• Journal of Chest Surgery
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• v.31 no.2
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• pp.108-112
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• 1998

Experimental trials of unilateral lung transplantation in dogs have been attempted and satisfactory results were obtained without any noticeable difficulty in surgical techniques. Fourteen dogs with the body weight of around 25 kg were anesthesized by 20~30 mg/kg of intravenous Entobar,; one was sacrificed to make available blood for use during transplantation for the recipient dog. A mid-sternotomy incision was performed and 20 mg/kg of Prostaglandin E1 was infused through the pulmonary artery and Euro-Collin's(E-C) preservation solution, cooled down to 4$^{\circ}C$, was perfused at the rate of 70cc/kg by a pressure of 30 cmH2O. The heart-lung block was then resected out and promptly immersed in the prepared preservation solution at 4$^{\circ}C$. One lung preserved in the EC solution at 4$^{\circ}C$ was anastomosed to the recipient dog in the order of the pulmonary vein, bronchus then pulmomary artery and the thoracotomy incision was closed after the bleeding control and tube thoracostomy. Then the pneumonectomy in the opposite side was perfomed in the same manner and the tailored lung was transplanted in the order of the pulmonary vein, bronchus, then pulmonary artery. We conclude that in the bilateral sequential lung transplantation, the right lung transplantation should precede to better expose the operative field and to prevent reperfusion injury; also, the cardiopulmonary bypass should be consider for certain appropriate cases.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.131-138
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• 2004

High-flow gas insufflation to get a bloodless field during off-pump coronary artery bypass may have adverse effects on the coronary endothelium. This study was designed (1) to elucidate the effect of carbon dioxide gas insufflations on the coronary endothelium at different flow rates and (2) to assess the protective effect of humidifcation against the coronary endothelial damage. Material and Method: In nine pigs, the left anterior descending coronary artery (LAD) was exposed after a median sternotomy. The LAD was divided into 4 segments and a coronary arteriotomy was made in each LAD segment in the beating heart. The far distal arteriotomy was exposed to room air for 10 minutes and was harvested as a control. Non-humidified carbon dioxide gas at a continuous flow rate of 5 L/min (Group I), humidified carbon dioxide gas at a continuous flow rate of 5 L/min (Group II), and humidified carbon dioxide gas at a continuous flow rate of 10 L/min (Group III) were insufflated for 10 minutes on each coronary arteriotomy site, respectively. After harvesting the coronary segments, hematoxylin-eosin staining, elastic fiber staining, and immunostaining with a CD34 monoclonal antibody were performed to evaluate the depth of endothelial damage and to count the residual endothelial cells, Result: In all three groups (Group I, II, and III), internal elastic laminae were preserved, however, the endothelial layers were significantly damaged by carbon dioxide gas insufflation. The mean percentages of remaining endothelial cells were 20,9$\pm$16.7%, 39.3$\pm$19.6%, and 6.8$\pm$5.3%, in groups I, II, and III, respectively. The percentages of remaining cells were significantly higher in group II than in groups I and III (p=0.008). The percentages of remaining cells were significantly higher in group I than in group III (p=0.008). Conclusions: The harmful effect of carbon dioxide gas insufflation on the coronary endothelium was dependent on the flow rate. The addition of humidification did not protect the coronary endothelium from denudation injury caused by high flow carbon dioxide gas insufflations.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.733-738
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• 2005

Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.329-340
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• 2007

Background: Matrix Metalloproteinase (MMP) inhibition has emerged as a potential therapeutic strategy for the left ventricular dilatation that occurs after myocardial infarction. This study is designed to evaluate which treatment is better for attenuating the left ventricular remodeling via MMP inhibition 1) during the early, short highly MMP producing period of the initial phase or 2) during most of the period of the initial phase after myocardial infarction. Material and Method: Myocardial infarction was induced by ligation of the left anterior descending coronary artery in rabbits. The experimental group was divided into 3 groups. The myocardial infarction only (MI only) group consisted of 7 cases. The MMP inhibitor administered for 5 days after MI (MMPI 50) group had 6 cases, and these rabbits were given MMP inhibitor for 5 days after myocardial infarction, beginning with the postoperative first day. MMP inhibitor administered for 9 days (MMPI 90) group consisted of 5 cases and these rabbits were given MMPI for 9 days the same manner as above. CG2300 was used as a selective MMPI; this is a potent MMP-2 and -9 inhibitor Two-D echocardiograms were performed on all the groups at the time of preoperative period, the post-operative 1st week, the postoperative 20 week and the postoperative 30 week, and we measured the end-diastolic dimension (EDD), the end-systolic dimension (ESD), and the ejection fraction (EF). Result: The echocardiograms generally showed postoperative left ventricular dilatation in the MI only group. The EDD was increased significantly higher in the postoperative 1 week compared to the preoperative value (p<0.05). The ESD was also increased significantly higher in the postoperative 1st week, the postoperative 20 week and the postoperative 30 week compared to the preoperative value (p<0.05). Left ventricular dilatation was noted to be less In the MMPI 9d group than in the MI only and MMPI 5d groups. In the MMPI 9d group, there was no significant change of EF postoperatively compared to the preoperative period. MMP-2 and MMP-9 were measured from the infarcted myocardial tissue at post-MI 4 weeks by performing western blotting and zymography. The changes the of protein expression and activity of MMP-2 and MMP-9 were not significant in the three MI groups and the normal heart group. Histopathologic examination revealed severe collagen deposition in the MI only group. Collagen accumulation was reduced in both the MMPI groups. The MMPI 9d group revealed an increased number of capillaries. Conclusion: Left ventricular dilatation developed rapidly after, MI from ligation of the coronary artery and MMPI attenuated the ventricular dilatation. The effect of MMPI seemed to have better a result from its usage during most of the period of the initial phase after myocardial infarction. This suggested that increased neovascularization by MMPI may also contribute to attenuation of the left ventricular remodeling.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.254-259
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• 2010

Background: Diagnosing chronic pulmonary embolism at an early stage is difficult because of the patient’s nonspecific symptoms. This condition is not prevalent in Korea, and in fact, there have been only a few case reports on this in the Korean medical literature. We analyzed the surgical outcome of performing pulmonary thromboendarterectomy in patients with chronic pulmonary embolism. Material and Method: The study subjects included those patients who underwent surgery for chronic pulmonary embolism from 1996 to 2008. For making the diagnosis, echocardiography, chest CT and a pulmonary perfusion scan were performed on the patients who complained of chronic dyspnea. Result: Pulmonary endarterectomy was performed as follows: by incision via a mid-sternal approach (7 patients); by incision via a left posterolateral approach (1 patient); using the deep hypothermic circulatory arrest technique (4 patients); under ventricular fibrillation (3 patients); and under cardioplegic arrest (1 patient). The postoperative systolic pulmonary artery blood pressure significantly decreased from a preoperative value of $78.9{\pm}14.5\;mmHg$ to $45.6{\pm}17.6\;mmHg$ postoperatively (p=0.000). The degree of tricuspid regurgitation was less than grade II after surgery. Two patients died early on, including one patient who had persistent pulmonary hypertension without improvement and right heart failure. Conclusion: Patients who have chronic pulmonary embolism are known to have a poor prognosis. However, we think that early surgical treatment along with making the proper diagnosis before the aggravation of right heart failure can help improve the quality of a patient's life.

• Korean Journal of Ichthyology
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• v.4 no.2
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• pp.44-54
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• 1992

The blenniid fish, Pictiblennius yatabei(Jordan et Snyder) is ditributed in the central and southern Japan and southern Korea. The fish grows to a maximum size of 9cm in total length, and it seems to be matured in two years. Sex dimorphisms of the fish appear in the crest and the anal fin. Five egg masses of the fish were collected in Tongyoung Bay near Kyeong Nam on June 16 and 20, 1991. The eggs were laid on inner surface of empty shells of the oyster, Crassotrea gigas and blue mussel, Mytilus edulis. Each egg mass was guarded by the male parent. Numbers of eggs in each of masses were as about 450~1000.The eggs were spherical but somewhat oval in shape and ranged from 0.72 to 0.80mm in longer axis and from 0.55 to 0.65mm in shorter axis. Each egg was provided with an adhesive pedestal. Hatching took place in 105 hours after formation of embyo at the water temperature varying from 20.0 to $21.4^{\circ}C$. Melanophores appearing on the yolk remarkably changed in form during the embryonic development.The newly hatched larvae, having 32~34 somites, were from 2.71 to 3.35mm in total length. The larvae absorbed the yolk material and oil globule completely in 7 days after hatching and became postlarvae. Nine days after hatching, the larvae averaged 5.35mm in TL and the caudal notochord flex at $45^{\circ}$ Total lengths of the larvae reached 6.00 and 6.58mm in 11 and 13 days after the hatching, respectively.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.135-142
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• 2010

Purpose: This study was aimed to compare the margin and internal fitness of single anterior all-ceramic crown zirconia core made by three deferent CAD/CAM systems. Material and methods: Five single zirconia cores were manufactured by three deferent CAD/CAM systems($Cerasys^{(R)}$system, KaVo $Everest^{(R)}$system, $LAVA^{TM}$system). The manufactured zirconia cores were duplicated through the use of replica technique, and a replicated sample was sectioned in the center of bucolingual and mesiodistal direction to measure the marginal and internal gap. Measurement was carried out by using measuring microscope ($AXIO^{(R)}$) and $I-Solution^{(R)}$ and analysed through the use of ANOVA. Results: As for the mean marginal fitness of the zirconia core, it was $84.74{\pm}27.57{\mu}m$, in $Cerasys^{(R)}$, $80.23{\pm}21.07{\mu}m$ in KaVo $Everest^{(R)}$ and $96.37 {\pm}11.45{\mu}m$ in $LAVA^{TM}$, and as for the mean internal gap, it was $94.11{\pm}30.07{\mu}m$ in $Cerasys^{(R)}$, $92.31{\pm}25.18{\mu}m$ in KaVo $Everest^{(R)}$, and $94.99{\pm}18.74 {\mu}m$ in $LAVA^{TM}$. There was no significant statistically deference among the total average gap of three systems. The internal gap in KaVo $Everest^{(R)}$ seemed to be smaller than $LAVA^{TM}$ (P < .05). The internal gap in the incisal area was larger in all of the three systems. Conclusion: There was no difference in marginal fitness in $Cerasys^{(R)}$, KaVo $Everest^{(R)}$ and $LAVA^{TM}$. As for the internal fitness, it was smaller in KaVo $Everest^{(R)}$ system than $LAVA^{TM}$ system. In all of the three systems, there was a larger gap in incisal area. The marginal and internal gap was within the clinically allowed range in all of the three systems.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.278-286
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• 2008

Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).

• Journal of Korea Foundry Society
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• v.38 no.5
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• pp.103-110
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• 2018

The effects of a heat treatment on the carbide formation behavior and mechanical properties of the cobalt-based superalloy X-45 were investigated here. Coarse primary carbides formed in the interdendritic region in the as-cast specimen, along with the precipitation of fine secondary carbides in the vicinity of the primary carbides. Most of the carbides formed in the interdendritic region were dissolved into the matrix by a solution treatment at $1274^{\circ}C$. Solutionizing at $1150^{\circ}C$ led to the dissolution of some carbides at the grain boundaries, though this also caused the precipitation of fine carbides in the vicinity of coarse primary carbides. A solution treatment followed by an aging treatment at $927^{\circ}C$ led to the precipitation of fine secondary carbides in the interdendritic region. Very fine carbides were precipitated in the dendritic region by an aging heat treatment at $927^{\circ}C$ and $982^{\circ}C$ without a solution treatment. The hardness value of the alloy solutionized at $1150^{\circ}C$ was somewhat higher than that in the as-cast condition; however, various aging treatments did not strongly influence the hardness value. The specimens as-cast and aged at $927^{\circ}C$ showed the highest hardness values, though they were not significantly affected by the aging time. The specimens aged only at $982^{\circ}C$ showed outstanding tensile and creep properties. Thermal exposure at high temperatures for 8000 hours led to the precipitation of carbide at the center of the dendrite region and an improvement of the creep rupture lifetimes.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.186-190
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• 2005

Purpose : The purpose of this study was to evaluate the responses and toxicities of risk-adapted chemotherapy in pediatric intracranial germ cell tumors(IC-GCT). Methods : Fourteen patients who were diagnosed as IC-GCT from October 2002 to December 2003 received chemotherapy as an initial treatment modality. The low risk(LR) group was defined as follows : Pure germinoma and normal AFP level. Beta-hCG level 50 mIU/mL or less. The others belonged to the high risk(HR) group. Chemotherapy was composed of cisplatin, cyclophosphamide, etoposide and vincristine. Double doses of cisplatin and cyclophosphamide was used in HR patients. Results : Pathologic confirmation was done in all but one. Median age at diagnosis was 11.6 yr (1.2-18.7 yr), and nine patients belonged to the HR group. Tumor markers were normalized after chemotherapy in all patients whose tumor markers had been elevated. Four LR patients(80 percent) and seven HR patients(77.8 percent) showed complete response(CR) at the end of chemotherapy. An additional two of the three patients with partial response(PR) achieved CR after radiation therapy (RT), and the remaining one relapsed before RT. Four LR and all HR patients experienced infectious episodes that required hospitalization. Four of the nine HR patients(44.4 percent) suffered from tinnitus, three of whom developed sensorineural hearing loss. All but one are surviving, event-free, with a median follow-up of 13.9 mo(8.1-22.3 mo). Conclusion : Risk-adapted cisplatin-based chemotherapy was effective even in HR patients, but regimen modification seems to be necessary to avoid an unacceptably high toxicity rate.