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Prognostic Implication of Right Ventricle Parameters Measured on Preoperative Cardiac MRI in Patients with Functional Tricuspid Regurgitation

  • Yura Ahn;Hyun Jung Koo;Joon-Won Kang;Won Jin Choi;Dae-Hee Kim;Jong-Min Song;Duk-Hyun Kang;Jae-Kwan Song;Joon Bum Kim;Sung-Ho Jung;Suk Jung Choo;Cheol Hyun Chung;Jae Won Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1253-1265
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    • 2021
  • Objective: To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR). Materials and Methods: The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51-66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality. Results: For the median follow-up duration of 5.4 years (interquartile range, 1.2-6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m2, p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m2 RVMI = 1.75, p < 0.001). After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005). Conclusion: RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.

Efficacy and Safety of Ultrasound-Guided Radiofrequency Ablation for Primary Hyperparathyroidism: A Prospective Study

  • Hui-hui Chai;Yu Zhao;Zeng Zeng;Rui-zhong Ye;Qiao-hong Hu;Hong-feng He;Jung Hwan Baek;Cheng-zhong Peng
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.555-565
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    • 2022
  • Objective: To assess the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) in patients with primary hyperparathyroidism (PHPT). Materials and Methods: This prospective study enrolled 39 participants (14 male, 25 female; mean age, 59.5 ± 15.3 [range, 18-87] years) between September 1, 2018, and January 31, 2021. All participants had parathyroid lesions causing PHPT, proven biochemically and through imaging. The imaging features of the PHPT nodules, including the shape, margin, size, composition, and location, were evaluated before treatment. Serum intact parathyroid hormone, calcium, and phosphorus levels; parathyroid nodule volume; and PHPT-related symptoms were recorded before and after treatment. We calculated the technical success, biochemical cure, and clinical cure rates for these patients. Complications were evaluated during and after the ablation. Results: Complete ablation was achieved in 38 of the 39 nodules in the 39 enrolled participants. All the patients were treated in one session. The technical success rate was 97.4% (38/39). The mean follow-up duration was 13.2 ± 4.6 (range, 6.0-24.9) months. At 6 and 12 months post-RFA, the biochemical cure rates were 82.1% (32/39) and 84.4% (27/32), respectively, and the clinical cure rates were 100% (39/39) and 96.9% (31/32), respectively. Only 2.6% (1/39) of the patients had recurrent PHPT. At 1, 3, 6, and 12 months after technically successful RFA, 44.7% (17/38), 34.3% (12/35), 15.8% (6/38), and 12.5% (4/32) of participants, respectively, had elevated eucalcemic parathyroid hormone levels. Recurrent laryngeal nerve paralysis occurred in 5.1% (2/39) of the patients, who recovered spontaneously within 1-3 months. Conclusion: US-guided RFA was effective and safe for PHPT patients. RFA may be an alternative treatment tool for patients who cannot tolerate or refuse to undergo surgery.

Effect of Modified Atmosphere Packaging Gas Composition on Quality Preservation of Korean Rockfish Fillets (조피볼락 필렛의 변형기체포장에서 품질보존에 미치는 기체조성의 영향)

  • Eo Jin Park;Su Chan Kim;Duck Soon An
    • KOREAN JOURNAL OF PACKAGING SCIENCE & TECHNOLOGY
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    • v.29 no.3
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    • pp.145-151
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    • 2023
  • In order to extend shelf life for rockfish fillets by modified atmosphere packaging (MAP), different package atmospheres were compared in the product quality preservation. Firstly, CO2 solubility was measured at 0, 5, 10, and 15℃ to be incorporated into the mathematical model to predict the volume and CO2 concentration of the package at expected storage temperature. The CO2 solubility given in Henry's constant decreased with temperature to be fitted with a linear equation. Then air packaging as control and four MAP conditions of 100 g fillets were prepared and stored for duration of 5 days at 10℃ to compare them in the quality preservation effect. Four MAP conditions employed were CO2(60):O2(30):N2(10), CO2(60):O2(0):N2(40), CO2(30):O2(30):N2(40) andCO2(30):O2(0):N2(70). MAP conditions with high CO2 concentration inhibited total aerobic bacteria, and the conditions containing O2 led to low TVB-N. MAP of CO2(60):O2(30):N2(10) was found to be the best condition for rockfish fillet preservation considering total aerobic bacteria growth and nitrogenous volatiles production.

Role and Clinical Importance of Progressive Changes in Echocardiographic Parameters in Predicting Outcomes in Patients With Hypertrophic Cardiomyopathy

  • Kyehwan Kim;Seung Do Lee;Hyo Jin Lee;Hangyul Kim;Hye Ree Kim;Yun Ho Cho;Jeong Yoon Jang;Min Gyu Kang;Jin-Sin Koh;Seok-Jae Hwang;Jin-Yong Hwang;Jeong Rang Park
    • Journal of Cardiovascular Imaging
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    • v.31 no.2
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    • pp.85-95
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    • 2023
  • BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.

A Study on the Thermal Properties of Binary Eutectic Mixed PCM Using Polyethylene Glycol and 1,4-Butanediol (Polyethylene glycol과 1,4-Butanediol을 활용한 이원 공융혼합 PCM의 열적 특성에 관한 연구)

  • Jooyoung Park;Kitae Park;Jongchul Seo
    • KOREAN JOURNAL OF PACKAGING SCIENCE & TECHNOLOGY
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    • v.30 no.2
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    • pp.101-106
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    • 2024
  • Current cold chain logistics relying on organic or eutectic materials within the 2~8℃ range as secondary fluids often face limitations in heat storage capacity, necessitating high energy consumption and large volume capacity. An effective approach to address this challenge is by incorporating polymers to enhance the heat storage capacity of eutectic materials. In this study, we investigated the impact of polyethylene glycols (PEGs) on phase change materials using Fourier transform infrared spectroscopy (FT-IR), differential scanning calorimeter (DSC), analyses of endothermic and exothermic phase change processes, and an accelerated thermal cycling test. Our findings indicate that the introduction of PEGs into the phase change materials can lead to improvements in latent heat, thermal conductivity, and 2~8℃ retention time. This enhancement is attributed to the high latent heat and thermal conductivity of the polymer, along with its ability to inhibit crystal formation in the eutectic mixture.

Clinical Study of Children Using Home Mechanical Ventilation (가정용 인공 호흡기를 사용하는 소아의 임상적 고찰)

  • Ahn, Young Joon;Lee, Seung Hyeon;Kim, Hyo-Bin;Park, Seong Jong;Ko, Tae Sung;Hong, Soo Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.401-405
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    • 2005
  • Purpose : The use of mechanically-assisted ventilators at home reduces morbidity and improves the quality of life in children with chronic respiratory failure. But in Korea there is no clinical data of children with home mechanical ventilation. We investigated ventilator types, duration, the causes of failure or death, and the cost needed for care. Methods : We retrospectively analyzed the medical records of 21 children who were admitted and who applied for home mechanical ventilation at the Pediatric Intensive Care Unit in Asan Medical Center. Phone interviews took place after discharge. and interviewed by phone after discharge. Results : The median age was 31 months; the median duration with ventilator was 25 months. Underlying diseases were 16 neuromuscular diseases, one metabolic disease and four chronic respiratory diseases. The types of ventilator were pressure and volume type(16 and five patients, respectively). The frequency of ventilation failure was once per 19 months. Weaning could be performed in three cases. Frequencies of admission after receiving ventilators were 1.7 times per year; the most common cause was pneumonia. Nine patients(43%) died; four of them died because of endotracheal tube obstruction. The costs for medical care were about 1,110,000 won per month. Conclusion : There is an increment in the numbers of individuals who need mechanical ventilation support. The most common cause of death was endotracheal tube obstruction. The most important problem for the patients was medical cost. There needs to be more interest in patients with ventilator and social welfare systems to support their families need to be prepared.

Effect of Water Management after Fertilizer Application on Fate and Efficiency of Applied Nitrogen (시식 후 물관리 방법이 실소의 동태 및 이용효율에 미치는 영향)

  • 이변우;명을재;최관호
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.40 no.2
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    • pp.157-166
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    • 1995
  • The fate and use efficiency of applied nitrogen were evaluated in a pot experiment with different fertilizers and water management practices during 30days after fertilizer application. N-P-K compound fertilizers, 13-10-1l(F-l) for upland Crop use and 15-10-10(F-3) for rice Crop use, and mixed fertilizer, 21-17-17(F-2) for basal dressing in rice were used. Fertilizers corresponding to 1.8g N were mixed thoroughly with the whole volume of sandy loam soil in a pot. The pots were flooded upto 3cm above soil surface for O(0dF), 10(10dF), 20(20dF), and 30(30dF) days after fertilizer application and all the treatments were flooded continuously from 30 days after fertilizer application. During the flooding period water percolation rate was adjusted to 2.5mm/day. Rice seedlings were transplanted 40 days after fertilizer application. The pH of infiltrated water increased with increasing duration of flooding. The pH of F-2 was higher than those of F-1 and F-3 between which there were no differences. The applied nitrogen remained 23% in F-1, 29% in F-2, and 29.1 % in F-3, and 45.0% in 0dF, 26.6% in 10dF, 24.8% in 20dF, and 20.3% in 30dF as inorganic nitrogen at 63 days after fertilizer application. Nitrogen losses by leaching amounted to 51.3%, 32.1% and 48.1% of applied nitrogen in F-1, F-2 and F-3, respectively. Nitrogen leaching losses increased with increasing duration of flood- ing, amounting to 25.7%, 29.8%, 32.7%, and 35.8% in 0dF, 10dF, 20dF and 30dF, respectively. Gaseous loss of applied nitrogen was greatest in F-2, followed by F-1 and F-3. Total loss of nitrogen due to gaseous volatilization and leaching was greatest in F -1, followed by F -2 and F-3, and were greater in the treatments with longer flooding after fertilizer application. Nitrogen recovery by rice shoot until 72 days after transplanting were 23.2%, 24.7% and 27.4% of applied nitrogen in F-1, F-2 and F-3, respectively and 34.1%, 25.5%, 21.1%, and 21.2% in 0dF, 10dF, 20dF and 30dF, respectively.

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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

Treatment of Intracranial Meningioma with Linac Based Radiosurgery (뇌수막종에서 선형가속기를 이용한 방사선수술 효과)

  • Kay Chul Seung;Yoon Sei Chul;Chung Su Mi;Ryu Mi Ryung;Kim Yeon Sil;Suh Tae Suk;Choi Kyuho;Son Byung Chul;Kim Moon Chan
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.81-86
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    • 2001
  • Prupose : To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. Methods and Materials : From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four $(20\%)$ were male and 16 $(80\%)$ were female. Mean age was 51 years old ($22\~78$ years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 $(30\%)$, postoperative residual lesions in 11 $(55\%)$ and regrowth after surgery in 3 $(15\%)$. Mean tumor volume was $5.72\;cm^3\;(0.78\~15.1\;cm^3)$ and secondary collimator size was 2.04 cm $(1\~3\;cm)$. The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy $(9\~30\;Gy)$ which was $40\~90\%$ of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. Results : By the follow up imaging studies, the tumor volume was reduced in 5 cases $(25\%)$, arrested growth in 14 cases $(70\%)$, and increased size in 1 case $(15\%)$. Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine $(45\%)$ patients were considered improved condition, 10 $(50\%)$ patients were stable and one $(5\%)$ was worsened to be operated. This partly resulted in necrosis after surgery. Conclusion : The overall control rate of meningiomas with linac based RS was $95\%$ by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.

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