• 대한핵의학회지
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• 제39권3호
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• pp.191-199
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• 2005

목적: 본 연구의 목적은 신장의 정확한 방사능 섭취량을 얻기 위해서 기하학적 평균 감쇠보정을 이용한 conjugate view 방법(CVM)을 평가하고 Gate 방법과 비교하는 것이다. 대상 및 방법 : 본 연구는 신장의 방사능 섭취량을 시뮬레이션하기 위해서 몬테칼로 코드, SIMIND와 Zubal 팬텀을 사용하였다. 또한 이중 감마카메라를 이용하여 직경 5cm인 팬텀들을 직경 20cm인 실제 팬텀에 삽입하여 실험을 하였다. CVM 방법을 평가하기 위해서 산란과 감쇠가 없는 이상적 데이터와 비교되었다. 또한, CVM 방법을 Gate 방법과 비교하였고, 산란보정의 적용 또는 비적용으로 나누어 CVM 방법을 실행하였다. Gate 방법은 임상에서 사용하는 것처럼 산란보정을 적용하지 않았으며, $0.12cm^{-1}$와 $0.15cm^{-1}$ 감쇠계수들을 적용하였다. 관심영역 내에 있는 평균계수, 신장영상 위에서 얻어진 프로파일, 선형회귀분석을 이용하여 데이터를 분석하였고, 이상적 데이터와의 상관계수를 계산하였다. 결과: 컴퓨터 시뮬레이션의 경우, 이상적 데이터, CVM 방법, Gate 방법으로부터 얻어진 평균계수들은 각각 (오른쪽: $998{\pm}209$, 왼쪽: $896{\pm}249$), (오른쪽: $911{\pm}207$, 왼쪽: $815{\pm}265$), (오른쪽: $1065{\pm}267$, 왼쪽 $1546{\pm}267$)이었다. CVM 방법은 이상적 데이터와 좋은 상관관계를 보여주었고, 이상적 데이터와 대한 CVM 방법, Gate방법의 상관계수는 각각 (오른쪽: 0.91, 왼쪽: 0.93)와 (오른쪽: 0.85, 왼쪽 0.90)이었다. 결론: 기하학적 평균 감쇠보정을 이용한 CVM 방법은 Gate 방법보다 정량적으로 더 정확한 값을 제공하였다. 결론적으로, 신장 깊이에 영향을 받지 않는 CVM 방법으로 더욱 정확하게 신장의 방사능 섭취량을 측정할 수 있을 것으로 생각된다.

• 동의생리병리학회지
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• 제22권4호
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• pp.930-942
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• 2008

Following conclusions were derived from researching various consumption caused after surgical operation. The meaning of surgery in HyungSang medical point of view is a big flaw of the original configuration. Therefore meaning, the loss of container to store something. Changes of the body after surgery can be formation of stagnated blood and abnormal cyst of the removed part and entangled undigested food and stagnant blood. After surgery when the symptoms become chronic or the patients develop side effects as they age, consumption and aging process begins. HyungSang medical treatments of consumption caused after surgery are the followings. We should prevent aging of the framework by using appropriate medication to make up for faults in Gall Bladder, Bladder type and six meridian type by considering its form, color, pulse and symptoms. Stability of emotion that can endure various mental stimulation is needed. Prevent stagnation, indigestion, obstruction and numbness by smoothing up the constructive energy and the defensive energy in the operated part. The Heart and Kidney should be under control and Stomach and Spleen should be reinforced so that food intake is accelerated and produce vital substances and Ki and blood. Eum blood and Yang Ki should circulate around the body well. Examine daily life and if small changes in skin complexion, appetite, sleep and excretion occur, also difference in adaptation of external stimulation and mental health occurs immediate treatment and care is necessary. Treatment of side-effects caused from both aging process and post-surgery in HyungSang's view point is considered better than other ways of treatment and will contribute in expanding the field of medical science.

• Archives of Plastic Surgery
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• 제35권4호
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• pp.431-438
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• 2008

Purpose: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1 mm thickness $Medpor{(R)}$ sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. Methods: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. $Medpor{(R)}$ sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6 mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. Results: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. Conclusion: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.

• Journal of Chest Surgery
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• 제40권8호
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• pp.582-586
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• 2007

48세 남자 환자가 조절되지 않는 고혈압 및 좌측 하지통증을 주소로 내원하였다. 컴퓨터 단층 혈관조영술에서 동맥경화에 의한 양쪽 신장동맥 폐쇄와 좌측 총장골동맥 폐쇄가 관찰되었으며, 2개월간의 내과적 치료로도 호전되지 않아 수술을 시행하였다. 수술은 8 mm 인공도관을 이용하여 대동맥-양측 신동맥간 우회수술 및 대동맥-좌측 대퇴동맥간 우회수술을 시행하였다. 수술 후 10개월간 1종류의 항고혈압제(안지오텐신 수용체 억제제)와 항응고제만 사용하면서 정상적인 혈압을 유지하고 있다. 수술을 통한 신혈관성 고혈압의 치료는 중재적 시술기법 및 약물치료의 발달 및 최근 감소하는 경향이나, 광범위한 동맥경화가 동반된 경우에는 수술치료가 필요하다. 본 증례는 광범위한 동맥경화에 의한 신혈관성 고혈압 및 좌측장골동맥 폐쇄 환자에 대한 수술치료로 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Ginseng Research
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• 제45권1호
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• pp.66-74
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• 2021

Background: Abnormal chloride (Cl-) transport has a detrimental impact on mucociliary clearance in both cystic fibrosis (CF) and non-CF chronic rhinosinusitis. Ginseng is a medicinal plant noted to have anti-inflammatory and antimicrobial properties. The present study aims to assess the capability of red ginseng aqueous extract (RGAE) to promote transepithelial Cl- secretion in nasal epithelium. Methods: Primary murine nasal septal epithelial (MNSE) [wild-type (WT) and transgenic CFTR-/-], fisher-rat-thyroid (FRT) cells expressing human WT CFTR, and TMEM16A-expressing human embryonic kidney cultures were utilized for the present experiments. Ciliary beat frequency (CBF) and airway surface liquid (ASL) depth measurements were performed using micro-optical coherence tomography (μOCT). Mechanisms underlying transepithelial Cl- transport were determined using pharmacologic manipulation in Ussing chambers and whole-cell patch clamp analysis. Results: RGAE (at 30㎍/mL of ginsenosides) significantly increased Cl- transport [measured as change in short-circuit current (ΔISC = ㎂/㎠)] when compared with control in WT and CFTR-/- MNSE (WT vs control = 49.8±2.6 vs 0.1+/-0.2, CFTR-/- = 33.5±1.5 vs 0.2±0.3, p < 0.0001). In FRT cells, the CFTR-mediated ΔISC attributed to RGAE was small (6.8 ± 2.5 vs control, 0.03 ± 0.01, p < 0.05). In patch clamp, TMEM16A-mediated currents were markedly improved with co-administration of RGAE and uridine 5-triphosphate (8406.3 +/- 807.7 pA) over uridine 5-triphosphate (3524.1 +/- 292.4 pA) or RGAE alone (465.2 +/- 90.7 pA) (p < 0.0001). ASL and CBF were significantly greater with RGAE (6.2+/-0.3 ㎛ vs control, 3.9+/-0.09 ㎛; 10.4+/-0.3 Hz vs control, 7.3 ± 0.2 Hz; p < 0.0001) in MNSE. Conclusion: RGAE augments ASL depth and CBF by stimulating Cl- secretion through CaCC, which suggests therapeutic potential in both CF and non-CF chronic rhinosinusitis.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.20-27
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• 2024

Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.23-28
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• 1999

ALP (alkaline phosphatase) is a membrane-bound metalloenzyme that is expressed in osteoblasts, hepatocytes, lung, kidney, endothelial cells, leukocytes and other cells. Normal soft tissue and skin show little tissue nonspecific ALP (TN-AP), However, scar tissue contains high levels of TN-AP activity, and in fact, TN-AP is expressed intensely in regenerating connective tissue after the wounding. The purpose of this study was to evaluate the change of ALP expression in hypertrophic scar model in rabbits and the effect of triamcinonolone on ALP expression. Adult male New Zealand white rabbits, weighing about 2.5 kg, were used. After full-thickeness wounding over the ventral surface of each ear, either saline (control ear) or triamcinolone (contralateral ear) was injected on day 16. Rabbits were sacrificed on day 3, 7, 15, 17, 19, 23, and the specimens were retrieved en bloc. Histologic and immunohistochemical examinations of tissue samples were done. The results obtained were as follows: On day 3, ALP reaction was observed on fibroblasts and inflammatory cells in wound margin. On day 7, ALP reaction was more intense than day p in capillaries, inflammtory cells, and fibroblasts behind newly formed epithelium. On day 15, ALP reaction was lessened in both groups and appeared mainly in subepidermal capillary network, Since day 17, ALP reaction was lessened in both groups and weaker in triamcinolone-injected group than in saline-injected group. These results suggest that ALP reaction isn't increased in triamcinolone-injected scar and triamcinolone reduces scar not by increasing TN-AP expression but other mechanism.

• Journal of Chest Surgery
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• 제19권1호
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• pp.174-179
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• 1986

Augmentin is a formulation of amoxycillin trihydrate and potassium clavulanate, a fused beta-lactam molecule produced by the fermentation of Streptomyces clavuligerus. Most clinically important resistance is due to the production by bacteria of antibiotic destroying enzymes. In the case of penicillins and cephalosporins these enzymes are termed beta-lactamase as they destroy the beta-lectern ring of these antibiotics, completely inactivating them. The presence of clavulanic acid extends the spectrum of amoxycillin to include bet On clinical study of the intravenous Augmentin in the field of thoracic and cardiovascular surgical cases, we selected randomly 30 patients, 21 male and 9 female, age from 13 to 72, in the period from April to December 1985. Among the total 30 patients, 22 were preoperatively infected [11 thoracic empyema, 5 lobar pneumonia, 2 lung abscess, 2 bronchiectasis, one acute pyelonephritis with ureter stone and one rheumatic carditis], and 8 were not infected preoperatively [Table 1, 2]. Of the preoperatively infected group, 11 cases [50%] were culture positive [4 staphylococcus, 3 pseudomonas, 2 Serratia group, and one E. coli], and preoperatively non-infected group [8 cases] revealed expectedly negative findings on bacterial culture. All of the culture positive bacteria were sensitive to Augmentin on disc culture sensitivity test except one case of E. coli. Daily doses of intravenous Augmentin were 2.-1-6.0gm divided in 2-5 injections. Every injection administered [1.2gm at Augmentin dissolved in 20ml distilled water] slowly for more than 20 minutes. Duration of injection was variable according to the clinical conditions from minimum 5 to maximum 31 days. The results of antibiotic treatment with Augmentin and some other antibiotic combinations pre- and postoperatively were subgrouped as EXCELLENT, EFFECTIVE, and FAILURE. Clinical criteria of the therapeutic result were symptomatic, objective and laboratory improvement. 8 cases were excellent, 13 effective, and one failure among the preoperatively infected group, and all 8 cases of the preoperatively non-infected group were effective as pro;hylactive antibiotic therapy. Overall effective ratio was 97% in both subgroup. There was no side effect clinically and laboratory study including liver and kidney function test during and after the I.V. administration of Augmentin. Oral swallow tablets which were administered after discharge from hospital also revealed good effects with some degree of gastrointestinal trouble.

• Journal of Chest Surgery
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• 제56권6호
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• pp.431-434
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• 2023

Background: The first 3 ribs are anatomically well-protected, shielded by the large thoracic muscles, the shoulder girdle, and the arm. A significant force is required to fracture these ribs; thus, such fractures suggest a high-energy trauma and are associated with injuries to vital organs of the thorax, such as the aorta, the heart, the lungs and the great vessels. Methods: A retrospective analysis was conducted over a 10-year period at a single hospital. The study assessed patients with fractures of the second rib, including their concurrent injuries and the overall severity of their trauma. Results: Among the 76 patients included in the study, the average age was 47.35 years, 81.5% were men, and 19.5% were women. Thirteen patients (17.1%) survived their injuries. The most common causes of injury were road traffic accidents (63%) and pedestrian injuries (22%). The patients who did not survive sustained injuries to an average of 5 additional organs, while survivors had injuries to an average of 2.07 additional organs. Left rib fractures were the most frequently observed (46%). The most serious concurrent injuries reported were to the aorta (5.26%), heart (10.52%), lung (52.36%), head (57.89%), liver (30.2%), spleen (26.31%), and kidney (17.1%). Conclusion: As indicators of serious injury to vital endothoracic organs, isolated fractures of the second rib should be considered equal to first rib fractures in clinical importance.

• Clinical Endoscopy
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• 제56권3호
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• pp.340-352
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• 2023

Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States. Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared. Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p<0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management. Conclusions: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.