• The Korean Journal of Pain
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• v.1 no.1
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• pp.106-119
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• 1988

For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.164-171
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• 1997

Heart transplantation is now accepted as a definitive therapeutic modality in patients with terminal hear failure. The first successful heart transplantation in humans was done in 1967 and the first case in Korea was performed in november, 1992. Since the first case in 1992, more than 50 cases have been performed in Korea. A total of 20 patients underwent orthotopic heart transplantation since November, 1992 in Asan Medicla Center. The purpose of this study is to evaluate the early results and the follow-up course of 20 cases of heart transplantation done in Asan Medical Center. The average age of 20 patients was 39.9$\pm$11.8 years old(20~58). The mean follow-up duration was 14.4$\pm$11.2 months(1~41). All patients are alive till now. The blood type was identical in 14 and compatible in 6 patients. ihe original heart disease was dilated cardiomyopathy in 16, valvular heart disease in 2, ischemic cardiomyopathy in 1, and giant cell myocarditis in 1 patient. HLA cross matching for recipient and donor was done in 18 cases and the results were negative for T-cell and B-cell in 16 patients, pos tive for warm B-cell in 2 patients. Among 6 loci of A, B, and DR, one locus was matched in 8 cases, 2 loci in 5 cases, and 3 loci matched in 1 case. The number of acute allograft rejection averaged 2.8$\pm$0.5 (0~6) per case and the number of acute allograft rejection requiring treatment averaged 1.0$\pm$0.9 (1~3) per case. The time interval from operation to the first acute rejection requiring treatment was 35.5$\pm$20.4 days (5~60). Acute humoral rejection was suspected strongly in 1 case and was successfully treated. The left ventricular ejection fraction measured by echocardiography and/or MUGA scan was dramatically increased from 17.5$\pm$6.8 (9~32)% to 58.9$\pm$2.0 (55~62)% after heart transplantation. Temporary pacing was needed in 5 patients over 24 hours but normal sinus rhythm appeared within 7 days in all cases. One patient has been taken permanent pacemaker implantation due to complete AV block appearing 140 days after heart transplantaion. One patient had cyclosporine-associated n urotoxicity during the immediate postoperative period and was recovered after 27 hours. The heart transplantation of Asan Medical Center is on a developing stage but the early result is comparable to that of well established centers in other countries, even though the long-term follow-up result must be reevaluated. We can conclude that the heart transplantion is a promising therapeutic option in patients with terminal heart failure.

• Applied Microscopy
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• v.26 no.4
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• pp.465-477
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• 1996

The influence of dehydrocholic acid, cholesterol and phosphstidylcholie to the fine structure of vacuolar apparatus was investigated to better understand the mechanism of intracellular transport of bile constituents in the hepatocytes of rats. The cis Golgi cisterns faced toward the bile canaliculi both in normal and experimental groups. In the hepatocytes from the rats of experimental groups, the primary organic solutes in bile influence the Gogi apparatus, ER and lysosome in the way of increase, cisternal dilation or budding to form the vacuoles. In the dehydrocholic acid group, the cis Golgi cisterns appeared to be sacculated and showed buds, which were probably separated to be vacuoles. Some of the vacuoles appeared to be fused to the bile canaliculi. In the cholesterol and phosphatidylcholine groups, the Golgi cisterns appeared to be dilated and lysosomes were increased in the vicinity of bile canaliculi. The cis Golgi cisterns showing linear saccular fashions were occasonally observed. The increase of lysosomes were more predominant in the cholesterol group. The evidence suggests that dehydrocholic acid is mainly transported through the ER and cis Golgi cisterns, and cholesterol and phosphatidylcholine are mainly transported through the ER and lysosomes via the trans Golgi cisterns, but the cholesterols are frequently transported via the lysosomes.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.43-51
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• 2005

Background: To examine the ultrasonographic and magnetic resonance (MRI) imaging findings of a cervical mass type cervical pregnancy. Materials and Methods: The ultrasonographic and MRI findings of 5 patients pathologically confirmed as having a cervical pregnancy were analyzed retrospectively. On ultrasonography, the size and echo pattern of the uterine cervix, the shape and echo pattern of the lesion, the degree and the pattern of blood flow on the color Doppler study and the spectral Doppler pattern were analyzed. The shape, signal intensity, and degree and pattern of enhancement of the lesion were evaluated on MRI. Results: The uterine cervix was enlarged and the size of the lesion was 6.1 to 7.1 (average, 6.5) cm. The endocervical canal was irregularly dilated and showed heterogeneous echogenicity in all 5 cases. Four of the 5 lesions were heterogeneously hyper- or mixed echoic and remaining one was relatively homogeneous echogenic. Doppler ultrasonography revealed an increased vascularity of the peritrophoblastic flow pattern. In all 4 cases where MRI performed, the lesion was irregular in shape and the margin was not sharply demarcated. The T2-weighed image showed that the lesions were mixed signal intensity. Three of the 4 lesions contained high signal intensity nodular portions and a low signal intensity rim was observed along the margin of the nodular portions. The T1-weighted image revealed multiple signal voids along the periphery of the lesions and high signal intensity portions as a result of hemorrhage were noted. The dynamic enhanced study showed that the high signal intensity portions on the T2-weighted image were strongly enhanced similar to the vessels on the early phase and the contrast enhancement gradually decreased with time. Conclusion: A cervical mass type cervical pregnancy can be correctly diagnosed using the patient's clinical symptom, the elevation in the serum ${\beta}$-HCG level, and characteristic ultrasonographic and MRI findings.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.267-276
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• 2018

Objective : The beneficial effect of hypothermia after hemicraniectomy in malignant middle cerebral artery (MCA) infarction has been controversial. We aim to investigate the safety and clinical efficacy of hypothermia after hemicraniectomy in malignant MCA infarction. Methods : From October 2012 to February 2016, 20 patients underwent hypothermia (Blanketrol III, Cincinnati Sub-Zero, Cincinnati, OH, USA) at $34^{\circ}C$ after hemicraniectomy in malignant MCA infarction (hypothermia group). The indication of hypothermia included acute cerebral infarction >2/3 of MCA territory and a Glasgow coma scale (GCS) score <11 with a midline shift >10 mm or transtentorial herniation sign (a fixed and dilated pupil). We retrospectively collected 27 patients, as the control group, who had undergone hemicraniectomy alone and simultaneously met the inclusion criteria of hypothermia between January 2010 and September 2012, before hypothermia was implemented as a treatment strategy in Dong-A University Hospital. We compared the mortality rate between the two groups and investigated hypothermia-related complications, such as postoperative bleeding, pneumonia, sepsis and arrhythmia. Results : The age, preoperative infarct volume, GCS score, National institutes of Health Stroke Scale score, and degree of midline shift were not significantly different between the two groups. Of the 20 patients in the hypothermia group, 11 patients were induced with hypothermia immediately after hemicraniectomy and hypothermia was initiated in 9 patients after the decision of hypothermia during postoperative care. The duration of hypothermia was $4{\pm}2days$ (range, 1 to 7 days). The side effects of hypothermia included two patients with arrhythmia, one with sepsis, one with pneumonia, and one with hypotension. Three cases of hypothermia were discontinued due to these side effects (one sepsis, one hypotension, and one bradycardia). The mortality rate of the hypothermia group was 15.0% and that of the control group was 40.7% (p=0.056). On the basis of the logistic regression analysis, hypothermia was considered to contribute to the decrease in mortality rate (odds ratio, 6.21; 95% confidence interval, 1.04 to 37.05; p=0.045). Conclusion : This study suggests that hypothermia after hemicraniectomy is a viable option when the progression of patients with malignant MCA infarction indicate poor prognosis.

• Applied Microscopy
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• v.24 no.3
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• pp.23-33
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• 1994

It is well known that dichlorvos (DDVP), an organophosphate insecticide in common use, is so easily and rapidly hydrolyzed and excreted that it has usually little toxic effect on human body. In these days, however, it is widely used as an industrial and domestic insecticide and as an anthelmintic agent for animals, so that the accident of chemical poisoning occurs frequently. DDVP acts as a powerful inhibitor of carboxylic esterase, which can cause accumulation of acetylcholine at the synapses so paralysis of muscle and the transmission failure in cholinergic synapses dueing to desensitization of acetylcholin receptor may occure. Moreover accumulation of the acetylcholine brings about the elevation of the cyclic-AMP, which alters the cellular metabolisms of nucleic acid, carbohydrate, protein and lipid. Present study has undertaken to investigate the cardiotoxic effect of DDVP by electron microscopic study. A total of 30 Sprague-Dawley strain rats, weighing about 250gm were used as experimental animals. 2mg/kg/day of DDVP is intraperitonealy injected 3 times with intervals of every other day. On 1 day, 3 days, 5 days, 7 days and 14 days after drug administration, the animals were sacrified by cervical dislocation. Left ventricular cardiac muscles were resected and sliced into $1mm^3$. The specimens were embedded with Epon 812 and prepared by routine methods for electron microscopical observation. All preparations were stained with lead citrate and uranyl acetate and then observed with Hitachi-600 transmission electron microscope. The results were as follows: 1. In the cardiac muscle of DDVP treated rats, mitochondria with disorganized double membrane and mitochondrial crista, and vacuole formation in mitochondrial matrix were observed. But structures of mitochondria were recovered to normal in 14 days group. 2. In the cardiac muscle of DDVP treated rats, cisternae of sarcoplasmic reticulum were dilated and sacculated. But these changes were recovered to normal in 14 days group. 3. In the cardiac muscle of DDVP treated rats, glycogen particles around damaged myofibrils were decreased. But amount of glycogen particles were restored in 14 days group. 4. In the cardiac muscle of DDVP treated rats, disruption and discontinuation of myofilaments and disorganization of Z-disc were observed. But the structures of myofibrils were recovered to normal in 14 days group. It is consequently suggested that DDVP would induce the reversible degenerative changes on the ultrastructures in cardiac muscle of rat.

• Korean Journal of Animal Reproduction
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• v.16 no.1
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• pp.21-38
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• 1992

The present study was carried out to investigate morphologic changes in the corpus luteum of the pregnant rat by electron microscope after administration of prostaglandin F2$\alpha$(PGF2$\alpha$). Pregnant rates were treated with PGF2$\alpha$(1,500$\mu\textrm{g}$/rat) and their corpura lutea were observed morphologically. The results obtained in this study were summarized as follows ; 1. The weight of the ovaries and corpura lutea were decreased slightly at 8~24 hours after PGF2$\alpha$ administratin but no significant differences were observed. 2. The number of corpora lutea and luteal cells decreased slightly at 12~48 hours and 18~24 hours after PGF2$\alpha$ tretment but there were no signifciant differences between control and treatment. 3. The weight of uterus and the unmber of embryo decreased slightly at 96 hours and at 18~96 hours after PGF2$\alpha$ administration but no significant differences were obtained. 4. In the electron microscopic observatons, lipid droplets which are electron dense and appear in the cytoplasm moderately increased in number after PGF2$\alpha$ treatment. The lipid droplets were surrounded by mitochodria and appeared in the autophagic vacuoles. 5. Moderated and high electron dense mitochondria which are round or elongated in shape showed pleomorphism from 3 hours after PGF2$\alpha$ treatment. Destruction of tubular of vesicular cristae was observed at 6 hours after the treatment. Dense body and myelin figures in matrix of mitochondria were also appeared. 6. Well-developed smooth endoplasmic reticulum(sER) showed tubular or vesicular cisternae. A number of whorl membranes containing ribosomes, mitochondria and lipid droplets were observed at 1.5 hour after treatment. sER was abundant in luteal cells at 12 hours were treatment. 7. Well-developed Golgi pparatus appeared obviously 6 hours and more prominently at 12 hours. Those Golgi vesicles were remarkably dilated. 8. Generally, a few rough endoplasmic reticulum (rER) were appeared after treatment and cisternae showed slight dilatation. No differences among the treatments were observed. However, slight dilation of cisternae was observed at 1.5 hours after treatment. 9. Ribosomes composed of free and polyribosomes were abundant before treatment but polyribosomes were appeared at 12 to 24 hours after treatment. 10. Intercellular space were slightly extended at 3 hours and markedly extended at 12 hours. Numerous microvillous protrusions were observed at these times. Membranous multivesicular structures and autophagic vacuoles were also appeared in the intercellular space. 11. At 3 hours after the treatment, autophagic vacuoles appeared in the cytoplasm of the cell. They increased in number with time and were observed to transfer to the intercellular space. Lysosomal dense body appeared in the cytoplasm and the inclusion body was also observed in nucleus at 12 to 24 hours after treatment.

• Journal of Aquaculture
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• v.9 no.3
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• pp.205-213
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• 1996

Experiments were carried out to investigate the effect of GnRH-analogue (GnRH-a) on the induction of ovulation in catfish, S. asotus. Fully matured female catfish ($250\~600\;g$) received a single intraperitoneal injection of GnRH-a ($50\~200\;{\mu}g/kg{\cdot}body$ weight) showed the successful induction of ovulation. More than $86\%$ of treated females were ovulated after injection of GnRH-a ($90\;{\mu}g/kg$) at $25{\pm}1^{\circ}C$. The majority of spawning took place within 22 to 25 hours after the injection. The gonadosomatic index (GSI) and pseudo-GSI in the group treated with $120\;{\mu}g/kg$ GnRH-a were $23-30\%$ and $18-21\%$, respectively. Average fertilization and hatching rates were $94\%\;and\;81\%$, respectively. Electron microscopically, gonadotrophs of maturing female catfish were characterized by the presence of numerous small, electron-dense granules of approximately $150\~300$ nm in diameter and a few larger, less electron-dense granules of approximately $800\~1000$ nm in size in their cytoplasm. Gonadotrophs of GnRH-a treated catfish showed that their was a distinct decrease in number of small and large granules. The rough endoplasmic reticulum was composed of numerous cisternae conspicuosly dilated to various degrees.

• Applied Microscopy
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• v.30 no.2
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• pp.141-152
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• 2000

This study aims to demonstrate the effect of squalene (SQ), one of the natural chelator, on the ultrastructural changes in the mouse liver caused by $CdCl_2$. A total of 40 healthy ICR that weighted 30 gm $({\pm}2gm)$ was used for experiment. The experimental group was divided into two groups; group A and B. The group A administrated $CdCl_2$ (4.0 mg/kg) to the intraperitoneal. The group B administrated $CdCl_2$ (4.0 mg/kg) to the intraperitoneal treated with SQ (180 mg/kg, 2 time/day). Each group was observed at 24, 48, 72, 96 hours after injected $CdCl_2$. The results were as follows: 1. Group A Nuclear membrane was observed very irregular at the 24 hours and keep rounded-shape from 48 hours. Mitochondria were observed destruction of inner cavity to the 72 hours and some showed inner cavity destruction at 96 hours. RER (rough endoplasmic reticulum) showed the dilation of inner cavity all the around and reformed typical lamellae from 72 hours. Lysosome were observed in the cytoplasm from 24 hours. From 72 hours, glycogen showed over cytoplasm. 2. Group B Nuclear membrane was observed regular at overall the time. Mitochondria showed normal shapes (round, rod) at overall the time. To 48 hours, inner cavity of rER dilated and destructed lamellae. But from 72 hours, observed typical lamellae of rER Lysosome were observed from 24 hours. And glycogen showed from 24 hours. These results suggest that squalene attenuates the toxic effect of the $CdCl_2$ in the mouse liver.

• Journal of fish pathology
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• v.24 no.3
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• pp.225-236
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• 2011

This study was aimed to determine the fish physical status according to the gross and histopathological findings of liver in cultured black rock fish, Sebastes schlegeli. All 47 fish submitted had no marked abnormalities in the external findings. 42.55% of fish showed normal liver, 25.53% yellow liver, 25.53% atrophic brown liver, 4.26% yellowish-green liver and 2.13% fatty liver in gross examination. Grossly normal liver showed no remarkable change in lobular structure but many vacuoles were found in hepatic cell. Hepatic cells took normal roundish, polygonal shapes containing spherical nuclei. In group of yellow-brown liver, many brown pigments were seen in hepatic cells, MMCs and brown-colored hyaline droplets within cytoplasm of hepatocytes. Yellowish green pigments were seen in hepatic cells and MMCs of yellow green liver and green colored hyaline droplets within hepatocytes. The dilated central veins are highlighted with atrophy of hepatic cells. Outline of atrophic hepatocyte became ambiguous and nucleus frequently become small and pyknotic. Fatty liver showed prominent vacuolar structures in cells as clear spaces or foamy cytoplasm with degenerative nuclei. From these results, it was strongly suggested that hepatic gross and histological findings could be used as important and critical health parameters of fish prior to progression to substantial manifestation as clinical disease.