• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.168-179
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• 2007

Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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• pp.416-428
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• 2006

Objectives : Arterial stiffness and pulse pressure are related to cardiovascular and cerebrovascular survival and longevity. This study is aimed at examining the effects of Chungpyesagan-tang on arterial stiffness and Pulse pressure in acute stroke Patients. Methods: The subject of this study was acute strike Patients within 1 week after ictus, with Cardio-ankle vascular index(CAVI) higher than 9.0. They were divided into two groups: A treatment group (n=44) and a control group(n=46). For two weeks, Chungpyesagan-tang was given to the former, other herbal medicines to the latter. used for stroke patients for the control group for 2 weeks. At the end of first and second week, CAVI, pulse Pressure, National Institute of Health stroke scale(NIHSS), Modified Barthel Index(MBI) were measured. Serum lipid Profile, aspartate transaminase(AST), alanine transaminase(ALT). blood urea nitrogen(BUN), creatinine were also measured at the end of the study. Results : After 2 weeks, CAVI and Pulse Pressure in Chungpyesagan-tane group were significantly tower than those in the control group(P<0.05). NIHSS and MBI were improved in both groups. But there was no significant difference between the treatment group and the control group in terms of the NIHSS and MBI. Conclusions : We suggest Chungpyesagan-tanghas desirable effects on arterial stiffness and Pulse Pressure of acute stroke patients. It can improve morbidity and mortality of patients on the basis of influencing vascular stiffness and increased pulse pressure.

• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.73-83
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• 2024

Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient's family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1075-1081
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• 2009

Renal transplantation is the treatment of choice for children with end-stage renal disease. The outcome of pediatric kidney transplantation has improved dramatically in recent years, with lower acute rejection rates, superior graft survival, and low mortality. These improvements have allowed increased attention to other aspects of care for long-term survivors. Taking this into consideration, this review article will focus on the key issues related to pediatric kidney transplantation such as growth, neurocognitive function, nonadherence, and posttransplantation infectious complications, including lymphoproliferative disease, to broaden the understanding of pediatricians who provide pre-and postoperative care to children with end-stage renal disease.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.470-474
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• 1986

In the treatment of the acute respiratory failure, ventilatory support with endotracheal intubation or tracheostomy is a life saving procedure in many cases but the development of postintubation tracheal stenosis is a very serious complication. Recently we have experienced one case of postintubation tracheal stenosis which occurred in the region of cuff site. Preoperative tracheogram showed a concentric stricture 3.0 cm in length located 4.0 cm proximal to the carina. Under the general anesthesia, the stenotic segment was resected and end-to-end anastomosis was performed successfully through the right posterolateral thoractomy. Her postoperative course was uneventful and the patient has remained well till now.

• Steel and Composite Structures
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• v.3 no.3
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• pp.169-184
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• 2003

This paper presents a generic modelling of composite steel-concrete beams with elastic shear connection. It builds on the well-known seminal technique of Newmark, Siess and Viest, in order to formulate the partial interaction formulation for solution under a variety of end conditions, and lends itself well for modification to enable direct quantification of effects such as shrinkage, creep, and limited shear connection slip capacity. This application is possible because the governing differential equations are set up and solved in a fashion whereby inclusion of the kinematic and static end conditions merely requires a statement of the appropriate constants of integration that are generated in the solution of the linear differential equations. The method is applied in the paper for the solution of the well-studied behaviour of simply supported beams with partial interaction, as well as to provide solutions for a beam encastr$\acute{e}$ at its ends, and for a propped cantilever.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.136-141
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• 2021

The crossing Y-stent method is one of the indispensable techniques to achieve sufficient neck coverage during coil embolization of bifurcation aneurysms with a wide neck and/or branch incorporation. However, the inevitable hourglass-like expansion of the second stent at the crossing point can result in insufficient vessel wall apposition, reduced aneurysm neck coverage, delayed endothelialization, and subsequent higher risks of acute or delayed thrombosis. It also interferes with engagement of the microcatheter into the aneurysm after stent installation. We expected to be able to reduce these disadvantages by installing a noncrossing type Y-stent using the Solitaire AB stent, which is fully retrievable with a tapered proximal end. Here we report the techniques and two successful cases.

• Journal of the Korean Society for Precision Engineering
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• v.29 no.12
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• pp.1279-1284
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• 2012

Micro structures which are widely used at various fields are commonly fabricated by lithograph, etching and laser methods. Recently, with the emergence of micro tools and ultra-precision machine tools, fabrication of the micro structures obtained using end-milling are studied. However, there are some problems due to the diameter of the micro end-mill getting smaller below $100{\mu}m$. The micro run-out resulted from miniaturization of end-mills have influence seriously on accuracy of micro structures. The error of run-out with a tooling jig showed a decrease of about $9.3{\mu}m$. Furthermore, micro structures with width of $30{\mu}m$ could be applied through experiments of slot machining obtained using 30 and $50{\mu}m$ end-mill. Also, narrow angle structures with $30^{\circ}$ angle could be applied through analysis of machining acute angle structures. Based on basic experiments, micro fluidics channels and spiral patterns for air bearing were machined.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.5 no.2
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• pp.23-33
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• 2007

Summary of background data: At the wound from life of the human being very regarding at and a healing process the wound in the portion which is important meantime the many research is accomplished and healing process at the wound the research is small very from the physical therapy territory. Purpose: This study was performed to examine the effects of cold therapy and pulsed ultrasound treatment in the process of acute wound healing. To this end, we measured changes in the length of the wounds, and observed tissues through an optical microscope in order to evaluate the healing process of the acute wounds. Methods: We divided twenty Sprague-Dawley rats into four experimental groups of five rats each and treated them for three days after wound creation. Then we extracted tissues from the wounds on day 6th after wound creation and then took them out for hematoxylin-eosin(HE) staining. We measured changes in the length of the wounds every other day. Result: We were able to detect significant statistical differences in the cold therapy and pulsed ultrasound-treated wounds compared with control wounds. We observed tissues through an optical microscope and found the tissues in cold therapy and pulsed ultrasound-treated wounds healed well. Conclusions: Overall results indicated that the use of cold therapy and pulsed ultrasound treatment were effective in the process of acute wound healing.