시멘트 통 속의 편지

葉山嘉樹『セメント樽の中の手紙』Translations Korean 한국

선천성 심질환에서 우심부전

Right-sided heart failure is a major problem among patients with congenital heart diseases, due to the prevalence of congenital heart defects and the association of pulmonary hypertension. More attention is focused on the structure of the right heart particularly in association with congenital heart defects and chronic lung disease. The right ventricle (RV) may support the pulmonary circulation, and sometimes the systemic circulation (systemic RV) in congenital heart defects. Despite major progress being made, assessing the RV remains challenging, often requiring a multi-imaging approach and expertise (echocardiography, magnetic resonance imaging, nuclear and cineangiography). Evidence is accumulating that RV dysfunction develops in many of these patients and leads to considerable morbidity and mortality. While there is extensive literature on the pathophysiology and treatment of left heart failure, the data for right-sided heart failure is scarce. Therefore RV function in certain groups of congenital heart disease patients needs close surveillance and timely and appropriate intervention to optimise outcomes. An understanding of RV physiology and hemodynamics will lead to a better understanding of current and future treatment strategies for right heart failure. This will review right- sided heart failure with the implications of volume and pressure loading of the RV in congenital heart diseases

급성 및 아급성 골다공증성 척추 골절의 자기공명영상 유형

Study Design: This is a retrospective radiologic study Objectives: The aim of this study is to analyze the signals and configurations of the MRI findings of osteoporotic vertebral fractures and the clinical consequences of each type of the MRI findings. Summary of Literature Review: There have been some reports that have focused on the MR findings for the differentiation of osteoporotic and metastatic fractures, but there are few reports on the characteristics of the early stage of osteoporotic vertebral fractures. Materials and Methods : From July 2002 to April 2008, the MRI findings and medical records of 97 patients who were diagnosed with acute or subacute osteoporotic vertebral fractures and who were followed-up for more than 1 year were analyzed. The patients with minor trauma within 3 months before obtaining MRIs and they had decreased bone density were included in this study. Those with fractures due to severe trauma or pathologic causes or normal bone density were excluded. Three spine surgeons evaluated, at three times per each surgeon, the T1-weighted, T2-weighted and fat suppression T1-enhanced sagittal images for the signal of the vertebral body bone marrow and the type of the intravertebral body lesion shape. The relationships between the type of MRI findings and the time from the trauma and the follow up clinical consequences were analyzed. Results: The MRI patterns of 97 patients with 111 fractures of the vertebrae were divided into three types. There were 56 cases of Type I (50.5%), which was defined as diffuse typical signal intensity in the vertebral body, 39 cases (35.1%) of Type II, which was defined as geographic low signal in the center of the vertebral body with typical signal changes, and 16 cases (14.4%). of type III, which was defined as atypical signal intensity or a shape of lesion that did not correspond to type 1 nor type 2. The average time from trauma was 10.8±19.0days (0~90) for type I, 19.1±24.9days (0~90) for type III and 37.5±31.1days (0~90) for type III, which showed differences among each types (p<0.001). Conclusions: The analysis of the relationship between the time from trauma and the signal intensity and the type of lesion on MRI examination revealed that the low signal intensity in the typical vertebral body signal or an atypical signal or shape were poor prognostic factors of osteoporotic vertebral fracture.연구계획: 후향적 방사선학 연구 연구목적: 골다공증성 척추골절의 수상 시간에 따른 자기공명영상의 신호 및 형태 양상을 분석하고 각 유형에 따른 임상적 결과를 알아보고자 하였다. 대상 및 방법: 2002년 7월부터 2008년 4월까지 흉추나 요추의 급성 또는 아급성 골다공증성 척추 골절로 진단되어 치료 받고, 1년 이상 추시된 환자 97명의 자기공명영상과 의무기록을 분석하였다. 자기공명영상을 시행하기 전 3개 월 이내의 경미한 외상력이 있으며, 골밀도 검사상 골밀도 감소 소견을 보이는 환자들을 포함하였다. 낙상이나 교통 사고 등 심한 외상에 의한 골절이나 종양 및 감염에 의한 병적 골절, 골밀도 검사상 정상인 환자들은 제외하였으며, 수상기간이 3개월 이상이거나 불유합, 진구성 골절 등은 제외하였다. 세 명의 척추 전임의가 각각 독립적으로 세번 씩 대상 환자들의 T1WI, T2WI 및 지방 억제 T1-조영 시상면 영상을 이용하여 척추체의 골수 신호 및 골절 추체내 병 변부 형태에 따른 유형을 분류하고, 각 유형에 따른 수상시간, 추시 결과를 분석하였다. 결과: 총 97명 환자에서 111례의 골절 척추체를 분석하여 세 유형으로 분류하였다. I형은 전형적 신호 강도가 추체내 미만성으로 나타나는 경우로 56례(50.5%)가 이에 해당하였으며, II형은 지방 억제 T1-조영 시상면 영상에서 전형적 추체 신호 강도 내에 중심부에 국소적(geographic)으로 저신호를 보이는 경우로 39례(35.1%)가 해당되었다. III형은 신호 강도나 골절부 형태가 I형이나 II형에 해당하지 않는 경우로 16례(14.4%)가 해당되었다. 수상일로부터 I형의 평 균 수상 시간은 10.8±19.0일(0~90), II형은 19.1±24.9일(0~90), III형은 37.5±31.1일(0~90)로서 각 유형간에 수상 시 간의 차이를 나타내었다(p<0.001). 추시된 증례 분석에서 I형은 94.3%에서 만족스런 임상 결과 및 유합을 보였으며, II형과 III형은 불유합이나 통증의 악화로 추체성형술을 시행한 빈도가 높았다. 결론: 골다공증성 척추골절의 수상 시간에 따른 자기공명영상의 신호 및 형태 양상을 분석한 결과, 지방 억제 T1-조 영 시상면 영상에서 추체 부종 신호 내에 국소적 저신호 강도를 보이는 경우나 비전형적 신호 및 형태를 보이는 경우 예후가 불량하였다

심한 복부손상에서 복강내 및 복막외 거즈충전

There have been incredible advances in surgical managements and radiologic interventions of a hemorrhagic control with severe abdominal organ injuries. However, it has been very challenging to stop the bleeding from some of the internal organs, such as a liver or pelvis. As those organs have plenty of vessel plexus inside, it has been very difficult to control the most of the bleeding applying surgical ligations and/or angioembolizations, because such tech-niques have a limitation on a reach all of the damaged vessels. Therefore, it is very important to reduce the amount of bleeding with a gauze packing. Furthermore, the time required for packing is fairly short, so that the patient is carefully monitored in a intensive care unit for hypothermia, acidosis and coagulopathy as soon as possible. Once the patient’s general condition is improved, trauma surgeons can plan for the re-operation. Packing is the most effective method than any other hemostatic maneuvers for a high-grad liver injury in particular. Complications caused by abdominal packing, such as intraabdominal sepsis, could be minimized by a removal of packing within 3 days. Currently, to control the major pelvic bleeding, preperitoneal packing is preferred than intraperitoneal method. Moreover, it can maximize an effective bleeding control, if both packing and angioembolization (pre- or post-operative) are applied complementarily. To facilitate the application of packing, trauma surgeons should understand the concept of ’damage control surgery’ including open abdominal techniques and optimize the patient’s general condition through an aggressive critical care

퇴행성 및 협부형 척추 전방전위증의 치료

The etiology of spondylolisthesis, which determines the pathoanatomy and natural course, includes the abnormal development of lumbosacrum and various acquired conditions. Many patients with symptomatic degenerative and isthmic spondylolisthesis respond to non-surgical treatments, such as modification of their daily activity, medication, physical therapy and nerve block. Surgical treatment is indicated for intractable pain, neurological symptoms and the progression of slip. The natural course and patient’s demographics are also considered. Decompression of the neural stenosis and the fusion of segmental instability are the main surgical treatments of degenerative and isthmic spondylolisthesis. Fusion and instrumentation should be chosen carefully for degenerative spondylolisthesis if it is stable. However, solid fusion is the most important procedure for isthmic spondylolisthesis. Anterior lumbar interbody fusion is an effective treatment regarding an anatomical restoration of slip, decompression of neural structures and optimal fusion for degenerative and isthmic spondylolisthesis

상하순에 동시에 발생한 선천성 이중구순 1예

Congenital double lip deformity is an infrequent developmental abnormality affecting the lips, more commonly the upper lip. It resulted from an accessory fold of redundant mucous membrane inside the vermilion border of the lips. Especially, there is no previous report on the bilabial congenital double lips. We present a very rare case of double lips occurred simultaneously in both upper and lower lips

VITROS 3600의 HBsAg 검사 평가

Background:The VITROS 3600 (Ortho Clinical Diagnostics, Johnson & Johnson, Buckinghamshire, UK), which uses the enhanced chemiluminescence immunoassay, has recently been introduced; however, it has not been evaluated for detection of HBsAg in Korea. We evaluated the ability of the VITROS 3600 for detection of HBsAg, compared with the ARCHITECT i2000 (Abbott Laboratories, Abbott Park, IL, USA), which is used widely in Korea to help in selection of an analyzer for detection of HBsAg. Methods:A total of 800 samples were tested randomly for HBsAg and 150 samples with positive HBV DNA detected by real-time PCR were used in this study. Precision, agreement, and Pearson correlations between two analyzers were evaluated. Results:The total standard deviations (SD) were 0.016 and 0.183 for the negative and positive HBsAg controls, respectively; the precision met the criteria suggested by the manufacturer. There were 100% agreements for the 800 random samples (positive 33, negative 767) and 150 samples with HBV DNA (positive 148, negative 2) between two analyzers. In addition, good correlation was observed between two analyzers for the 767 HBsAg negative samples (r=0.691, P=0.004), and 148 HBV DNA positive samples (r=0.763, P＜0.001). Conclusion:The VITROS 3600 showed good precision and agreement. And, correlation between the VITROS 3600 and the ARCHITECT i2000 was excellent. Therefore, this result will be helpful in selection of an analyzer for detection of HBsAg

진주종상피에서 Apoptosis를 통한 세포의 사멸기전

BACKGROUND AND OBJECTIVES: Accumulation of keratin debris in the middle ear is one of the characteristics of the cholesteatoma. It is related to increased rate of cell death and differentiation of keratinocytes compare to normal skin. This kind of cell death is known as apoptosis. In this study, we plan to investigate the apoptotic cell death and expression of Fas in both normal and cholesteatoma epithelia. MATERIALS AND METHODS: Seven cholesteatomas and retroauricular skins were obtained from patients undergoing middle ear operations. Detection of the fragmented DNA in apoptosis was done by in situ TUNEL methods and agarose gel electrophoresis. For the morphologic confirmation of apoptosis, transmission electron microscopy (TEM) was done. Immunohistochemistry was also performed for detection of Fas expression on the tissue. RESULTS: In TUNEL staining, many positive staining nuclei were observed in upper layers of cholesteatoma epithelium whereas a few positive cells were found on the granular layer of retroauricular skin. Typical "ladder pattern" was seen on the gel electrophoresis of the genomic DNA of cholesteatoma. On TEM study, we observed condensation of chromatin in the keratinocytes of the cholesteatoma epithelium. Immunohistochemical studies revealed that Fas protein was expressed in all layers of cholesteatoma epithelium, while retroauricular skin showed weak reactions only in the granular layer. CONCLUSION: We confirmed that increased apoptosis and up-regulated expression of Fas in cholesteatoma epithelium. Since Fas is known as apoptosis triggering protein, the authors suggest that accumulation of keratin debris is due to increased apoptotic cell death and further investigation should be needed about the mechanism of cell death in cholesteatoma

Korea&#39;s Participation in Global Value Chains: Measures and Implications

This paper measures the extent to which South Korea participated in global value chains (GVCs) from 1995 through 2011 and scrutinizes the consequences of such participation on the Korean economy. To this end, the World Input Output Database is utilized to calculate GVC income, GVC employment, and value-added exports created by Korean and foreign industries. Our findings show that Korea radically internationalized its production activities during the sample period, widening the gap between gross exports and value-added exports.We also document that Korea&rsquo;s participation in GVCs has changed the value-added and employment structures in domestic industries in accordance with their comparative advantages while exacerbating the degree of wage inequality