• Journal of Chest Surgery
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• v.30 no.1
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• pp.27-33
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• 1997

Retrograde myocardial protection is widely accepted in CABG operation because of the limitations of the antegrade method in the coronary arterial stenosis lesions. We analyzed 76 c ses of retrograde myocardial protection among 96 cases of CABG operation performed between April 1994 and August 1995, There were 48 males and 25 females, and the mean age was 58.2 $\pm$ 8.3 years. 53 patients (70%) were operated for unstable angina, 14 (18%) for stable angina, 6 (8%) for post-infarct angina, 1 (1%) for acute myocardial infarction, and 2()%) for failed PTCA. Preoperative coronary angiography revealed 3-vessel disease in 42 cases, 2-vessel disease in 11, 1-vessel disease in 10, and left main disease in 13 cases. We used SVG(63 cases), LIMA(69 cases), RIMA(11 cases), radial artery(6 cases), and gastroepiploic artery(1 case) for the grafts. Mean anastomosis was 3.2 $\pm$ 1.1. We protected the myocardium with antegrade induction and retrograde maintenance in all the cases except a case of retrograde induction and maintenance. During the aortic cross-clamping, blood cardioplegia was administered intermittently in 19 cases, and continuously in 57 In 39 cases, we used retrograde ardioplegia and antegrade perfusion of RCA graft simultaneously. We had no operative motality. Perioperative complications were arrhythmia in 15 cases, perioperatve myocardial infarction in 10, low cardiac output syndrome In 8, transient neurologic problem in 7, transient psychiatric problem in 6, ARF in 3, bleeding in 2, pneumonia in 2, wound infection in 1, and duodenal ulcer perforation in 1 . In this report, we experienced 76 cases of CABG operation with retrograde myocardial protection under the acceptable operative risk without operative mortality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.5
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• pp.301-314
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• 2003

The purposes of this retrospective study were to assess the change of serum parameters in oral and maxillofacial surgery patients after operation and to determine what laboratory parameters on treatment periods were associated with the recovery of systemic condition. For purposes of assessing systemic nutritional status, several serum parameters were chosen. The sample patients were randomsubjects extracted from three category patient groups- oral cancer, odontogenic abscess, facial bone fracture based on treated patients at department of oral and maxillofacial surgery in Pusan National University Hospital from September 1, 1998, to September 1, 2002. Each groups were consisted with 10 patients. Each patient chart was examined and blood sample parameters were reviewed with clinical signs, symptoms and vital sign at preoperative day, postoperative 1 day, postoperative 1 week. Several parameters were analyzed statistically for extraction of mean values and differences between the periods groups. The findings of serum parameters of cancer, abscess and fracture groups were as follows: 1. In cancer patients, Hb, MCV, albumin, cholesterol, LDH, AST, ALT, neutrophil, platelet, leukocyte, Na, K, Cl, BUN, creatinine were analyzed. Values of Hb, albumin, AST, neutrophil, leukocyte, Cl showed significantly differences according to periods. 2. In abscess patients, CRP, ESR, leukocyte, body temperature, neutrophil were analyzed. Values of CRP, leukocyte, body temperature, neutrophil showed significanlty differences according to periods. 3. In fracture patients, same parameters with cancer patient's were chosen. Values of platelet, Cl only showed significantly differences according to periods. 4. In cancer patients, data regarding correlation was analyzed statistically as Pearson's value. A positive correlation was found between Hb and albumin, K, Na(P<0.05). A positive correlation was also found between neutrophil and leukocyte(P<0.05). Positive correlations were found between cholesterol and ALT, LDH and platelet, creatinine both, Platelet and BUN, Na and K(P<0.01). 5. In abscess patients, Peason's correlation values were analyzed on parameters. A positive correlation was found only between CRP and neutrophil(P<0.05). 6. In fracture patients, The correlations of parameters also were statistically analyzed. Positive correlations were found between MCV and K, albumin and LDH, AST and three parameters of creatinine, Na, Cl, K and neutrophil, neutrophil and three parameters of leukocyte, BUN, K(P<0.05). Positive correlations were found between LDH and AST, ALT and AST, creatinine both(P<0.01). This retrospective clinical study showed the CRP levels only on abscess patients may be useful in determination of clinical infected status, but the levels of other parameters on cancer, fracture patients did not showed significant values as diagnostic aids for clinical status.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.413-421
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• 1999

Purpose: This study was performed to evaluate the usefulness of $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy for diagnosing prosthetic infection after total knee replacement arthroplasty without the aid of following bone marrow scintigraphy Materials and Methods: The study subjects were 25 prostheses of 17 patients (one man and 16 women, mean age. 65 years) who had total knee replacement arthroplasty. After injection of $^{99m}Tc$-HMPAO-labelled leucocyte, the whole body planar and knee SPECT images were obtained in all patients. The subjects were classified into three groups according to clinical suspicion of prosthetic infection. Group A (n=11) with high suspicion of infection; Group B (n=6) with equivocal suspicion of infection, and Group C (n=8) with asymptomatic contralateral prostheses. Final diagnosis of infection was based on surgical, histological and bacteriological data and clinical follow-up. Results: Infection was confirmed in 13 prostheses (11 in Group A and 2 in Group B). All prostheses in Group A were true positive. There were two true positives, one false positive and three true negatives in Group B, and six true negatives and two false positives in Group C. Overall sensitivity, specificity, and accuracy for diagnosis of the infected knee prosthesis were 100%, 75% and 88%, respectively Conclusion: $^{99m}Tc$-HMPAO-labelled leucocyte scintigraphy is a sensitive method for the diagnosis of infected knee prosthesis. However, false positive uptakes even in asymptomatic prosthesis suggest that bone marrow scintigraphy may be needed to achieve improved specificity.

• Parasites, Hosts and Diseases
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• v.21 no.1
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• pp.32-39
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• 1983

실험동물에서 짧은 기간 감염시킨 후 얻은 간흡충(Clonorchis sinensis)에서는 거의 볼 수 없지만, 간, 담도 수술 또는 부검을 실시할 때 사람에서 얻은 간흡충중에는 검은 색소를 갖는 것을 관찰할 때가 있다. 이 색소는 살아 있는 간흡충에서도 명백하며, 색소가 없는 간흡충은 색이 분홍빛이고 투명한데 비하여 색소가 있는 것은 검은색을 띠고 불투명하다. 사람에서 얻은 간홉충 모두가 검은 색소를 갖고 있는 것은 아니며, 이제까지의 경험으로는 30세 이상 어른에서 얻은 간흡충중 그 길이가 약 1cm이상인 것에서 나타난다. 이 색소의 성분에 대하여 과거에는 빌리루빈, 또는 숙주 혈구세포에서 유래한 철을 포함하는 색소일 것이라고 생각하고 있었다. 저자등은 이 색소가 간흡충의 노쇠현상과 관련된 것으로 생각하고, 그렇다면 lipofuscin일 것이라고 생각하였다. 위의 가정을 확인하기 위하여 육안적으로 분명히 검은 색소가 있은 충체의 조직절편을 만들고, H & E, prussian blue, bilirubin, Fontina-Masson, PAS, amylase-PAS, Ziehi-Neelsen 및 AFIP method for lipofuscin등 8가지 조직화학적 염색을 실시하였다. 색소는 H & E, prussian blue, bilirubin, montana-Masson염색으로 착색되지 않았으며, PAS, amylase-PAS, Ziehi-Neelen, 및 AFIP method for lipofuscin에 염색되어 이것이 조직화학적으로 리포푸신 색소임을 확인하였다. 색소를 다시 전자현미경으로 관찰한 바 색소과립안에는 모양이 등글거나 타원형이고 크기가 $0.05~0.240{\mu}m$인 세포막구조가 산재하였음을 발견할 수 있어 간흡충의 검은 색소는 리포푸신 색소임을 다시 확인할 수 있었다.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.73-77
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• 2002

Medical application of leeches, by means of leech's blood suction, has advantages in not only directly removing blood congestion, but also preventing hindrance to venous drainage by inhibiting local thrombus formation and inducing continuous bleeding. Nevertheless, Aeromonas hydrophila infection secondary to such suction is most common and may develop into serious conditions from local inflammatory reaction to total necrosis of replanted parts and enterocolitis as well as sepsis. Once infected, it requires infection treatment, removal of necrotic tissues and reconstruction. Hence, duration and cost of treatment increase while functional recovery falls markedly. Accordingly, we present measures to reduce Aeromonas infections as follows: First, do not manipulate as much as possible while the leeches are sucking or moving. Second, the site which suction plates of the leeches are attached, should be selected away from the surgical wound site or open wound as much as possible. Third, contaminated or blood-wet gauze should be replaced often so that the skin of surgical areas would not swell. Furthermore, bleeding or oozing should be well-drained. Fourth, the areas other than the sites of leech attachment should be covered with sterilized gauzes in order to limit leech movement.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.111-116
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• 2006

An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.74-77
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• 2013

The guidelines for the treatment of massive bone defects caused by bone resection due to tumors have changed from amputation to limb salvaging surgery. Limb salvaging surgery using endoprotheses is a well-established procedure. However, Aseptic loosening, infection, and mechanical defect remain significant problems. Among them, we experienced the case with a breakage of polyethylene lock of MUTARS$^{(R)}$ distal femur tumor Endoprostheses.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.1
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• pp.46-54
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• 1995

Postoperative infection following orthognatic surgery is rare. When postoperative infections occur, the initial treatment consists of incision and drainage of the affected area, culturing to identify bacterial stains and verify antibiotic sensitivity, and the institution of the appropriate antibiotic regimen. Some plates and screws may eventually require removal, the initial therapy should be attempted to retain the plates and screws until adequete healing has taken place. In orthoganthic surgery, intra-operative complications as a lesion of inferior alveolar nerve, fracture of osteomised segments, incomplete sectioning, malposition of segments, haemorrhage may occur. The surgeon should be familiar with possible complications to be caused and how to manage them. Prevention of postoperative infection following the orthognathic surgery consists of minimal periosteal reflection, aseptic management of operation field, proper surgical technique, rigid fixation, prophylactic antibiotics.

• Korean Journal of Veterinary Research
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• v.33 no.3
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• pp.443-454
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• 1993

Shiga-like toxin-II(SLT-II)-producing Escherichia coli 0157 : H7 strain B2387이 분비하는 SLT-II가 gnotobiotic자돈에서의 뇌혈관 병변을 일으키는 pathogenesis에 관해서 실험을 했다. 제왕절개 수술로 태어난 자돈들을 두 그룹으로 나누어서, 한 그룹에는 SLT-II 중화항체를 포함한 혈청을 구강을 통해서 수동면역을 시키고, 또다른 한 그룹에는 SLT-II 중화항체가 포함되어 있지 않은 혈청을 구강을 통해서 수동면역시켰다. 24시간후 두 그룹 모두에게 SLT-II producing Escherichia coli O157 : H7 strain B2387를 구강으로 접종했다. SLT-II 중화항체가 포함되어 있지 않은 혈청으로 수동면역시킨 그룹의 자돈들은 설사와 맹결장염, 신경증상, 뇌혈관병변을 일으키고, plasma의 prostacyclin의 level이 증가했다. 하지만 SLT-II 중화항체가 포함되어 있는 혈청으로 수동면역시킨 그룹의 자돈들은 설사와 맹결장염은 유발했지만, 신경증상과 뇌혈관병변은 관찰되지 않았고, prostacyclin의 level도 증가하지 않았다. 이런 실험결과는 SLT-II 중화항체는 뇌혈관병변은 방어하지만 맹결장염은 방어하지 못한다는 의미를 나타내며, prostacylin의 증가는 뇌혈관의 endothelium의 병변을 의미한다.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.823-826
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• 1997

Myocardial abscess usually occurs as a complication of infective endocarditis or overwhelming septicemia. Coronary artery occlusion caused by myocardial abscess has been rarely reported. A 61-year-old man presented with fever and chill that developed 6 weeks prior to admission. He had a history of cardiopulmonary resuscitation for ventricular fibrillation and cardiac arrest 4 weeks prior to admission. Echocardiography showed a 3xfcm sized mass in the area of the right atrioventricular groove and coronary angiography showed complete occlusion of the proximal right coronary artery. Under the diagnosis of myocardial infarction complicating myocardial abscess, debridement of abscess and coronary artery bypass grafting with right internal mammary artery to distal right coronary artery was performed. Culture from the abscess cavity demonstrated Salmonella arizona.