• Journal of the Korean Society of Radiology
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• v.6 no.1
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• pp.19-26
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• 2012

It is very important for early diagnosis and therapy with ischamic cerebral infarction patients. This study was to know the ischemic penumbra lesion which compared CT-perfusion and diffusion weighted MRI(DWMRI) with acute cerebral infarction patients. 12 acute cerebral infarction patients had performed perfusion CT and performed DWMRI. Perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), time to peak(TTP) and mean transit time(MTT) maps obtained the values with defect lesion and contralateral normal cerebral hemisphere and DWMRI was measured by signal intensity and compared of lesion size between each perfusion map. All perfusion CT maps showed the perfusion defect lesions in all patients. There were remarkable TTP and MTT delay in perfusion defect lesions. The lesions on CBF map was the most closely correlated with the lesions on DWMRI. The size of perfusion defect lesions on TTP and MTT map was larger than that of lesions on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra, but also hemodynamic status in the perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

• Korean Journal of Veterinary Pathology
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• v.2 no.2
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• pp.95-106
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• 1998

The prevalence of primary liver carcinoma (PLC) is relatively high in Clonorchis sinensis (CS) endemic areas in Korea. PLC is a malignant tumor which can be subclassified into hepatocellular carcinoma and cholangiocarcinoma(CC). CC has been associated with clonorchiasis, but it is unclear whether clonorchiasis is associated with hepatocarcinogenesis. This experiment was designed to investigate relationships between clonorchiasis and early changes of hepatocarcinogenesis. Sixteen Sprague-Dawley rats weighing 150g were divided into two groups of 8 rats in each. All rats were fed choline-devoid(CD) diet for 4 weeks. Group 1 was given 0.015-0.020% diethylnitrosamine(DEN) as drinking water for 1 week. After one week, the rats were treated orally with 1% N-acetylaminofluorene(AAF) (5 times per week for 2 weeks). Group 2 was treated equally to group 1 except for CS infection during AAF treatment. Two rats in each group were sacrificed at 4th, 5th, 6th and 7th week of the experiment. Livers were stained with OV -6, proliferating cell nuclear antigen(PCNA) and GST-p. Results were as follows: Group 2 livers showed more oval cell proliferation in parenchyma and portal areas at the 4th, 5th, 6th and 7th weeks than did livers of group 1 (p＜0.01). PCNA was mostly localized in oval cell populations, rather than hepatocytes and biliary cells. The ratio of oval cells to hepatocytes was much higher in group 2 than in group l(p＜0.01 The ratio of hepatocytes to biliary cells is higher in group 2 than in group 1 (p＜0.05), More group 2 acidophilic foci reacted to GST-p monoclonal antibody than in the noninfected group. It appeared that CS infection promoted potentially precancerous acidophilic foci and oval cell proliferation.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.19-28
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• 1975

The thoracoscopic study was reported on 21 cases of spontaneous pneumothorax requiring surgical management, and clinical values of thoracoscopic examination on spontaneous pneumothorax were also discussed. patients were treated in the Department of .Thoracic Surgery, Hanyang University Hospital for the period of two Years from May 1972 to April 1974. For exact detection of etiologic factors on spontaneous pneumothorax, the thoracoscopic examination in the intrapleural space was performed in parallel with X-ray study. this study, the difference of diagnostic and therapeutic significance between radiological and thoracoscopic findings were observed and compared simultaneously. The results are summerized as follows: Patients age was distributed between 3 and 70 years old with highest incidence in the age group of sixty decade [33. 3%], and sex ratio of male to female was 5:2. The tuberculous processes which developed superficial subpleural layer in the lung parenchyme, on the pulmonary surface could be observed by thoracoscopic examination in a characteristic picture. detection ratio of pulmonary tuberculosis by the radiologic study to that by thoracoscopy was 8:2. The adhesion between the visceral and the parietal pleura which could possibly make a rupture of the alveola and the visceral pleura was found to be localized in a small area of the lung surface. The other part of the lung surface was free of the adhesion and, therefore, the movement of the lung took place completely without any difficulty. The ruptured orifice of the pleura and pathological changes surrounding the orifice can be detected by thoracoscopy, but not by other means such as radiologic examination. A single tuberculous bleb and multiple emphysematous blebs were found on 6 cases out of 21 cases of spontaneous pneumothorax. Among these cases, radiologic Study revealed the bleb only in one patient. On the other hand, the blebs were found in all the six patients by means of thoracoscopic examination. It gives the detection ratio of bleb by radiologic study to that by thoracoscopy was 1:6. By thoracoscopy, the rupture on the lung surface were visualized on the 10 patients out of a total of 21 patients [10 patients of visual rupture]. However, the rupture of the pleura was not observed on the rest of 11 patients even by thoracoscopic examination [11 patients of non visual rupture]. Five patients [50%] out of ten who had the visual rupture on the lung surface was required a surgical operation to remove pneumothorax. For the patients who were detected to have the visual rupture of the pleura by thoracoscopy, be considered in the early stage of closed thoracostomy. of 21 patients, 16 patients [11 patients of non visual rupture of the pleura and 5 patients of visual rupture of the pleura] who received no surgical management, were treated with closed thoracostomy with continuous suction, and the` pneumothorax was healed completely up in each cases. Therapeutic measures for the remaining 5 patients of visual rupture of the pleura who were subjected to surgical approach for radical treatment of spontaneous pneumothorax were accordingly complicated, and the following different procedures were properly indicated case by case, that is, rib resection thoracostomy, simple closure of ruptured visceral pleura, wedged resection of the lung, and lobectomy.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.248-250
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• 2002

A 56 year-old man complaining of dry cough, dyspnea, chest pain, fever, and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy and subsequent radiotherapy because of an esophageal cancer. After the emergency echocardiography revealed a small amount of pericardial effusion and pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach and the pericardium, and an emergency operation was done under the diagnosis of gastropericardial fistula. The patient expired postoperative seven days later. Gastropericardial fistula caused by a peptic ulcer perforation after the esophagectomy and esophagogastrostomy operation is a very rare complication and brings forth a disastrous result. Early detection using the chest radiography, electrocardiogram, upper Gl study, echocardiography and a review of physical examination, and an immediate treatment are therefore mandatory.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.13-19
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• 1998

Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

• The Korean Journal of Nuclear Medicine
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• v.24 no.2
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• pp.229-236
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• 1990

Perfusion and ventilaion imagings of the lung are well established procedure for diagnosing pulmonary embolism, differentiation it from chronic obstructive lung disease, and making an early detection of chronic obstructive lung disease. To evaluate the usefulness of radioaerosol inhalation imaging (RII) in chronic obstructive lung disease, especially pulmonary emphysema, we analyzed RIIs of five normal adult non-smokers, five asymptomatic smokers (age 25-42 years with the mean 36), and 21 patients with pulmonry emphysema (age 59-78 years with the mean 67). Scintigrams were obtained with radioaerosol produced by a BARC nebulizer with 15 mCi of Tc-99m-phytate. Scanning was performed in the anterior, posterior, and lateral projections after five to 10-minute inhalation of the radioaerosol on sitting position. The scans were analyzed and correlated with the results of pulmonary function studies and chest radiographs. Also lung perfusion scan with $^{99m}Tc-MAA$ was performed in 12 patients. In five patients, we performed follow-up scans for the evaluation of the effects of a bronchodilator. Based on the X-ray findings and clinical symptoms, pulmonary emphysema was classified into four types: centrilobular (3 patients), panlobular (4 patients), intermediate (10 patients), and combined (4 patients). RII findings were patternized according to the type, extent, and intensity of the aerosol deposition in the central bronchial and bronchopulmonary system and lung parenchyma. 10 controls, normal five non-smokers and three asymptomatic smokers revealed homogeneous parenchymal deposition in the entire lung fields without central bronchial deposition. The remaining two of asymptomatic smokers revealed mild central airway deposition. The great majority of the patients showed either central (9/21) or combined type (10/21) of bronchopulmonary deposition and the remaining two patients peripheral bronchopulmonary deposition. Parenchymal aerosol deposition in pulmonary emphysema was diffuse (6/21), discrete(6/21), intermediate (3/21), or combined (6/21). In 12 patients studied also with perfusion scans, perfusion defects matched closely with ventilation defects in location and configuration. But the size of the ventilation defects was generally larger than the perfusion defects. In all four patients treated with bronchodilators, the follow-up study demonstrated decrease in abnormal of radioaerosol deposition in the central airway with improvement of ventilation defects. RII was useful technique for the evaluation of regional ventilatory abnormality and the effects of treatment with bronchodilators in pulmonary emphysema.

• The Journal of Internal Korean Medicine
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• v.26 no.1
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• pp.265-274
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• 2005

Diabetic gastroparesis is a disorder in a diabetic of delayed gastric emptying in the absence of mechanical obstruction. It is estimated that about 20%-50% of diabetics suffer from gastroparesis. Clinical Sympoms include early satiety, bloating, nausea, anorexia, vomiting, abdominal pain, and weight loss. Severe gastroparesis might result in recurrent hospitalization, malnutrition, and even death, but, no exact treatment has yet been established. Electrogastrography has been known to be a simple, non-invasive, and effective method in assessing gastric motility and EGG has been used to diagnosis diabetic gastroparesis and to estimate its prognosis. Recently, two cases of diabetic gastroparesis were observed. For this cases, manual acupucture, electroacupucture, lumbar skin warming and herb medicine were applied. After application of these therapies, gastrointestinal symptoms improved and these therapeutic effects were confirmed in EGG. Moreover, blood glucose control improved, so patients were able to discontinue insulin injection and change to p.o.medication. In light of this encouraging application of oriental medicine, this is reported along with investigation of the literature.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.14 no.2
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• pp.123-134
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• 2014

Recent advances in the diagnosis and treatment of inborn errors of metabolism (IEM) have improved substantially the prognosis of many of these diseases, if diagnosed early enough before irreversible damage occurs. Diseases of inborn errors of metabolism are so diverse over several hundred disease up to now and may be several thousand in near future, and these diversities of IEMs make clinicians embarassed. The signs of neurological dysfunctions of many IEMs manifesting in the neonatal period is very nonspecific, such as poor feeding, poor sucking, apnea or tachypnea, vomiting, hypertonia, hypotonia, seizure, letharginess, consciousness change and coma. But after neonatal period, the signs of neurological deficits become specific and localized. The results of routine basal laboratory tests such as metabolic acidosis, hyperammonemia, lactic acidemia, ketonemia or hyperuricemia can give very important clinical clues for the diagnosis of IEMs. Even no abnormal findings on routine laboratory test could be very important clue for NKH, sulfite oxidase deficiency and peroxisomal disorders. These various clinical manifestations of these diverse diseases can be categorized and summarized. This makes it essential that the practicing clinicians be familiar with the clinical presentations and symptomatic and systematic approaches of these disorders. Characteristic clinical presentations, methods of symptomatic and systematic approach and typing of various disorders is discussed in this review.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.329-334
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• 2003

Backgound: Cryoablation and radiofrequency ablation have been used to treat the atrial fibrillation. Some reports insisted that the microwave ablation Is a better method for a deep and extensive lesion. Material and Method: From December 2001 to July 2002, we peformed 8 microwave ablations in patients who needed mitral valve surgery (7 MVR, 1 MVR+AVR). There were 3 men and 5 women, and their mean age was 43.4$\pm$8.3 years and mean follow up period was 5.6$\pm$2.4 months respectively. The microwave was applied on endocardium or epicardium by Lynx (Afx, inc.) using a power of 45 watts for 25 seconds. We studied the left atrial dimension, the left atrial function and the sinus conversion with echocardiography and electro-cardiography at three times; 1) before the operation, 2) immediately after the operation, and 3) 6 months after the operation. Result: There was no complication and no mortality. The mean aortic clamping time was 104.6$\pm$25.0 minutes, and the mean total bypass time was 130.5$\pm$28.7 minutes. The rate of sinus conversion was 75%, A wave across the mitral valve was a mean of 77.0$\pm$24.8 cm/sec, and the AVE was a mean of 0.46$\pm$0.17 at 5.6 months postoperatively Conclusion: There was no difference in the early result of microwave ablation compared to other methods. The microwave ablation was an acceptable method due to its convenient application especially in beating heart.

• Korean Journal of Animal Reproduction
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• v.21 no.3
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• pp.265-274
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• 1997

The purpose of this study was attempted to investigate the a, pp.arences of healthy or artretic follicles in ovaries following repeats of pregnant mare serum gonadotropin(PMSG) treatments for superovulation in nulliparous rats. Thirty two rats(Sprague-Dawely, about 200-250 gm) were randomized into 4 groups. Control group rats were sacrified at estrus phase confirmed by vaginal smear. PMSG-treated group 1 rats, PMSG-treated group 2 rats and PMSG-treated group 3 rats were sacrified at 48 hrs after injection once with PMSG 25 IU, after 2 repeated injection by a week interval, and 3 repeated injection, respectively. The ovaires of rats were removed and then sections by paraffin embedding were stained with H-E or immunohistochemical staining using proliferating cell nuclear antigen monoclonal antibody (PCNA m Ab) and apoptotic kit. The criteria of follicle classification was based as small follicles with preantral follicles with 2~4 layers of granulosa cells surrounding the oocyte, as secondary follicles with more than 5 layers of granulosa cells and early signs of antral cavity or with small clefts on either side of the oocytes, and as tirtiary follicles with a single medium sized antral cavity or large well-formed antral cavity, respectively. The proportions of atretic follicles from small and middle follicles in immunohistochemical staining using PCNA m Ab were 17.9% and 21.3% in control group, 15.5% and 23.5% in PMSG-treated group 1, 24.3% and 26.7% in PMSG-treated group 2, 18.1% and 30.2% in PMSG-treated group 3, respectively. Groups with atretic follicles of higher proportion were ordered as PMSG-treated group 3, PMSG-treated group 2, PMSG-treated group 1 and control group. The proportions of positive cells in small, middle and large follicles were 31.1%, 33.5% and 28.5% respectively. The follicles with positive cells of higher proportion were ordered middle, small and large follicles. In immunohischemical staining using apoptotic kits, small follicles in all 4 groups did not contain positive cells, and proportions of atretic follicles from middle and large follicles were 24.9, 30.7, 33.8 and 40.1% in control, PMSG-treated gruop 1, PMSG-treated group 2 and PMSG-treated group 3, respectively. These results suggested that repeats of PMSG treatment increased proportion of atretic follicles in ovaries, and middle follicles are more quickly developing than small or large follicles.