• Journal of Chest Surgery
• /
• v.36 no.9
• /
• pp.659-665
• /
• 2003

The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6％ (272/276) for ITAs and 97.0％ (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9％ (234/244) for ITAs and 88.6％ (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0％) immediate postoperatively and 7 of the 88 patients (8.0％) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.

• Journal of Chest Surgery
• /
• v.37 no.6
• /
• pp.482-491
• /
• 2004

Background: The xenogenic or allogenic valves after in Vitro repopulation with autologous cells or in vivo repo-pulation after acellularization treatment to remove the antigenicity could used as an alternative to synthetic polymer scaffold. In the present study, we evaluated the process of repopulation by recipient cell to the acellu-larized xenograft treated with NaCl-SDS solution and grafted in the right ventricular outflow tract. Material and Method: Porcine pulmonary valved conduit were treated with. NaCl-SDS solution to make the grafts acellularized and implanted in the right ventricular outflow tract of the goats under cardiopulmonary bypass. After evaluating the functions of pulmonary valves by echocardiography, goats were sacrificed at 1 week, 1 month, 3 months, 6 months, and 12 months after implantation, respectively. After retrieving the implanted valved conduits, histopathologic examination with Hematoxylin-Eosin, Masson' trichrome staining and immunohistochemical staining was performed. Result: Among the six goats, which had been implanted with acellularized pulmonary valved conduits, five survived the expected time period. Echocardiographic examinations for pulmonary valves revealed good function except mild regurgitation and stenosis. Microscopic analysis of the leaflets showed progressive cellular in-growth, composed of fibroblasts, myofibroblasts, and endothelial cells, into the acellularized leaflets over time. Severe inflammatory respon-se was detected in early phase, though it gradually decreased afterwards. The extracellular matrices were regenerated by repopulated cells on the recellularized portion of the acellularized leaflet. Conclusion: The acellularized xenogenic pulmonary valved conuits were repopulated with fibroblasts, myofibroblasts, and endothelial cells of the recipient and extracellullar matrices were regenerated by repopulted cells 12 months after the implantation. The functional integrity of pulmonary valves was well preserved. This study showed that the acellularized porcine xenogenic valved conduits could be used as an ideal valve prosthesis with long term durability.

• The Journal of the Korea Contents Association
• /
• v.12 no.3
• /
• pp.244-250
• /
• 2012

The results of analyzing the difference between performances of individual dosimeters on this research subjecting the PLD and TLD, which are the official personal dosimeters, through dosimetry are as follows. After scanning the integral dose using an automatic scanner, the values of two devices that went through dose adjustment process had a statistical difference in TLD and PLD measurements under each filming conditions which were 70kVp, 200mA, 0.012sec and 42kVp, 100mA, and 0.012sec (p<0.001 and p<0.001 respectively). As for the difference of measurement value between DAP and the two particles under 70kVp, 200mA, 0.012sec filming condition, TLD had a value lower than DAP average value by $44.2mGy{\cdot}cm^2$ and PLD had a value of $246.8mGy{\cdot}cm^2$ which was lower than DAP average value by $15.5mGy{\cdot}cm^2$, while under 42kVp, 100mA, 0.012sec filming condition, TLD had a value lower than DAP average value by $17.9mGy{\cdot}cm^2$ and PLD had a value of $82.6mGy{\cdot}cm^2$ which was lower than DAP average value by 7.6$mGy{\cdot}cm^2$. Also, compared to PLD, each of 10 devices measured dose value in TLD had a larger deviation between the particles, and for a reproducibility test which repeatedly measured one particle, PLD had ${\pm}1%$ which was lower than TLD's ${\pm}2%$. As such, PLD had a superior performance result in dose measurement capacities aspect compared to TLD, and therefore we could verify that PLD is more appropriate and advantageous in managing radiation-related task performing worker's personal radiation exposure management in the diagnostic radiation field.

• Journal of Chest Surgery
• /
• v.35 no.7
• /
• pp.542-547
• /
• 2002

Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

• Journal of Korean Ophthalmic Optics Society
• /
• v.19 no.1
• /
• pp.87-92
• /
• 2014

Purpose: Comparison with contrast sensitivity between binocular and monocular of 20s adult was measured by spatial frequency 3.0, 6.0, 12.0 and 18.0 cpd and compares difference between monocular and binocular and difference between male and female. Methods: Topcon CV-3000 Phoroptor was used for full correction of 99 ophthalmic optics students and contrast sensitivity were measured by using Vector Vision CSV-1000E at 2.5 m in photopic condition (100 $cd/m^2$). Results: Photopic condition at 2.5 m, average contrast sensitivity of entire subject was 52.54, 80.40, 36.79 and 13.56 with right eye and 52.33, 81.29, 41.73 and 14.22 with left eye in 3, 6, 12 and 18 cpd. For both eye 65.46, 113.69, 52.04 and 19.44 were measured. The contrast sensitivity of male was 58.22, 83.52, 37.89 and 13.82 with right eye and 56.03, 46.68 and 15.67 with left eye in spatial frequency of 3, 6, 12 and 18 cpd. Both eyes were measured to 70.89, 120.96, 56.56 and 19.89. The contrast sensitivity of female was 46.50, 77.09, 35.61 and 13.28 with left eye and 48.40, 70.43, 36.47 and 12.68 with left eye in spatial frequency of 3, 6, 12, 18 cpd. Both eyes were 59.68, 105.97, 47.23 and 18.95. Conclusions: Contrast sensitivity value of binocular shows higher than monocular to both male and female. Contrast sensitivity of difference between male and female were statistically remarkably higher to male in right eye 3 cpd, left eye 6 cpd, 12 cpd and both eye 3 cpd. In other frequency, there was no statistical significance but male shows higher.

• Journal of Chest Surgery
• /
• v.37 no.8
• /
• pp.672-683
• /
• 2004

Background: The treatment results of the advanced lung carcinoma is not satisfactory with the present therapeutic modalities: surgical resection, anti-cancer chemotherapy, and radiotherapy or combination therapy. To predict the prognosis of the non-small-cell lung carcinoma, TNM classification has been was as the basic categorization; however, it has been not satisfactory. It is necessary to consider the causes and the prognosis of the lung carcinoma from another points of view rather the conventional methods. We intended to find out the relationship between the major apoptotic factor, p53 gene and the prognosis of the patient with lung carcinoma. Material and Method: Three hundreds and fifty-nine patients with lung carcinoma who underwent surgery were analysed. We observed p53 protein accumulated in the cellular nuclei. The p53 protein was detected by immuno-histo-chemical method. We collected information of the patient retrospectively. Result: p53 protein densities were observed in 40% in average as a whole. The protein density was 44 percent in man, 25 percent in woman, 49 percent in the squamous cell carcinoma, and 38 percent in the adenocarcinoma. There were significant correlations between the p53 protein density and the mortality in the squamous cell carcinoma (p=0.025), follow-up duration in TNM stage I group (p=0.010), and follow-up duration in the lobectomy patient group (p=0.043), and tumor cell differentiation (p=0.009). p53 protein densities were significantly different between the lobectomy and the pneumonectomy group (p=0.044). Conclusion: The authors found that p53 protein had some correlations with the prognosis of the lung cancer partially in some factors. We suggest the p53 protein density could be used as a marker of prognosis in the non-small-cell lung carcinoma.

• Journal of Chest Surgery
• /
• v.41 no.2
• /
• pp.170-176
• /
• 2008

Background: Bioprosthetic devices for treating cardiovascular diseases and defects may provide alternatives to autologous and homograft tissue. We evaluated the mechanical and physical conditions of a porcine pericardial bioprosthesis treated with Glutaraldehyde (GA), Ethanol, or Sodium dodecylsulfate (SDS) before implantation. Material and Method: 1) Thirty square-shaped pieces of porcine pericardium were fixed in 0.625%, 1.5% or 3% GA solution. 2) The tensile strength and thickness of these and other bioprosthesis, including fresh porcine pericardium, fresh human pericardium, and commercially produced heterografts, were measured. 3) The tensile strength and thickness of the six treated groups (GA-Ethanol, Ethanol-GA, SDS only, SDS-GA, Ethanol-SDS-GA and SDS-Ethanol-GA) were measured. Result: 1) Porcine pericardium fixed in 0.625% GA the thinnest and had the lowest tensile strength, with thickness and tensile strength increasing with the concentration of GA solution. The relationship between tensile strength and thickness of porcine pericardium increased at thicknesses greater than 0.1mm (correlation-coefficient 0.514, 0<0.001). 2) There were no differences in tensile strength or thickness between commercially-produced heterografts. 3) Treatment of GA, ethanol, or SDS minimally influenced thickness and tensile strength of porcine pericardium, except for SDS alone. Conclusion: Porcine pericardial bioprosthesis greater than 0.1 mm thick provide better handling and advantageous tensile strength. GA fixation did not cause physical or mechanical damage during anticalcification or decellularization treatment, but combining SDS-ethanol pre-treatment and GA fixation provided the best tensile strength and thickness.

• Journal of Chest Surgery
• /
• v.37 no.5
• /
• pp.410-415
• /
• 2004

Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.

• Korean Journal of Food Science and Technology
• /
• v.40 no.2
• /
• pp.152-159
• /
• 2008

The purpose of this study was to determine the accurate quantification of vitamin A in infant formula by comparing two different standard stock solutions as well as various sample weights using high performance liquid chromatography. The sources of uncertainty in measurement, such as sample weight, final smaple vloume, and the instrumental results, were identified and used as parameters to determine the combined standard uncertainty based on GUM(guide to the expression of uncertainty in measurement) and the Draft EURACHEM/CITAC Guide. The uncertainty components in measuring were identified as standard weight, purity, molecular weight, dilution of the standard solution, calibration curve, recovery, reproducibility, sample weight, and final sample volume. Each uncertainty component was evaluated for type A and type B and included to calculate the combined uncertainty. The analytical results and combined standard uncertainties of vitamin A according to the two different methods of stock solution preparation were 627 ${\pm}$ 33 ${\mu}$g R.E./100 g for 1,000 mg/L of stock solution, and 627 ${\pm}$ 49 ${\mu}$g R.E./100 g for 100 mg/L of stock solution. The analytical results and combined standard uncertainties of vitamin A according to the various sample weighs were 622 ${\pm}$ 48 ${\mu}$g R.E./100 g, 627 ${\pm}$ 33 ${\mu}$g R.E./100 g, and 491 ${\pm}$ 23 ${\mu}$g R.E./100 g for 1 g, 2 g, and 5 g of sampling, respectively. These data indicate that the preparation method of standard stock solution and the smaple amount were main sources of uncertainty in the analysis results for vitamin A. Preparing 1,000 mg/L of stock solution for standard material sampling rather than 100 mg, and sampling not more than 2 g of infant formula, would be effective for reducing differences in the results as well as uncertainty.

• Journal of Chest Surgery
• /
• v.39 no.5 s.262
• /
• pp.359-365
• /
• 2006

Background: Arterial grafts have been used to achieve better long-term results for coronary revascularization. Bilateral internal thoracic artery (ITA) grafts have a better results, but it may be not used in some situations such as diabetes and chronic obstructive pulmonary disease (COPD). We evaluated the clinical and angiographic results of composite left internal thoracic artery-radial artery (LITA-RA) Y graft. Material and Method: Between April 2002 and September 2004, 119 patients were enrolled in composite Y graft for coronary bypass surgery. The mean age was $62.6{\pm}8.8$ years old and female was 34.5%. Preoperative cardiac risk factors were as follows: hypertension 43.7%, diabetes 33.6%, smoker 41.2%, and hyperlipidemia 22.7%, There were emergency operation (14), cardiogenic shock (6), left ventricle ejection fraction (LVEF) less than 40% (17), and 17 cases of left main disease. Coronary angiography was done in 35 patients before the hospital discharge. Result: The number of distal anastomoses was $3.1{\pm}0.91$ and three patients (2.52%) died during hospital stay. The off-pump coronary artery bypass (OPCAB) was applied to 79 patients (66.4%). The LITA was anastomosed to left anterior descending system except three cases which was to lateral wall. The radial Y grafts were anastomosed to diagonal branches (4), ramus intermedius (21), obtuse marginal branches (109), posterolateral branches (12), and posterior descending coronary artery (8). Postoperative coronary angiography in 35 patients showed excellent patency rates (LITA 100%, and RA 88.5%; 3 RA grafts which anastomosed to coronary arteries <70% stenosed showed string sign with competitive flow). Conclusion: The LITA-RA Y composite graft provided good early clinical and angiographic results in multivessel coronary revascularization. But it should be cautiously used in selected patients.