• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.498-504
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• 2002

Purpose : The purpose of this study was to evaluate the perioperative myocardial damage in pediatric congenital heart disease with the cardiac specific protein of cardiac troponin I(cTpn-I). Methods : All 25 pediatric patients who were diagnosed with tetralogy of Fallot or double outlet right ventricle were classified as group A(acyanotic, $SaO_2$ >90%), group B(mildly cyanotic, $SaO_2$ >80-90%) and group C(moderately cyanotic, $SaO_2$ <80%). The control group D was consisted of 10 patients with ventricular septal defects who were operated in the same period. We measured preoperative hemoglobin, preoperative and postoperative(24 and 72 hour) arterial oxygen saturation, cTpn-I and creatine kinase(CK-MB). Results : Total 25 patients were subdivided into 6 of group A, 12 of group B and 7 of group C. The concentrations of preoperative cTpn-I were $0.23{\pm}0.12ng/mL$ in group A, $0.25{\pm}00.12 ng/mL$ in group B, $0.26{\pm}0.13ng/mL$ in group C. And the concentrations of cTpn-I in postoperative 24 hour were $10.04{\pm}5.28ng/mL$ in group A, $12.50{\pm}6.86ng/mL$ in group B, $12.55{\pm}9.90ng/mL$ in group C. Which revealed cTpn-I in group C was higher than that of the another less cyanotic groups. In addition, the concentration of cTpn-I of group C in postoperative 72 hour was higher than any other groups. The concentration of cTpn-I in postoperative 72 hour was statistically correlated with that in postoperative 24 hour and preoperative arterial oxygen saturation(P=0.001). Conclusion : Preoperative chronic cyanosis can influence on the postoperative concentration of cTpn-I in pediatric cardiac patients, which means impairment on the postoperative myocardial recovery.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.703-709
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• 2008

Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

• Journal of Acupuncture Research
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• v.29 no.1
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• pp.139-150
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• 2012

Objectives : The puropse of this study was to report the availability of Hyeongsang diagnosis compensating for visceral pattern identification in applying Sa-am acupuncture therapy. Methods : Eight cases was presented to substantiate the above. Results : According to the characteristic diagnostic method of Hyeongsang medicine by feature such as face, ears, eyes, nose and mouth shape, There are 8 pattern differentiations, including essence family, Qi family, spirit family, blood family, fish type, bird type, beast(running) type and crust(crustacea) type which are correlated with essence deficiency, heat harassing the heart spirit, Qi stagnation, blood stasis, kidney essence deficiency, intense heart fire, liver blood deficiency and lung Qi deficiency in the established visceral pattern identification, respectively. Eight patients was diagnosed by the above Hyeongsang 8 pattern differentiations, of whom Sinjeonggyeok(kidney reinforcing prescription) was applied to a patient with fish type and essence family to nourish kidney essence, and Giul prescription(Qi stagnation prescription) was given to a patient with Qi family for regulating Qi, and Sanghwa priscription(ministerial fire prescription) was delivered to a patient with Spirit family to clear the heart fire and tranquilize, and Sojangjeonggyeok(small intestine reinforcing prescription) was used for a patient with blood family to nourish blood and remove blood stasis, and Sinjeonggyeok(kidney reinforcing prescription), Simhangyeok(heart heat clearing prescription), Ganjeonggyeok(liver reinforcing prescription) and Pyejeonggyeok(lung reinforcing prescription) were utilized for fish type, bird type, beast(running) type and crust(crustacea) type respectively to reinforce the relevant visceral function. Conclusions : It was suggested that characteristic diagnostic method of Hyeongsang medicine should be helpful for enhancing the accuracy of the established visceral pattern identification, applying Sa-am acupuncture therapy more appropriately.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.207-218
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• 2002

Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.720-732
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• 1995

The use of transforming growth $factor-{\beta}1$ which functions as a potent biologic mediator regulating numerous activities of wound healing has been suggested for the promotion of periodontal regeneration. The mitogenic effects of transforming growth $factor-{\beta}1$ on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of $[^3H]-thymidine$ into DNA of the cells dose-dependently. Cells were prepared with primary cultured fibroblasts and periodontal ligament cells from humans, and used in experiments were the fourth or sixth subpassage. Cells were seeded with serum free Dulbecco's modified Eagle medium containing 0.1% bovine serum albumine. The added concentrations of transforming growth $factor-{\beta}1$ were 0.25, 0.5, 1, 2.5, 5ng/ml and transforming growth $factor-{\beta}1$ were added to the quiescent cells for 24hours, 48hours, 72hours. They were labeled with lnCi/ml $[^3H]$ thymidine for the last 24hour of the each culture. The results were presented as the mean counts per minute (CPM) per well and S.D. of four determinations. The results were as follows. : The DNA synthetic activity of human gingival fibroblasts was increased dose-dependently by transforming growth $factor-{\beta}1$ at 24 hours, 48 hours and 72 hours. The maximum mitogenic effects were at the 48 hour application of transforming growth $factor-{\beta}1$. The DNA synthetic activity was generally more decreased at the 72 hour application than at the 48 hour the application of transforming growth $factor-{\beta}1$. The DNA synthetic activity of human periodontal ligament cells was increased dose-dependently by transforming growth $factor-{\beta}1$ at 24 hours and 48 hours. But the DNA synthetic activity was decreased at 5ng/ml of the 72 hour application. The maximum mitogenic effects were also at the 48 hour application of transforming growth $factor-{\beta}1$. The DNA synthetic activity of human periodontal ligament cells was generally more decreased at the 72 hour application than at the 48 hour application of transforming growth $factor-{\beta}1$. In the comparision of DNA synthetic activity between the human gingival fibroblasts and human periodontal ligament cells, the human gingival fibroblasts had more activity than the human periodontal ligament cells at all time application with the concentration of transforming growth $factor-{\beta}1$. In conclusion, transforming growth $factor-{\beta}1$ has an important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, which means an increase in collagen synthesizing cells and thus, may be useful for clinical application in periodontal regenerative procedures.

• Journal of Bio-Environment Control
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• v.26 no.4
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• pp.393-401
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• 2017

The nitrate ($NO_3{^-}$) accumulation of hydroponically grown leafy vegetables may increase in the condition of a closed-type plant production system with low light intensity due to low activity of enzymes involved in nitrogen assimilation and the use of $NO_3-N$ as major nitrogen source. The objective of this study is to investigate the effects of light intensities, nutrient solution compositions and the time of nutrient solution removal before harvest on nitrate contents of hydroponically-grown lettuces in a closed plant production system. The reduction of nitrate contents in leafy lettuces 'Cheongchima' was higher in the treatments of 'TW' (nutrient solution removal) and '$(NH_4)_2CO_3$' (use of ammonium carbonate as nitrogen source) than those in other treatments, which significantly lowered fresh weight and leaf area of the plants. In the light intensity of $100{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$, the nitrate content was effectively reduced without causing any growth retardation, by substitution of the nutrient solution composition that $NO_3-N$ was removed ('$NO_3-N$ removal' treatment) or the half strength of standard nutrient solution was applied ('1/2 S' treatment), for 7days before harvest. The effects of light intensity and the time of nutrient solution removal before harvest on growth and nitrate contents in leafy lettuces were investigated. The nitrate contents in leaves under the light condition of $300{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ before nutrient solution removal were lower than those of 100 or $200{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$. The removal of nutrient solution for 7 days before harvest quickly reduced the amount of nitrates in leaves in all the light intensities with a greater degree under the $300{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ of light condition, while the 7 days-removal with both 200 and $300{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ of light conditions caused decrease in 16~31% of leaf area and 20~35% of fresh weight, compared to the 3 days-removal treatment. The nitrate contents were greatly reduced from 3,018 to 1,035 in $200{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$, and 2,021 to 480 ppm in the light condition of $300{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$, with the nutrient solution removal for 3 days before harvest, without causing any deterioration in growth and product quality. The vitamin C contents in leaves were higher in the treatment of nutrient solution removal for both 3 and 5 days before harvest with the light condition of $300{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ than those in the light condition of 100 or $200{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.20-25
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• 2006

Purpose : To evaluate the NMR relaxation properties of newly developed high performance paramagnetic complexes. Materials and methods : 4-aminomethylcyclohexane carboxylic acid (0.63g, 4 mmol) was mixed with the suspension solution of DMF (15mL) and DTPA-bis-anhydride (0.71g, 2 mmol) to synthesize the ligand. The ligand was then mixed with Gd2O3 (0.18g, 0.5 mmol) to synthesize Gd-chelate. For the measurement of magnetic relaxivity of paramagnetic compounds, the compounds were diluted to 1mM and then the relaxation times were measured at 1.5T(64 MHz). Inversion-recovery pulse sequence was employed for T1 relaxation measurement and CPMG(Carr-Purcell-Meiboon-Gill) pulse sequence was employed for T2 relaxation measurement. Using MATLAB(Version 7.1) program, T1 magnetic relaxation map, R1 map, T2 magnetic relaxation map and R2 map were developed to represent magnetic relaxation time and magnetic relaxivity as image. Results : Compared to $R1=4.9mM^{-1}sec^{-1}$ and $R2=4.8mM^{-1}sec^{-1}$ of Omniscan (Gadodiamide), which is commercially available paramagnetic MR agent, R1 of SUK090(Gd-C32H74N5O24) was $12.46mM^{-1}sec^{-1}$ and R1 of SUK091(Gd-C34H78N5O24) was $12.77mM^{-1}sec^{-1}$. However, R1 of SUK092(Gd-C30H56N5O17) was decreased to $2.09mM^{-1}sec^{-1}$. In case of R2, SUK090(Gd-C32H74N5O24) was $8.76mM^{-1}sec^{-1}$ and SUK091(Gd-C34H78N5O24) was $7.60mM^{-}1sec^{-1}$ whereas SUK092(Gd-C30H56N5O17) was decreased to $1.82mM^{-1}sec^{-1}$. Conclusion : Among three new paramagnetic complexes, SUK090(Gd-C32H74N5O24) and SUK091(Gd-C34H78N5O24) showed higher T1, T2 magnetic relaxation rates than that of commercially available paramagnetic MR agent and thus expected to have more contrast enhancement effect.

• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.83-93
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• 2003

Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

• The Korean Journal of Nuclear Medicine
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• v.38 no.3
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• pp.259-267
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• 2004

Purpose: NEMA NU2-2001 was proposed as a new standard for performance evaluation of whole body PET scanners. in this study, system performance of Siemens CTI ECAT EXACT 47 PET scanner including spatial resolution, sensitivity, scatter fraction, and count rate performance in 2D and 3D mode was evaluated using this new standard method. Methods: ECAT EXACT 47 is a BGO crystal based PET scanner and covers an axial field of view (FOV) of 16.2 cm. Retractable septa allow 2D and 3D data acquisition. All the PET data were acquired according to the NEMA NU2-2001 protocols (coincidence window: 12 ns, energy window: $250{\sim}650$ keV). For the spatial resolution measurement, F-18 point source was placed at the center of the axial FOV((a) x=0, and y=1, (b)x=0, and y=10, (c)x=70, and y=0cm) and a position one fourth of the axial FOV from the center ((a) x=0, and y=1, (b)x=0, and y=10, (c)x=10, and y=0cm). In this case, x and y are transaxial horizontal and vertical, and z is the scanner's axial direction. Images were reconstructed using FBP with ramp filter without any post processing. To measure the system sensitivity, NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves were scanned at the center of transaxial FOV and 10 cm offset from the center. Attenuation free values of sensitivity wire estimated by extrapolating data to the zero wall thickness. NEMA scatter phantom with length of 70 cm was filled with F-18 or C-11solution (2D: 2,900 MBq, 3D: 407 MBq), and coincidence count rates wire measured for 7 half-lives to obtain noise equivalent count rate (MECR) and scatter fraction. We confirmed that dead time loss of the last flame were below 1%. Scatter fraction was estimated by averaging the true to background (staffer+random) ratios of last 3 frames in which the fractions of random rate art negligibly small. Results: Axial and transverse resolutions at 1cm offset from the center were 0.62 and 0.66 cm (FBP in 2D and 3D), and 0.67 and 0.69 cm (FBP in 2D and 3D). Axial, transverse radial, and transverse tangential resolutions at 10cm offset from the center were 0.72 and 0.68 cm (FBP in 2D and 3D), 0.63 and 0.66 cm (FBP in 2D and 3D), and 0.72 and 0.66 cm (FBP in 2D and 3D). Sensitivity values were 708.6 (2D), 2931.3 (3D) counts/sec/MBq at the center and 728.7 (2D, 3398.2 (3D) counts/sec/MBq at 10 cm offset from the center. Scatter fractions were 0.19 (2D) and 0.49 (3D). Peak true count rate and NECR were 64.0 kcps at 40.1 kBq/mL and 49.6 kcps at 40.1 kBq/mL in 2D and 53.7 kcps at 4.76 kBq/mL and 26.4 kcps at 4.47 kBq/mL in 3D. Conclusion: Information about the performance of CTI ECAT EXACT 47 PET scanner reported in this study will be useful for the quantitative analysis of data and determination of optimal image acquisition protocols using this widely used scanner for clinical and research purposes.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.18-24
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• 2012

Purpose : Although lung ventilation SPECT (LV-SPECT) has a good sensitivity in detection of deep lung lesions, it is difficult to apply the LV-SPECT to patients having breathing problems due to limited examination time. In this study, we evaluated the usefulness of LEAP collimator, which provides high detection sensitivity and tolerable resolution, for the LV-SPECT in terms of diagnostic accuracy and examination time. Materials and Methods : Four volunteers inhaled Technegas (370 MBq) and the lung ventilation planar scan (LVPS, 300 counts/view (cpv)) with LEHR collimator was performed using Siemens E.cam scanner as a reference test. LV-SPECT scans were performed with three collimators, LEHR, LEUHR, and LEAP, in low (7 kcpv) and high (70 kcpv) counting modes. The count ratios of left (LT) and right (RT) lung segments were calculated on the geometric mean view of anterior and posterior images for LVPS and on the summed coronal images of LV-SPECT, respectively. Comparing to LVPS, the usefulness of three different collimators for LV-SPECT was evaluated through statistical analysis (paired t-test), on count ratios of lung segments. Results : The average LT:RT ratio in LVPS was 47:53. For LV-SPECT, there were negligible difference of the LT:RT ratios (48:52 on average) among three different collimators in low and high counting modes. Comparing to standard LVPS with LEHR, all LV-SPECTs with different collimators resulted in similar diagnostic accuracy through paired t-test (p>0.05). The scan time in LVPS (6 views) was 17.3 min. For LV-SPECT (128 views) in low counting mode, it took 18.7 (LEUHR), 15.0 (LEHR), and 12.3 min (LEAP), respectively. Conclusion : Comparing to standard LVPS, the LV-SPECT with LEAP in low counting mode provided the comparable diagnostic accuracy in addition to shortened scan time.