• Journal of Chest Surgery
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• v.30 no.2
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• pp.158-163
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• 1997

From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years (range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction hi tory. Five patients had preoperative left ventricular ejection fraction of 40% or less, The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases.21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery,)1, radial artery; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.5
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• pp.562-570
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• 2008

Most purulent maxillofacial infections are of odontogenic origin. Treatment of infection includes the surgical intervention, such as incision and drainage, and adjunctive treatment. The use of high-dose antibiotics is also indicated. The choice of an antibiotics should be based on the knowledge of the usual causative microbes and the results of antibacterial sensitivity test. We have undertaken clinical studies on 119 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from January 2000 to December 2007. Many anaerobic microbes are killed quickly when exposed to oxygen. Thus the needle aspiration techniques and the transfer under inert gas were used when culturing. The aim of this study was to obtain informations for the bacteriologic features and the effective antimicrobial therapy against maxillofaical odontogenic infections. The obtained results were as follows: 1. The most frequent causes of infections were odontogenic (88.3%), and in odontogenic cause, pulpal infections were the most common causes(53.8%). 2. The buccal and submandibular spaces (respectively 23.5%) were the most frequent involved fascial spaces, followed by masticator spaces (14.3%). 3. The most common underlying medical problems were diabetes (17.6%), however the relation with prognosis was not discovered. 4. The complications were the expiry, mediastinitis, necrotizing fasciitis, orbital abscess, and osteomyelitis. 5. The most common admission periods were 1-2 weeks, and the most patients were discharged within 3 weeks. However, patients who admitted over 5 weeks were about 10%. 6. A total of 99 bacterial strains (1.1 strains per abscess) was isolated from 93 patients (78.2%). The most common bacterium isolated was Streptococcus viridans (46.2%), followed by $\beta$-hemolytic group streptococcus (10.1%). 7. Penicillins (penicillin G 58.3%, oxacillin 80.0%, ampicillin 80.0%) have slightly lower sensitivity. Thus we recommend the antibiotics, such as glycopeptides (teicoplanin 100%, vancomycin 100%) and quinolones (ciprofloxacin 90.0%) which have high susceptibility in cases in which peni cillin therapy failed or severe infections.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.586-591
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• 2001

Objective : Transseptal or sublabial transsphenoidal surgery has been standard teatment for pituitary tumors for decades. However, as an alternative to this surgery endonasal endoscopic technique has been reported with encouraging results. We have started endoscopy-assisted transsphednoidal surgery from May 1998. In this paper we analyzed the methods, outcome, advantage and disadvantage of this surgical approach for the purpose of planning optimal treatment of pituitary tumors. Methods : This study consisits of 13 cases of pituitary tumors who were treated by endoscopy-assisted transsphenoidal surgery using one nostril from May 1998 to July 1999. Mean follow up period was 12.9 months. Results : There was no septal or sublabial incision and little surgical damage to nasal structure. With this technique, rapid surgical approach and short hospital day were possible, being 3-6 days in patients without CSF leakage. Using various angled endoscope, good surgical view was obtained. Initially it was difficult to use various instruments in narrow nasal cavity, but became feasible after several procedures. Among 13 cases, total removal was possible in 11 cases. One of two cases in whom tumor was incompletely removed underwent gamma-knife radiosurgery and second underwent reoperation through subfrontal approach. There were 6 cases of hormone secreting tumors and hormonal remission was achived in all of these cases. Postoperative complications were CSF leakage(6 cases), diabetes insipidus(2 cases) and panhypopituitarysm(1 case). Lumbar drainage was done in all cases of CSF leakage. Conclusion : The advantage of endoscopy-assisted transsphenoidal surgery are rapid surgical approach, low postoperative morbidity, short hospital day and good surgical view. The disadvantage of this appoach are difficulty in manupulating various instruments in narrow nostril and difficulty in distance perception but these problems can be overcome by practice and using stereoscopic endoscope.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.104-110
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• 2013

Background: We reviewed the long-term outcomes of aortic root replacement at Asan Medical Center and investigated the predictors affecting mortality. Materials and Methods: A retrospective analysis was performed on 225 consecutive adult patients undergoing aortic root replacement with mechanical conduits (n=169), porcine aortic root prosthesis (n=23), or aortic homografts (n=33) from January 1992 to September 2009. The median follow-up duration was 6.1 years (range, 0 to 18.0 years). Results: The porcine root group was older than the other groups (freestyle $55.9{\pm}14.3$ years vs. mechanical $46.3{\pm}14.6$ years, homograft $48.1{\pm}14.7$ years; p=0.02). The mechanical group had the highest incidence of the Marfan syndrome (mechanical 22%, freestyle 4%, homograft 3%; p=0.01). Surgery performed for infective endocarditis was more frequent in the homograft group (mechanical 10%, freestyle 10%, homograft 40%; p<0.001). The overall 30-day mortality was 5.3% (12/225). Actuarial survival rates in the mechanical, porcine root, and homograft groups were 79.4%, 81.5%, and 83.5% at 5 years and 67%, 61.9%, and 61.1% at 10 years, respectively (p=0.73). By multivariate analysis, preoperative diabetes mellitus, older age, and longer cardiopulmonary bypass time were independent predictors of mortality. Incidence of postoperative complications, including infective endocarditis and thromboembolism were comparable in all of the groups. Conclusion: Aortic root replacement can be safely performed with different types of prostheses as the outcome was not affected by the choice of prosthesis. Further studies are required to assess the long-term durability of biological prostheses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.449-455
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• 2018

This study was conducted to analyze the correlation between changes in white matter and homocysteine concentration through brain computed tomography of healthy 50-75 year old subjects without stroke or dementia history. We studied 722 out of 900 patients who underwent health screening at one hospital from 2016 to 2017. Based on the medical records, retrospective studies were conducted and analyzed using SPSS. A chi-square test, T-test and univariate logistic regression analysis were used for analysis. After the subjects were divided into the group with and without white matter changes, the population characteristics were analyzed. The mean age, homocysteine concentration and prevalence of hypertension and diabetes were higher and the duration of education was shorter in the group with white matter changes. In the group with white matter changes, the population increased as homocysteine concentration increased. When the odds ratio was compared based on the lowest group (Q1), age [p<0.001], hypertension [p<0.001] and hyperhomocysteinemia [p=0.021] were risk factors for white matter changes. We also identified modifiable risk factors such as hypertension and hyperhomocysteinemia to prevent complications of white matter changes. However, there has been no report of risk for the each causes of hyperhomocysteinemia and relationship between white matter changes and homocysteine concentration in Koreans. Therefore, large scale prospective studies are needed to better understand this topic.

• Journal of Nutrition and Health
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• v.53 no.1
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• pp.1-12
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• 2020

Purpose: Diabetic nephropathy is one of the most important diabetic complications prompted by chronic hyperglycemia, characterized by glomerulosclerosis, tubular fibrosis, and it eventually causes kidney failure. Nobiletin is a polymethoxyflavone present in tangerine and other citrus peels, and has anti-cancer and anti-inflammatory effects. This study investigated the effects of nobiletin on glomerular fibrosis through inhibition of the transforming growth factor (TGF)-β1-Src-caveolin-1 pathway. Methods: Human renal mesangial cells (HRMC) were incubated in media containing 33 mM glucose with or without 1-20 uM nobiletin for 3 day. The cellular expression levels of fibrogenic collagen IV, fibronectin, connective tissue growth factor (CTGF), TGF-β1, Src and caveolin-1 were all examined. In addition, TGF-β1, Src and caveolin-1 proteins were screened to reveal the relationship among TGF-β1-Src-caveolin-1 signaling in glomerular fibrosis. Results: High glucose promoted the production of collagen IV, fibronectin and CTGF in HRMC, which was inhibited in a dose dependent manner by 1-20 uM nobiletin. The Western blot data showed that high glucose elevated the expression of TGF-β1, Src, caveolin-1 and Rho GTPase. When nobiletin was treated to the HRMC exposed to high glucose, the expression of TGF-β1-Src-caveolin-1 was dampened. Finally, TGF-β1-Src-caveolin-1 signaling pathway was activated in high glucose-exposed HRMC, and such activation was encumbered by nobiletin. Conclusion: These result demonstrated that nobiletin blunted high glucose-induced extracellular matrix accumulation via inhibition of the TGF-β1-Src-caveolin-1 related intracellular signaling pathway. Nobiletin may be a potent renoprotective agent to counteract diabetes-associated glomerular fibrosis that leads to kidney failure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.10
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• pp.2873-2878
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• 2009

Since Germany was unified in 1990, Korea became the only country that has the division in the world. This division has various bad effects on Korea's status with not reliable security, forfeited national impression, loss of tourism income and so on. Kim Jung-Il national defense committee chairman is the current dictator of North Korea which is a socialist state. Even if he is getting old, his successor is not proclaimed. In this situation, his sudden aggravation of health can cause seriously bad effects on diplomatic relations especially with South Korea. Therefore, the health information about Kim Jung-Il national defense committee chairman will be very important information. In order to deal this problem, we propose the method of extracting the Kim Jung-Il national defense committee chairman's health from his pictures which are recently open to the public by employing the diagnosis Ocular Inspection used in Oriental medicine. n order to get an accurate result, revising the Kim Jung-Il national defense committee chairman's pictures, which are not taken in a controled equal situation, is necessary. Therefore we employed the color analysis process with color revising and color differential comparing process without color revising. With these processes, we can make diagnosis of his diabetes and complications.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.3
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• pp.185-195
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• 2000

Vascular diseases are significant complications of diabetes mellitus (DM), and the endothelial cells may play a pivotal role in the development of vascular disease in DM. Endothelin-1 (ET-1) released from endothelium is a potent vasoconstrictor peptide and circulating level of ET-1 is increased in a variety of disease states. The purpose of this study was to determine the changes of responsiveness to ET-1 in DM, and we experimented on the changes in the ET-1-induced contraction, levels of nitrite and lipid peroxidation, and ET-1 immunoreactivity in aorta from streptozotocin-induced DM rats. DM was induced by single injection of streptozotocin (55 mg/kg, i.p.). The immunoreactive ET-1 levels in endothelial layer of thoracic aorta were much higher in DM rats than control rats. Nitrite in tissue homogenate was decreased and plasma nitrite was increased in DM rats. Malondialdehyde (MDA) was significantly increased in DM rats and cGMP was not significantly different between control and DM rats. ET-1 produced concentration- dependent contractile responses that are significantly attenuated in DM rats compared to controls. In the presence of selective $ET_A$ receptor antagonist BQ610, the maximum contraction was decreased and the concentration ratios for BQ610 yielded $pA_2$ values of 7.3 (slope, 0.65) in control rats, whereas BQ610 had no antagonistic effect on ET-1-induced contraction in DM rats. However, pretreatment with BQ788, an $ET_B$ receptor antagonist, maximum response was decreased and the dose-response curves for ET-1 were shifted to the right in both groups and $pA_2$ values were 7.9 and 7.7 (slope, 1.05 in control and DM rats), respectively. IRL 1620 and sarafotoxin S6c, $ET_B$ agonists, induced relaxation in control rats but not in DM rats. These results indicate that endothelial cell dysfunction and enhanced immunoreactivity of ET-1 have been found in DM rat and ET-1-induced contraction was attenuated in DM rat. These attenuated responses might be at least in part caused by the alteration of $ET_A$ receptor properties (e.g. desensitization), and partly related with an alteration in intracellular mechanism for contraction to ET-1.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.12-20
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• 2015

Purpose: To evaluate treatment outcomes and determine prognostic factors in patients with esophageal cancer treated with esophagectomy after neoadjuvant chemoradiotherapy (NCRT) Materials and Methods: We retrospectively evaluated 39 patients with esophageal cancer who underwent concurrent chemoradiotherapy followed by esophagectomy between 2002 and 2012. Initial clinical stages of patients were stage IB in 1 patient (2.6%), stage II in 5 patients (12.9%), and stage III in 33 patients (84.6%). Results: The median age of all the patients was 62 years, and the median follow-up period was 17 months. The 3-year overall survival (OS) rate was 33.6% in all the patients. The 3-year locoregional recurrence-free survival (LRFS) rate was 33.7%. In multivariate analysis with covariates of age, the Eastern Cooperative Oncology Group performance status, hypertension, diabetes mellitus, tumor length, clinical response, clinical stage, pathological response, pathological stage, lymphovascular invasion, surgical type, and radiotherapy to surgery interval, only pathological stage was an independent significant prognostic factor affecting both OS and LRFS. The complications in postoperative day 90 were pneumonia in 9 patients, anastomotic site leakage in 3 patients, and anastomotic site stricture in 2 patients. Postoperative 30-day mortality rate was 10.3% (4/39); the cause of death among these 4 patients was respiratory failure in 3 patients and myocardial infarction in one patient. Conclusion: Only pathological stage was an independent prognostic factor for both OS and LRFS in patients with esophageal cancer treated with esophagectomy after NCRT. We could confirm the significant role of NCRT in downstaging the initial tumor bulk and thus resulting in better survival of patients who gained earlier pathological stage after NCRT.

• Journal of Life Science
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• v.18 no.9
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• pp.1278-1283
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• 2008

The purpose of this study was to investigate the effects of 12-week aerobic exercise training on cardiac QT intervals and cardiovascular risk profiles in type 1 diabetic children. Eleven type 1 diabetic children aged 9-17 years took part in this study as subject. The participants performed aerobic exercise training three times a week for total 12 weeks. The intensity of the training was adjusted at HRR 45% until three weeks and at HRR 55% since four weeks. After a 12-week aerobic exercise training systolic (p<0.05) and diastolic (p<0.05) blood pressure of the subjects was decreased. There was significant decrease in cardiac QT intervals (p<0.05), TC level (p<0.05), and HDL-C level (p<0.05). Therefore, the results of this study suggest that long-term regular physical activity of type 1 diabetic children considered exercise intensity and frequency may effect and play a important role in the prevention of diabetic complications and cardiovascular health care.