• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.67-76
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• 2021

Objectives : The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). Independent t-test was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions. Results : The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001). Conclusions : ADLs of AD and MCI patients had significant association with MTA. Our study, which identifies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is needed to confirm the association between certain brain structures and ADLs.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.359-365
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• 2006

Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.496-500
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• 2005

There was no difference between the bileaflet mechanical valves on the midterm and longterm clinical outcome. We reviewed the hemodynamic comparison between recently available mechanical valves by Doppler Echocardiography. Material and Method: We retrospectively reviewed 396 postoperative hemodynamic datas (EOA, MDPG, and MSPG) by doppler echocardiography in 345 patients. Mechanical valves from 5 venders (Sorin Bicarbon, SJM, ATS, On-X, and Edward MIRA) were compared. There were 232 valves in mitral position, 162 in aortic, and 2 in tricuspid. Result: There were 178 men (mean age; $50.6\pm13.9$ years old) and 167 women $(52.6\pm,4.6)$. MDPG/EOA of 27 mm in mitral position was Sorin; $4.2\pm1.5 mmHg/3.0\pm0.9cm^2,\;SJM;\;2.3\pm1.2/3.5\pm0.6$. In 29mm, Sorin, SJM, ATS, On-X, MIRA revealed $3.4\pm1.2/3.1\pm0.6,\;3.3\pm1.1/2.7\pm0.4,\;3.8\pm0.8/3.2\pm0.6,\;4.0\pm3.0/3.1\pm0.9,\;2.9\pm0.9/3.0\pm0.8$ In 31mm, Sorin, SJM, ATS, MIRA revealed $3.9\pm1.9/2.9\pm0.6,\;3.5\pm1.2/3.0\pm0.6,\;3.4\pm0.8/2.8\pm0.2,\;3.7\pm1.5/2.7\pm0.7$. In 33mm, Sorin, SJM, MIRA revealed $4.4\pm0.9/2.5\pm0.4,\;3.4\pm1.5/3.3\pm0.5,\;4.7\pm2.4\3.0\pm0.3$. MSPG/EOA of 19mm aortic position was Sorin, SJM, ATS, On-X, MIRA $18.0 mmHg/1.2cm^2,\;25.6\pm8.7/1.1\pm0.3,\;25.9\pm12.6/1.2\pm0.3,\;23.0/1.3,\;27.9\pm7.1/1.2\pm0.1$ in that order. In 21mm, SJM, ATS, On-X, MIRA revealed $18.3\pm6.7/1.5\pm0.5,\;13.7\pm2.1/1.7\pm0.3,\;17.0/1.4,\;17.1\pm5.5/1.8\pm0.5$. In 23mm Sorin, SJM, ATS, On-X, MIRA revealed $14.0\pm4.6/1.7\pm0.6,\;12.8\pm3.2/2.0\pm0.2,\;16.8\pm12.2/2.1\pm0.9,\;14.0/1.5,\;15.0\pm5.5/1,8\pm0.5$. In 25mm, SJM and MIRA revealed $14.0\pm5.1/1.8\pm1.0,\;11.0/2.3$. There was no statistically significant difference in these values between the venders given the same position and size. 2 redo valve replacements were performed, 1 due to severe hemolysis in ATS and 1 due to leaflet immobilization in SJM. Conclusion: Postoperative hemodynamic comparison by doppler echocardiography shows no statistically significant difference between recently available mechanical valves in this country.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.10-18
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• 2009

Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.233-238
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• 2006

Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

• Restorative Dentistry and Endodontics
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• v.33 no.1
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• pp.54-65
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• 2008

The purpose of this study was to determine the effect of sodium hypochlorite and steam autoclaving on the cyclic fatigue of nickel-titanium endodontic files. Two types of files with a .06 taper and #30 were used, $K3^{(R)}$ (SybronEndo, Glendora, California, USA) and Hero $642^{(R)}$(Micro-Mega, BesanCon, France). The files were divided into 6 experimental groups containing 10 files each group depending the soaking time in 6% sodium hypochlorite solution and number of cycles of steam autoclave. After sterilization, a cyclic fatigue test was performed on each file, and the fracture time was recorded in seconds. The control group underwent the cyclic fatigue test only. After the test, the surface characteristics of the files were observed using scanning electron microscopy (SEM). All groups containing the Hero 64~ files showed a similar cyclic fatigue fracture time. However, the cyclic fatigue fracture time with the $K3^{(R)}$ files was significantly shorter in groups which were treated with sodium hypochlorite than in the control group (P < 0.05), SEM revealed both Hero $642^{(R)}$ and $K3^{(R)}$ files to have significant corrosion on the file surface in groups treated with sodium hypochlorite, compared with the sharp and regular blades of the control group. $K3^{(R)}$ files showed more corrosion than the Hero $642^{(R)}$ files. Bluntness of the blades of the $K3^{(R)}$ file was observed in groups treated with steam autoclave. Although there was no obvious destruction on the surface of steam autoclaved Hero $642^{(R)}$ files, slight bluntness was observed. Sterilizing with a steam autoclave is much less destructive to $K3^{(R)}$ files than sodium hypochlorite. The longer time exposed to sodium hypochlorite, the more destructive pattern was shown on the blades of the files. Therefore, when using sodium hypochlorite solution, the exposure time should be as short as possible in order to prevent corrosion and increase the cyclic fatigue fracture time.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.142-149
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• 2003

To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.

• Geophysics and Geophysical Exploration
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• v.14 no.1
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• pp.80-87
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• 2011

Autonomous underwater vehicles (AUVs) present the important advantage of being able to approach the seafloor more closely than surface vessel surveys can. To collect bathymetric data, bottom material information, and sub-surface images, multibeam echosounder, sidescan sonar (SSS) and subbottom profiler (SBP) equipment mounted on an AUV are powerful tools. The 3000m class AUV URASHIMA was developed by the Japan Agency for Marine-Earth Science and Technology (JAMSTEC). After finishing the engineering development and examination phase of a fuel-cell system used for the vehicle's power supply system, a renovated lithium-ion battery power system was installed in URASHIMA. The AUV was redeployed from its prior engineering tasks to scientific use. Various scientific instruments were loaded on the vehicle, and experimental dives for science-oriented missions conducted from 2006. During the experimental cruise of 2007, high-resolution acoustic images were obtained by SSS and SBP on the URASHIMA around the northern Kumano Basin off Japan's Kii Peninsula. The map of backscatter intensity data revealed many debris objects, and SBP images revealed the subsurface structure around the north-eastern end of our study area. These features suggest a structure related to the formation of the latest submarine fan. However, a strong reflection layer exists below ~20 ms below the seafloor in the south-western area, which we interpret as a denudation feature, now covered with younger surface sediments. We continue to improve the vehicle's performance, and expect that many fruitful results will be obtained using URASHIMA.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.5 no.4
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• pp.320-334
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• 2000

Deep-sea surface sediment were analyzed for their geotechnical properties, and the sediment samples were collected with a multiple-corer from 31 stations along the track line (131$^{\circ}$30'W, 5-12$^{\circ}$N) in the northeast equatorial Paciflc. Most of the sediments from the northern part (8-12$^{\circ}$N) showed typical properties of siliceous sediments, whereas the southern part (5-6$^{\circ}$N) showed calcareous characteristics due to high biogenic carbonate productivity in the surface waters, where its water depth was shallower than the carbonate compensation depth (CCD: 4,400 m). Geotechnical properties changed sharply at the boundary of 7$^{\circ}$N. Calcareous sediments from the southern part had low water contents, low porosity, low shear strength, high bulk density and high specific grain density, whereas siliceous sediments from the northern part attained high water content, high porosity, high shear strength, low bulk density and low specific grain density. Higher sediment activities were observed in the northern sediment samples than the southern sediment samples. The core samples of the northern sediments were divided into a semi-liquid upper layer and a consolidated lower layer with a boundary at 5-8 cm. These sediment samples showed a rapid increasing pattern along the downcore in original shear strength when an opposite trend was observed in the southern samples. The results showed that sediment variabilities in geotechnical properties between the northern and southern parts such as productivities of surface water, grain solubility due to water depth variation, sedimentation rate, erosion and redistribution of sediment, and combined sedimentary processes were distinctly different along the latitude.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.79-84
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• 2010

Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.