• Tuberculosis and Respiratory Diseases
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• v.50 no.6
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• pp.693-703
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• 2001

Background : Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyond just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD according to patient's smoking habits. Method : To evaluate the differences in the smoking patterns of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). Result : The patients with emphysema smoked earlier and had a higher smoking history(ie, more packyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of inhalation was also significantly higher in the emphysema patients after taking into account age, cumulative cigarette consumption and the type of cigarette smoked. Conclusion : Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.

• Tuberculosis and Respiratory Diseases
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• v.55 no.1
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• pp.88-97
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• 2003

Background : Although smoking is a major cause of chronic obstructive pulmonary disease (COPD), only 10-20% of cigarette smokers develop symptomatic COPD, which suggests the presence of genetic susceptibility. This genetic susceptibility to COPD might depend on variations in the activities of the enzyme that detoxify hazardous chemical products, such as microsomal epoxide hydrolase (mEPHX) and glutathione-S transferase M1 subunit (GSTM1) genes. Methods : The genotypes of 58 patients with COPD, and 79 age matched control subjects, were determined by a polymerase chain reaction, followed by restriction fragment length polymorphism (PCR-RFLP) for the mEPHX, and multiplex PCR for the GSTM1. Results : GSTM1 was deleted in 53.3% of the subjects. There was no difference in GSTM1 deletion rates between the COPD patients (32/58, 55.2%) and the control subjects (41/79, 51.9%). The combination patterns of two polymorphisms of mEPHX showed slow enzyme activity in 29(21.2%), normal in 73(53.3%) and fast in 32(23.4%). The COPD group (7/57, 12.3%) showed a significantly lower incidence of slow enzyme activity compared to the control subjects (22/77, 28.6%, p<0.05). However, when the COPD and control groups were compared with smokers only, there were no significant differences in the genotypes of GSTM1 and mEPHX. Conclusion : The genotypes of GSTM1 and mEPHX were not significant risk factors of COPD in this cohort of study.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.285-291
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• 2009

The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was $0.739{\pm}0.137\;mm$ and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.363-372
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• 1997

One hundred forty-four patients underwent operation for coarctation of the aorta at Seoul National University Children's Hospital between June 1986 and Decembsr 1995. Age ranged 0.1 to 191 months. Of these 78.5%(113) were infants. We classified the patients in terms of the anatomic location of coarctatiln and the associatCd anomalies(I[401= primary coarctation, 11(741=isthmic hypoplasia, lIIf30)=tubular hypoplasia involving transverse arch, Ar63 =with ventricular septal defect, B(28)=with other major cardiac defects). Subcalvian flap coarctoplasty(60), resection & anastomosis(44), extended aortoplasty(26), and onlay patch(14) were used as surgical methods. Overall operative mortality was 16.0(23/144)%. The hospital mortality was signific'antly higher in patheints with type 111, subtype B, younger age(under 3 months), extended aortoplasty(p(0.01). However, one-stage total repair in patients with subtype A or B were not found to be a predictor of hospital death. Restenosis had occured in 18 patients among 121 survivals(14. 9%). The mean follow-up period was 29.1 $\pm$28.8(0~129.2) months. Preoperative, immediate postoperative(within 3 months after operation) and postoperative(later than 6 months after operation) echocardiographic data on the dimensions of ascending aorta(AA), transverse arch(TA), an4 aortic isthmus(Al) were available in 77 patients(I=20, ll=42, 111= 15). Preoperative and postoperative aortic isthmus(All) and tra sverse arch indices(TAI), defined as TAIAA & AIIAA respectively, were compared. Immediate postoperative All in type 1, II and TAI in type 111 were significantly smaller in stenotic than non-stenotic group suggesting incomplete relieves of stenotic segment Younger age, subclavian coarctoplasty in patient under 3 months of age were round to be the risk factors for restenosis in this series. In conclusion, We found that aortic arch index and transverse arch index can be a useful tool to figure out the anatomic and clinical characteristics of the patients with aortic coarctation, and that anatomy, associated anomalies, age, and surgical methods may influence the surgical outcome of the coarctation repair.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.897-902
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• 2004

Background: Although great concerns have been raised regarding the suitability of the use of the radial artery as a bypass conduit after transradial catheterization, there has been no studies that examined this issue in Korea. The purpose of this study was to compare clinical and angiographic results of radial artery grafting between patients with and without previous transradial catheterization. Material and Method: From January 2000 to February 2004, a total of 93 patients underwent coronary artery bypass grafting using the radial artery: 49 patients received preoperative transradial catheterization for coronary angiography (group I) and 44 patients did not (group II). These patients were retrospectively reviewed. Result: There was no significant difference in sex ratio, age, clinical diagnosis, risk factors, ejection fraction and early clinical outcomes between two groups. The graft patency rates in groups I and II were both 100% in the internal thoracic artery and in the radial artery, and 85% and 86% in the saphenous vein. respectively. The stenosis-free graft patency in groups I and II were 93% and 81% in the radial artery respectively but no statistical significance was shown. Conclusion: There was no significant difference in graft patency at postoperative coronary angiography between two groups. Radial artery graft after transradial catherization seems to be suitable for bypass conduit in short-term analysis.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.652-659
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• 2004

Background: In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. Material and Method: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1$\pm$61.5 (1∼223) months. The mean follow up was 50.8$\pm$30.2 (3∼121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0$\pm$33.0 mmHg, and the mean grades of AR were 3.1$\pm$0.9. Result: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5$\pm$21.0 mmHg (p < 0.05), and AR improved with mean grades of 1.9$\pm$0.8 (p < 0.05). At mean follow up of 35.0$\pm$23.0 months, AS maintained with mean peak pressure gradients of 31.5$\pm$24.0 mmHg, but AR progressed with mean grades of 2.8$\pm$1.3 (p < 0.05). Reoperation was required in 6 patients 38.3$\pm$21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9$\pm$3.1%, 79.5$\pm$5.5%, and 56.8$\pm$11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR. Conclusion: Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.348-355
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• 2003

Background: The prognostic significance of lymph node micrometastasis in non-small cell lung cancer remains controversial. We therefore investigated the clinicopathologic factors related to lymph node micrometastsis and evaluated the clinical relevance of micrometastasis with regard to recurrence. Material and Method: Five hundred six lymph nodes were obtained from 41 patients with stage 1 non-small ceil lung cancer who underwent curative resection between 1994 and 1998. Immunohistochemical staining using anti-cytokeratin Ab was used to detect micrometastasis in these lymph nodes. Result: Micrometastatic tumor cells were identified in pN0 lymph nodes in 14 (34.1%) of 41 patients. The presence of lymph node micrometastasis was not related to any clinicopathoiogic factor (p) 0.05). The recurrence rate was higher in patients with micrometastasis (57.1%) than in those without (37.0%), but the difference was not significant (p=0.22). Patients with micrometastasis had a lower 5-year recurrence-free survival rate (48.2%) than those without micrometastasis (64.1%), with a borderline significance (p=0.11), The S-year recurrence-free survival rate (25.0%) in the patients with 2 or more micrometastatic lymph nodes was significantly lower than that in the patients with no or single micrometastasis (p=0.02). In multivariate analysis, multiple lymph node micromestasis us was a significant independent predictor of recurrence (p=0.028, Risk ratio=3.568). Conclusion: Immunehistochemical anti-cytokeratin staining was a rapid, sensitive, and easy way of detecting lymph node micrometastasis. The presence of lymph node micrometastasis was not significantly associated with the recurrence, but had a tendency toward a poor prognosis in stage 1 non-small cell lung cancer. Especially, the presence of multiple micrometastatic lymph nodes was a significant and independent predictor of recurrence.

• Journal of the Korean Society of Food Science and Nutrition
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• v.31 no.2
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• pp.306-314
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• 2002

The purpose of this study is to examine the relation between vegetarian diet and the risk factors of cardiovascular disease. The subjects of the study were 127 Buddhist nuns (age: 23 ~79 yr) for vegetarians and 235 healthy female adults (age: 23 ~79 yr) for non-vegetarians. This study covers food consumption survey, anthropometric measurement, amount of energy expenditure, physical activity and clinical examination. Average body mass index (BMI) of vegetarians and non-vegetarians were 22.47 and 21.08, waist/hip ratio (WHR) was 0.85 and 0.84, percentage of body fat (%BF) was 28.79 and 26.55, respectively. Average duration of vegetarian diet of the vegetarians was 13.16 years. The triglyceride levee of the vegetarians was significantly lower for those who take nutrient tablet compared to those who either take vitamins or who do not take any nutrient supplement. Taking vitamins or nutrient tablet did not give any significant difference in total-cholesterol and LDL-cholesterol for vegetarians, while significantly high triglyceride was observed for the non-vegetarians taking nutrient tablet than the ether non-vegetarians. Taking vitamins or nutrient tablet did not affect the lever of HDL-cholesterol for either vegetarians or non-vegetarians. Athrogenic index (AI) was lower for the vegetarian group tailing nutrient tablet and for the non-vegetarian group not taking vitamins and nutrient tablet, than the other respective groups. Blood sugar of the vegetarians who take nutrient tablet was significantly lower than those tailing vitamins, while blood sugar of the non-vegetarians not taking any nutrient supplement was significantly lower than those taking nutrient tablet.

• Tuberculosis and Respiratory Diseases
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• v.55 no.4
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• pp.353-360
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• 2003

Background : Although most patients with tuberculous pleurisy respond well to anti-tuberculous drugs, some are known to progress into severe pleural thickening which needs decortication despite adequate anti-tuberculous treatment. Therefore, the purpose of this study was to identify factors associated with the development of severe pleural thickening in patients who finally underwent pleural decortication in tuberculous pleurisy. Patients and Methods : From retrospective medical records review, 121 patients initially diagnosed as tuberculous pleurisy without initial pleural fluid loculation were enrolled between January 1998 and December 2002. They were separated into two groups: 85 patients in group 1 who improved by anti-tuberculous drugs only, and 36 patients in group 2 who had progressed into pleural adhesion and finally underwent pleural decortication despite adequate (more than 6 months) anti-tuberculous treatment. Results : Males were more common in group 2 (M/F=31/5) than in group 1 (M/F=53/32) (p=0.010). Group 2 patients tended to have lower pleural fluid glucose level ($58{\pm}4$ mg/dL) than group 1 ($89{\pm}3$ mg/dL) (p=0.001) and higher pleural fluid adenosine deaminase level ($86{\pm}5$ IU/L) than group 1 ($76{\pm}3$ IU/L), (p=0.038). There were no significant differences in age, symptom duration, pleural fluid amount, or pleural fluid LDH level between groups 1 and 2. Conclusions : There was a relative risk of tuberculous pleurisy progression into severe pleural thickening which needed decortication in the case of male patients, low pleural fluid glucose or high adenosine deaminase level. But further, large-scale, prospective studies should be investigated.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.781-789
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• 1999

Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.