficiency(FE), specific growth rate(SGR) and protein efficiency ratio(PER) than those of fish fed control diet(P<0.05), however there were no significant differences in WG, FE, SGR and PER among fish fed the BP, BL and BP+SC diets. Fish fed BP and BP+SC diets showed significantly higher condition factor(CF) than that of fish fed control and BL diets. Fish fed BP, BL, BP+SC diets showed significantly higher hepatosomatic index(HSI) than that of fish fed control diet, however there was no significant difference in HSI among fish fed BP, BL and BP+SC diets. Fish fed BP+SC diet showed significantly lower serum glucose than that of fish fed control diet, however there was no significant difference in serum glucose among fish fed BP, BL and BP+SC diets. Fish fed BP+SC diet showed significantly higher respiratory burst activity(NBT assay) than that of the fish fed control and BL diets, however there was no significant difference in NBT assay between fish fed BP and BP+SC diets. Fish fed BP and BL diets showed significantly higher lysozyme activity than that of the fish fed control diet, however there was no significant difference in lysozyme activity among fish fed BP, BL and BP+SC diets. Fish fed BP and BP+SC diets showed significantly lower cumulative mortality than that of the fish fed control diet, however there was no significant difference in cumulative mortality among fish fed BP, BL and BP+SC diets after the challenge test. From these results, dietary B. polyfermenticus, B. licheniformis and B. polyfermenticus plus S. cerevisiae supplementation in juvenile Korean rockfish diet could enhance growth performances, non-speicific immunities and a higher resistance against the specific pathogen.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.427-436
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• 2008

Purpose. The objective of this study was to evaluate the behavioral response and assess the effectiveness of additional intranasal (IN) and submucosal (SM) administration of midazolam during pediatric sedation for dental procedure. Material and methods. Thirty-three cases of healthy (ASAⅠ), uncooperative children aged from 24 to 72 month old at pediatric dental clinic of Ewha Womans University Hospital were selected for this study. Children received oral chloral hydrate 50 mg/kg with hydroxyzine 1.0 mg/kg. After waiting for 45 minutes, midazolam 0.2 mg/kg was administrated via IN route and via SM route randomly maintaining 50% of $N_2O$. A pulse oximeter and a capnograph were used for measuring vital signs ($SpO_2$, PR, RR, $EtCO_2$) throughout the sedation. Behavioral response was evaluated as Quiet (Q), Crying (C), Movement (M) or Struggling (S) in every 2 minutes for 40 minutes. Results. There were also no statistically significant differences in vital signs of the two groups. The behavioral response for the first ten minutes during sedation was a statistically significant difference (P < 0.05) between the two groups. After the first ten minutes, it was revealed that there was no significant difference. Conclusion. This study demonstrated that the addition of IN midazolam to the combination of oral chloral hydrate with hydroxyzine and nitrous oxide/oxygen inhalation is as safe and effective as that of SM midazolam in pediatric sedation for dental procedure.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.1
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• pp.65-71
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• 2007

Five different commercial chungkukjang powders (A$\sim$E) were compared based on their physicochemical, organoleptic and functional properties. The proximate composition of the five samples ranged from 6.07 to 8.54% in moisture, 15.31 to 27.07% in crude protein, 20.19 to 24.75% in crude lipid, 34.84 to 52.41% in carbohydrate, and 3.69 to 5.26% in ash. The pH of the samples ranged from 5.58 to 6.11, and Hunter's colors showed 70.01$\sim$77.22 for L value, 0.91$\sim$4.64 for a value and 23.72$\sim$31.00 for b value depending on the product. The microbial counts were 8.16$\sim$g.60 log CFU/g for aerobic bacteria, $\sim$4.16 log CFU/g for yeasts & molds, and 1.07$\sim$3.88 log CFU/g for coliforms. The contents of reducing sugars and amino-N were 1.89$\sim$2.41% and 2.83$\sim$7.31%, respectively. Free amino acids were mainly composed of glutamic acid, valine, leucine, phenylalanine, and lysine. The amounts of total phenolics and total flavonoids were 108$\sim$302 mg% and 2.73$\sim$9.41, respectively, with some variations in the products. However, the isoflavone contents, which were composed of genistein (63.26$\sim$217.16${\mu}g/g$), daidzein (58.24$\sim$166.65${\mu}g/g$), genistin (2.66$\sim$55.68${\mu}g/g$), and glycitein (12.26$\sim$17.82${\mu}g/g$), were apparently different per product. The sensory scores for color, smell, taste and overall preference for the five chungkukjang products, which were evaluated by panels in their 20's and 30's using 7-point scoring test, ranged from 3.20 to 4.05.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.354-363
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• 2001

Background : Although lung involvement has been reported in 5 to 46% of dermatomyositis/polymyositis(DM/PM) patients, reports of the condition in Korea are rare. This study evaluated the clinical features of lung involvement in DM/PM patients. Methods : The medical records, laboratory results and radiologic findings of 79 DM/pM patients, who attended the Seoul National University Hospital (SNUH) between 1989 and 1999, were reviewed retrospectively. Results : A total 79 patients of whom 24 patients(33%) showed lung involvement, were enrolled in this study. More patients with lung involvement were female(F:M=11:1), and older compared with those without lung involvement. Patients with lung involvement presented with dyspnea(79%), coughing(67%), an elevated ESR, and CK/LD. Anti-Jo 1 antibody test was positive in 30%, which is significantly higher in patients with lung involvement. A simple chest X-ray of the patients with lung involvement exhibited reticular opacity(50%), reticulonodular opacity(30%), patchy opacity(29%), nodular opacity(13%) and linear opacity(4%). HRCT(n=24) showed ground glass opacity(75%), linear or septal thickening(50%), patchy consolidation(42%), honey-combing(33%) and nodular opacity(17%). The pulmonary function test showed a restrictive ventilatory pattern(77%) and a lower diffusing capacity(62%). The patients were followed up during a mean duration of $30{\pm}28$ months. They were treated with steroid only(50%) or a combination of steroids and cytotoxic agents(46%). Muscle symptoms were improved in 89% with treatment, but an improvement in the respiratory symptoms or in the pulmonary function test was rare. Patients with lung involvement had a higher mortality rate(21%) than those without lung involvement(10%) during the follow-up periods. Conclusion : DM/PM patients with lung involvement were mostly female, older and had a higher positive rate Anti-Jo 1 antibodies, but there was no significant difference in prognosis.

• Parasites, Hosts and Diseases
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• v.32 no.4
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• pp.249-258
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• 1994

Recently, the importance of toxoplasmosis is raised as a complication in immunosuppressed or AIDS patients. Our study focused on the identification of a variety of Toxoplasma antigens by immunoblotting. Rabbits and BALB/c mice were immunized with Toxoplosmo Iysate (RH strain) , frozen tachyzoites (RH strain) or cysts (Beverly and Fukaya strain) . Blood were collected from ear vein, heart or orbital plexus for detecting the serum antibody levels. For excretory-secretory (E.S) antigens, T gondii (RH) tachyzoite were cultured in CHL (Chinese hamster lung) cells with MEM containing of 5% FCS. After 72hrs, culture supernatant was collected. BALB/c mice were inoculated with RH tachyzoite intraperitoneally and peritoneal fluids were extracted three days later. E.S antigens were detected in culture supernatant and infected mouse peritoneal fluid by EITB. Serum IgG levels in rabbit were 1 :512 of 10 days after primary immunization, 1 : 2,048 of 10 days after secondary immunization, 1: 1,024 of 20 days after secondary immunization by IFAT, respectively. Serum IgG levels of immunized mice were 1:128 after 7 weeks. Tachyzoite antigens of the RH strain were detected 25 protein bands ranging 10 kDa-220 kDa of molecular weights with Coomassie blue stain. Toxoplcsma major antigens corresponding to n of 24 kDa, 27 kDa,30 kDa, 35 kDa, 38 kDa were recognized by IgG and IgM antibodies. Excretory-secretory antigens present in culture supernatant with M. W. of 20, 30 kDa and in infected mouse peritoneal fluid with M.W. of 33 (P30), 45 kDa. When RH tachyzoite antigen was probed with different mice sera immunized with 2 strains of T gondii, the IgG antibody bud of Fukaya and Beverly strain (8 week-serum) is identical to those of RH strain. It is considered that the 30 kDa polypeptide detected in excretory- secretory materials and Iysate was important major antigen of T gondii (RH).

• Nuclear Medicine and Molecular Imaging
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• v.40 no.5
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• pp.249-256
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• 2006

Purpose: Although computed tomography (CT) is widely used for diagnosing liver metastasis from colorectal cancer, diagnostic accuracy of CT is not satisfactory. Magnetic resonance (MR) imaging and F-18 FDG PET has been reported to be superior to CT. However, studies on direct comparison of PET and MR are scarce. We compared the diagnostic accuracy of FDG PET and MR in detecting liver metastasis from colorectal cancer. Materials and Methods: Among 363 colorectal cancer patients who underwent F-18 FDG PET (ECAT, Siemens-CTI, Knoxville; Gemini, Philips, Milpitas, U.S.), 26 patients (M:F=17:9, age=$62{\pm}11$) underwent MR to evaluate suspicious metastatic liver lesions. Finally, 35 liver lesions detected by CT from 26 patients were enrolled for analysis. PET and MR results were compared with pathologic reports, clinical findings or follow-up results. Results: Of the 35 lesions, 18 lesions (51.4%) were diagnosed as liver metastases, while remaining 17 (48.6%) as benign. The sensitivity and the specificity of PET were 94.4% and 94.1%, respectively, compared to 100% and 82.4% for MR. MR and PET was concordant in 30 lesions (85.7%: 17 metastatic (94.4%) and 13 benign (76.5%) lesions. ROC curve analysis revealed maximal SUV of 3.1 as the optimum standard in differentiating metastatic from benign liver lesions (AUC=0.897, p<0.001, sensitivity 83.3%, specificity 94.1%). For small lesions less than 1 cm ln diameter (n=20), diagnostic accuracy of PET was comparable to that of MR. Conclusion: F-18 FDG PET showed good diagnostic performance in detecting liver metastasis from colorectal cancer, which was comparable to MR.