• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.477-482
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• 2014

The aim of this study was to investigate and compare technique, surgical time, and complications of laparoscopic ovariectomy using $LigaSure^{TM}$ and bipolar vessel sealing system in cats. Laparoscopic ovariectomy was performed under general anesthesia on 10 healthy female cats admitted for elective ovariectomy. Surgery was performed through three midline portals. Each ovary was randomly-assigned to removal by use of either $LigaSure^{TM}$ or bipolar vessel sealing system. Duration of predetermined surgery intervals and complications were compared. Bipolar OVE ($2:16{\pm}1:14$ minutes) took significantly longer surgical time compared to the $LigaSure^{TM}$ OVE ($1:24{\pm}0:59$ minutes, P = 0.021). The ovarian pedicle fat and obesity did not influence surgery duration. Intraoperative hemorrhage occurred with bipolar OVE in three cats, but had no significant influence on surgical time. The results suggest that both $LigaSure^{TM}$ and bipolar devices appear to be effective, but $LigaSure^{TM}$ can be used as a stand-alone device that decreases surgical time and complication compared with bipolar vessel sealing system.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.1
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• pp.33-38
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• 2002

Purpose: The incidence of shigellosis had been decreased due to the use of antibiotics and the improvement of environmental sanitation but recently increases again. Shigellosis occurrs in mass outbreak through unsanitized meal preperation refered from welfare facility and school. We observed epidemic aspect and clinical coarse of childhood shigellosis. Methods: from December 2001 to January 2002, 22 inpatients with shigellosis in Dongbu Municipal Hospital were observed epidemiologically, clinically and microbiologically. Results: 1. The sexual ratio was 1:1 and mean age was $5.5{\pm}1.4$ years (14 months to 11 years). 2. The clinical manifestations were following: diarrhea (95.5%), high feve (10%) and asymptomatic (4.5%). The mean duration was $3.9{\pm}2.1$ days (1 to 12 days). All patients had no complication and normal serologic test. 3. S. sonnei was cultured in rectal swab, and was resistant to TMP/SMX and ampicillin, but susceptible to ampicillin/sulbactam and the 3rd generation cephalosporins. 4. The patients were treated by antibiotics with conservative treatment including electrolytes and fluid therapy for 5 days, resulting in improvement confirmed by negative reaction on stool culture. 5. These cases were all occurred in mass outbreak in day care center and were suspected to be secondary infection by members of family. Conclusion: This shigellosis occurred in day care center was secondary infection due to S. sonnei and had mild clinical coarse and improvement after antibiotic treatment.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.86-91
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• 2013

Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.97-100
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• 2010

Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.41-46
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• 2003

Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

• Annals of Clinical Neurophysiology
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• v.3 no.2
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• pp.136-142
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• 2001

Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.

• Journal of Biomedical Engineering Research
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• v.24 no.6 s.81
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• pp.515-522
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• 2003

Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

• Journal of Biomedical Engineering Research
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• v.19 no.2
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• pp.163-170
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• 1998

The ultimate goal of total artificial heart is permanent substitute for a failed heart in a patient without any other therapeutic modality. Until now, infection has been the main problem related to the mechanical circulatory support system. The best way to solve this catastrophic complication and to improve the quality of life of TAH patients in terms of tethering must be implantation of TAH totally. The EH-TAH has been developed in NCVC from 1987 for this purpose. The system consists of an energy converter and pumps, which are designed to be placed in abdomen and pericardial space separately for a good anatomical fit. To evaluate the anatomical fit and hemodynamic performance of the EH-TAH, in vivo test was done. General condition of the animal and hemodynamic status had been stable until the TAH stopped on the 11th pumping day. The estimated cardiac output was about 7.7L/min. The values of mean aortic pressure, left and right atrial pressure were 93$\pm$10, 19$\pm$3 and 15$\pm$4 mmHg, respectively. The correlation coefficient between left and right atrial pressure was 0.96, which represents the dynamic function of the interatrial shunt in controlling left-right imbalance of cardiac output. During pumping days, the temperature on the surface of actuator had been maintained at 39.7$\pm$0.4$^{\circ}C$, less than 1$^{\circ}C$ higher than the rectal temperature. The TAH stopped on the 11th day due to mechanical problems. We concluded that the EH-TAH possessed satisfactory basic performance including anatomic fit and hemodynamic adequacy, although there were several mechanical problems to be solved yet.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.203-210
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• 2001

Objective : Paraclinoidal aneurysms termed that aneurysms arising from proximal internal carotid artery(ICA) between the site of emergence of the carotid artery from roof of the cavernous sinus and origin of the posterior communicating artery(PCoA). These aneurysms pose conceptual and technical surgical problems with regard to acquisition of proximal control and safe intracranial exposure. The efficiency of surgical technique according to the location of paraclinoidal aneurysm was studied for minimal exposure. Materials and Methods : Over the past four years, the authors treated surgically 171 cases of cerebral aneurysm, among them ten patients were paraclinoidal aneurysms with two patients unruptured aneurysms. Mean age was 47 years old, and all patients were female. Three patients were proximal posterior carotid artery wall aneurysms(one large, one giant), four patients carotid-ophthalmic artery aneurysms and three patients superior hypophyseal artery aneurysms. Results : There could be done clip in all cases, there were no deaths and no complication. And no patient developed sustained neurological deficits including visual function except hydrocephalus in one case. Four patients complained of visual disturbance but two patients had recovery after postoperation and two patient were not longer to bad. Conclusion : Our recent experience suggests that preoperative scrutiny of diagnostic angiography allows classification of all paraclinoidal aneurysms regardless of size and surgical technique which this classification has focused on operative approaches unique to each aneurysm projection was helpful to improve the operative outcome with good visual function and to shorten the operative time.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.317-323
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• 2000

Objective : To evaluate the role of stereotactic LINAC radiosurgery in treatment of meningiomas, the authors retrospectively analyzed the result of radiosurgery in our institute. Method: During last ten years, twenty patients underwent stereotactic LINAC radiosurgery(LINAC SRS) for meningiomas. The mean age of the patients was 51 years(22-78 years). The most common tumor location for radiosurgery was parasagittal, sphenoid wing and tentorial area. With regards to indications of radiosurgery for meningiomas, LINAC radiosurgery was done for primary treatment in six patients, for postoperative residual tumors in eleven patients, for postoperative regrowth in three patients. Mean tumor volume was $5.14cm^3$($0.28-15.1cm^3$), mean field diameter was 2.01cm(1.2-3cm). The mean marginal dose was 20.55Gy(13-30Gy). The follow-up evaluation was done annually with radiologic findings and clinical status. The mean follow-up period was 46.8(24-120) months. Result : In the radiologic response, the tumor volume was reduced in five(25%) of twenty patients, fourteen showed arrested growth(70%), but one patient showed increased growth(5%). In the clinical response, nine patients improved clinically(45%), ten patients was stable(50%) and one patient worsened during follow-up period. With regards to correlation with radiologic and clinical response, in nineteen patients who showed radiologic response to radiosurgery(decreased and arrested growth after radiosurgery), nine patients(47.4%) improved and ten patients (52.6%) showed no change, one patient(5%) had symptomatic radiation necrosis at four years after SRS, which needed craniotomy. Conclusion : The overall control rate of meningiomas with LINAC radiosurgery was 95% in radiologic follow up and 95% clinically. The radiation complication rate was 5%. These results indicate that LINAC radiosurgery can be considered as safe and effective method for meningiomas.