• Journal of Chest Surgery
• /
• v.51 no.4
• /
• pp.266-272
• /
• 2018

Background: Limited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility. Methods: A total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups. Results: At 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063-6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B ($53.1%{\pm}11.5%$ vs. $59.1%{\pm}6.3%$, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was $80.1%{\pm}3.6%$ in group A and $92.1%{\pm}2.9%$ in group B (p=0.400). The 5-year MACCE-free survival rate was $70.3%{\pm}4.0%$ in group A and $70.9%{\pm}5.6%$ in group B (p=0.818). Conclusion: Cryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

• Korean Journal of Biological Psychiatry
• /
• v.22 no.4
• /
• pp.223-232
• /
• 2015

Objectives In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. Methods The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. Results In patients with aMCI, old age (> 80) and APOE ${\varepsilon}4$ carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. Conclusions Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.

• The Journal of the Korea Contents Association
• /
• v.10 no.2
• /
• pp.286-294
• /
• 2010

This study was performed to identify the cerebral network associated with sensation through the tickling stimulation, which is distinctive from the rest of other networks processing normal stimulation and to investigate the difference of laughing mechanism which is closely related to tickling using functional MRI(fMRI). A 16 healthy volunteers (mean age: 28.9) on a 3.0T MR scanner during two sensation conditions. Counterbalanced stimulus were presented across the participants, and the stimulation was used block design. Acquired data was analyzed by the statistical parametric mapping (SPM 99). Subject and group analysis was performed. Individual analysis showed the activation of somatic sensation area in both tasks and the tickling sensation test showed more activated area in the Wernicke's area(BA40) compared to the normal sensation. The group analysis result shows that under normal stimulations, both sides of somatosensory cortices(BA 1,2 and 3) were activated and under tickling stimulation, not only the cortices but also those huge activation on thalamus, cingulate gyrus and insular lobe were detected. When the tickling was stopped, significant activations were shown in right cingulate gyrus, left MFG area and left insular lobe. A cerebral area responsible for recognizing tickling sensation was examined and the primitive stimulation such as tickling is much closely related to laugh, which is an important factor for various social activities.

• Journal of Veterinary Clinics
• /
• v.29 no.4
• /
• pp.344-347
• /
• 2012

Bilateral convergent strabismus with exophthalmus(BCSE) is an eye disorder affecting many cattle breeds worldwide. BCSE is the most common in cattle at various types of strabismus. Divergent strabismus is of relatively low incidence than convergent strabismus. This report is the to shown a case of convergent and divergent strabismus with unilateral in the exophthalmus in a heifer Holstein cow. A female Holstein calf born with congenital progressive divergent strabismus in right eye and convergent strabismus in left eye was tested. Ocular and blood examination, and activity were checked from the first week, 8 month, and 16 month after birth. The ocular examination includes general inspection, fixation reflex and menace response. The general inspection is checking the degree of deviation of both eyes from the normal visual axis, which was determined by the amount of sclera permanently visible in the temporal corner of the eye. The stage is divided into 4 stages depending on the degree of deviation. The right eye shown in stage 4 continues after birth and the left eye shown stage 2, stage 3 and stage 4 at 1 week, 8 month and 16 month after birth, respectively. In fixation reflex and Menace response, both eye balls showed a normal response at 1 week, 8 month and 16 month after birth. Blood count and serum chemistry test were performed, but a specific factor was not detected outside the reference range.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.1
• /
• pp.65-71
• /
• 2016

Although high mammographic density is one of the strongest predictors of breast cancer risk, X-ray based mammography cannot be performed before the recommended screening age, especially not in adolescents and young women. Therefore, new techniques for breast density measurement are of interest. In this pilot study in Guam and Hawaii, we evaluated a radiation-free, bioimpedance device called Electrical Breast Densitometer$^{TM}$ (EBD; senoSENSE Medical Systems, Inc., Ontario, Canada) for measuring breast density in 95 women aged 31-82 years and 41 girls aged 8-18 years. Percent density (PD) was estimated in the women's most recent mammogram using a computer-assisted method. Correlation coefficients and linear regression were applied for statistical analysis. In adult women, mean EBD and PD values of the left and right breasts were $230{\pm}52$ and $226{\pm}50{\Omega}$ and $23.7{\pm}15.1$ and $24.2{\pm}15.2%$, respectively. The EBD measurements were inversely correlated with PD ($r_{Spearman}=-0.52$, p<0.0001); the correlation was stronger in Caucasians ($r_{Spearman}=-0.70$, p<0.0001) than Asians ($r_{Spearman}=-0.54$, p<0.01) and Native Hawaiian/Chamorro/Pacific Islanders ($r_{Spearman}=-0.34$, p=0.06). Using 4 categories of PD (<10, 10-25, 26-50, 51-75%), the respective mean EBD values were $256{\pm}32$, $249{\pm}41$, $202{\pm}46$, and $178{\pm}43{\Omega}$ (p<0.0001). In girls, the mean EBD values in the left and right breast were $148{\pm}40$ and $155{\pm}54{\Omega}$; EBD values decreased from Tanner stages 1 to 4 ($204{\pm}14$, $154{\pm}79$, $136{\pm}43$, and $119{\pm}16{\Omega}$ for stages 1-4, respectively) but were higher at Tanner stage 5 ($165{\pm}30{\Omega}$). With further development, this bioimpedance method may allow for investigations of breast development among adolescent, as well as assessment of breast cancer risk early in life and in populations without access to mammography.

• Korean Journal of Applied Biomechanics
• /
• v.19 no.3
• /
• pp.457-466
• /
• 2009

This study puts the purpose in providing the scientific basis of dance motion as an artistic expression by analyzing the kinematic variable and the distribution factor of power affecting the motion, which is connected to the turn, right after the arabesque motion according to the existence and non existence of using the arm in the arabesque motion of modern dance. As a result of this study, arabesque turn motion, not using the upper limbs, used more turning force of head and body than the arabesque turn motion, using the upper limbs, and arabesque turn using the upper limbs obtained the turning force, using the right shoulder. The range of the hip joint on the left and the position change of left tiptoe in the Arabesque turn motion using the upper limbs is largely ascended to the vertical axis, while, the position of tiptoe in the Arabesque turn motion, not using the upper limbs is dropped to the lower part of each event. In the replacement of body center, Arabesque turn motion using the upper limbs is moved more to the turning axis than arabesque turn motion not using the upper limbs. As a result of maximum vertical ground reaction force, Arabesque turn motion using the upper limbs appeared to be a lower value than the Arabesque turn motion not using the upper limbs.

• Journal of the Korean Society of Fisheries and Ocean Technology
• /
• v.53 no.4
• /
• pp.423-429
• /
• 2017

As invigoration plan of the marine tourism, Busan City has the plan to operate the cruise ship inside of the harbor, but the area has narrow water way with heavy traffic. As a result it is requested to evaluate the safety for the preparation of actual navigation. In this study, the Ship Handling Simulation (SHS) Assessment was conducted, which is regulated by the Maritime Traffic Safety Audit Scheme (MTSAS) in compliance with the Marine Safety Law and the Maritime Traffic Risk Assessment System based on the Electronic Chart Display and Information System (ECDIS). The proximity assessment, control assessment and subjective assessment were implemented, which is enacted by the Marine Safety Law by using the SHS. In the case of proximity assessment, the probability of trespass was not analyzed. As the control assessment, the swept path was measured at 11.7 m and 11.5 m for port entry and port departure respectively, which exceeded the width of the model vessel, 10.4 m over; it was considered as a marginal factor. As a result of the subjective evaluation of the navigator, there would be no difficulty on ship maneuvering by paying particular attention to the mooring vessel nearby the Busan Bridge and Yeongdo Bridge as well as the coming vessel from the invisible sea area when the vessel is entering and departing the port. The Marine Traffic Risk Assessment System analyzed as [Cautious] level until the vessel passed the Busan bridge and the curved area at 5 kts and it became to [Dangerous] level from where it left 75 m to the Busan Bridge. When the vessel passed the Busan Bridge and the curved area at 10 kts and entered the narrow area, it indicated the [Dangerous] level and became to [Very dangerous] level from where it left 410 m to the Busan bridge. In conclusion, the vessel should maintain at the speed of 5 kts to reduce the risk when it passes this area.

• Journal of Korean Academy of Nursing
• /
• v.47 no.6
• /
• pp.794-805
• /
• 2017

Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.649-653
• /
• 2001

The Chiari malformation is a deformation within the central nervous system which the lower brain stem and the cerebellum migrate into the foramen magnum causing herniation. In 1891, Arnold Chiari classified such symptoms into 3 categories. This case report is of a 8-year-old female with the complaint of a slight facial swelling and pain on the upper right molar during tooth brushing since 10 days before. Clinical examination showed gingival pocket formation on distal of the upper right first molar with pain and mobility of the tooth. Radiographic examination showed generalized low bone density in the upper molar area, and especially no bone support above the upper right and left first molars were noted. With a temporary diagnosis of Early-onset periodontitis, consultations with medical doctors for the possibility of an underlying systemic disease were made during periodontal treatment. 3D CT was taken with after a final diagnosis of Chiari malformation. Generalized thinning and defect of the cranial bone was noted and the foramen magnum was slightly enlarged. The occipital and maxillary bone was low in density, and the alveolar bone of maxillary posterior teeth was especially almost non-existing causing the upper right and left first molar to be floating. For this, the patient went under consultation with the department of neurosurgery and is still under observation. Periodontitis in childreren is very rare. When symptoms of periodontitis appear in a child, due to the possibility of an underlying systemic disease such as leukemia, histiocytosis X, and hypophosphatasia, proper examinations should be carried out so that the primary factor the symptoms can be treated.

• Journal of Chest Surgery
• /
• v.47 no.3
• /
• pp.233-239
• /
• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.