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Diffuse alveolar hemorrhage after percutaneous coronary intervention is a rare but fatal complication. Although timely application of extracorporeal membrane oxygenator and discontinuation of antiplatelet/anticoagulation is the treatment of choice, bleeding is often irreversible. Herein, we introduce a patient with refractory diffuse alveolar hemorrhage after prolonged extracorporeal membrane oxygenator and percutaneous coronary intervention, who was eventually rescued with heart-lung transplantation.

The joint angle during gait is an important indicator, such as injury risk index, rehabilitation status evaluation, etc. To analyze gait, inertial measurement unit (IMU) sensors have been used in studies and continuously developed; however, they are difficult to utilize in daily life because of the inconvenience of having to attach multiple sensors together and the difficulty of long-term use due to the battery consumption required for high data sampling rates. To overcome these problems, this study propose a multi-joint angle estimation method based on a long short-term memory (LSTM) recurrent neural network with a single low-frequency (23 Hz) IMU sensor. IMU sensor data attached to the lateral shank were measured during overground walking at a self-selected speed for 30 healthy young persons. The results show a comparatively good accuracy level, similar to previous studies using high-frequency IMU sensors. Compared to the reference results obtained from the motion capture system, the estimated angle coefficient of determination (R2) is greater than 0.74, and the root mean square error and normalized root mean square error (NRMSE) are less than 7° and 9.87%, respectively. The knee joint showed the best estimation performance in terms of the NRMSE and R2 among the hip, knee, and ankle joints.

A 22-year-old woman with a 1-month history of shortness of breath that was treated as a case of tuberculosis and pulmonary embolism was referred to the authors’ hospital. Because of the hemodynamic instability in this patient, venoarterial extracorporeal membrane oxygenation (ECMO) was administered in the intensive care unit. She underwent a pulmonary embolectomy for the treatment of progressive circulatory collapse secondary to a pulmonary embolism. The histopathologic result was consistent with a metastatic choriocarcinoma. Despite the surgical management, persistent refractory cardiogenic shock occurred. Subsequently, the patient was treated with chemotherapy in the presence of ECMO and responded well to chemotherapy. She was discharged after 3 months. This case suggests that metastatic choriocarcinoma should be considered as a differential diagnosis in women of childbearing age presenting with a pulmonary embolism, and ECMO may be beneficial in patients with pulmonary embolism for bridging to surgical embolectomy and chemotherapy.

PURPOSES: This study investigates the mechanical performance of carbon-capturing concrete that mainly contains blast furnace slag. METHODS: The mixture variables were considered; these included Portland cement content, which was varied from 10% to 40% of the blast furnace slag by weight. The specimens were exposed to different conditions such as high and concentrations, laboratory conditions and high conditions. Mechanical performances, including compressive and flexural strengths and carbon-capturing depth, were evaluated. RESULTS : The slump, air content and unit weight were not affected significantly by the variation in cement content. The strength development when the specimens were exposed to high purity air was slightly greater than that when exposed to high . As the cement content increased the compressive and flexural strength increased but not considerably. The carbon-capturing capacity decreased as the cement content increased. The specimens exposed in the field for 70 days had flexural strength greater than 3 MPa. CONCLUSIONS : The results indicate that cement content is not an important parameter in the development of compressive and flexural strengths. However, the carbon-capturing depth was higher for less cement content. Even after field exposure for 70 days, neither any significant damage on the surface nor any decrease in strength was observed.

PURPOSES: As a part of our research into repair techniques for roads that have collapsed as a result of a natural disaster, this study set out to find the optimum mix proportion for gravels to be used to restore a damaged area. METHODS: This study considered flow and strength-development characteristics. The experimental variables were the W/C ratio, the usage of the admixture, the types of cement, and the quantity of fine aggregate over three different experimental stages. The compressive strength was measured at 12 hours, one day, three days, and seven days. RESULTS : The flow varied with the amount of fine aggregate and the use of a high-range water-reducing (HRWR) admixture. The compressive strength also varied with respect to the type of cement and the W/C ratios. The strength satisfied the expected requirement of 21 MPa after one day, provided the mix proportion was appropriate. CONCLUSIONS: A gravel-filling high-flow cement-based mortar exhibited strength and consistency with a W/C ratio in the range of 0.40 to 0.45, assuming the use of HRWR at 0.5 to 0.7% and a fine aggregate/cement ratio of 1.0 to 1.5.

Seung-Won Kim･Cheol-Woo Park*･ Seong-Wook Kim･ Hyun-Myung Cho･ Sang-Pyo Jeon･Min-Kwan Ju(Received August 5, 2014 / Revised September 23, 2014 / Accepted September 25, 2014)As political circumstances in oversea countries and Korea varies, the risk of vulnerability from unexpected extreme loading con ditions,such as explosions or extreme impacts, also increased. In additi on, construction companies in Korea recently have taken chances of overseas expansion to countries where their domestic situations are not in rest. Therefore, the resistance of construction mate rials forblast or impact loading become taking more consideration from engineering field. This study is a part of the research to develo p a highperformance fiber reinforced cementitious composite materials with high volume steel fibers and primary purpose of this study i s to find an optimum mix proportions of in-fill slurry. In order to accomplish the tasks this study performed experimental investiga tions onthe slurry for consistency, compressive strength, flowability, J-penetration, bleeding and rheology properties as well as mecha nical properties, compressive and flexural strength, with respect to different mix proportions.키워드 : 강섬유보강 시멘트 복합체, 폭발 및 충격하중, 최적배합, 충전슬러리Keywords : Steel fiber reinforced cementitious composite, Blast and Impact loading, Optimum mix proportions, In-fill slurry* Corresponding author E-mail: tigerpark@kangwon.ac.kr

Mycobacterium massiliense is an emerging pathogen that is increasingly reported as a causative agent occurring during medical procedures, at surgical sites, and intramuscularly [1]. Although previously classified as part of M. abscessus, M. massiliense has recently been identified as a new species of rapidly growing nontuberculous mycobacteria [1,3] via a comparative sequence analysis of rpoB and hsp65 [3,5]. However, the clinical manifestations of M. massiliense have not been well characterized. We report here in a case of recurrent pneumonia for 3 years that improved with antibiotic treatment for M. massiliense in a 37-year-old woman with Sjogren’s syndrome. The patient showed a substantial response to treatment with a combination of antimicrobial therapies comprising clarithromycin and amikacin without cefoxitin for 6 months. This is the first report of pulmonary infection of M. massiliense with Sjogren’s syndrome in Korea. (Korean J Med 2012;83:243-248)

Background : Tumor associated antigens, which are produced specifically by tumor cells, are promising targets for the early diagnosis and immunotherapy. Among the tumor associated antigens, MAGE (a melanoma antigen), BAGE, GAGE, PRAME and NY-ESO were named as cancer/testis specific antigens they are detected exclusively in the testis or cancer cells If MAGE is easily detectable in the sputum, it would become a convenient method for diagnosing lung cancer. This study was undertaken to investigate MAGE expression in the induced sputum obtained from lung cancer patients. Materials and Methods : In 14 control patients and 30 lung cancer patients, the induced sputum was collected after inhaling 3% saline(5 cc) delivered by nebulizer for approximately 5 minutes after a mouth rinse and bronchodilator inhalation. The induced sputum was placed in a conservative-mixed solution (guanidinium isothiocyanate, Triton X-100). The total cellular mRNA was extracted from the cells and RT PCR and nested PCR were run in 30 and 35 cycles respectively, with two different types of primers specially designed to detect six subtypes of MAGE DNA simultaneously. Results : MAGE expression was not detected in the 14 controls, but in the 30 cancer patients, MAGE was found in 24 patients (80%, p=0.001). In the cancer patients, there were no differences in the expression level according to the tissue types (squamous cell cancer 13/17, adenocarcinoma 7/9, and small cell cancer 4/4, p-0.56). Among the 24 MAGE-positive patients, the tumor was not visible on a bronchoscopy in 11 patients (45.8%). Conclusion : A study of MAGE in induced sputum appears to be a useful and complementary method in the diagnosis of lung cancer. A further prospective study with more patients is recommended.

Background : In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and in healthy children. Method : PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children(age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of by PEF were derived. Results : 1. The regression equation for PEF(L/min) was: age(year)+height(cm)-263() in boys, and age(year)+height(cm)-293() in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for (ml) by PEF(L/min) was:PEF-550() in boys, and PEF-146 () in girls, respectively. Conclusion : This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for , a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.

Cytomegaloviruses (CMVs) are ubiquitous but highly species-specific agents which commonly infect many animals, including humans. Cytomegalovirus (CMV) pneumonia has been one of the most important opportunistic infections in the immunocompromised host for those who have acquired immunodeficiency syndrome (AIDS) or who have received kidney, bone marrow or other organs. Cytomegalovirus infection has been known to be associated with congenital, infantile and adult nephrotic syndrome. We report a rare case of CMV pneumonia with nephrotic syndrome in a 62-year-old female who recovered fully with ganciclovir.

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, max, and focal score of BDI were significantly low in the severe group(pmax(ml/kg/min) and max(%), the parameters of resting PFTs, except were not significantly different between non-severe and severe(p>0.05). According to focal score((%), FVC(%), MW(%), , and max were significantly lower in the severe group(pmax(ml/kg/min) and max(%) were low(p(%) was correlated with max(%)(r=0.52;pmax and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

Background : Primary malignant tumors of the trachea are extremely rare entities and account for a mere 0.1 per cent of all malignancies of the respiratory tract. Because of vague localizing signs, symptoms and a usually negative routine chest film, the patients with tracheal tumors are often treated for asthma or chronic obstructive pulmonary disease for considerable period of time before correct diagnosis. Method : We have made a review of the 17 cases of primary tracheal tumors in recent 15 years. We reviewed the clinical features including history of smoking and respiratory symptoms, the official readings of initial routine chest film, the cytologic examination of sputum, the time of delay in diagnosis, and the response according to the therapeutic modalities. Results : Eight out of 9 patients with squamous cell carcinoma(SCC) were above 50 years old, five out of 6 patients with adenoid cystic carcinoma(ACC) were below 50 years old. The most common location of primary tracheal tumors was the upper one-third of trachea in 8 cases(47%). The most frequent symptoms were dyspnea in 13/17 cases(76%) and then stridor or wheezing, cough. and sputum in order. The routine chest roentgenographic examinations were not helpful to diagnose tracheal carcinoma and the cytologic examinations of sputums were helpful to diagnose tracheal carcinoma in only one case with adenocarcinoma. The mean times of delay in diagnosis of patients with sec and ACC were 5 months and 24.9 months respectively. We had bronchial asthma in 8 cases(47%) and tracheal tumors in 4 cases(23%) as initial clinical impression. Conclusion : We would like to perform more comprehensive diagnostic tools(high KVP technique, the fibroptic bronchoscopic examination, chest CT scan etc.) in patients who had the suggestive points for the tracheal tumorse(1. unexplained hemoptysis or hoarsness, 2. inspiratory wheezing or stridor, 3. wax and waning of dyspnea according to changes of position, 4. progressive asthmatics unresponsive to antiasthmatic therapy) and radical resection of tumor or external radiation therapy with curative aim as possible.