BACKGROUND: Clinical and experimental studies have suggested that brain death may cause hemodynamic, electrocardiographic, functional or histopathologic changes of the heart. METHODS: Brain death was induced by increasing intracranial pressure(ICP) abruptly by intermittent bolus injection of saline(model ) or gradually by continuous infusion of saline(model ) to the epidural catheter in 5 mongrel dogs, respectively. Hemodynamic and biochemical changes during the process of brain death and histopathologic changes of the myocardium were analyzed and compared in two brain death models, and the association of apoptosis was also evaluated. RESULTS: 1) Two predominant subsets of acute contraction band lesion were produced in both brain death models : paradiscal and holocystic contraction band lesions. Both contraction band lesions were more prevalent in brain death model . 2) The frequency of both contraction band lesions was lowest in the epicardial layer and highest in the endocardial layer in both models, but no correlation was observed between the degree of contraction band lesions and ICP, LV maximum +dp/dt or catecholamine levels. There was no statistical difference between any of the LV circumferential blocks and either type of contraction band lesion, and transaxial distribution was not also different in both models. 3) There was no remarkable histopathologic changes in the analysis of major epicardial coronary arteries. Apoptotic cells were suggested in the scattered myocytes in the light microscopy and apoptosis was detected by in situ nick end labeling method. Electron microscopy revealed a condensation of nuclear chromatin and convolution of nuclear membrane in those myocytes. CONCLUSIONS: Myocardial changes due to brain were observed frequently, and few apoptotic cells were found in the brain death heart. Studies on the treatment strategy to minimize damages of myocardial structure and function caused by brain death should be followed in the near future.
Animals ; Apoptosis ; Brain Death* ; Brain* ; Catheters ; Chromatin ; Coronary Vessels ; Dogs ; Electrocardiography ; Heart ; Hemodynamics ; In Situ Nick-End Labeling ; Microscopy ; Microscopy, Electron ; Muscle Cells ; Myocardium* ; Nuclear Envelope

Objective: : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including non-contrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods: : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results: : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; p<0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective management plan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION: This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.
Licensure ; Methods ; Programming, Linear

PURPOSE: This study aimed to identify the best way of developing equivalent item sets and to propose a stable and effective managementplan for periodical licensing examinations. METHODS: Five pre-equated item sets were developed based on the predicted correct answer rate of each item using linear programming. These pre-equated item sets were compared to the ones that were developed with a random item selection method based on the actual correct answer rate (ACAR) and difficulty from item response theory (IRT). The results with and without common items were also compared in the same way. ACAR and the IRT difficulty were used to determine whether there was a significant difference between the pre-equating conditions. RESULTS: There was a statistically significant difference in IRT difficulty among the results from different pre-equated conditions. The predicted correct answer rate was divided using 2 or 3 difficulty categories, and the ACAR and IRT difficulty parameters of the 5 item sets were equally constructed. Comparing the item set conditions with and without common items, including common items did not make a significant contribution to the equating of the 5 item sets. CONCLUSION This study suggested that the linear programming method is applicable to construct equated-item sets that reflect each content area. The suggested best method to construct equated item sets is to divide the predicted correct answer rate using 2 or 3 difficulty categories, regardless of common items. If pre-equated item sets are required to construct a test based on the actual data, several methods should be considered by simulation studies to determine which is optimal before administering a real test.

No abstract available.
Agaricales ; Dermatitis

It has been known that the usual findings of SPECT in patients with Todd's paralysis is the hypoperfusion of the corresponding hemisphere. We experienced a patient who developed transient hemiparesis after a seizure attack with hyperperfusion rather than hypoperfusion over the corresponding hemisphere on brain SPECT. A 36-year-old female presented with left hemiparesis after a secondarily generalized tonic seizure. No additional seizure-like attack was noted during admission. EEG showed intermittent focal slow waves over the right frontotemporal area on admission and returned to a normal pattern 72 hours after admission. Tc-99m ECD SPECT showed hyperperfusion on the right frontoparietal area in spite of the normalization of EEG. The degree of hyperperfusion was diminished as time passed for at least 72 hours. We report a patient who had Todd's paralysis associated with contralateral frontoparietal hyperperfusion. Todd's paralysis may be explained as the result of focal discharges that lead to local vasomotor changes.
Adult ; Brain ; Electroencephalography ; Female ; Humans ; Paralysis* ; Paresis ; Seizures ; Tomography, Emission-Computed, Single-Photon

Blossom blight in strawberry was first observed in a green house in Nonsan, Damyang, and Geochang areas of Korea, between early January to April of 2012. Disease symptoms started as a grey fungus formed on the stigma, which led to the blossom blight and eventually to black rot and necrosis of the entire flower. We isolated the fungi purely from the infected pistils and maintained them on potato dextrose agar (PDA) slants. To test Koch's postulates, we inoculated the fungi and found that all of the isolates caused disease symptoms in the flower of strawberry cultivars (Seolhyang, Maehyang, and Kumhyang). The isolates on PDA had a velvet-like appearance, and their color ranged between olivaceous-brown and smoky-grey to olive and almost black. The intercalary conidia of the isolates were elliptical to limoniform, with sizes ranging from 5.0~10.5 x 2.5~3.0 microm to 4.0~7.5 x 2.0~3.0 microm, respectively. The secondary ramoconidia of these isolates were 0- or 1-septate, with sizes ranging betweem 10.0~15.0 x 2.5~3.7 microm and 8.7~11.2 x 2.5~3.2 microm, respectively. A combined sequence analysis of the internal transcribed spacer regions, partial actin (ACT), and translation elongation factor 1-alpha (TEF) genes revealed that the strawberry isolates belonged to two groups of authentic strains, Cladosporium cladosporioides and C. tenuissimum. Based on these results, we identified the pathogens causing blossom blight in strawberries in Korea as being C. cladosporioides and C. tenuissimum.
Actins ; Agar ; Chungcheongnam-do ; Cladosporium* ; Flowers* ; Fragaria* ; Fungi ; Glucose ; Korea* ; Necrosis ; Olea ; Peptide Elongation Factors ; Sequence Analysis ; Solanum tuberosum ; Spores, Fungal

The hypokalemic periodic paralysis is characterized by intermittent falccid paralysis of extremities with spontaneous recovery. It is rarely accompanied by cardiac arrhythmia, especially fatal ventricular tachycardia or torsades de pointes. We observed a 29 year old man, who had suffered from intermittent periodic paralysis and fatal ventricular tachyarrhythmia. He had the first episode of muscle weakness in his low grade of elementary school, which lasted for 20 -30 hours. Similar episodes of muscle weakness occurred 1 -7 times per year, especially after carbohydrate rich food. On admission to emergency room, his chief complaints were generalized weakness and chest tightness, serum potassium level was 1.6mEq/l, and four extremities showed Grade 0 motor weakness. His electrocardiography(ECG) showed Atrioventricular dissociation due to sinus tachycardia and accelerated junctional rhythm, intraventricular conduction distrubance. During intravenous potassium administration, ECG showed sustained ventricular tachycardia and cardiovascular collapse occurred. So we carried out resuscitation and cardioversion. After resuscitation, he recovered from cardovascular collapse and ECG showed sinus tachycardia. But during continuous monitoring ECG showed torsades de pointes with cardiovascular collapse. We carried out resuscitation and defibrillation repeatedly. Serum potassium level was 1.7 - 1.8mEq/L at that time. After successful resuscitation, ECG showed sinus rhythm, and his mental status was fully recovered. After he admitted to intensive care unit, paralytic attack and cardiac arrhythmia did not occurred any more. Serum potassium level was maintained between 3.9 -6.1lmEq/L during his hospital days. He was fully recovered but could not take any medications(e.g. acetazolamide, potassium supplying agent and antiarrhythmic drugs) due to severe gastrointestinal disturbances. During the 30 months of postdischarge period, he experienced three mild paralysis attacks, but they were not accompanied by chest tightness, palpitation or syncope.
Acetazolamide ; Adult ; Arrhythmias, Cardiac* ; Electric Countershock ; Electrocardiography ; Emergency Service, Hospital ; Extremities ; Heart Block ; Humans ; Hypokalemia ; Hypokalemic Periodic Paralysis* ; Intensive Care Units ; Muscle Weakness ; Paralysis ; Potassium ; Resuscitation ; Syncope ; Tachycardia ; Tachycardia, Sinus ; Tachycardia, Ventricular ; Thorax ; Torsades de Pointes

The aconite root has been used in oriental medicine to improve metabolism of debilitated patient and to cure acute dysuria, cardiac weakness, gout, neuralgias and rheumatism. The crude drug "bu-shi" or "cho-oh", which is obtained from the Aconitum roots, contains the potent poisons aconitine, mesaconitine, jesaconitine, and hypaconitine, which are C
Aconitine ; Aconitum* ; Adult ; Alkaloids ; Animal Experimentation ; Arrhythmias, Cardiac* ; Dizziness ; Dysuria ; Gout ; Hemodynamics ; Humans ; Medicine, East Asian Traditional ; Metabolism ; Nausea ; Neuralgia ; Poisons ; Rheumatic Diseases ; Shock* ; Tachycardia ; Tachycardia, Ventricular ; Torsades de Pointes ; Ventricular Fibrillation ; Vomiting

Purpose: To report a case of bilateral calcific band keratopathy treated with dipotassium edetic acid (EDTA) in a blood collection tube, an approach that has not been used previously in the Republic of Korea.Case summary: A 77-year-old male patient, with a history of diabetes and hypertension, presented with decreased vision in both eyes that had begun 1 year prior. Five years prior, the patient had undergone cataract surgery in the right eye and had received a diagnosis of prostate cancer for which he was currently under observation without surgical treatment. At the initial eye examination, his best-corrected visual acuity was 0.15 in the right eye and 0.1 in the left eye. Calcium deposition was observed in the center of the cornea by slit-lamp examination, resulting in a diagnosis of band keratopathy. We proceeded to dissolve the dipotassium EDTA coated on a blood collection tube with distilled water. Using the dissolved dipotassium EDTA, we peeled off the corneal epithelium under local anesthesia to remove the calcium deposition. One week after surgery, the visual acuity of both eyes improved to 0.6, and no recurrence or complications occurred for 7 months. Conclusions As a new treatment for band keratopathy, we discovered that dipotassium EDTA is more convenient to obtain than the conventional disodium EDTA. We expect that dipotassium EDTA will be widely used in the treatment of band keratopathy.