• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.292-296
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• 2007

Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter ($Pleuracan^{(R)}$) for the initial treatment of primary spontaneous pneumothorax. Material and Method: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P ($Pleuracan^{(R)}$ group). Result: Initially, the $Pleuracan^{(R)}$ catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%) : three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time ($T:\;2.1{\pm}1.5\;days,\;P:\;2.1{\pm}1.3\;days$), hospital stay ($T:\;6.4{\pm}5.4\;days,\;P:\;5.2{\pm}2.9\;days$) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy(T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage ($T:\;0.5{\pm}0.7\;days,\;P:\;0.5{\pm}1.2\;days$) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. Conclusion: Application of the $Pleuracan^{(R)}$ catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.110-115
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• 2009

Background: A forceps-biopsy is performed to acquire tissue from patients with an endobronchial carcinoma using a flexible bronchoscope. Recently, a cryo-biopsy has also been used to acquire tissue samples. Cryo-biopsy is the diagnostic application of extreme cold for the local destruction of abnormal living tissue. This technique is safe, with no radiation danger, no risk of electrical accidents, and a little risk of bleeding. This study compared a forceps-biopsy with a cryo-biopsy using a flexible bronchoscope, and examined the chemosensitivity and level of VEGF (vascular endothelial growth factor) in the specimens obtained from the cryo-biopsy. Methods: We present a prospective study of 30 consecutive patients who underwent a forceps-biopsy between January 2007 and October 2007 with a mean age of 62.1 years and a male:female ratio of 5 : 1. A flexible bronchoscope was inserted to the area of the abnormal lesions, and a cryo-probe was then applied through the working channel of the flexible bronchoscope. A temperature of approximately -h80 was delivered to the tumor site for 8 seconds. The cryo-biopsy was performed after destroying the tumor mass. Results: The mean size of the tissue from the forceps-biopsy and cryo-biopsy were 2.0${\pm}$1.2 mm and 6.0${\pm}$3.0 mm. A chemosensitivity test was performed on 5 specimens obtained using cryo-biopsy and the level of VEGF was examined in 2 specimens obtained from a cryo-biopsy. There were no side effects in either group. Conclusion: Cryo-biopsy using a flexible bronchoscope is a safe and effective technique for acquiring tissue samples.

• Journal of radiological science and technology
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• v.35 no.4
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• pp.327-333
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• 2012

Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.261-266
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• 2003

Background: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years' experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. Material and Method: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center Mean age was $62.8{\pm}12.7$ and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was $8.8{\pm}2.4$cm. Result: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p<0.05), preoperative BUN level (p<0.05), and DM (p<0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was $3.6{\pm}0.2$ years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed $81.7{\pm}7.6$% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. Conclusion: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.43-48
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• 1999

Background: Although treatment of spontaneous pneumothorax by video-assisted thoracic surgery(VATS) has generally shown better clinical results than conventional thoracotomy, treatment of spontaneous pneumothorax by midaxillary thoracotomy(MAXT) has also shown good clinical results. The author studied to compare the clinical results of MAXT group I and VATS group II. Material and Method : Group I included 30 midaxillary thoracotomy among 83 operative cases of spontaneous pneumothorax from Jan. 1992 to Dec. 1993. Group II included 30 VATS among 101 operative cases of pneumothorax from Jan. 1994 to Aug. 1995. The author selected the 30 patients, age 18 to 25 years, with recurrent spontaneous pneumothorax in each group. The author analyzed the operative indication, gender, operating time, amounts of the used staplers, tube drainage, total amounts of analgesics used during postoperative 24hr, tube stay time, postoperative complications and mortality. Result: The follow-up periods of both procedures were from 6 to 43 months. The operating time from start of skin incision to end of skin closure was 84.79${\pm}$21.70(from 40 to 150) minutes in MAXT group I and 108.8${\pm}$42.02(from 58 to 120) minutes in VATS group II(P<0.001). The numbers of the used staples useo was 1.31${\pm}$0.6(from 0 to 3) in group I and 3.41${\pm}$2.37(from 0 to 11) in group II. The amounts of postoperative 24hour tube drainage were 220.76${\pm}$106.73(from 65 to 400) ml in group I and 260.63${\pm}$233.18(from 70 to 320) in group II(P>0.05). The amounts of postoperative 24 hourly used analgesics(Tarasyn ) was 1.38${\pm}$1.32(from 0 to 5) amples in group I and 0.72${\pm}$1.02(from 0 to 4) amples in group II (P<0.05). The postoperative tube stay is 5.45${\pm}$30.9 (from 3 to 7) days in group I and 4.75${\pm}$3.1(9 from 2 to 14) days in group II(P>0.05). The number of complications after operations was 2 cases of prolonged air leakage in group I, and in group II. (P is not significant). The number of recurrence after the operation was one in group I and also one in group II(P is not significant). In conclusion, there were no statistical differences in the postoperative 24 hour chest tube drainage, days of postoperative tube stay, postoperative complications and recurrence in the analysis between group I and group II. Conclusion: The author found that group II of VATS between 18 years and 25 years of age in recurrent spontaneous pneumothorax, statistically, requires longer operative time, more number of autosuture staples and less postoperative analgesic dosage than the midaxillary thoracotomy group I.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.2
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• pp.139-145
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• 2002

In a primary teeth, dental caries is rapidly advanced the pulp disease, because the primary teeth have the thinner and the weaker enamel layer and the wider pulp chamber than relatively the permanent teeth. And the pulps of primary teeth are exposed during caries removal or even they are exposed by unexpected movement of the children or by trauma. For successive pulp treatment in primary teeth, it is necessary to understand completely about multiple canal morphology, variation of root canal anatomy and specific problem related to root formation and resorption of primary teeth. In upper primary molar, canal configuration of mesial root has the most variation same as upper molar. If not canal treatment is completely, most of all endodontic treatment should be failed. In a clinical case report, upper primary molars existed persistent pain or bleeding during treatment were founded the second MB canal and were performed the endodontic treatment of theirs. As a result, the upper primary molars have no symptom and good prognosis. In the examination of extracted upper primary molar, we found that 8 of 35 teeth(22.8%) in the upper primary first molars and 22 of 33 teeth(66.6%) in the upper primary second molar had the second mesiobuccal canal. It has revealed the high prevalence of two canals in mesiobuccal roots of upper primary molars. The frequency of occurrence of the second mesiobuccal canal must be taken into consideration when endodontic treatment is planned and as a possible cause of otherwise un explained failure.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.325-333
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• 1992

Background and Methods: To study the effects of corticosteroid (CS) on the parquat (PQ) induced lung injury, serial cellular analyses of bronchoalveolar lavage (BAL) fluid were done with simultaneous histopathologic examination after intraperitoneal injection of PQ on the rats. The sacrificed animals were divided into three groups; control group, PQ group received intraperitoneal injection of 20 mg/kg of PQ, and CS group received daily injection of Methylprednisolone sodium succinate (20 mg/kg) in addition to PQ. Results: 1) Cellular analyses of BAL fluid: The total cell count in the BAL fluid were increased gradually from 6 hours after PQ administration (p<0.05), and was decreased at 3 days after (p<0.05). These changes were mainly due to the effects of PQ on the neutrophil influx (p<0.05). But, the number of macrophage and the percentage of lymphocyte in total cells showed little changes. The CS administration showed the suppression of neutrophil influx in the BAL fluid (p<0.05), but could not show any significant effect on the number of macrophage and lymphocyte. 2) Histopathologic examination: In the PQ group, inflammatory changes especially with prominant neutrophil infiltration were gradually progressed over time. Those changes were found in both alveolar space and interstitium with resultant alveolar structural changes, but subsided from 3 days after. CS suppressed inflammatory changes in the alvolar space and interstitium, especially with decreased infiltration of neutrophil. Conclusion: CS suppressed neutrophil infiltration in the acute lung injury induced by PQ, those findings were ascertained by serial cellular analyses of BAL fluid and histopathologic examination.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.198-206
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• 2000

Background : Pulmonary complications following bonemarrow transplantation (BMT) are common and associated with a high mortality rate. We investigated the yield, safety, and impact of fiberoptic bronchoscopy (FOB) for diagnosis of postBMT pneumoniae. Methods : From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with respiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL (bronchoalveolar lavage), TBLB (transbronchial lung biopsy), PSB (protected specimen brush). Results : The characteristics of the subjects were as follows : 37 males, 15 females, mean age of 31.3 years(l7-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following : 12 cytomegalovirus (CMV) (21.4 %), 7 pneumocystis carinii (PC) (12.5 %), 11 CMV with PC (19.6 %), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases (23.2%), 13 died of CMV pneumoniae (n=2), PCP (n=2),mixed infection with CMV and PC (n=3), underlying GVHD (n=1), underlying leukemia progression (n=1), or respiratory failure of unknown origin (n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleeding and 1 episode temporary hypoxemia. Conclusion : Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.

• Journal of Periodontal and Implant Science
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• v.27 no.3
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• pp.603-619
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• 1997

The use of laser in the treatment of soft tissue minimizes hemorrhage, provides better view of the operating field, and thereby minimizes operating time. Also, there will be far less post-operative swelling, pain and scar formation, and sterilizing effect are shown in some portions of the wound site. All these advantages of laser therapy contribute to its widespread use in the field of medicine and dentistry. Regarding such facts, we used CO2 laser of different watts in gingivectomy for white rats to compare initial healing process. For the control group, the least amount of output in performing gingivectomy(4watts) was offered, and for the experimental group, 6watts was given. Animals were sacrificed on the second, third days, 1 weeks, 2 weeks, and 3 weeks after operation, and their specimens were histologically analyzed. The following results were obtained: 1. Blood clot of small size was observed in both the control and experimental groups after two days, and no more thereafter. 2. In both the control and experimental groups, the inflammation zone size was the greatest after two days, and it decreased gradually to become almost invisble by the second week. The experimental group showed larger size of inflammation zone during second and third days: however, there was no difference after one week. 3. Granulation tissue in both the control and experimental groups showed gradual maturation with time, and by the second week, it was almost replaced by normal connective tissue. By the third week, complete healing pattern was observed. The experimental group showed larger granulation tissue than the control group until the third day, but there was no significant difference after one week. 4. In both the control and experimental groups, gingival epithelialization began on the second day. After one week, regeneration of rete peg and partial formation of junctional epithelium were observed: by the second week, keratinization of oral sulcular epithelium began, and it was completed by the third week.