Background: The postoperative management following lung transplantation has dramatically improved in the recent decade. However, some complications still remain as troublesome problems. We retrospectively reviewed the gastrointestinal complications and their management after lung transplantation. Material and Method: We performed a retrospective review of the medical records of 25 cases in 23 patients who underwent lung and heart-lung transplantations from July 1996 to March 2009. The definition of gastrointestinal complication was the gastrointestinal tract-related disease that occurred after lung transplantation. There were eight postoperative deaths (within postoperative 30 days) that were excluded from the analysis. Result: Twenty three gastrointestinal complications occurred in 11 (64.7%) of the 17 cases. The median follow-up period was 6.9 months (range: 2 months to 111 months), and chronic gastritis (23.5%, 4 of 17 cases) was the most common complication. Severe, prolonged (more than 2 weeks) diarrhea occurred in 3 cases. Three patients had gastric ulcer with one case requiring gastric primary closure for gastric ulcer perforation. This patient had gastric bleeding due to recurrent gastric ulcer 2 months after laparotomy. Cytomegalovirus gastritis and esophagitis occurred in 2 cases and 1 case, respectively, and esophageal ulcer occurred in 2 cases. There were esophageal strictures in 2 patients who underwent esophageal stent insertion. Other complications were one case each of ileus, early gastric cancer requiring endoscopic mucosal resection, gall bladder stone accompanied with jaundice, and pseudomembranous colitis. Conclusion: The incidence of gastrointestinal complication is relatively high in patients after they undergo lung transplantation. Since gastrointestinal complications can induce malnutrition, which might be related to considerable morbidity and mortality, close follow-up is necessary for the early detection and proper management of gastrointestinal complications.
Kim, Do-Hyung;Kim, Kil-Dong;Hwang, Jung-Joo;Choi, Jin-Ho;Lee, Jun-Wan
Journal of Chest Surgery
/
v.43
no.5
/
pp.513-517
/
2010
Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.
The purposes of this study were to develop Hazard Analysis Critical Control Point plan applicable to cook/chilled Pork Bulkogi (broiled sliced pork with sauces) in school foodservice operations and to establish reasonable shelf-life limits by assessing food quality during chilled storage period of 5 days. During the product flow, time-temperature profile was recorded and microbiological analyses including mesophilic and psychrotrophic total plate counts, coliform, and fecal coliform and qualitative analyses of Salmonella and Listeria monocytogenes were done. Chemical analyses (pH, acid value, total volatile basic nitrogen), sensory evaluation, and quantitative analysis of thiamin were conducted for 5 days of chilled storage. The number of mesophiles in raw pork ($4.26{\pm}0.11\;Log\;CFU/g$), seasoning mixture ($5.97{\pm}O.04\;Log\;CFU/g$) and marinated pork ($5.56{\pm}0.21\;Log\;CFU/g$) were below the microbial standards for "requires further cooking" food items. Listeria monocytogenes was detected in seasoning mixture. After heating, the number of mesophiles ($5.17{\pm}0.04\;Log\;CFU/g$) were slightly reduced but it did not meet the microbial guidelines of $5\;Log\;CFU/g$ for "ready-to-eat" foods. No other microbes including pathogens were detected. By reheating the menu item after chilled storage, the number of mesophiles were reduced in every phase of 1st day ($4.62{\pm}0.22\;Log\;CFU/g$), 3rd day ($4.55{\pm}0.20\;Log\;CFU/g$) and 5th day ($4.25{\pm}0.16\;Log\;CFU/g$) of chilled storage, and the number of microbes was below the standard limits for "ready-to-eat" foods. At the fifth day of chilled storage, pH (p<0.05), acid value (p<0.01) and TVBN (p<0.05) showed significant increases. Sensory evaluation results did not show any significant change for 5 days of chilled storage. Thiamin content showed a decrease for 5 days of chilled storage. Consequently, the ideal shelflife recommended for Pork Bulkogi was within 3 days of chilled storage. CCPs for Pork Bulkogi were purchasing and receiving of raw meat and some seasoning ingredients, heating, chilling, chilled storage, reheating, and distribution.
Yoo, Jung-Wan;Kim, Wongyoung;Choi, Chang Min;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
Tuberculosis and Respiratory Diseases
/
v.66
no.1
/
pp.6-12
/
2009
Background: The efficacy of several thrombolytic agents for treating massive pulmonary thromboembolism (PTE) has been reported to be similar. However, the difference of the bleeding complications caused by two commonly used thrombolytic agents in PTE patients is not well known. The aim of this study was to compare the therapeutic efficacy and the bleeding complications between urokinase and recombinant tissue-type plasminogen activatior (rt-PA, alteplase) in a Korean medical center. Methods: We retrospectively reviewed the clinical data of the patients who were treated with thrombolytic agents (urokinase and alteplase) because of massive PTE. Results: A total of 40 patients were included: 16 (40%) treated with urokinase and 24 (60%) with alteplase. The patients treated with alteplase showed a shorter duration of using vasopressor agents than did the patients who were given urokinase, but the duration of mechanical ventilation, the length of the ICU stay and the hospital stay were not different between the thrombolytic agents. Five patients treated with urokinase and eight patients treated with alteplase died (p=0.565): One patient in the urokinase group and four patients in the alteplase group died due to pulmonary thromboembolism. Bleeding complications after thrombolysis were observed in 3 patients (7.5%) treated with urokinase and in 11 (27.5%) patients treated with alteplase (p=0.079). Major bleeding complication occurred in 2 patients who were treated with alteplase. Conclusion: Urokinase seems to have fewer bleeding complications with an equivalent efficacy, as compared to alteplase, in Korean patients who suffer with massive pulmonary thromboembolism.
Purpose: This study was aimed to compare the margin and internal fitness of single anterior all-ceramic crown zirconia core made by three deferent CAD/CAM systems. Material and methods: Five single zirconia cores were manufactured by three deferent CAD/CAM systems($Cerasys^{(R)}$system, KaVo $Everest^{(R)}$system, $LAVA^{TM}$system). The manufactured zirconia cores were duplicated through the use of replica technique, and a replicated sample was sectioned in the center of bucolingual and mesiodistal direction to measure the marginal and internal gap. Measurement was carried out by using measuring microscope ($AXIO^{(R)}$) and $I-Solution^{(R)}$ and analysed through the use of ANOVA. Results: As for the mean marginal fitness of the zirconia core, it was $84.74{\pm}27.57{\mu}m$, in $Cerasys^{(R)}$, $80.23{\pm}21.07{\mu}m$ in KaVo $Everest^{(R)}$ and $96.37 {\pm}11.45{\mu}m$ in $LAVA^{TM}$, and as for the mean internal gap, it was $94.11{\pm}30.07{\mu}m$ in $Cerasys^{(R)}$, $92.31{\pm}25.18{\mu}m$ in KaVo $Everest^{(R)}$, and $94.99{\pm}18.74 {\mu}m$ in $LAVA^{TM}$. There was no significant statistically deference among the total average gap of three systems. The internal gap in KaVo $Everest^{(R)}$ seemed to be smaller than $LAVA^{TM}$ (P < .05). The internal gap in the incisal area was larger in all of the three systems. Conclusion: There was no difference in marginal fitness in $Cerasys^{(R)}$, KaVo $Everest^{(R)}$ and $LAVA^{TM}$. As for the internal fitness, it was smaller in KaVo $Everest^{(R)}$ system than $LAVA^{TM}$ system. In all of the three systems, there was a larger gap in incisal area. The marginal and internal gap was within the clinically allowed range in all of the three systems.
Journal of the korean academy of Pediatric Dentistry
/
v.35
no.2
/
pp.268-277
/
2008
Authors evaluated 1171 patients at the department of Pediatric Dentistry in Kyoungpook National University Hospital through clinical records and radiographs. And the following features were studied ; age, sex distribution, number of mesiodens per patients, cause of discovery of mesiodens, location, status of eruption, shape and orientation of crown, complication, dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens and the relationship between the resolution rate of complication after extraction of mesiodens and the dental age of adjacent upper incisor tooth, length of diastema, the eruption status of lateral incisor and the crowding status of premaxilla. The followings are the results : 1. The cause of discovery of mesiodens were as follows ; delayed eruption of the permanent incisors in 13.8%, midline diastema in 11.6%, radiographs taken for other reasons in 23.4% and for caries treatment in 15.1%. 2. Complication due to the presence of mesiodens did not occur in 36.8%, delayed eruption of adjacent teeth was observed in 16.1%, midline diastema in 34.4%, rotation in 8.8%, displacement in 2.4%, and crowding in 1.0% of all evaluated patients. 3. As for the dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens, below 1/3 of total root length were observed in 3.5%, $1/3{\sim}1/2$ of total root length in 19.9%, $1/2{\sim}2/3$ of total root length in 54.7% and over 2/3 in 21.9% of all evaluated patients. 4. Resolution rate of delayed eruption after the extraction of mesiodens was significant higher in the group with the root length below 1/2. Resolution rate of midline diastema was significant higher in the group with diastema width below 3mm and with non-crowding of adjacent upper incisor teeth.
Journal of the Korean Society of Food Science and Nutrition
/
v.41
no.6
/
pp.759-765
/
2012
This study was performed to investigate improvements in diabetes mellitus by extracts of yacon in streptozotocin (STZ)-induced diabetic rats. Fifty rats were divided into a normal group and four experimental groups. STZ (45 mg/kg) was injected intraperitoneally to induce type I diabetes in the four experimental groups. Yacon extracts were administered for 5 weeks. Forty-five ICR mice were also divided into one positive control group and four experimental groups for the oral glucose tolerance test (OGTT) after fed yacon extract. The control group did not eat any yacon extracts, while Group 1 (GI) was fed 125 mg/kg of yacon extracts, Group 2 (GII) was fed 250 mg/kg of yacon extracts, and Group 3 (GIII) was fed 500 mg/kg of yacon extracts. After treatment for 5 weeks, blood glucose in GIII group showed decreased tendency at the 5 week. In OGTT by glucose, the glucose level of yacon treatment group in diabetic rats was significantly decreased compared to the glucose level of the control group, but there was no difference in OGTT by maltose. In ICR mice, the glucose level of the experimental group in OGTT by maltose was significantly decreased compared to the control group. The area of the islets of Langerhans was increased by yacon treatment in a dose-dependent manner on diabetic rats. Insulin concentration of the GIII group was also decreased compared to the control group, while the concentration of fructosamine, total cholesterol, and triglycerides in serum showed no difference. OGTT by glucose or maltose in ICR mice or diabetic rats, area of the Islets of Langerhans, and insulin concentration improved. Yacon treatment may be a useful therapeutic and preventive strategy for diabetes mellitus.
Kim, Min Jae;Kim, Chae-Ri;Park, Jin Wan;Pak, Doo Hyun;Shin, Hyoung Doo;Choi, Ihn-Geun;Hahn, Sang Woo;Hwang, Jaeuk;Lee, Yeon Jung;Woo, Sung-Il
Korean Journal of Biological Psychiatry
/
v.23
no.4
/
pp.148-156
/
2016
Objectives According to previous studies, the cannabinoid receptor 1 (CNR1) gene could be an important candidate gene for schizophrenia. Some studies have linked the (AAT)n trinucleotide repeat polymorphism in CNR1 gene with the risk of schizophrenia. Meanwhile, smooth pursuit eye movement (SPEM) has been regarded as one of the most consistent endophenotypes of schizophrenia. In this study, we investigated the association between the (AAT)n trinucleotide repeats in CNR1 gene and SPEM abnormality in Korean patients with schizophrenia. Methods We measured SPEM function in 167 Korean patients with schizophrenia (84 male, 83 female) and they were divided according to SPEM function into two groups, good and poor SPEM function groups. We also investigated allele frequencies of (AAT)n repeat polymorphisms on CNR1 gene in each group. A logistic regression analysis was performed to find the association between SPEM abnormality and the number of (AAT)n trinucleotide repeats. Results The natural logarithm value of signal/noise ratio (Ln S/N ratio) of the good SPEM function group was $4.34{\pm}0.29$ and that of the poor SPEM function group was $3.21{\pm}0.70$. In total, 7 types of trinucleotide repeats were identified, each containing 7, 10, 11, 12, 13, 14, and 15 repeats, respectively. In the patients with $(AAT)7$ allele, the distributions of the good and poor SPEM function groups were 18 (11.1%) and 19 (11.0%) respectively. In the patients with $(AAT)_{10}$ allele, $(AAT)_{11}$ allele, $(AAT)_{12}$ allele, $(AAT)_{13}$ allele, $(AAT)_{14}$ allele and $(AAT)_{15}$ allele, the distributions of good and poor SPEM function groups were 13 (8.0%) and 12 (7.0%), 4 (2.5%) and 6 (3.5%), 31 (19.8%) and 35 (20.3%), 51 (31.5%) and 51 (29.7%), 36 (22.2%) and 45 (26.2%), 9 (5.6%) and 4 (2.3%) respectively. As the number of (AAT) n repeat increased, there was no aggravation of abnormality of SPEM function. Conclusions There was no significant aggravation of SPEM abnormality along with the increase of number of (AAT)n trinucleotide repeats in the CNR1 gene in Korean patients with schizophrenia.
Lee, Jun Ah;Kim, Min Suk;Lee, Jin Kyung;Kim, Dong Ho;Hong, Young Joon;Song, Won Seok;Cho, Wan Hyeong;Lee, Soo-Yong;Lim, Jung Sub;Park, Kyung Duk;Jeon, Dae-Geun
Clinical and Experimental Pediatrics
/
v.52
no.5
/
pp.581-587
/
2009
Purpose : To evaluate the correlation between serum methotrexate (MTX) peak levels and clinical outcome of osteosarcoma, as well as to determine the correlation of these levels with the histologic response and event-free survival (EFS). Methods : To maintain the homogeneity of the study population, we selected 52 patients with localized extremity osteosarcoma who had received two cycles of neoadjuvant chemotherapy consisting of high-dose (HD) MTX ($12g/m^2$), cisplatin ($100mg/m^2$), and doxorubicin ($60mg/m^2$). Results : Totally, 204 courses of HD MTX were administered. The serial MTX levels ($mean{\pm}SE$) at 4 h (peak), 24 h, 48 h, and 72 h were $1292.14{\pm}12.83{\mu}m$, $9.29{\pm}3.89{\mu}m$, $1.73{\pm}1.37{\mu}m$, and $0.58{\pm}0.44{\mu}m$, respectively. The peak MTX serum level was $1292.14{\pm}12.83{\mu}m$. Neither the continuous average MTX peak level nor the dichotomized MTX peak level was related to the histologic response. However, the patients with a high 24-h MTX level ($3.4{\mu}m$) had a poor histologic response (P=0.044). An inverse relationship was observed between MTX levels and survival: the EFS was better in the patients with a mean MTX peak level of less than $1,400{\mu}m$ (P=0.002) and mean 24-h MTX level of less than $3.4{\mu}m$ (P=0.011). Conclusion : The inverse correlation between the MTX level and the outcome is an unexpected finding. Further study on the pharmacokinetics of MTX is required to substantiate our findings and elucidate the mechanism involved.
In this study, crude extracts of the halophyte Limonium tetragonum and their solvent fractions were evaluated on anticancer activity in AGS and HT-29 human cancer cells using MTT assay. Each of the crude extracts (MeOH and $CH_2Cl_2$) of Limonium tetragonum showed a significant inhibitory effect on the growth of human cancer cells. The combined crude extracts of MeOH and $CH_2Cl_2$ were partitioned between $CH_2Cl_2$ and water. The organic layer was further partitioned between 85% aq. MeOH and n-hexane, and then the aqueous layer was fractionated with n-BuOH and $H_2O$, successively. Growth inhibition effects of crude extracts and their solvent fractions from Limonium tetragonum increased in a dose-dependent manner. Among them, 85% aq. MeOH, n-hexane and n-BuOH fractions revealed very good inhibition effects on the growth of human cancer cells. These results suggest that we can isolate active compounds from Limonium tetragonum to show much more strong anticancer activity.
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