We are calling the erupting ground water as drug water or mineral water in Korea and thinking those water and food making water. Authors tried to investigate the evidence of contamination by user on the 10 erupting ground water and gained following results: 1. All of the mineral waters on 10 area in Seoul were unfittable to drinking water standard. 2. In the view of the bacteriology 80% were contaminated by coliform group. 3. The highest value of the free carbon dioxide contents were 652.96 ppm at Sam Sun Mineral Water.
Bacteriology ; Carbon Dioxide ; Drinking Water ; Groundwater ; Korea ; Mineral Waters* ; Seoul* ; Solar System ; Thinking ; Water

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

The T cell responses to hepatitis B surface antigen (HBsAg) were analyzed in acute hepatitis patients, chronic active hepatitis (CAH) patients and asymptomatic carriers. Neither proliferative responses nor substantial cytokine production of peripheral blood mononuclear cells (PBMC) in response to HBsAg was detected. For further studies, HBsAg- reactive T cell lines were prepared from PBMC of the hepatitis patients and asymptomatic carriers. No proliferative response of the T cell lines was observed. Interestingly, however, T cell lines obtained from acute hepatitis patients were found to produce IFN-r, but not IL- 4, in response to HBsAg stimulation, whereas T cell lines obtained from CAH patients and carriers were not. Results of this study suggest that HBsAg-reactive T cells producing Thl type cytokines may play an important role in the viral clearance during acute infections, while defects in those T cells may be responsible for the viral persistency.
Cell Line ; Cytokines ; Hepatitis ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; T-Lymphocytes*

To evaluate the effectiveness of superselective transcatheter arterial embolization (STAE) for hepatocelluar carcinoma (HCC) with a mixture of ethanol and Lipiodol, STAE was done in 12 male patients with HCC. Three were diagnosed clinically with angiographic findings and elevated alphafetprotein levels and three were recurrent tumors after surgery. Sono-guided aspiration biopsy proved the diagnosis of hepatocellular carcinoma in another six patients. The tumor was a small single nodule (2-5cm in diameter) in 11 patients. In one patient, two nodules were found. Superselective catheterization was done using 3F Tracker catheter(Target Therapeutics USA) coaxially through 6F catheter into the feeding hepatic artery, usually the third order branch. One to four cc of 75% ethanol mixed with Lipiodol was infused under fluoroscopy immediately after imjection of 2% lidocaine. Immediate angiography and CT after 2 weeks were undertaken. Complete segmental or subsegmental devascularization including feeding arteries and tumor vascularities occurred in all patients. Follow-up angiography after 6 to 15 months revealed the tumor opacified by Lipiodol. The tumor decreased in 5 cases and recurrence was found in three patients. CT taken 2 weeks after STAE showed low density halo around the tumor in 5 cases. Subsequest segmentectomy in four patients revealed total or near total necrosis of the tumor and no evidence of damage in surrounding parenchyme. STAE for HCC with a mixture of ethanol and Lipiodol is an effective and safe measure for small HCC.
Angiography ; Arteries ; Biopsy, Needle ; Carcinoma, Hepatocellular* ; Catheterization ; Catheters ; Diagnosis ; Ethanol* ; Ethiodized Oil* ; Fluoroscopy ; Follow-Up Studies ; Hepatic Artery ; Humans ; Lidocaine ; Male ; Mastectomy, Segmental ; Necrosis ; Recurrence

As a new interventional procedure for the control of variceal bleeding, a portosystemic shunt can be established with the installment of metallic stent through the transjugular approach. In order to evaluate the clinical usefulness of the procedure, transjugular intrahepatic portosystemic chunt procedure were performed in 5 patients with variceal bleeding due to liver cirrhosis. The metallic stents were mainly a self expandable Wallstent(Schneider, Switzerland). An 8 to 10 mm shunt was formed by the insertion of the stent and balloon dilatation after puncture of the proximal portal vein from the right or middle hepatic vein. The patency of the shunt was proven by portography after the procedure. The portal pressure measured in 3 patients before and after the procedure improved with decrease from 31 mmHg to 25 mmHg. The procedure failed in 1 patient due to preexsisting portal vein thrombosis. During the follow-up period from 1 month to 4 months, shunts were patent in all 4 patients. However, hepatic encephalopathy occured in one patient one week following the procedure. Though the follow-up period was not long enough for full evaluation. We found the transjugular intrahepatic portosystemic shunt was a safe and effective procedure for the control of variceal bleeding by lowering the portal pressure. For the appropriate application for this procedure, the optimal size of the shunt and optimal degree of the resultant decompression are yet to be determined in the future.
Decompression ; Dilatation ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hepatic Encephalopathy ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Portal Pressure ; Portal Vein ; Portasystemic Shunt, Surgical ; Portography ; Punctures ; Stents ; Venous Thrombosis

No abstract available.
Pulmonary Artery* ; Takayasu Arteritis*

Digital subtraction angiography(DSA) was made in 72 patients at department of radiology, Seoul National University hospital from February 1982 to January 1983 with our system, SRM-II, developed by cooperation of department of medical engineering, Seoul National University Hospital. The results were as follows; 1. In the total 72 cases, vascular disease was 28 cases in which aortic disease including Takayasu's aortitis was 18 cases. Others were vascular tumors in 32 cases and various conditions such as renal donor and artificial arteriovenous shunt. 2. Extent of the lesion was well delineated especially in aortic disease in cluding 8 cases of Takayasu's aortitis, 6 cases of aortic aneurysm and 2 cases of Behcet's syndrome. 3. DSA can be done to outpatient without admission because of its simplicity and non-invasiveness. DSA is useful especially in the evaluation and follow-up of vascular disease and the diagnostic value is expected to grow continuously according to the renewal of system.
Angiography, Digital Subtraction* ; Aortic Aneurysm ; Aortic Diseases ; Aortitis ; Behcet Syndrome ; Follow-Up Studies ; Humans ; Outpatients ; Seoul ; Tissue Donors ; Vascular Diseases

Osteoblastomas were originally thought to be lesions that could be controlled with minimal local therapy, including curettage. However, at least some of the osteoblastomas with an unexpectedly active clinical course had histologic features which differed from ordinary osteoblastomas, and the term aggressive osteoblastoma was given to these lesions. In the aggressive osteoblastoma the osteoblasts are cytologically atypical. In addition, the well organized trabecular patterns of typical osteoblastoma is partly lacking, especially in the areas that are rich in atypical osteoblasts. The case report deals a case of aggressive osteoblastoma of the left iliac wing in a 44 year old male. The interesting radiologic manifestationa(plain x-ray CAT and radionuclide bone scan) and characteristic histologic findings are presented along with review of pertinent literatures.

Dendritic cells (DCs) are the most potent antigen presenting cells that can activate naive T cells. Mature DCs exress high levels of MHC and costimulatory molecules on their surface and have capacity to produce IL-12, a 75 kDa heterodimeric cytokine composed of p35 and p40 subunit. IL-12 is currently thought to be one of most critical determinants for skewing the immune response towards Th1. Expression of IL-12 in dendritic cells seems to be regulated by various stimuli including CD40L. In the present study we investigated expression of IL-12 in mature DCs, which were cultured from bone marrow cells in the presence of GM-CSF. Maturity of the DCs was confirmed by morphologic characteristics, immunophenotypes, and allostimulatory activities. Exprssion levels of IL-12 p40 in the DCs were measured by semi-quantitative RT-PCR. Increases in IL-12 p40 expression were observed after treatment with lipopolysaccharide (LPS), an anti-MHC class II monoclonal antibody, or an anti-CD40 monoclonal antibody. The most remarkable increases, however, were observed in the DCs treated with an anti-CD40 monoclonal antibody. These results support a previous notion that signals through CD40/CD40L interaction may be important for the production of IL-12 by DCs. Moreover, results of this study show a possibility of using monoclonal antibodies against CD40 molecules for preparing DCs producing high amount of IL-12, which can be used for anti-tumor or anti-viral immunotherapy.
Animals ; Antibodies, Monoclonal ; Antigen-Presenting Cells ; Bone Marrow Cells ; CD40 Ligand ; Dendritic Cells* ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunotherapy ; Interleukin-12* ; Mice* ; T-Lymphocytes

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies