• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.3 no.1
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• pp.78-90
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• 1993

This study was designed obtain and early detection the workers exposed to excessive copper dust and also to present biological exposure index. The exposed group consisted of 62 male workers at the metallurgy workplaces. To evaluate the degree of individual exposure the copper dust, each personal air sampling was collected. Biological exposures in the exposed group was quantified for the blood and urine copper levels using flameless atomic absorption spectrophotometer. The control group consisted of 70 male adults with the history of nonexposure to copper by the inhalation occupationally. The average concentration of copper in blood and urine of the exposed group was $49.44{\pm}8.90(29.05-80.63){\mu}g/dl$, $39.99{\pm}11.04(29.62-80.63){\mu}g/l$ respectively. The average concentration of air borne copper was $0.48{\pm}0.31(0.03-1.18)mg/m^3$. The average concentration of blood and urine copper in the control group was $42.93{\pm}5.84(25.05-57.85){\mu}g/dl$, $33.02{\pm}13.38(12.00-82.05){\mu}g/l$ respectively. The difference observed in the average concentration of blood and urine copper of the exposed and control groups was statistically significant seperately (blood copper, p<0.05 ; urine copper, p<0.05). The relationship between the individual exposure concentration of air borne copper and the concentration of the blood and urine copper was statistically significant, respectively (blood copper, r=0.54, p<0.05 ; urine copper, r=0.37, p<0.05). The relationship between the working duration and the concentration of blood and urine was not statistically significant respectively (blood copper, r=0.14 ; urine copper, r=0.12). The relationship between the age and the concentration of blood and urine copper was statistically not significant respectively (blood copper, r=013 ; urine copper, r=-0.06). The relationship between blood and urine copper concentration in the exposed group was statistically significant (r=0.62, p<0.05), and the relationship between blood and urine copper concentration in the control group was also statistically significant (r=0.39, p<0.05).

• Journal of Chest Surgery
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• v.29 no.4
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• pp.386-392
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• 1996

Preoperative and postoperative evaluation was done in 60 adult patients above 20 years of age among 152 patients, who had operation for the congenital atrial septal defect from January 1984 to June 1993 in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Anatomically, the secundum type defect was present In 58 cases and the other two were ostium primum type defect. The defect were closed directly in 45 cases and with patches in 15 cases. Preopera ive EKG findings revealed regular sinus rhythm in 81%, arrhythmia 19%, RVH 32%, RAD 30%, Postoperative findings were regular sinus rhythm in 76%, arrhythmia 24%, RVH 25%. RAD 25%. In hemodynamic data, the mean SPAP in patients over 40 years old was 41.91 $\pm$ 14.33mmHg compared to 31.46 $\pm$ 13.77 mmHg in patients under 40 years old, and the difference between the two groups was stastistically significant. And then the patients were classified into two groups (group A sinus group, and group B : arrhythmia group) according to their preoperative rhythm. The patients in group B were older, had greater value of mean SPAP and Rp/Rs. Mean Qp/qs was higher in group A. But the difference between two groups about the mean Qp/qs and Rp/Rs was not significant. Postoperative complications such as arrhythmia, pneumothorax or hemothorax occurred in 7 cases, but there was no operative mortality. The functional improvement were remarkable in half of the patients who underwent surgery.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.776-780
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• 1998

Background: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular(LV) function after surgical revascularization. Materials and methods: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography(DSE) (dobutamine: baseline, 5, 10, 20$\mu$g/kg/min) before coronary artery bypass grafting(CABG) and underwent echocardiography at least 2 months after CABG. Results: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8(50%) of 16 patients in DSE. Among them, 6 patients(75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients(38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments(74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments(23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.920-926
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• 2006

Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.72-78
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• 2009

Background: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). Material and Method: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. Result: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). Conclusion: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.34-40
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• 2009

Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

• Development and Reproduction
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• v.12 no.1
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• pp.1-8
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• 2008

Specific protocols to increase the differentiation of neuronal cells from embryonic stem (ES) cells have been well established, such as retinoic acid induction and lineage selection of neuronal cells. For the neuropathological studies, ES-derived neurons (ES neurons) must show normal physiological characteristics related to cell death and survival and should be maintained in vitro for a sufficient time to show insults-specific cell death without spontaneous death. When mouse ES cells were plated onto astrocytes monolayer after retinoic acid induction, most ES cells differentiated into neuronal cells, which were confirmed by the presence of specific neuronal markers, and the cultures were viable for at least four weeks. When these cultures were examined for vulnerability to glutamate excitotoxicity, ES neurons were vulnerable to excitotoxic insults mediated by agonist-specific receptors. The vulnerability to excitotoxic death increased with developmental age of ES neurons in vitro. Specific receptors for Neurotrophin and GDNF family ligands were present in ES neurons. GDNF and NT-3 could modulate the survival and excitotoxic vulnerability of ES neurons. The vulnerability and resistance to toxic insults, which are essential requirements of model culture systems for neuropathological studies, make ES neurons to a useful model culture system. Especially ES cell are highly amenable to genetic modification unlikely to primary neuronal cells, which will give us a chance to answer more complicated neurophysiological questions. Recently there was an outstanding attempt to explore the cellular toxicity using human ES cells (Schrattenholz & Klemm, 2007) and it suggested that ES cells could be a new model system for neurophysiological studies soon and go further a large-scale screening system for pharmacological compounds in the future.

• Journal of Animal Science and Technology
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• v.45 no.4
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• pp.569-576
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• 2003

An experiment was conducted to investigate the effect of microbial phytase (Natuphos$^{\circledR}$) supplementation, individually and in combination with carbohydrase enzyme complex (composed of enzymes targeted to SBM dietary components such as $\alpha$-galactosides and galactomannans; ENDO-POWER$^{\circledR}$) to corn-soy basis diet with low nutrient levels on growth performance and nutrient digestibility of growing pigs. A total of 48 crossbred weaned pigs (Landrace${\times}$Yorkshire${\times}$Duroc), 29.1$\pm$0.14 kg of initial body weight, were randomly allotted to four dietary treatments, based on weight and age, according to a Randomized Complete Block Design. There were three pens per treatment and 4 pigs per pen. The dietary treatments were 1) CON (control diet with 3,380 kcal/kg of metabolizable energy, 18.96% of crude protein, 1.10% of lysine, 0.75% of calcium and 0.35% of available phosphorus), 2) LP+NTPS (CON diet with 0.15% unit lower available P levels+0.1% phytase (500 FTU/kg; Natuphos$^{\circledR}$)), 3) LEL+ENP (CON diet with 3.0% unit lower ME and lysine levels + 0.1% carbohydrase enzyme complex (ENDO-POWER$^{\circledR}$), and 4) LPEL+ENZ (CON diet with 0.15% unit lower available P levels and 3.0% unit lower ME and lysine levels+0.1% ENDO-POWER$^{\circledR}$ and 0.1% Natuphos$^{\circledR}$ (500 FTU/kg). There was no significant difference (p〉0.05) in average daily gain (ADG), average daily feed intake (ADFI) and feed conversion ratio (FCR) among dietary treatments during the whole experimental period (0 to 4 weeks). Apparent digestibility of gross energy was greater in LP+NTPS and LPEL+ENZ groups than in the LEL+ENP (p<0.05). Apparent digestibility of phosphorus was greater in LP+NTPS than in LEL+ENP (p<0.05). Dry matter excretion was lowest in LPEL+ENZ and phosphorus excretion was lowest in LP+NTPS (p<0.05). Overall, pigs fed on LPEL+ENZ group tended to have better nutrient digestibility (dry matter, gross energy, crude protein and phosphorus) than pigs fed on control group. All dietary enzyme treatment groups showed lower feed cost/body weight gain of pigs than control group. In conclusion, the results from the present study suggest that the simultaneous inclusion of phytase and carbohydrase enzyme complex to diets is advantageous with respect to reducing nutrient excretion of growing pigs and may contribute to increased economic return when added to corn-soy based growing pig diets.

• Health Policy and Management
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• v.15 no.1
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• pp.97-117
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• 2005

This study was designed to compare the differences m results of supervisor and subordinate rating. Data was collected from personnel evaluation and subordinate rating results for middle managers(n=68) in hospital from 3rd January to 20th March in 2004. Supervisor rating consisted of performance, ability and attitude evaluation. Subordinate rating consisted of leadership, ability and attitude evaluation. Collected data included sociodemographic characteristics, work department, work level, years of work, years at present level and whether working in a patient serving department. The difference of standardized supervisor and subordinate rating score was used to define groups as 'higher in supervisor rating group'. Groups were defined in total score, ability score and attitude score. Main results were as follows: 1. In total score, sectional chiefs were apt to be 'higher in subordinate rating group' while chief clerks were apt to be 'similar group' or 'higher in supervisor rating group'. Staffs in patient serving department were likely to be 'higher in supervisor rating group' and staffs in non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 2. In ability score, there were no statistically significant differences in age, sex, years of education, work department, work level, years of work and whether working in a patient serving department among 'higher in supervisor rating group', 'similar group' and 'higher in subordinate rating group'. 3. In attitude score, staffs in the department of medical affairs and the department of administration were apt to be 'higher in subordinate rating group'. Staffs in the department of nursing were apt to be 'higher in supervisor rating group'. Staffs in a patient serving department were likely to be 'higher in supervisor rating group' and staffs in a non-patient serving department were likely to be 'higher in subordinate rating group'. All these results were statistically significant. 4. Logistic analysis about total score showed that sectional chiefs had higher Odds Ratio(OR) to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. Both these results were statistically significant. 5. Logistic analysis about ability score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group'. Staffs in a non-patient serving department had higher OR to be in 'higher in subordinate rating group'. These results were not statistically significant. 6. Logistic analysis about total score showed that sectional chiefs had higher OR to be in 'higher in subordinate rating group', but the difference was not statistically significant. Staffs in a non-patient serving department had significantly higher OR to be in 'higher in subordinate rating group'. In conclusion, there is no clear superiority between supervisor and subordinate rating in personnel evaluation. It would be better to use a mixed model. It's also suggested to use an intervening rate of application or scores considering work levels and work department in personnel evaluation. These results would be helpful for hospitals planning a supervisor and subordinate rating system for personnel evaluation.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.723-730
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• 2005

Purpose : This study was performed to characterize the etiology and clinical features of acute viral lower-respiratory tract infections(LRI). Methods : Etiologic agents and clinical features of acute viral LRI were studied from October. 2003 through March. 2004 in hospitalized children with LRI(253 cases) at Samsung Cheil Hospital. The viruses were identified by indirect immunofluorescent method. Medical records of patients with proven viral LRI were reviewed retrospectively. Results : Ninety two cases(36.4%) were confirmed as viral infections. The identified pathogens were respiratory syncytial virus(RSV, 76.0%), adenovirus(ADV, 12.0%), influenza virus type A(INFA, 9.8 %), influenza virus type B(INFB, 1.1%) and parainfluenza virus(PIV, 1.1%). Eight four point eight% of patients were younger than 2 years of age. Clinical diagnosis of LRI were pneumonia(56.5%), bronchiolitis(35.9%), tracheobronchitis(4.3%) and croup(3.3%). The clinical symptoms and signs were cough(98.8%), rhinorrhea(82.6%), fever(70.7%), rale(67.4%), wheezing(29.3%), chest retraction(28.3%) and cyanosis(4.3%). The severe respiratory symptoms and signs were more common in RSV-infected patients, even cyanosis could be observed. Seventeen point four percent of patient had fever of $38.5^{\circ}C$ or higher and their most common etiologic agent was INFA(66.7%). Twenty three point nine percent had fever more than 5 days and common etiologic agent was INFA(77.8%). The elevated WBC count($>14{\times}10^3/{\mu}L$) was in 14.1%, and common etiologic agents were INFA(22.2%) and ADV(18.2%). C-reactive protein(CRP >4.0 mg/dL) was increased in 13.0%, and common in ADV(63.6 %). Increased aspartate aminotransferase(AST)/alanine aminotransferase(ALT) was detected in 10.9%, and the most common etiologic agent was RSV(12.9%). Conclusion : The common agents of acute viral LRI were RSV, ADV and INF, respectively. Because the etiologic agents present variable clinical features, it may be helpful to treat and to evaluate acute viral LRI that we should understand their etiologic variability.