• Journal of Chest Surgery
• /
• v.43 no.1
• /
• pp.20-24
• /
• 2010

Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.

• Korean Journal of Veterinary Research
• /
• v.2 no.1
• /
• pp.1-13
• /
• 1962

10두(頭)의 홀스타인 자우(仔牛)에 glucagon, insulin 등 홀몬과 reserpine 및 nicotine을 투여(投與)하여 그들이 췌장(膵臟)의 Langerhans 도서(島嶼)에 미치는 세포학적(細胞學的) 영향을 전자현미경(電子顯微鏡)에 의해서 연구하는 도중 거대(巨大)한 크기의 도서(島嶼)를 관찰하였다. 이 거대도서(巨大島嶼)들은 상기(上記)한 약품투여에 영향을 받지 않으며 거의 beta 세포(細胞)들로만 되어 있으므로 보통 크기의 도서(島嶼)들과의 혼동을 피하기 위하여서는 그 분포상태(分布狀態)와 세포학적(細胞學的) 및 조직학적(組織學的) 특징(特徵)을 구명(究明)하는 것이 필요하게 되어 본연구(本硏究)에 착수하였든 것이며 아울러 췌장(膵臟) 각부분(各部分)에 함유되는 Langerhans 도서수(島嶼數)의 평균치(平均値)를 산출(算出)하였다. Langerhans 도서(島嶼)는 편의상 그 크기에 따라서 직경(直徑) $200{\mu}$이하(以下)의 것을 "Regular islets" $200{\sim}500{\mu}$까지의 것을 "Intermediate islets" 그리고 $500{\mu}$ 이상(以上)의 것을 "Giant islets"라 이름지어서 구별하였다. 지금까지 알려진 최대(最大)의 도서(島嶼)는 개에서 관찰된 $333{\mu}$의 도서(島嶼)이었는데 필자는 본연구(本硏究)에서 직경 $1.395{\mu}$에 달하는 것과 기리 $2,700{\mu}$에 달하는 거대(巨大)한 도서(島嶼)들을 관찰하였다. 본연구(本硏究)의 결과(結果)를 요약(要約)하면 다음과 같다. 1. 자우췌장(仔牛膵腸) 50평방(平方)mm 면적(面積)내에 함유되는 Langerhans 도서(島嶼)의 수(數)는 평균(平均) 191개로서 다른 연구자에 의해서 보고된 수치(數値)보다 훨씬 많은 것이었다. 2. 거대도서(巨大島嶼)의 크기는 직경(直徑) $200{\sim}1,400{\mu}$이며 그 분포상태(分布狀態)는 보통 크기의 도서(島嶼)와 마찬가지로 췌장(膵臟)의 십이지장부(十二指腸部) 중간부(中間部) 및 췌장부(膵臟部)의 순서(順序)로 많이 함유되고 있다. 즉 십이지장부(十二指腸部)에는 2% 중간부(中間部) 1.8% 췌장부(膵臟部)에는 0.8%의 거대도서(巨大島嶼)가 함유되어 있으며 직경(直徑) $200{\mu}$이상(以上)의 도서평균치(島嶼平均値)는 1.53%이었다. 3. 중간대(中間大)의 도서(島嶼)와 거대도서(巨大島嶼)들은 거의 beta 세포(細胞)들로서만 되어있음으로 "중간대(中間大) beta 도서(島嶼)" 및 "거대(巨大) beta 도서(島嶼)"라고 각 각 명명하였으며 alpha세포(細胞)들이 있는 경우에는 작은 세포집합체(細胞集合體)를 이루고 도서전반(島嶼全般)에 걸쳐서 산재(散在)한다. 4. 췌장(膵臟)에 함유되고 있는 거대(巨大) beta 도서(島嶼)의 수(數)는 적지마는 보통 크기의 도서(島嶼)와 비교할때 그 용량(容量)은 막대한 것이며 따라서 insulin 분비량(分泌量)도 많을것이므로 우췌장(牛膵臟)의 insulin 분비(分泌)를 연구할 때에는 반듯이 이 사실(事實)을 고려해야 할 것이다. 5. 불규칙한 색상(索狀)의 실질세포(實質細胞)들로된 거대(巨大) beta 도서(島嶼)에는 간질결합조직(間質結合組織)이 풍부하며 그 간질(間質) 속에는 비교적 큰 혈관(血管)과 개재관양(介在管樣) 구조물(構造物)이 들어있다. 거대(巨大) beta 도서(島嶼)는 출생(出生)후 도서내외(島嶼內外)에 산재(散在)하고 있는 외분비도관세포(外分泌導管細胞)들의 증식(增殖)에 의해서 발생(發生)하며 그 크기도 증대(增大)하는 것으로 믿어진다. 6. 거대(巨大) beta 도서(島嶼)의 beta 세포(細胞)들은 현저한 Golgi 장치(裝置)와 비대(肥大)한 핵소체(核小體) 및 포상핵(胞狀核)등의 세포학적(細胞學的) 특징을 가지며 이것은 거대(巨大) beta 도서(島嶼)가 보통 크기의 Langerhans 도서(島嶼)에 비하여 더 활발하게 insulin을 분비(分泌)한다는 것을 시사(示唆)하는 것이다.

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.2
• /
• pp.177-185
• /
• 1994

Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent coronary vasodilator with rapid onset of action, short half-life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed $^{99m}Tc$-MIBI imaging after intravenous Infusion of adenosine In 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during $^{99m}Tc$-MIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused Intravenously at a dose of 0.14mg/kg per minute lot 6minutes and $^{99m}Tc$-MIBI was injected at 3 minute. We then com-pared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased $90{\pm}19$ beats/minute in the group with ST depression compared with $80{\pm}16$ beats/minute in the group without ST depression(p<0.05). Baseline systolic blood pressure was significantly higher in the group with ST depression($152{\pm}27$ mmHg) than in the group without 57 depression($140{\pm}21$mmHg, p<0.05). Double product at baseline($10.90{\pm}2.77$ versus $9.55{\pm}2.34\;beats/minute{\times}mmHg$) and during adenosine infusion($12.72{\pm}3.89$ versus $10.83{\pm}2.98\;beats/minute{\times}mmHg$) were significantly higher in the group with ST depression(p<0.05). The incidence of anginal chest pain was also significantly higher in the group with ST depression(ST versus 29%, p<0.0001). The $^{99m}Tc$-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p<0.05). In patients with ST segment depression, there were more reversible perfusion defects than in patients without ST segment depression(83 versus 55%, p<0.05). The number of abnormal segments were significantly higher in the group with ST depression($3.05{\pm}2.01$ versus $1.51{\pm}1.45$, p<0.005). In patients with ST segment depression, there were more segments of reversible perfusion defects than in patients without segment depression($2.15{\pm}2.11$ versus $0.89{\pm}1.24$, p<0.05). There were no differences in the angiographic severity by vessel(p ; NS). We concluded that ST segment depression during $^{99m}Tc$-MIBI myocardial perfusion scintigraphy with Intravenous adenosine is related to the severity of coronary artery disease.

• Korean Journal of Agricultural and Forest Meteorology
• /
• v.6 no.1
• /
• pp.38-48
• /
• 2004

Tropospheric ozone data in Korea for 1998-2002 were analyzed to assess the impact on vegetation. SUM06(sum of hourly concentrations at or above 0.06 ppm) and AOT40(accumulated exposure over a threshold of 40 ppb), widely used as ozone indices in the U.S. and Europe, were calculated based on hourly ozone concentration in 612 areas during 1998-2002 in Korea. SUM06 of the highest 30 areas were 5-12 ppm/hr which were almost the same levels of the U.S. average, and a crop loss of 5% would be expected. Ozone pollution in Seoul during 1998-2002 had decreased compared to that for 1990-97 except in the Northern area; however, ozone pollution in Kyunggi during 1998-2002 had been increased twice compare to the previous 5 years. Korea was divided into four regions: Seoul Metropolitan area, Jungbu, Honam, and Youngnam. Ozone pollution in the Seoul Metropolitan area was much higher during 1998-2000 than the other areas, but ozone pollution during 2001-2002 was almost the same in all four regions. Chunnam-Kwangyang na Kyungbuk-Gumi, famous industrial complexes in southern Korea, were significant ozone pollution areas. However, other industrial complexes, such as Incheon, Ulsan, and Kyunggi-Sihwa, were not polluted compared to their neighbors. Comparing all ozone indices, SUM06(yr), SUM06(3mon), AOT40(yr), AOT40(3mon), number of hours exceeding 100 ppb, 95 percentile, 99 percentile, and maximum concentration, it was determined reasonable to use SUM06(3mon), AOT40(3mon) and number of hours exceeding 100 ppb for evaluation of the chronic impact of ozone on vegetation.

• Journal of Sericultural and Entomological Science
• /
• v.8
• /
• pp.41-50
• /
• 1968

In order to achieve efficiency of laying eggs of silkworms, it is very important to eliminate noncocooning silkworms. This study is written on the basis of observation and analysis of mechanism of silkworms physiologically and anatomically. It is hoped that given herein will contribute to the effecting elimination work. Outline of the study summarize as follows: 1. It is observed through microscope that the silkworms which are seen normal state in the silk gland but no ability of cocoon making have polyhedrosis in the nerve, trachea and muscle near the tissue of the spinneret. 2. Relatively high proportion of non-cocooning silkworms are caused by the grasserie of the silkworms. 3. As a result of inoculation with purulent discharges against silkworms from first fooding through 8th day of 5th instar, number of cocooning silkworms were increased when inoculation are applied at laterer day of the instar. In the case of non-cocooning silkworms, meanwhile, resulted not big varriation when it is apllied in the early and middle of the period, but number of non-cocooning silkworm was reduced when the inoculation are given at laterer of the instar. Number of death during rearing and mounting are increased when earliest application of inoculation are carried out. 4. Symptom of grasserie was appeared more or less three days after application of the inoculation. Some silkworms which were inoculated just before mounting has ability of cocooning making even taken grasserie, in this case the silkworm can make thin cocoon. since the silkworm fall sick during cocoon making and unable of spinning soon. when the worm was affected by grasserie slightly, it was observed that the silkworm can spinning. It is supposed to be the light paralysis of spinneret is not very much influenced to spinning. 5. As a result of observation of original stock and hybrid including other 44 kinds of silkworm, many non-cocooning silkworms were found in the original stock especially originated from japanese than in hybrid. 6. A number of undulations are found in the middle division of the silk gland of non-cocooning silkworms. 7. According to the observation of the sizes of the body and digestive organs, normal natured silkworms and non-cocooning silkworms are more or less same in length, but the width, circumference of bodies and digestive organs were more larger in the later. If silkworm which was in the period of active eating of 5th instar was given shock of dropping to the floor, the silkworm receives little more shock when hit to side of the body than to head, and concrete floor than ondol and wooden floor.

• Radiation Oncology Journal
• /
• v.13 no.4
• /
• pp.321-330
• /
• 1995

Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients were managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A : minimal 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using Co-60 teletherapy machine. A total of 10Gy(2Gy/fr. x 5days) was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due to multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients($86{\%}$) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who were received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary change. One patient who refused RT after 2Gy died due to pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggresive supportive treatment appears to decrease Pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.

• Journal of Chest Surgery
• /
• v.39 no.11 s.268
• /
• pp.815-821
• /
• 2006

Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.4
• /
• pp.294-300
• /
• 2009

Purpose: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. Materials and Methods: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. Results: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P = 0.03, the THW group; P = 0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0$\leq$5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. Conclusion: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.

• Journal of Chest Surgery
• /
• v.40 no.3 s.272
• /
• pp.209-214
• /
• 2007

Background: Failed percutaneous transluminal coronary angioplasty (PTCA) is occasionally required for emergency coronary artery bypass grafting (CABG). The aim of this study was to assess the outcome of patients receiving emergency CABG after failed PTCA. Material and Method: Between May 1988 and May 2005, 5712 patients underwent PTCA, where 84 (1.4%) failed. 27 patients underwent emergency CABG after failed PTCA. The mean age was $63.7{\pm}8.9\;(46{\sim}80)$ years, with 14 male patients (51.9%). Result: All patients underwent emergent surgical revascularization within 6 hours. 22 patients underwent conventional CABG and 5 underwent off-pump CABG. The causes of PTCA failure were coronary obstruction due to new thrombi formation during the procedure (n=4), coronary dissection (n=17), coronary artery rupture (n=3) and 3 due to other causes. The rate of in-hospital operative mortality after emergent operation was 18.5% (5/27). A univariate analysis revealed that patients who died more often had left anterior descending artery disease, a preprocedural shock status, postoperative use of multiple isotropics and postoperative use of intra-aortic balloon pump. The mean follow up duration was $53.6{\pm}63.4$ months. Conclusion: Although PTCA is known to be life saving, there is still a high risk for morbidity and mortality following emergency CABG after failed PTCA, despite the advancement in PTCA techniques. This result will help identify and more effectively treat patients selected for PTCA when emergency CABG is required.

• Korean Journal of Head & Neck Oncology
• /
• v.14 no.2
• /
• pp.182-190
• /
• 1998

Background: Most of the cancers of maxillary sinus are the squamous variety, but various histopathologic types of malignant tumor can occur in the maxillary sinus. These non-squamous cell tumors have quite different patterns of clinical behavior compared with squamous variety, such as invasive characters, route of metastasis, treatment modality, and so on. Objectives: The authors intend to establish the clinical characteristics and treatment modalities of non-squamous cell tumors of the maxillary sinus. Material and Methods: We experienced 16 cases of non-squamous cell tumors arisen from the maxillary sinus during the 10-year period from 1987 to 1996. We analyzed their clinical features, therapeutic modalities and results with review of literatures. Results: According to AJCC TNM system, 13 patients presented with $T_{1-2}$, 3 with $T_{3-}4$, Two patients were treated with surgery after radiotherapy, 3 patients with surgery after chemotherapy and radiotherapy, 4 patients with chemotherapy and radiotherpy, 5 patients with chemotherapy and radiotherapy after surgery. Conclusion: In cases of adenoid cystic carcinoma, adenocarcinoma and sarcoma, we believe that the best form of therapy is wide surgical excision. If there is microscopic evidence of disease at or close to the resection margin, postoperative radiation was used to achieve better local control. In cases of undifferentiated carcinoma, preoperative chemotherapy and radiation therapy showed improved outcomes.