• Journal of the Korean Society of Radiology
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• v.3 no.1
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• pp.29-39
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• 2009

In this paper has proposed to the recognition of the disease on medical images using neural network. The neural network is constructed as three-layers of the input-layer, the hidden-layer and the output-layer. The training method applied for the recognition of disease region is adaptive error back-propagation. The low-frequency region analyzed by DWT are expressed by matrix. The coefficient-values of the characteristic polynomial applied are n+1. The normalized maximum value +1 and minimum value -1 in the range of tangent-sigmoid transfer function are applied to be use as the input vector of the neural network. To prove the validity of the proposed methods used in the experiment with a simulation experiment, the input medical image recognition rate the evaluation of areas of disease. As a result of the experiment, the characteristic polynomial coefficient of low-frequency area matrix, conversed to 4 level DWT, was proved to be optimum to be applied to the feature parameter. As for the number of training, it was marked fewest in 0.01 of learning coefficient and 0.95 of momentum, when the adaptive error back-propagation was learned by inputting standardized feature parameter into organized neural network. As to the training result when the learning coefficient was 0.01, and momentum was 0.95, it was 100% recognized in fifty-five times of the stomach image, fifty-five times of the chest image, forty-six times of the CT image, fifty-five times of ultrasonogram, and one hundred fifty-seven times of angiogram.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1391-1398
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• 1992

The hypothesis tested is that shifts in pH, induced when a cardioplegic solution is oxygenated, can be detrimental. The object of this study is to evaluate the effect of the pH of the oxygenating cardioplegic solution on postischemic recovery in the isolated rat heart. Either 100% oxygen or 95% oxygen: 5% carbon dioxide was added to the cardioplegic solution[St. Thomas` Hospital No. 2] and determined postischemic recovery of isolated rat hearts after 2 hours and 3 hours of 20oC cardioplegic protected ischemia. Heart were arrested and reinfused every 30 minutes throughout the ischemic period with cardioplegic solution. When 100% oxygen was added, the pH of the cardioplegic solution increased from 7.8[no oxygen] to 8.5[100% oxygen] without any change in postischemic functional recovery. But when 95% oxygen ; 5% carbon dioxide was added, the pH of the cardioplegic solution reversely decreased to 6.84 in the 2-hour ischemic group and 6.73 in the 3-hour ischemic group, associated with improved postischemic functional recovery. After 2-hour ischemia, systolic pressure improved from 88.2$\pm$3.7%[no oxygen] and 88.7$\pm$3.8%[100% oxygen] to 96.6$\pm$1.8%[95% oxygen : 5% carbon dioxide], p<0.05, aortic flow from 43.3$\pm$3.1% and 38.4$\pm$10.6% to 74.5$\pm$5.0%, p<0.001, cardiac output from 55.5$\pm$4.6% and 47.4%$\pm$10.6% to 73.1$\pm$4.6%, p<0.05, stroke volume from 62.7$\pm$4.6% and 52.0$\pm$10.1% to 77.2$\pm$4.6%, p<0.05, and dP/dT from 59.3$\pm$7.2% and 56.7$\pm$7.6% to 78.9$\pm$4.6%, p<0.05. The infused amount of the cardioplegic solution during 2-hour ischemic period was similar in three groups. After 3-hour ischemia, cardiac output improved from 17.0$\pm$3.8%[no oxygen] to 45.9$\pm$7.5%[95% oxygen: 5% carbon dioxide], p<0.05, and stroke volume from 21.0$\pm$3.9%[no oxygen] to 50.1$\pm$6.6%[95% oxygen: 5% carbon dioxide], p<0.01. In conclusion, the St. Thomas` Hospital No. 2 cardioplegic solution should be oxygenated but with 95% oxygen: 5% carbon dioxide and not 100% oxygen because of the additive effect of a relatively "Acidotic" pH.t; pH.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.87-93
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• 2002

Background: Predicting the important role of intercellular adhesion molecule-1 expression on the acute ischemia-reperfusion injury, we set out to demonstrate it by assessing the degree of expression of ICAM-1 after warm ischemia-reperfusion in canine unilateral lung ischemia model. Material and Method: Left unilateral lung ischemia was induced by clamping the left hilum for 100 minutes in seven adult mongrel dogs. After reperfusion, various hemodynamic pararmeters and blood gases were analyzed for 4 hours, while intermittently clamping the right hilum in order to allow observation of the injured Ieft lung function. The pulmonary venous blood was collected serially to measure TNF- and cICAM-1 level. After 4 hours of reperfusion, the lung tissue was biopsied to assess cICAM-1 expression, and to measure tissue malondialdehyde(MDA) and ATP level. Result: The parameters including arterial oxygen partial pressure, pulmonary vascular resistance and tissue MDA and ATP level suggested severe lung damage. Serum TNF-$\alpha$ level was 8.76$\pm$2.37 ng/ml at 60 minutes after reperfusion and decreased thereafter. The cICAM-1 level showed no change after the reperfusion during the experiment. The tissue cICAM-1 expression was confirmed in 5 dogs. Conclusion: The increase of TNF-$\alpha$ Ievel and expression of tissue ICAM-1 were demonstrated after ischemia reperfusion injury in canine lung model.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.48-54
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• 1997

Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1232-1236
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• 1997

Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.1-10
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• 1997

The successful cardiac transplantation depends partly on the donor heart preservation by a solution that will ensure recovery of myocardial function. The purpose of this study was to perform the evaluation of various preservation solutions and to accumulate the data on the requisites for ideal preservation solution. The experimental setup was the constant pressure Langendorffs perfusion system. Isolated rabbit hearts were perfused for 20minutes with unarm Krebs-Henseleit solution, stored for 4 hours in cold preservation solution after cardioplegia, and then were reperfused for 20minutes. The 4 experimental groups were prepared Hartmann's solution group (group 1, control), modified Euro-collins solution group(group II. MEC), modified University of Wisconsin group (group n, MUW), and CK solution(made by the author) group (group W, CK). The parameters for assessing the preservation ability were levels of enzymes in freezed myocardial tissues (lactate, creatine kinase-MB and adenosine deaminase), coronary flow. left ventricular developing pressure and dpldt. In conclusion, the ability of preservation for isolated rabbit heart was excellent in CK solution and modified University of Wisconsin solution, and poor in modified Euro-collins solution, compared with Hartmann solution. CK solution has low potassium concentrations(34.2mEq/L) and includes various substrates to be salutary on myocardial preservation. This fact may indicates the necessity of further refinements in selection or composition of electrolytes and substrates.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.274-285
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• 1994

The effects of resin on the respiratory health have been investigated in 309 workers from four iron and steel foundries and the results compared with those from 122 workers who were not significantly exposed to resin gas and silica dust at the same industries. Phenol-formaldehyde resin was used in the core making and molding processes and workers were exposed to their decomposition products as well as to silica dust containing particulates. The subjects were grouped according to formaldehyde, dust and other gas exposures, and smoking habits were considered also in thi analysis. Standardized respiratory symptom questionnaire was administered by trained interviewers. Chest radiograph, pulmonary funtion tests, and methacholine challenge tests were done. Environmental measurements at the breathing zone were carried out to determine levels of formaldehyde, respiable dust and total dust. Foundry workers had a higher prevalence of symptoms of chronic bronchitis with chronic phlegm and chronic cough when exposed to dust. Exposure to gas was significantly associated with lowered $FEV_1$ and obstructive pulmonary function changes. Exposure to formaldehyde and phenol gas was associated with wheezing symptom among workers, but $FEV_1$ changes after methacholine challenge were not significantly different among different exposure groups. When asthma was defined as the presence of bronchial hyperreactivity with more than 20% decrease in $FEV_1$ after methacholine challenge, 17 workers out of 222 tested had asthma. Fewer asthmatic welters were found among groups exposed to formaldehyde, gas and dust, which indicates a healthy worker effects ill a cross-sectional study. The concentration of formaldehyde gas ranged from 0.24 to 0.43 ppm among studied foundries. The authors conclude that formaldehyde and phenol gas from combusted resin is probably the cause of asthmatic symptoms and also a selection force of those with higher bronchial reactivity away from exposures.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1169-1180
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• 2005

First, I read all the materials, including Dongeuibogam(Encyclopedia Medica Koreana), classical writings on Lacca sinica exsiccata, herbal writings on lacquer poison, and herbal books on how to treat lacquer poison. And then after 1 examined all the details on qi and taste of Lacca sinica exsiccata, its efficacy, detoxification, lacquer poison, and its effects on body symptom, 1 got the following results. The order of frequency that Lacca sinica exsiccata is used in Dongeuibogam is pressure-feeling, blood circulation, and insect biting. Its way of intake is not so much through herb-boiling or powdered medicine as through hand-made pills. When medicine is used in the form of pills, the Lacca sinica exsiccata is more included among other ingredients. When old doctors treated pressure-feeling in the chest, they mixed up other herbs, with not putting more emphasis on the efficacy of lacquer 010 doctors believed that toxicity of Lacca sinica exsiccata is not having its own poison, but having biased dominance in the use of its qE and taste. The way or detoxification or Lacca sinica exsiccata is used in the order of crab-boiled water, egg, Xanthoxylum piperitum, Perilla frutescens, Astar tataricus, a weeping willow, iron-tempered water, and Allium toberosum. Special point in detoxificating lacquer poison is that they used medicines for well-ciruculating pulmonary stream, medicines for promoting to urinate or discharge by helping large colons to move, medicines for making the lacquer scar small, medicines for helping digest, and medicines for improving vessel function in the poisoned area. With the above results, the more profound study, based on the crab-boiled water and egg, is expected to go on to increase the effect on the one hand, and to make the new way of lessening or removing the toxicity of lacquer with more safe use on the other hand.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.213-220
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• 1983

Pulmonary function is the determinant of blood gas tension. However, Acid-Base disturbances can also alter partial pressures of oxygen and carbon dioxide in arterial blood. During respiratory acidosis $PO_2$ will be lowered and reverse changes will be produced during respiratory alkalosis. On the other hand, in metabolic acidosis $PO_2$ will be elevated and $PCO_2$ will be lowered by the respiratory compensation, and reverse response will be induced in metabolic alkalosis. Urinary gas tension has many influencing factors than arterial blood and difficult to estimate the tendency of its alterations. Urinary $PO_2$ and $PCO_2$ are not always identical level as venous blood. It is to be altered by blood gas tension, flow rate of urine, metabolic rate of kidney, and Acid-Base status of blood. Particularly countercurrent exchange of oxygen and carbon dioxide in the renal medulla will make larger alteration of gas tension than venous blood. After induction of Acid-Base disturbances [disturbances] arterial and urinary $PCO_2$, $PO_2$, urinary volume, and osmolarity were determined in dogs, and the relationships between arterial and urinary $PCO_2$ , $PO_2$ Acid-Base disturbances, urinary volume, and osmolarity were investigated. 1. During the acute Metabolic and Respiratory disturbances urinary pH did not respond on respiratory origin. However, there were immediate urinary response in pH on metabolic origin. 2. Urinary $PO_2$, $PCO_2$, did not always follow arterial or venous gas tension and Acid-Base disturbance. Urinary $PCO_2$, correlate well with the urinary volume. The larger the urinary volume, $PCO_2$ lowered to the venous level. The smaller the urinary volume, urinary $PCO_2$ tends to be higher. However urinary $PO_2$ did not have any particular correlation with urinary volume. 3. Correlation between urinary $PCO_2$ and $PO_2$ were inversely proportional to arterial blood. Differences of $PCO_2$ between arterial blood and urine also did not have any particular correlation with urinary volume. This may suggest that changes on blood gas tensions can influence on urinary $PCO_2$. 4. There were eminent clear inverse correlation between urinary $PCO_2$ and osmolar concentrations of urine. Above results strongly suggest that partial pressure of gas in urine primarily depend upon counter-current exchanges in renal medullary tissues.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.648-654
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• 2000

Background: Cardiopulmonary bypass during open heart surgery causes systemic inflammatory respose. IL-10 is an anti-inflammatory cytokine that inhibits inflammatory process and protects organ function by down regulation of pro-inflammatory cytokine release and maintenance of blood level balance with pro-inflammatory cytokines. Mateial and Method: Plasma IL-10 levels were measured and analyzed in 22 patients who underwent open heart surgery (11 cases of coronary artery bypass graft, 11 cases of valve replacement) under cardiopulmonary bypass since 1988 January to July at Department of Thoracic and Czardiovascular surgery, Yeungnam University Hospital. 1g of methylprednisolone was administrated to thirteen patients randomly. Blood samp.es were taken and collected at the time of induction of anesthesia, 10 min before cardiopulmonary bypass, 10 min after starting of CPB, 10 min aftr aortic cross clamping, 10 min after ACC release, and 10 min, 2 hours, and `5 hours after CPB respectively. The plasma levels of IL-10 were determined by enzyme-linked immunosorbent assays(ELISA). Wilcoxon-Raule Sum test was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was used for statistical analysis. Result: In all 22 patients, cardiopulmonary bypass time was 171$\pm$41.4 min and aortic cross clamp time was 118$\pm$36.5 min. Peak IL-10 level was achieved at 10 min after ACC(361.0$\pm$52.81pg/ml) and was decreased sharply at 2 hours after CPB. Peak IL-10 level was correlated positively with aortic cross clamp time(p=0.011); however, it did not correlated with bypass time(p=0.181). In valve replacement group, mean IL-10 level at peak point was 567.89$\pm$107.69 pg/ml and was significantly higher than that of coronary artery bypass group(205.67$\pm$192.70 pg/ml)(p<0.001). ACC time in valve replacement group was significantly longer than that of coronary artery bypass group(p<0.01), however, bypass time was not(p=0.212). Thirteen patients with steroid pretreatment before starting of CPB showed relatively higher plasma IL-10 level than in control group, however, no statistical significance was noted(p=0.19). Conclusion: plasma level of IL-10 was increased in association with cardiopulmonary bypass and revealed peak at 10 min after ACC release. IL-10 level was correlated positively with ACC time. Therefore, systemic inflammatory respeonse in association with cardiopulmonary bypass could be decreased by reducing ACC time during cardiac surgery.