• Journal of Chest Surgery
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• 제22권2호
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• pp.220-224
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• 1989

In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.

• Journal of Chest Surgery
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• 제21권2호
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• pp.211-222
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• 1988

Tetralogy of Fallot is a cyanotic congenital heart disease characterized by large ventricular septal defect[VSD] and stenosis of right ventricular outflow tract[RVOT] and the degree of RVOT stenosis and the state of pulmonary arteries are the major determinant of prognosis of this anomaly after operation. The sum of blood flow through RVOT and collateral flow from systemic arteries determine the total pulmonary blood flow and it is drained to left atrium and left ventricle. Therefore the degree of development of left ventricle not only reflects pulmonary blood flow and the status of peripheral pulmonary arteries but also affects postoperative prognosis as a systemic ventricle. In this article, left ventricular volume and its influence on postoperative cardiac function in tetralogy of Fallot were studied in 34 patients operated on at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital in 1985. Mean age of the patients was 5 1/12*3 9/12 years[range 9/12 - 14 8/12 years], mean body surface area[BSA] 0.65*0.20m2[range 0.38 - 1.22m2], mean body weight 15.6k6.48kg[range 7.0 - 36kg]and mean hematocrit 50.6*9.77%[range 32.0 - 73.5%]. Left ventricular end-diastolic volume[LVEDV] of them were from 11.2 to 113cc and there was a good linear correlation between BSA[m2, X]and LVEDV[cc, Y][Y= - 20.0+923x, r= 0.84, p < 0.005]. Mean LVEDV/m2 was [57.6 * 18.3 cc / m2[range 28.7 - 95.8 cc / m2] and there was a significant reduction of volume compared with normal value. As body surface increases, there was a increasing tendency in LVEDV/m2 but there was no statistical significance. Mean total amount of postoperatively infused dopamine in these 33 patients[except one who expired postoperatively] was 65.6*74.5mg / kg and it was 40.6*44.0mg / kg in routine RVOT widening group [Group I] and 205*49.3mg / kg in transannular RVOT widening group[Group II]. There was a statistically significant difference between two groups. In group I patients there was a good linear inverse correlation between dopamine total amount[mg / kg, Y] and LV volume[cc / m2, X] [Y = 150 - 1.89 X, r = - 0. 77, p < 0.005]. But there were no correlations between dopamine total amount and Hct, cardiopulmonary bypass time and aorta cross clamp time. In conclusion, the patient with small preoperative left ventricular volume required more amount of dopamine as an inotropic agent for the maintenance of a cardiac function in postoperative period. But this is a result of immediate postoperative period and does not reflect the long term effect of left ventricular volume in tetralogy of Fallot. There must be more study for the evaluation of its long term effect.

• 대한핵의학회지
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• 제30권1호
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• pp.86-94
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• 1996

디피리다몰부하 및 휴식기 심근 SPECT를 통해 수술결과를 평가하였다. 수술전 관류감소를 보이는 분절들의 74%에서 심근관류가 호전되었으며 중증 지속적 관류결손을 보였던 분절도 일부(43%) 수술후 관류가 호전되었다. 관상동맥영역별로는 62%의 영역이 수술후 관류가 호전되었으며, 환자예를 기준으로 하면 수술환자 47%가 수술후 심근관류가 호전되었다. 수술전에 정상이었던 관류가 악화된 예와 수술전 관류보다 나빠진 관류소견을 보이는 예가 있었다. 수술대상 관상동맥을 결정하는데 수술전 부하/심근 SPECT를 참고하여야 할 것인지 조사하여야 한다고 생각하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권1호
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• pp.24-39
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• 2000

Various methods and graft materials have been used to fill in the defect adjacent to the implants and considered as clinically acceptable. But it is not clear whether the regenerated bone increases the implant-bone contact and supports the implant. The purpose of this study is to evaluate regenerated bone surrounding implants using bone morphogenetic protein(BMP) and demineralized freeze-dried bone(DFDB), and the interfaces between implants and regenerated bone. bBMP was extracted and partially purified from the bovine bone matrix using heparine chromatography. Demineralized freeze-dried bone was made from the dog. Inactive insoluble collagenous bone matrix(IBM) of dog was used as carrier of bBMP. Interfaces of titanium coated epoxy resin implants were processed for demineralized section for transmission electron microscopy(TEM) and those of screw type implants were for nondemineralized section for light and fluoromicroscopic examination. Implants were inserted in the inferior border of mandible of adult dogs and artificial bony defects($3{\times}3{\times}4mm$) were made at the mesial and distal side of implants. Defects were filled with BMP(BMP group) and DFDB(DFDB group). For the fluoromicroscopic examination, the fluorescent dyes(oxytetracycline, calcein green, alizarin red) were injected 2, 4, 6, 8, 12 weeks after implantation. The experimental animals were sacrificed at the 6th and the 12th week and their mandible were extirpated and processed for examination with light microscopy, fluoromicroscopy and TEM. The obtained results were as follows : 1. By the light microscopic findings, the defects were filled with woven bone at the 6th week and compact bone at the 12th week, and the osseointegrations were seen in both groups. There was no histological difference between them. 2. On the basis of the histomorphometric analysis, BMP group(6th week: 40.25%, 12th week: 56.04%) had higher bony contact ratio than DFDB group(38.37%, 42.63%). There was significant difference between two groups at the 12th week(p<0.05). 3. The amount of bone formation in BMP group was more prominent than in DFDB group. Significant difference was noted among two groups at the 6th and the 8th week(p<0.05). 4. By the transmission electron microscopic findings, $0.4-2{\mu}m$ soft tissue layer was found in adjacent to the interfaces and over the collagen fibrils of bone at the 6th week. However, about 100nm amorphous layer was noted at the interface or collagen fibrils directly extended to the titanium surface at the 12th week. There was no significant difference between two groups. 5. These results suggest that BMP and DFDB can be used as good graft materials in the regeneration of bone adjacent to implant, and BMP is more valuable as a bone inducer than DFDB.

• 구강회복응용과학지
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• 제28권1호
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• pp.15-25
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• 2012

치주치료에 있어 교합치료의 타당성은 오래전부터 연구되어오고 있으나 아직도 논란이 많은 부분이다. 그 중에서도, 교합삭제를 이용한 수동적 정출(passive eruption)의 치료 효과에 대한 연구는 아직 보고된 바가 많지 않다. 본 연구의 목표는 교합삭제를 이용한 수동적 정출이 치주부착수준, 치주낭깊이 등의 치주임상지표들에 미치는 효과를 평가하는 것이다. 본 연구는 부산대학교 치과병원 치주과에서 중등도 치주염으로 치료받은 환자 중, 연구대상조건을 만족하는 16명의 환자, 40개의 치아를 대상으로 하였다. 연구 시작 단계에서 임의로 분류한 실험군과 대조군 치아 모두 임상적, 방사선적 검사를 시행하였다. 치석제거술과 치근활택술, 구강 위생 교육을 포함한 초기치료를 시행하고 4주 후 임상적, 방사선적 검사를 재실시하였다. 이 때 실험군은 교합면 삭제를 이용한 수동적 정출을 시행하고 대조군은 아무런 처치를 하지 않았다. 그 후 6개월 이후 임상적, 방사선적 검사를 재실시하였다. 그 결과 1)연구시작 단계와 비교 시, 초기치료에 의해 임상지표를 통한 치주조직의 염증상태가 개선되었으며, 2)실험군에서 치주낭깊이, 치아동요도, 치조골 소실 감소와 각화치은 폭경 증가가 더 큰 것으로 나타났다 (p<0.05). 이 결과로 볼 때, 초기치료와 함께 교합조정을 이용한 수동적 정출술이 치주치료에 도움을 줄 수 있을 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제43권4호
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• pp.147-152
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• 2013

Purpose: An animal periodontitis model is essential for research on the pathogenesis and treatment of periodontal disease. In this study, we have introduced a lipopolysaccharide (LPS) of a periodontal pathogen to the alveolar bone defect of experimental animals and investigated its suitability as a periodontitis model. Methods: Alveolar bone defects were made in both sides of the mandibular third premolar region of nine beagle dogs. Then, the animals were divided into the following groups: silk ligature tied on the cervical region of tooth group, Porphyromonas gingivalis LPS (P.g. LPS)-saturated collagen with silk ligature group, and no ligature or P.g. LPS application group as the control. The plaque index and gingival index were measured at 0 and 4 weeks postoperatively. The animals were then euthanized and prepared for histologic evaluation. Results: The silk ligature group and P.g. LPS with silk ligature group showed a significantly higher plaque index at 4 weeks compared to the control (P<0.05). No significant difference was found in the plaque index between the silk ligature group and P.g. LPS with silk ligature group. The P.g. LPS with silk ligature group showed a significantly higher gingival index compared to the silk ligature group or the control at 4 weeks (P<0.05). Histologic examination presented increased inflammatory cell infiltration in the gingival tissue and alveolar bone of the P.g. LPS with silk ligature group. Conclusions: An additional P.g. LPS-saturated collagen with silk ligature ensured periodontal inflammation at 4 weeks. Therefore, P.g. LPS with silk ligature application to surgically created alveolar bone defects may be a candidate model for experimental periodontitis.

• 한국지반공학회논문집
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• 제29권5호
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• pp.29-38
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• 2013

G-class 시멘트는 지열발전소 가동 시에 지열정에서 고온의 지열수나 증기를 심부에서 지표면까지 이동시키는 케이싱을 보호하는 시멘팅 재료로서 이용된다. 지열정을 통한 원활한 지열발전을 위해서는 시멘팅 재료의 물리적 특성들이 만족되어야 한다. 본 연구에서는 G-class 시멘트를 지열정 시멘팅 재료로서의 중요한 물리적 특성인 유동성, 일축압축강도, 열전도도, free fluid 함유율(Free fluid content) 등을 평가하기 위해, 다양한 물/시멘트 비 조건에서 실내실험을 수행하였다. G-class 시멘트에 대한 물리적 특성 평가를 통해 다음과 같은 결론을 도출하였다. (1) G-class 시멘트의 유동성은 소량의 응고지연제(retarder)를 첨가하여 증가 시킬 수 있다. (2) 유동성 확보를 위해 물/시멘트 비를 높일 경우, 일축압축강도가 감소하여 지열정의 구조적 문제를 야기할 수 있다. (3) G-class 시멘트의 열전도도는 지열정 가동 시에 지열정에서 외부 지반으로의 열손실이 거의 없을 정도로 낮게 평가되었다. (4) G-class 시멘트를 시멘팅 재료로 이용할 경우, 블리딩(bleeding) 가능성은 매우 낮은 것으로 판단된다. (5) 페놀프탈레인 지시약은 지열정 시공시 지표면에서 시추용 이수와 G-class 시멘트를 구분하기 위해 적합할 것으로 판단된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.295-307
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• 2006

Styela clava, called non-native tunicate or sea squirt, is habitat which include bays and harbors in Korea and several sites in the sea faced world. We fabricate cellulose membrane nerve conduit (CMNC) from this native sea squirt skin, and evaluate the capacity of promoting peripheral nerve regeneration in the rat sciatic nerve defect model. After processing the pure cellulose membrane from the sea squirt skin as we already published before, CMNC was designed as a non-tubular sheet with 14 mm length and 4 mm width. Total eleven male Spraque-Dawley rats (12 weeks, weighing 250 to 300g) were divided into sham group (n=2), silicone tube grafted control group (n=3) and experimental group (n=6). Each CMNC grafted nerve was evaluated after 4, 8 and 12 weeks in the experimental group, and after 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were all examined using image analyzer and electromicroscopic methods in the all groups. The regenerated axon and nerve sheath were found only in the inner surface of the CMNC after 4 weeks and became more thicker after 8 and 12 weeks. In the TEM study, CMNC grafted group showed more abundant organized myelinated nerve fibers with thickened extracellular matrix than silicone conduit grafted group after 12 weeks. The sciatic function index (SFI) and ankle stance angle (ASA) in the functional evaluation were $-47.2{\pm}3.9$, $35.5^{\circ}{\pm}4.9^{\circ}$ in CMNC grafted group (n=2) and $-80.4{\pm}7.4$, $29.2^{\circ}{\pm}5.3^{\circ}$ in silicone conduit grafted group (n=3), respectively. And the myelinated axon was 41.59% in CMNC group and 9.51% in silicone conduit group to the sham group. The development of a bioactive CMNC to replace autogenous nerve grafts offers a potential and available approach to improved peripheral nerve regeneration. As we already published before, small peptide fragment derived from the basement membrane matrix proteins of squirt skin, which is a kind of anchoring protein composed of glycocalyx, induced the effective axonal regeneration with rapid growth of Schwann cells beneath the inner surface of CMNC. So the possibilities of clinical application as a peripheral nerve regeneration will be able to be suggested.

• 한국산학기술학회논문지
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• 제17권10호
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• pp.280-288
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• 2016

본 연구의 목적은 마찰교반용접을 마그네슘 합금에 응용하기에 앞서 형상이 다른 두 종류의 용접 툴을 마찰교반용접 시험에 적용 및 비교하여 마그네슘 합금 마찰교반용접에 더 적합한 용접 툴을 제안하였다. 용접 툴의 효과를 알아보기 위해서 용접조건 변수 중 이송속도는 200mm/min으로 고정하였고 회전속도를 400, 600, 800rpm으로 변화시키면서 용접부의 거동과 용접 툴 변화에 따른 효과를 평가 및 관찰하였다. 기계적 물성 평가를 위해 인장시험과 경도시험을 수행하였으며, 용접부 내 거동 및 결함의 유무를 확인하기 위하여 용접부에 수직인 방향의 횡단면을 광학현미경을 통해 관찰하였다. 용접 툴에 관계없이 회전속도가 400rpm일 때 결함이 관찰되었으며, 회전속도가 증가할수록 결함이 감소하는 경향을 보였다. 최종적으로 회전속도 800rpm에서 결함이 없는 용접부를 얻었다. 용접 툴 변화에 따른 기계적 물성 평가 결과 C type 용접 툴을 적용한 경우 보다 우수한 결과가 나타났다. 기계적 물성이 가장 우수한 용접조건은 회전속도 800rpm, 이송속도 200mm/min 이었고, 이때 용접부의 인장강도, 항복강도 그리고 연신율은 모재 대비 90.0%, 69.1%, 83.2% 수준으로 각각 나타났다.

• 한국환경생태학회지
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• 제36권5호
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• pp.535-549
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• 2022

강풍, 폭우 등 이상기후의 대형화와 빈도 증가로 인해 나무가 부러지거나 쓰러지는 훼손이 증가하고 있으나 나무 내부의 공동, 부후 등 구조적 결함은 육안조사로 판별이 어렵기 때문에 예측을 통한 사전대응에 한계가 있다. 비파괴음파단층촬영은 나무에 미치는 물리적 훼손을 최소화하면서 내부결함을 추정하는 방법으로 내부결함 진단에 효율적이나 수종별 정확도에 차이가 발생하기 때문에 현장적용 전 측정결과의 신뢰성 분석이 선행되어야 한다. 이번 연구는 우리나라 대표 수종인 소나무와 은행나무 노거수를 대상으로 음파단층촬영의 신뢰성 검증을 위해 침입성 드릴저항 측정을 교차 적용하여 목재 내부결함을 측정하고 평가결과를 비교하였다. 두 집단 간 결함부 측정 평균값에 대한 t검정 결과 소나무는 통계적으로 유의한 차이가 없는 반면, 은행나무는 유의성에 차이가 있었다. 선형회귀분석 결과 두 수종 모두 드릴저항그래프의 결함이 증가할 때 음파단층영상 결함이 증가하는 양의 상관관계를 보였다.