• Title/Summary/Keyword: 이식 전이

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Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

Early Result of Surgical Management of the Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (관상동맥-폐동맥 이상 기시증에 대한 수술의 조기 결과)

  • Yoon Yoo Sang;Park Jeong Jun;Yun Tae Jin;Kim Young Hwue;Ko Jae Kon;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.18-27
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    • 2006
  • Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

Short-term Mechanical Circulatory Support with Centrifugal Pump in Cardiac Arrest or Cardiogenic Shock - Report of 5 cases- (심정지 혹은 심인성 쇼크에서 원심성 펌프를 이용한 단기목표의 기계적 순환 보조)

  • 양희철;성기익;뱍계현;전태국;박표원;양지혁;이영탁
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1003-1009
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    • 2004
  • Mechanical circulatory support (MCS) has been used for myocardium failure, but moreover, it may be essential for the life support in cardiac arrest or cardiogenic shock. Many commercial devices can be used effectively for the long-term support. However, there are some limitations in the aspects of the cost and technical support by production company. Short-term support with centrifugal type has been reported numerously with the purpose of bridging to heart transplantation or recovery. We successfully treated 5 patitents who were in the status of cardiogenic shock (n=3) or arrest (n=2) with the technique of extracorporeal life support system (ECLS) or left ventricular assist device (LVAD) using the centrifugal type pump. The MCS were performed emergently (n=2) under cardiac arrest caused by ischemic heart disease, and urgently (n=3) under cardiogenic shock with ischemic heart disease (n=1) or acute fulminant viral myocarditis (n=2). All patients were weaned from MCS. Complications related to the use of MCS were bleeding and acute renal failure, but there were no major complications related to femoral cannulations. Mechanical circulatory support may be essential for the life support and rescue in cardiac arrest or cardiogenic shock.

Prospect for 3D Printing Technology in Medical, Dental, and Pediatric Dental Field (의료 3D 프린팅 기술의 전망 및 소아치과분야에서의 활용)

  • Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.93-108
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    • 2016
  • One of the fields to which the 3D printing technology can be applied is the field of medicine. Recently, the application of 3D printing technology to the bio-medical field has been gradually increasing with the commercializing of the bio-compatible or bio-degradable materials. The technology is currently contributing to the biomedical field by reducing times required for operations or minimizing adverse effects through preoperative identification of post-surgical consequences or model surgery with artificial bones and organs. This technology also enables the production of customized biomedical auxiliary products like hearing aids or artificial legs etc. For the field of dentistry, the 3D printing technology is also expected to elevate the level of dental treatment by making the customized orthodontic models, crown, bridge, inlay, and surgical guides for implant and surgery. However, issues remaining unidentified or incomplete in printing materials, modeling technology, software technology associated with CAD, verification of bio-stability and bio-effectiveness of materials or in compatibility and standardization of the technology are yet to be solved or be clarified for the full-scale application of the 3D printing technology, thus, it seems such issues should be resolved through further studies.

Optimization of a protocol for the production of transgenic lily plants via particle bombardment (유전자총 실험조건 최적화를 통한 형질전환 백합 식물체 생산)

  • Kim, Jong Bo
    • Journal of Plant Biotechnology
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    • v.44 no.1
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    • pp.82-88
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    • 2017
  • Transgenic lily plants have been obtained after particle bombardment, using PDS-1000/He system and scale explants of lilies, followed by PPT (D-L-phosphinothricin) selection. In this study, scales of the lily plants cv. 'red flame' were bombarded with a plasmid containing the bar gene as a selectable marker, and the AtSIZ gene as a gene of interest, showing salt tolerance and drought tolerance respectively, and both being driven by the CaMV 35S promoter. For optimization of a protocol, factors which optimized and showed a high transformation efficiency under following conditions, were considered: a bombardment pressure of 1100 psi, a target distance of 6 cm and $1.0{\mu}m$ of gold particle, and 24-h pre-culture and post-culture on MS medium containing 0.2 M sorbitol and 0.2 M mannitol as osmoticum agents. After bombardment, all the bombarded scales of lily were transferred to MS medium without selective agents, for a week. Subsequently, these bombarded scales were transferred to a selection MS medium containing 10 mg/l PPT, and incubated for a month for further selection, after which they were cultured for another 4-8 weeks with a 4-week subculture regime on the same selection medium. After transferring into hormone-free MS medium, the PPT-resistant scales with shoots were successfully rooted and regenerated into plantlets. PCR analysis revealed that the surviving putatively transformed plantlets indicated the presence of both the bar gene and the AtSIZ gene. In conclusion, when 100 scales of lily cv. Red flame are bombarded, this study produced approximately 17-18 transgenic plantlets with an optimized bombardment protocol. The protocol described here can contribute to the breeding program of lilies.

A Case of Portopulmonary Hypertension Associated with Primary Biliary Cirrhosis (원발성 담관성 간경변과 동반된 문맥폐고혈압 1예)

  • Kim, Se Joong;Lee, Eun Ju;Jung, Ki Hwan;Kang, Eun Hae;Lee, Sung Yong;Lim, Hong Euy;Yim, Hyung Joon;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.421-426
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    • 2007
  • Portopulmonary hypertension (PPHTN) is a clinically and pathophysiologically distinct complication of advanced liver disease. PPHTN is characterized by the development of pulmonary arterial hypertension in association with advanced hepatic disease-related portal hypertension. A characteristic feature of PPHTN is an obstruction to the pulmonary artery flow caused by vasoconstriction, the proliferation of the endothelium and smooth muscle components of the vascular wall, as well as in situ thrombosis. This disorder is commonly underdiagnosed but the clinical implications are significant because it has substantial effects on survival and requires special treatment. We report a case of portopulmonary hypertension in a 53-year-old woman with primary biliary cirrhosis who presented with exertional dyspnea.

Identification of Mycobacteria Using Polymerase Chain Reaction and Sputum Sample (객담을 이용한 Mycobacteria의 검출과 중합효소 연쇄반응의 민감성 비교)

  • Jang, Hyung Seok
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.2
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    • pp.83-89
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    • 2015
  • Although Mycobacterium tuberculosis complex strains remain responsible for the majority of diseases caused by mycobacterial infections worldwide, the increase in HIV (human immuno deficiency virus) infections has allowed for the emergence of other non-tuberculous mycobacteria as clinically significant pathogens. M. tuberculosis was detected by two-tube nested polymerase chain reaction (PCR) and non-tuberculous mycobacteria was detected by PCR-restriction fragment length polymorphism (RFLP) with Msp I. Result of niacin test is equal to result of two-tube nested PCR after culture for M. tuberculosis. In this study, acid fast bacilli stain (AFB. stain) >2+ case, Detection of Mycobacteria is similar to result before culture and after culture. AFB. stain <1+ case, result of mycobacteria is distinguished. Conclusionly, these results suggest that identification of mycobacteria must go side by side both culture and PCR for more fast and accuracy.

Effect of Light Conditions on Photoinhibition of Ginseng and Tobacco (광조건이 인삼과 잎담배의 광저해에 미치는 영향)

  • ;Il Hou
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.30 no.2
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    • pp.126-130
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    • 1985
  • Photoinhibition studies were conducted with ginseng (Panax ginseng) grown under shade and tobacco (N. tobaccum cv. Bulgaria) grown under full sunlight. The plants were exposed to light intensity of 580, 1280, 1770, 2580 ${\mu}$E/㎡/sec in normal air for 3.6 9 hours. Light saturation of ginseng was observed at 550 ${\mu}$E/㎡/sec and that of tobacco was at 1600 ${\mu}$E/㎡/sec. Tobacco exposed to high light intensity and long duration of light irradiation didn't show entire reduction in photosynthetic capacity. But in ginseng, 20.3% of photosynthesis was reduced in light intensity of 2,580 ${\mu}$E/㎡/sec during 9 hours. Light response in photosynthesis differed considerably between tobacco and ginseng, and ginseng exposed to high light intensity showed remarkable reduction in photosynthesis. The extent of photoinhibition of ginseng was dependent on the length of exposure to the high light intensity. Stomatal resistance of ginseng seemed not to be changed by photoinhibition but mesophyll resistance was increased.

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Thermal Inhibition to Photosynthesis of Ginseng and Tobacco Plants (인삼과 잎담배의 광합성저해에 미치는 온도조건)

  • ;Il Hou
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.30 no.3
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    • pp.223-228
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    • 1985
  • Photosynthetic inhibition to temperature were conducted with ginseng(4 year old) and tobacco(var. Bulgaria). The plants were kept under various temperature conditions from 1$0^{\circ}C$ to 4$0^{\circ}C$ and 440$\mu$E/$m^2$/sec for 3 and 6hrs, and net $CO_2$ uptake were measured after 2hrs at $25^{\circ}C$. Photosynthetic optimal leaf temperature of ginseng was 21$^{\circ}C$ and tobacco was $25^{\circ}C$. Stomatal resistance and mesophyll resistance increased at high temperature. Especially, stomatal resistance seemed to have a significant role in determining the temperature responses of photosynthesis. In tobacco photosynthetic capacity was not changed by temperature treatment for 3hrs. However, 6hrs exposure reduced 8% of net photosynthesis at 4$0^{\circ}C$ and 12% at 1$0^{\circ}C$. Ginseng plants exposed for 6hrs at 4$0^{\circ}C$ lost photosynthetic capacity by 83%. Temperature responses of ginseng were very sensitive at above-optimum temperature resulting greater thermal inhibition other than photoinhibition.

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