• Title/Summary/Keyword: 이식 전이

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The Clinical Results of ACL Reconstruction with Tibialis Allograft Using Hybrid Femoral Fixation and $Retroscrew^{(R)}$ (Hybrid 대퇴 고정과 $Retroscrew^{(R)}$를 사용한 동종 경골건 이용 전방 십자 인대 재건술의 임상적 결과)

  • Kim, Doo-Sub;Rah, Jung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.8-13
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    • 2009
  • Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.

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Effects of Feeding Ferritin Gene Transferred Yeast (Saccharomyces serevisiae) on Performance, Iron Concentration in Organs and Egg of Chickens (Ferritin 유전자 전이 효모(Saccharomyces serevisiae)의 급여가 닭의 생산성, 장기 및 계란의 철분함량에 미치는 영향)

  • Ryu, Byeong-Seon;Park, Jae-Hong;Kim, Dae-Hyeok;Ryu, Kyeong-Seon
    • Korean Journal of Poultry Science
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    • v.30 no.4
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    • pp.245-251
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    • 2003
  • Three experiments were conducted to investigate the effect of feeding yeast accumulated transgenic ferritin(FRT, Saccharomyces cerevisiae) as a probiotic on the performance, iron contents in the liver, spleen, bone and yolk of laying hens and broiler chicks. Effects of feeding FRT were compared with that of feeding wild-type yeast(W0) and yeast grown on 20 mM ferric citrate-added medium (W20). In Expt 1, to investigate the effect of feeding yeast (control, W0 FRT) on performance and iron content of organs of broiler chicks which were fed basal diet supplemented with 75mg/kg iron(Fe75) or not (Fe0), three hundred sixty one-day-old male broiler chicks were fed a corn-sov based diet for five weeks. Weight gain, feed intake and feed conversion were measured weekly. In Expt 2, fifteen 33-week-old ISA Brown laying hens were placed in individual cages and were fed control, W0 and FRT diets for Four weeks. In Expt 3, twenty four 45-week-old ISA Brown laying hens were placed in individual cages and were fed a basal diet for a week. Then, experimental diets (control, W0, W20, FRT) were fed for three weeks. Iron contents in the liver, heart, spleen and tibia were determined at the end of all experiments. Iron content in yolk was measured weekly (expt 2, 3). The level of yeast added and iron concentration of FRT were $1{\times}10^8$cfu/kg diet and 500 mg/kg cell (DM) respectively in Expt 3, yeast was supplemented at $2{\times}10^{10}$cfu/kg diet and the iron content of FRT was 1000mg/kg cell (DM). In Expt 1. birds fed Fe75 showed significantly higher weight gain compared with Fe0 (P<0.05). However, weight gain and feed intake of birds fed FRT was significantly lower than control (P<0.05). In Expt 2, the iron content of the liver was decreased in the FRT treatment (P<0.05). In Expt 3, iron concentration of the liver and spleen tended to be increased by feeding FRt. However, the iron content of the tibia tended to be decreased in the FRT treatment. These results suggest that feeding FRT as a probiotic cannot improve performance and iron content in organs of broiler chicks and laying hens.

Analysis of Domestic Water Consuming Pattern and Metered Water Use (생활용수 소비패턴 및 실사용량 분석)

  • Kim, Ju Hwan;Cho, Im Young;Park, Noh Heuk;Woo, Hyoung Min;Ahn, Hyo Won
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.1310-1315
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    • 2004
  • 용수수요 추정의 기본은 수도계획에 사용할 수 있는 실사용량에 대한 조사로 이에 대한 자료가 거의 없기 때문에 각 수도사업별로 제시되는 추정방법이 조금씩 상이하며, 추정방법의 진위를 가릴 수 없이 수요추정의 악순환을 초래하고 있는 실정이다. 기존 물사용량 예측은 급수량 기준의 도시 전체에 내한 평균 LPCD를 이용함에 따라 물사용 특성을 충분히 고려찬 수 없어 지역별 실제 물사용량과 큰 오차가 유발되었다. 그러므로 수도계획 및 설계에 사용할 수 있는 신뢰성 있는 설계인자를 도출하기가 불가능하여 물수요 관리정책 수립, 수도요금체계 조정 및 누수방지계획 수립 등 경제적인 수도시설의 건설에 애로를 겪고 있다. 본 연구에서는 생활용수 중 가정용수에 대하여 세탁기, 변기, 싱크대 등 수도전에 유량계를 설치 실제 가정에서 사용하고 있는 용도별 사용량을 실측, 파악하였으며, 이로부터 얻은 용도별 사용량에 대한 기간별 소비특성을 분석하였다. 이로부터 생활용수 사용량의 소비패턴 및 시간대별 부하율 산정이 가능하며, 각종 용도별 사용수량의 소비형태를 찾아낼 수 있었다. 또한 가정용수 중 용도별 물 사용비율은 세탁용수, 변기, 주방, 목욕용수의 순으로 나타났으며 주택유형별로는 아파트 연립주택, 다세대 주택, 단독주택의 순으로 단독주택에서의 물사용량이 가장 적게 나타났다. 생활용수 공급량에 내해서는 시간별, 주별, 월별 그리고 계절변동 총량을 파악하였으며 시간대별로는 오후 3시경이 최대 소비량을 보였고, 주별로는 월요일 그리고 월별로는 7월의 용수사용량이 가장 큰 것으로 조사 되었다. 본 연구로부터 도출된 용도별 실측 물사용량 자료 및 분석결과로부터, 지금까지 공급량 기준의 계획수립이 이루어져왔던 파종 수도시설 규모결정시 합리적인 용수수요예측 및 수요관리가 이루어질 수 있을 것으로 판단되며, 용수수요의 과다예측 오해 해소 등 경제적, 과학적 물관리 정책수립을 위한 기초자료를 제공할 수 있을 것으로 기대된다.는 경제적인 방법이 될 수 있다. 하천수 등의 상호 관계 분석을 통해 장기간의 유역 물순환체계 변화를 분석할 수 있었다.골풀과, 닭의장풀과가 각 1종씩으로, 조사지점( I )보다 좀 더 많은 종이 분포하는 것으로 조사되었다. 또한 어류는 조사지점( I )에서 3회에 걸쳐 총 396개체가 채집되어 3목 8과 21종이었다. 이 중 한국 고유종은 11종이었고, 외래 어종은 검정우럭과 2종이 조사되었으며, Zacco platypus(피라미), Zacco temmincki(갈겨니), Acheilongnathus koreanus(칼납자루), Odontobutis platycephala(동사리), Coreoleuciscus splendidus(쉬리) 순으로 분포하고 있었고, Acheilognathus signifer(묵납자루)는 댐 건설 전에는 많이 분포하였으나 현장조사에서 서식을 확인 할 수 언어 개체수의 큰 감소내지 멸종된 것으로 추정되었다.에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carriage rat

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Application of WEP Model to the Cheonggecheon Watershed (청계천 유역에 대한 WEP 모형의 적용)

  • Noh, Seong Jin;Kim, Hyeon Jun;Cheong, Il Moon;Jang, Cheol Hee;Kim, Dong Pil
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.148-152
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    • 2004
  • 본 연구에서는 물순환의 재생이나 보전에 필수적인 유역 물순환의 정량화와 유역변화의 영향예측을 위해 개발된 WEP (Water and Energy Transfer Process) 모형의 국내 유역에 내한 적용성을 검토하고, 청계천 유역의 물순환 양상을 모의하였다. WEP 모형은 복잡한 토지이용이 이루어지고 있는 도시하천 유역에 내한 물순환의 정량화를 목적으로 일본의 토목연구소 (PWRI; Public Works Research Institute), 과학기술진흥사업단, Jia 박사 등에 의해 공동으로 개발되었으며 지표면 및 비포화 토양층의 물${\cdot}$열 플럭스 계산, 하도흐름의 추적계산 및 지하수 유동계산, 격자내 토지이용의 불균질성 반영 등이 가능한 물리적인 기반의 공간 분포형 모형 (Physically Based Spatially Distributed)이다. 모형을 적용한 청계천 유역 (유로연장 13.75 km, 유역 면적 $50.96km^2$)은 전체 토지이용중 도시지역이 $75.9\%$를 차지하고, 유역내 인구가 120만명에 이르는 도시유역으로 높은 불투수 면적비율, 인공계 물순환 요소의 영향 등의 도시 유역 특성이 물순환의 구조 전반에 미치는 영향에 대한 연구가 부족하였다. WEP 모형 적용 결과, 모의 기간 동안의 하천 유출량은 실측치에 근사한 값을 나타내었으며 유역의 물순환 양상을 모의할 수 있었다. 청계천 유역은 전형적인 도시 유역의 특성을 보여주었는데, 강우시의 직접유출이 크고, 강우의 유출에 대한 반응이 빠르며, 증발산의 경우는 산림지역보다 도시지역이 상대적으로 적은 것으로 분석되었다. 이번 연구를 통하여 WEP 모형이 유역 물순환 해석에 적절한 모형임을 확인할 수 있었으면, 향후 청계천 유역의 물리적 특성에 대한 매개변수와 인공계 물순환 자료의 보완을 통해 보다 향상된 모의가 가능할 것으로 판단된다. 하였던 Cd과 Mg이 Ca 및 Ca과 vitamin D의 동시(同時) 급여(給與)로 감소(減少)하였고 Cu는 전체적(金體的)으로 변화(變化)가 없었으며 Zn은 Cd 급여(給與)로 감소(減少)하였으나 Ca과 vitamin D의 급여(給與)에 의하여 증가(增加)하였고 Ca은 Ca과 viamin D의 급여(給輿)로 유의(有意)하게 증가(增加)하였다. 신장(腎臟)중의 무기질(無機質) 함량(含量)은 Cd급여(給輿)로 Cu, Mg은 감소(滅少)하였으나 Ca, Zn은 변화(變化)가 없었고 Ca 및 Ca과 Vitamin D의 급여(給與)로 Cd, CU, Zn은 증가(增加)하였다.ce area)는 수술 전100.8$\pm$25.6 mm/$m^{2}$에서 79.3$\pm$ 15.8 mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론: 좌관상동맥 페동맥이상 기시증은 드물기는 하나, 영유아기에 심근경색 및 허혈성 심근증 또는 선천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히 교사들이 중요하게 인식하는 해방적 행동에 대한 목표를 강조하여 적용할 필요가 있음을 시사하고 있다.교하여 유의한 차이가 관찰되지 않았다. 또한 HSP 환자군에서도 $IL1RN^{*}2$ allele 빈도와 carriage

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Assessment of Nutrition Status and Quality of Life after Curative Resection in Patients with Upper Gastric Cancer: Comparison of Total Gastrectomy and Proximal Gastrectomy (상부 위암에 대한 근위부 위절제술 뜻 위전절제술을 시행한 환자의 영양상태와 삶의 질 비교)

  • Lee, Hyun-Soo;Park, Jong-Hyun;Choi, Hun;Kim, Jae-Hee;Min, Lac-Kee;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.152-157
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    • 2005
  • Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

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Consideration of Normal Variation of Perfusion Measurements in the Quantitative Analysis of Myocardial Perfusion SPECT: Usefulness in Assessment of Viable Myocardium (심근관류 SPECT의 정량적 분석에서 관류정량값 정상변이의 고려: 생존심근 평가에서의 유용성)

  • Paeng, Jin-Chul;Lim, Il-Han;Kim, Ki-Bong;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.285-291
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    • 2008
  • Purpose: Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. Materials and Methods: In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F = 28:27) of low-likelihood for coronary artery disease were enrolled and $^{201}TI$ rest/$^{99m}Tc$-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. $^{201}TI$ rest/$^{99m}Tc$-MIBI stress / $^{201}TI$ 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, $Q_{delay}$ (perfusion measurement), ${\Delta}_{delay}$ ($Q_{delay}$ - m) and $Z_{delay}$ (($Q_{delay}$ - m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Results: Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was $51.8{\pm}6.5$ and the highest segmental perfusion was $87.0{\pm}5.9$, and they are $58.7{\pm}8.1$ and $87.3{\pm}6.0$, respectively in women. In the viability assessment $Q_{delay}$ showed AUC of 0.633, while those for ${\Delta}_{delay}$ and $Z_{delay}$ were 0.735 and 0.716, respectively. The AUCs of ${\Delta}_{delay}$ and $Z_{delay}$ were significantly higher than that of $Q_{delay}$ (p = 0.001 and 0.018, respectively). The diagnostic performance of ${\Delta}_{delay}$, which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. Conclusion: On automatic quantification of myocardial perfusion SPECT, the normal variation of perfusion measurements were considerable among segments. In the viability assessment, the parameters considering normal variation showed better diagnostic performance than the direct perfusion measurement. This study suggests that consideration of normal variation is important in the analysis of measurements on quantitative myocardial perfusion SPECT.

Glomerular Filtration Rate Test Methods and Guidelines (Glomerular Filtration Rate 검사방법 및 가이드라인)

  • Park, Min-Ho;Lee, Ha-Young;Ryu, Hwa-Jin;Yoo, Tae-Min;Noh, Gyeong-Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.97-100
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    • 2018
  • Purpose The glomerular filtration rate (GFR) test is an important indicator of glomerular filtration and has been used to test renal function and the extent of its function. The GFR test is performed by intravenous injection of radioactive medicines made of $^{51}Cr$-EDTA, and blood concentration is measured by taking blood according to the elapsed time. also, PET-CT, bone scan, transfusion and so on will affect the outcome. Therefore, we will improve the quality of the test by providing guidelines for the GFR test for more accurate testing. Materials and Methods 5 mL of physiological saline solution and 2 mL of $^{51}Cr$-EDTA solution are used to make 5 mL of the radiopharmaceutical solution to be injected into the patient. First, the syringe weight is measured before the injection, and then the radioactive medicine is injected into the patient's vein and the syringe weight is measured after the injection. Blood sampling is performed twice in total. In adults, blood is collected 3 hours / 5 hours after injection and in children 2 hours / 5 hours after injection. The blood sample is centrifuged at 3300 rpm for 5 minutes. Standard solution is prepared by filling diluent water up to the scale indicated in the 200-mL volumetric flask, discarding $500{\mu}L$, injecting $500{\mu}L$ of GFR reagent and mixing well. $500{\mu}L$ each of the standard solution is dispensed into two test tubes, and $500{\mu}L$ of each of the plasma samples collected in time is dispensed into two test tubes and measured with a Cobra Counter. Results At present, the reference range applied in this study is $119.5{\pm}30.3ml/min/1.73m2$ for males and $125.2{\pm}28.2ml/min/1.73m^2$ for females. Conclusion The GFR test is conducted using radioactive medical products. GFR testing is performed as a scheduled test, but PET-CT, dialysis and transfusion, which may affect GFR testing, may be scheduled during GFR testing. Therefore, we could get accurate GFR test results by notifying the ward and department beforehand when booking.

Growth and Useful Component of Angelica gigas Nakai under High Temperature Stress (고온 스트레스에 따른 참당귀의 생육 및 유용성분 특성)

  • Jeong, Dae Hui;Kim, Ki Yoon;Park, Sung Hyuk;Jung, Chung Ryul;Jeon, Kwon Seok;Park, Hong Woo
    • Korean Journal of Plant Resources
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    • v.34 no.4
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    • pp.287-296
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    • 2021
  • Recently, the pace of global climate change has tremendously increased, causing extreme damage to crop production. Here, we aimed to examine the growth characteristics and useful components of Angelica gigas under extreme heat stress, providing fundamental data for its efficient cultivation. Plants were exposed to various experimental temperatures (28℃, 34℃, and 40℃), and their growth characteristics and content of useful components were analyzed. At the experimental site, the ambient and soil temperature were 19.38℃ and 21.34℃, ambient and soil humidity were 81.3 % and 0.18 m3/m3, solar radiation was 162.05 W/m2. Moreover, the soil was sandy-clay-loam (pH 6.65), with 2.66% organic matter, 868.52 mg/kg soil available phosphate, and 0.14% nitrogen. Values of most growth characteristics, including the survival rate (85%), plant height (38.66cm), and fresh and dry weight (41.3 g and 14.24 g), were the highest at 28℃. Although the highest content of useful components was observed at 34℃ (3.24%), there were no significant differences across temperatures. Growth characteristics varied across temperatures due to detrimental effects of heat stress, such as accelerated tissue aging, reduced photosynthesis, and delay of growth. Similar content of useful components across temperatures may be due to poor accumulation of anabolic products caused by impaired growth at extremely high temperatures.

Minimally Invasive Coronary Artery Bypass Grafting (소침습적 관상동맥우회술)

  • Na, Chan-Young;Lee, Young-Tak;Park. Joong-Won;Chung, Do-Hyun;Jung, Ill-Sang;Jung, Yoon-Seup;Kim, Ok-Sung;Bang, Jung-Hyun;Lee, Sub;Chung, Chul-Hyun;KIM, Woong-Han;Park, Young-Kwan;Kim, Chong-Whan;Hong, Sung-Nok;Han, Jae-Jin;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.118-124
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    • 1998
  • Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.

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Clinical Outcomes of Off-pump Coronary Artery Bypass Grafting (심폐바이패스 없는 관상동맥우회술의 임상성적)

  • Shin, Je-Kyoun;Kim, Jeong-Won;Jung, Jong-Pil;Park, Chang-Ryul;Park, Soon-Eun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.34-40
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    • 2008
  • Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.