• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.628-635
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• 1999

Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

• Clinical and Experimental Pediatrics
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• v.52 no.1
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• pp.99-104
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• 2009

Purpose : Magnetic resonance diffusion tensor imaging-based three-dimensional fiber tractography (DTI-FT) is a new method which demonstrates the orientation and integrity of white matter fibers in vivo. However, clinical application on children with cerebral palsy is still under investigation. We present various abnormal patterns of DTI-FT findings and accordance rate with clinical findings in children with hemiplegic cerebral palsy, to recognize the use fulness of DTI-FT. Methods : The thirteen children with hemiplegic cerebral palsy evaluated at Yeungnam University hospital from March, 2003 to August, 2007 were enrolled in this study and underwent magnetic resonance DTI-FT of the corticospinal tracts. Two regions of interest (ROI) were applied and the termination criteria were fractional anisotropy ${\geq}0.3$, angle ${\leq}70^{\circ}$. Results : The patterns and distribution of abnormal DTI-based corticospinal tractographic findings were interruption(10 cases, 76.9%), reduction of fiber volume (8 cases, 61.5%), agenesis of corticospinal tract (3 cases, 23.1%), transcallosal fiber (2 cases, 15.4%) and, aberrant corticospinal tracts (4 cases, 30.8%). Abnormal DTI-based corticospinal tractographic findings were in accordance with the clinical findings of cerebral palsy in 84.6% of the enrolled patients. Conclusion : Our results suggest that DTI-FT would be a use ful modality in the assessment of the corticospinal tract abnormalities in children with hemiplegic cerebral palsy.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.72-79
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• 2010

Purpose: Left ventricular (LV) hypertrophy and impaired diastolic function may occur early in systemic hypertension. Diastolic dysfunction is associated with increased cardiovascular risk. Tissue Doppler imaging (TDI)-derived tissue velocity and strain rate are new parameters for assessing diastolic dysfunction. The aim of this study is to determine whether TDI and strain rate imaging (SRI) would improve the ability to recognize early impaired diastolic and systolic functions compared with conventional echocardiography in hypertensive adolescents. Methods: We included 38 hypertensive patients with systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg. Ejection fraction and myocardial performance index (MPI) were estimated by conventional echocardiography. Peak systolic myocardial velocity, early diastolic myocardial velocity (Em), and peak late diastolic myocardial velocity (Am) were obtained by using TDI and SRI. Results: In the hypertensive group, interventricular septal thickness was significantly increased on M-mode echocardiography. Em/Am was significantly decreased at the mitral valve annulus. Among hypertensive subjects, the E strain rate at basal, mid, and apex was significantly decreased. Systolic strain was significantly decreased at the septum in the hypertensive group. Conclusion: Strain rate might be a useful new parameter for the quantification of both regional and global LV functions and could be used in long-term follow up in hypertensive patients. Early identification by SRI of subjects at risk for hypertensive and ventricular dysfunction may help to stratify risk and guide therapy. Further studies, including serial assessment of LV structure and function in a larger number of adolescents with hypertension, is necessary.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.183-198
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• 2000

Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.3-7
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• 2010

Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.9-16
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• 2000

Purpose: The aim of this study was to determine how much acid exposure would occur in the proximal esophagus, both in normal and in patients with abnormal distal esophageal acid exposure. Methods: Fourty-six patients with suspected GER were classified into two groups, 24 patients with pathological distal reflux (group I); 22 patients with normal distal reflux (group II). The ambulatory dual-probe esophageal pH monitoring was performed for 18-24hr. The abnormal reflux was defined when the percent of time that pH was below 4.0 exceeded the 95th percentile of normal value. Results: The siginficant differences between distal and proximal esophageal pH recordings in group I persisted for all parameters except for the longest episode, but didn't persist in group II. At the distal esophageal site, the median percent time with pH<4.0 in group I was 19.3 and significantly higher than at proximal site. Half of patients with pathological distal reflux also had proximal acid reflux. Correlation coefficients between the distal and proximal esophageal sites in group I of the number of reflux episodes and time of the longest episode were 0.451 and 0.646 respectively. Conclusion: The 50 percent of patients with pathological distal acid reflux also had abnormal acid exposure in the proximal esophageal site. Therefore, we recommand simultaneous pH recordings from dual probe esophageal sites in children with gastroesophageal reflux.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.672-679
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• 2001

Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

• The korean journal of orthodontics
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• v.26 no.1 s.54
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• pp.83-94
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• 1996

Substance P is one of the neuropeptide which presents highly in tension site of periodontal ligament during the orthodontic tooth movement. It has bnn also hon as one of the neuropeptides which cause neurogenic inflammation in various tissues and organs. However, there is no report about the effect of substance P on major extracellular matrix protein, collagen production. The purpose of this study was to evaluate the collagen production by substance P in human periodontal ligament cell. The collagenase-digestion method was used to evaluate collagen production and also used Northern blot hybridization for the evaluation of collagen mRNA level. This study also Included in terms of prostanglandins and gelatinase production with respect to collagen production. For the collagen degradation, zymography was used to estimate denatured collagen degradation. Dose-dependent effect of substance P on noncollagen protein, collagen, and percent collagen was that substance P increased noncollagen protein synthesis, but decreased collagen sytnsis. So the percent collagen, which determined by relative collagen production against total protein production, w3s decreased from $7\%\;to\;3.6\%$. This inhibitory effect of substance P on collagen production was disappeared when cells were treated concomitantly with indomethacin. It means that substance P-induced inhibitory effect on collagen production was due at least in part to the production of prostaglandins. To evaluate whether substance P-induced inhibitory effect on collagen production is correspond to the steady-state levels of procollagen mRNA, Northern blot hybridization was performed and it showed that substance P has no effect on the steady-slate level of ${\alpha}1(I)$ procollagen mRNA. It means that the inhibitory effect of substance P on collagen production was due to the change of a certain mechanism after posttranscription. In this context, gelatinase production by substance P in periodontal ligament cells was evaluated by zymography. Zymogram showed that substance P has no effect on gelatinase production in periodontal ligament cells. To explore wheter substance P-induced inhibitory effect on collagen production is selevtive in periodontal ligament cells or not, MC3T3-E1 cells which originated from mouse calvaria was used. It showed that substance P has no effect on collagen production in MC3T3-E1 cells. Taken together, substance P inhibits collagen production in human periodontal ligament cells. This effect was not due to the change of the steady-state level of procollagen mRNA and gelatinase production, but due at least in part to the change of prostaglandins production.

• Korean Journal of Poultry Science
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• v.15 no.1
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• pp.21-29
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• 1988

This study was conducted to obtain more detailed information on the characteristics of body fat distribution, genetic variation and correlation of fat amount at different location in broiler type chicken. A total of 429 offsprings, produced by mating 13 sires with 52 dams of WPR, were used for this study. All experimental analyses were made on dressed carcasses of 8 weeks of age. The average live body weight was 1,856g in male and 1,483g in female, the proportions of each part to live body weight were higher in male group except skin and abdominal fat pad. The total body fat was more in male (40.76g), but fat rate of total body, skin, and abdomen to live body weight were significantly higher in female group. The fat percentages in each body location were significantly higher in the fatty group and in each sex. The rates of abdominal fat to total body fat were increased by fattening, while subcutaneous fat percentages were lowered. There were high correlations between body weight and fat deposit in each location. The genetic correlation coefficients of body weight to fat percentages of skinned carcass, skin, abdomen, and total body fat to live body weight were negative in both sexes, but those to total body fat, eviscerated carcass fat, and skin fat were positive. In conclusion, the fat weight and fat percentage in individual chickens became higher by fattening however, genetic correlation between live body weight and percentages total body fat to live body weight were so low(negative) that decreasing body fat could be possible without decreasing body weight.

• The Korean Journal of Nuclear Medicine
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• v.32 no.3
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• pp.225-237
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• 1998

Purpose: We investigated the statistical methods to compose the functional brain map of human working memory and the principal factors that have an effect on the methods for localization. Materials and Methods: Repeated PET scans with successive four tasks, which consist of one control and three different activation tasks, were performed on six right-handed normal volunteers for 2 minutes after bolus injections of 925 MBq $H_2^{15}O$ at the intervals of 30 minutes. Image data were analyzed using SPM96 (Statistical Parametric Mapping) implemented with Matlab (Mathworks Inc., U.S.A.). Images from the same subject were spatially registered and were normalized using linear and nonlinear transformation methods. Significant difference between control and each activation state was estimated at every voxel based on the general linear model. Differences of global counts were removed using analysis of covariance (ANCOVA) with global activity as covariate. Using the mean and variance for each condition which was adjusted using ANCOVA, t-statistics was performed on every voxel To interpret the results more easily, t-values were transformed to the standard Gaussian distribution (Z-score). Results: All the subjects carried out the activation and control tests successfully. Average rate of correct answers was 95%. The numbers of activated blobs were 4 for verbal memory I, 9 for verbal memory II, 9 for visual memory, and 6 for conjunctive activation of these three tasks. The verbal working memory activates predominantly left-sided structures, and the visual memory activates the right hemisphere. Conclusion: We conclude that rCBF PET imaging and statistical parametric mapping method were useful in the localization of the brain regions for verbal and visual working memory.