• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.841-845
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• 2022

Objective : Chiari III malformations are extremely rare hindbrain malformations that are associated with a high early mortality rate, or severe neurologic deficits in the survivors. The treatment is early operative closure and cerebrospinal fluid diversion (CSF) shunting. Methods : We operated on 15 patients by repair and excision between July 2014 till June 2020 and retrospective data collection was done. Only one patient doesn't need ventriculoperitoneal (VP) shunt and the other 14 patients need a VP shunt. We described stepwise dissection and untethering of the cerebellum from the bony edge to regrowth and herniation of cerebellum again into this potential space and simple dural closure or repair with graft was done. Results : We started with VP in eight patients (53%) and the other seven patients (46.7%) started with excision and then six patients need VP shunt later on because four patients developed CSF leak and two patients developed increased high intracranial tension. Only four patients (26.7%) needed a blood transfusion. Conclusion : There are variations in the outcome and not all cases of Chiari malformation III will die and severe developmental delay is not a must. Proper management and repair carry a good prognosis.

• Journal of Korean Medical classics
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• v.10
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• pp.450-493
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• 1997

Three-yum and three-yang(三陰三陽) is the change state of yum-yang(陰陽) which is caused by six gi(六氣). They mean the flow of six gi(六氣) which exist throughout the viscera, the channel(經絡), and the skin. But it is not easy to understand the meaning because the contents of the attribute of three-yum and three-yang(三陰三陽), the bolt-leaf-hanges(關闔樞) theory and large or small of gi-blood(氣血多少) which is the main clue that explain it in ${\ll}$Somun(素問)${\gg}$ and ${\ll}$Yeongchu(靈樞)${\gg}$ don't coincide with each other. I, the writer, tried to understand the uncertain meaning and the contents which are written about three points above differently in each of the books that are ${\ll}$Somun(素問)${\gg}$ and ${\ll}$Yeongchu(靈樞)${\gg}$. So, from that the course that the book, ${\ll}$Huangjenegeong(黃帝內經)${\gg}$ is handed down is so relatively simple in a wood block-printed book, that the ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$ has less wong-words than the Somun(素問) and the Yeongchu(靈樞), and from that Yangshangsun(楊上善) wrote the note in the ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$ by royal order about 100 years former than Wangbing(王氷), as making projects of Yangshangsun(楊上善)'s note and the original of the ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$ which has relation to the yum-yang(陰陽) attribute of three-yum and three-yang(三陰三陽), the bolt-leaf-hanges(關闔樞) theory, and the large or small of gi-blood(氣血多少) and researching the Yangshangsun(楊上善)'s theory. The result is summarized like this. First, wherease the order of the change of three-yum and three-yang(三陰三陽) which is explained by Yangshangsun(楊上善) consider the change of yangi(陽氣) in body most important, the order of the change gaeggi(客氣)'s three-yum and three-yang(三陰三陽) considers chungi(天氣) most important, and the order of jugi(主氣)'s three-yum and three-yang(三陰三陽) considers jigi(地氣)'s change of ohaeng(五行) most important. If the order of change three-yum and three-yang(三陰三陽) in the ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$ is considered, each of taeyang(太陽) and soyum(少陰) are expressed as the base of yum-yang(陰陽) and yangmeong(陽明) and taeyum(太陰) are expressed as the palmy days of yum-yang(陰陽), soyang(少陽) and gyolyum(厥陰) are expressed as pacemaker(樞杻) which controls the change of yum-yang(陰陽). Thus, each has something in common that is fettered by the inside and outside. In the flow of channel(經絡), taeyang(太陽) and soyum(少陰) take charge of the behind of body, yangmeong(陽明) and taeyum(太陰) take charge of the front of body and soyang(少陽) and gyolyum(厥陰) take of the side of body. Second, in Yangshangsun(楊上善)'s bolt-leaf-hanges(關闔樞) theory, three-yum(三陰) is regarded as inside, three-yang(三陽) as outside, so when bolt, leaf and hanges fulfil their duties in inside and outside, the life(life force) is thought to be revealed normally. It is impossible to understand the bolt-leaf-hanges with the conception of the inside and outside which divide three-yum and three-yang(三陰三陽) into taeyang-soyum(太陽-少陰), yangmeong-taeyum(陽明-太陰), soyang-gyolyum(少陽-厥陰) according to yum-yang(陰陽) attribute, hence it need the special conception that is taeyang(太陽)-taeyum(太陰), yangmeong(陽明)-gyolyum(厥陰), soyang(少陽)-soyum(少陰) which center on their duties in inside and outside. In the denunciation of the word open(開) and bolt(關), because Yangshangsun(楊上善) said that the duities of taeyang(太陽) and taeyum(太陰) are shutter(閉禁), bolt(關) is coincided with that significance. Third, with explaining the large or small of gi-blood(氣血多少) of three-yum and three-yang(三陰三陽), Yangshangsun(楊上善) expressed the inside and outside either in the same way or differently. Because the inside and outside is interior of body and exterior of body, it is the explanation that is noticed by the fact that the property of large or small of gi-blood(氣血多少) is either able to be same or different. In this viewpoint, if we unite the contents about large or small of gi-blood(氣血多少) of ${\ll}$Somun(素問)${\gg}$, ${\ll}$Yeongchu(靈樞)${\gg}$, we will find that the descriptions of large or small of gi-blood(氣血多少) of three-yang(三陽) in ${\ll}$Somun(素問)${\gg}$ ${\ll}$Yeongchu(靈樞)${\gg}$ correspond with the ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$, but in three-yum(三陰), the contrary presentations exit. The reason is that large or small of gi-blood(氣血多少) of three-yum(三陰) isn't only expressed as che(體) in the point of che-yong(體用), but as a point of yong(用) that is a phenomenon. As researching the original of ${\ll}$Huangjenegeongtaeso(黃帝內經太素)${\gg}$ and Yangshangsun(楊上善)'s notes as a center about three problems that are yum-yang(陰陽) attribute, the bolt-leaf-hanges(關闔樞) and large or small of gi-blood(氣血多少) of three-yum and three-yang(三陰三陽), I, the writer, tried to explain the part which is written differently or has uncertain conception in the book ${\ll}$Somun(素問)${\gg}$ and the book ${\ll}$Yeongchu(靈樞)${\gg}$, but the concrete result of the work like this will be judged according to the question how many theories are correspondent with real presence at a sickbed. Hence, the work to veryfy the theories in the future will be left as assignment.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.1-9
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• 1976

The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.617-622
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• 2006

Purpose : High-Sensitivity C-reactive protein(hs-CRP) has been recognized as a very useful and sensitive predictor of the future risk of myocardial infarction. But the clinical significance of hs-CRP in children remains uncertain. To confirm the existence of obesity-induced vascular inflammation and the association between metabolic syndromes and elevation of CRP in children, we investigated the relationship among CRP, obesity, blood pressure(BP), and serum lipids in schoolboys. Methods : Twenty-eight obese(BMI $29.61{\pm}3.29kg/m^2$) and 93 non-obese(BMI $18.99{\pm}2.21kg/m^2$) boys aged 14 years were examined. Serum CRP levels was measured by the high sensitive latex turbidimetric immunoassay and subjects with CRP levels below 0.3 mg/dL were adopted to avoid the influence of acute infection. Results : Obese children had significantly higher hs-CRP levels than their non-obese group($0.104{\pm}0.075$ vs. $0.054{\pm}0.005mg/dL$). In the obese group, BMI, systolic blood pressure, diastolic blood pressure, apolipoprotein B, atherogenic index, and triglyceride were significantly higher than in nonobese. The BMI, diastolic blood pressure, apolipoprotein E, atherognic index, and triglyceride showed positive correlation with log CRP by simple regression. Multiple regression analysis indicated that BMI and apolipoprotein E were strongly related to CRP. Conclusion : This study revealed that obese children tended to have higher levels of serum hsCRP, BP elevation and dyslipidemia than the control group and that BMI and apolipoprotein E were strongly related to CRP. These results indicate that obesity related metabolic syndrome can be developed in children.

• Journal of radiological science and technology
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• v.31 no.3
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• pp.249-258
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• 2008

Purpose : Abdominal obesity with visceral fat accumulation have been known to be intimately associated with the development of metabolic syndrome. Therefore, it is important to estimate the precise amount of visceral fat. Ultrasonography has been reported that it is a simple and noninvasive method for visceral fat evaluation. Purpose of this study is to evaluate the association of ultrasonographic visceral fat thickness, anthropometric indexes, and risk factor of metabolic syndrome, and to investigate the cut-off value of abdominal visceral fat thickness leading to increased risk of metabolic syndrome. Materials and methods : The subject included 200 men and 200 women who visited D healthcare center in Daejeon from January to April 2008. The subcutaneous fat thickness and visceral fat thickness were measured by ultrasonograph. As anthropometric index, we measured body mass index, waist circumference and waist/height ratio. As for the risk factor of metabolic syndrome, we measured blood pressure, high density lipoprotein cholesterol, triglyceride and fasting serum glucose. Results : VFT was significantly correlated with waist circumference, (r=0.683/M, r=0.604/F), waist to height ratio (r=0.633/M, r=0.593/F) and BMI (r=0.621/M, r=0.534/F) in both men and women. In addition it was significantly correlated with Systolic blood pressure (r=0.229/M, r=0.232/F), Diastolic blood pressure ((r=0.285/M, r=0.254/F), high density cholesterol (r=-0.254/M, r=-0.254/F), Triglyceride (r=0.475/M, r=0.411/F), and Fasting blood sugar (r=0.158/M, r=0.234/F) in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm (sensitivity89.2%, specificity 71.2%) in men and 3.50cm (sensitivity61.2% specificity 80.8%) in women respectively. The odds ratio of the risk of metabolic syndrome was dramatically increased with the abdominal visceral fat thickness level over 6cm in men and 5cm in women. Conclusion : The visceral fat thickness using ultrasonography was significantly correlated with anthropometric indexes and risk factors of metabolic syndrome in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm in men and 3.50cm in women.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.407-412
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• 2017

The aim of this study was to shorten the time required for subculture and bacterial identification and obtain a simple and rapid identification method for new test methods for bloodstream infections. The following results were obtained using a mass spectrometer. In Vitek 2, 208 (81.8%) cases were well-identified and 45 isolates were not identified in blood cultures. Among 208 cases, 146 (57.5%) were Gram positive bacteria and 108 (42.5%) were Gram negative bacteria. In total, 233 were identified to the species level and 21 were identified to the genus level. The identification error was found to be Propionibacterium acnes as Clostridium bifermentans. The accuracy of Enterobacteriaceae, glucose non-fermentative bacilli (GNFB), and staphylococci were 81/83 (97.6%), 12/15 (80.0%), and 72/85 (84.7%), respectively. The concordance rate of Vitek 2 and Vitek MS by the direct method was 81.8% and 45 isolates were not identified. Most of the unidentified bacteria were Gram positive bacteria (N=37). The Gram positive bacteria were streptococci (14), coagulase-negative staphylococci (CNS) (11), enterococci (3), Staphylococcus aureus (2), Micrococcus spp. (2), Bacillus spp. (2) and Actinomyces odontolyticus, Finegoldia magna, and Peptostreptococcus spp. The results reporting time was reduced to 24~72 hours compared to the conventional method. The rate of identification of the aerobic and anaerobic cultures was similar, but the use of an anaerobic culture did not require a dissolution process, which could shorten the sample preparation time. These results suggest that the method of direct identification in blood cultures is very useful for the treatment of patients. In further studies, it might be necessary to further improve the method for identifying streptococci and CNS, which were lacking in accuracy in this study.

• Journal of Community Nutrition
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• v.4 no.2
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• pp.118-129
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• 2002

Nutrition is important in the management of diabetes mellitus, however, there are few little education materials specifically designed for older adults. The objective of this study was to develop nutrition education materials for prevention and management of diabetes moll for older adults. Materials developed were a booklet and four leaflets. The contents of materials were based on lesson plans. After several revisions of the draft of materials, illustrations and icons appropriate to the contents were designed using illustrator 9.0 and Photoshop 6.0. The booklet was composed of five chapters and 40 pages. The first chapter began with an introduction about diabetes and diabetes management by diet, exercise and medication. The second chapter dealt with ideal body weight, calculation of adequate caloric intake and food exchange list. The third chapter provided information for meal planning and sample menus. The fourth chapter focused on practical tips on nutritional care of diabetes, by providing tips on reducing sugars, fat and salt, and suggestions on eating for special occasions. The fifth chapter dealt with information in case of low blood sugars, exercise and foot care. The topics of the four leaflets were “Diabetes, what is it and care”, “Food exchange list and meal planning”, “Healthy eating for diabetes”, “Special care for diabetes low blood sugars, exercise and foot care” Each leaflet was composed of six sections and was printed in large paper (B4 size) for older adults. The draft of educational materials were re-viewed by four nutrition professionals and finally pilot-tested with ten adults aged 50 and older. The characteristics of the developed materials are as follows, i) messages are delivered using simple, specific information, ⅱ) messages focused on practical applicable tips, ⅲ) various pictures, illustrations and artwork were created and inserted to enhance understanding and interest, ⅳ) sections including risk factor assessment, calculation of ideal body weight and meal planning were designed to induce the user's participation, ⅴ) sample menus and food pictures were inserted in the booklet, vi) characteristics of older adults and transformed characteristics are diversely used to help the user feel familiarity. These materials are self-explanatory and can be used by older adults. These materials also can be used widely in nutrition education at public health centers or senior centers.

• Progress in Medical Physics
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• v.22 no.4
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• pp.172-177
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• 2011

The purpose of this study was to analyze $^{68}Ga$-BAPEN dynamic PET image in rat myocardium to evaluate potential of this radiotracer as a perfusion imaging agent. Animal PET/CT scan was done in 9 rats during 120 minutes. Especially we synthesized $^{68}Ga$-BAPEN with kit which is simple and low cost method. PET images showed the in vivo dynamic distribution of $^{68}Ga$-BAPEN in the chest region of rats. Initially $^{68}Ga$-BAPEN PET images showed aorta and liver activities and a few minutes later, $^{68}Ga$-BAPEN moved to myocardium. Regions of interest were drawn on myocardium, liver, lung and blood pool. Time-activity curves showed significant uptake of $^{68}Ga$-BAPEN in myocardium. The contrast ratios of myocardial to blood pool, lung and liver at 60 minutes after injection were 1.66, 2.82 and 0.60. To estimate accurate kinetic parameters, 60 minutes after injection was required to PET scan as myocardium image contrast ratios reached to constant values. As a result, $^{68}Ga$-BAPEN would be suitable radiotracer for PET which can applied to diagnosis of myocardial perfusion diseases after further preclinical and clinical investigations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.495-509
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• 2016

In this study, 60 seniors aged at least 65 years who attended C Senior College in Daegu were selected and randomly allocated to test and control groups of 30 subjects each. The Clean Diet Program was only applied to the test group, and the differences in self-efficacy, depression, health behavior, subjective perception of health, wellness, and physiological indices (blood pressure, blood glucose levels, hyperlipidemia, and BMI) between the test and control groups were compared. The results show a significant difference in the test group exhibiting improved or mitigated self-efficacy (t=6.003, p<.001), depression (t=4.038, p<.001), health behavior (t=6.196, p<.001), subjective perception of health (t=6.624, p<.001), and wellness (t=7.069, p<.001). Among the physiological indices, there was a significant decrease in BMI (t=5.974, p<.001). The results demonstrate the mediation effects of the Clean Diet Program. Since the Clean Diet Program can be implemented through walking, simple exercises, and eating habits, it provides great economic efficiency and usefulness and provides a very reasonable intervention program for the elderly. Based on the results, we discuss how to improve the elderly's attitude toward health promotion and their quality of life.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.13-18
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• 1980

The ultimate goal of treatment of carton monoxide poisoning is to promote dissociation of carboxyhemoglobin and to maintain arterial $PO_2$ above 50mmHg throughout the course of treatment to protect vital organs from damage caused by hypoxia. The hyperbaric chamber designed and manufactured for this purpose has obviousely made an enormous contribution and yet has several handicaps to be overcome by any means. These handicaps are: the financial impact to purchase the chamber (especially in a small, remote community), an extra manpower requirement to operate the device, limitation in the capacity of the chamber (one man type), and the possible hazard of oxygen intoxication and dysbarism. The primary objective of this study is to develope a new therapeutic measure as an alternative to the hyperbaric chamber when it is not available or contraindicated. The effect of intestinal perfusion with hydrogen peroxide has been studied by many investigators and was known to be an excellent way of extrapulmonary oxygen supply. the advantage of this method will include; 1) much more amount of oxygen is delivered to the tissue than one would expect from 100% saturation with oxygen at 1 ata, 2) the procedure is simple and most economical, 3) neither sophisticated equipment nor extra manpower is required. As a study preliminary to the clinical application, authors conducted a series of experiment to observe the effect of hydrogen peroxide enema on dissociation of carboxyhemoglobin in intoxicated rabbit blood. Using an animal gas chamber, 20 rabbits were exposed to CO gas of 6,000 ppm for 60 minutes. Ten rabbits of control group were given 10cc of warmed normal saline solution by reactal perfusion and for the other 10 of the experimental group, the same amount of 1% $H_{2}O_{2}$ solution was given by the same way. Two blood specimens were drawn from each rabbit: the first one immediately following the exposure and the second one after rectal perfusion, about 30 minutes after the first sampling. The result was as follows; 1) The decrease in carboxyhemoglobin concentration during the first 30 minutes in the control and experimental group were $18.18{\pm}4.49%\;and\;23.03{\pm}4.13%$ respectively shelving the significant difference (p<0.05) between the two groups. 2) Hemoglobin and hematocrit value showed no significant difference between two groups and not altered significantly by intestinal perfusion with $H_{2}O_{2}$.