• Journal of Chest Surgery
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• v.37 no.10
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• pp.839-844
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• 2004

Background: The Y-composite graft of internal thoracic artery and radial artery is commonly used in coronary bypass surgery. The aim of this study is to look for a way to raise the free flow of the internal thoracic graft and to see flow dynamics of the Y-graft. Material and Method: In 15 patients undergoing coronary bypass surgery, free flow of the in-situ internal thoracic artery graft was measured using two different papaverine application methods; extraluminal papaverine spray in 7 patients and intraluminal papaverine injection in 8. In 18 other patients for whom the Y-graft was used, total free flow and flow changes from the two ends were measured. Result: The free flow of the in-situ internal thoracic artery graft almost doubled with internal papaverine injection than with external papaverine spray $(47.7\pm9.6$ mL/min $vs.100.8\pm26.3$ mL/min, p<0.001). Total flow of the Y-composite graft was significantly more than either flow of the internal thoracic artery end or radial artery graft end $(173.3\pm45.3$ mL/min vs. $121.1\pm34.3$ mL/min or $117.5\pm42.8$ mL/min). When both ends of the Y-composite graft were opened, free flows from the two ends were similar $(85.4\pm27.8$ mL/min vs: $87.9\pm42.4$ mL/min, p=0.772). The flow of one end of the Y-composite graft was increased significantly by clamping of the other-end than when both ends were opened. Conclusion: Intraluminal papaverine injection is very effective in raising free flow of the internal thoracic artery graft, and the free flow of the Y-composite graft of in-situ internal thoracic artery and free radial artery graft is more than that of the in-situ internal thoracic artery graft. The flow of one end flow of the Y-graft may be altered by the flow change of the other end.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.427-433
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• 2006

Background: Current vascular prostheses are considered still inadequate for reconstruction of small-diameter vessels. To evaluate the potential use of xenograft vessels as small diameter arterial grafts, we implanted porcine vessels in goats. The grafts were treated with two different processes, freezing and acellularization, before implantation, and gross inspection as well as microscopic examination followed after a predetermined period. Material and Method: Bilateral porcine carotid arteries were harvested and immediately stored at $-70^{\circ}C$ within tissue preservation solution. One of them was designated as frozen xenograft vessel. The other one was put on acellularization process using NaCl-SDS solution and stored frozen until further use. Grafts were implanted in the place of carotid arteries of the same goat. The grafts have remained implanted for 1, 3, and 6 months in three animals, respectively. Periodic ultrasonographic examinations were performed during the observation period. After explantation, the grafts were analyzed grossly and histologically under light microscope. Result: All animals survived the experimental procedure without problems. Ultrasonographic examinations showed excellent patency of all the grafts during the observation period. Gross examination revealed nonthrombotic, patent lumens with smooth surfaces. Microscopic examinations of the explanted grafts showed cellular reconstruction at the 6-month stage in both grafts. Although more inflammatory responses were observed in the early phase of frozen xenografts, there was no evidence of significant rejection. Conclusion: These findings suggest that porcine xenograft vessels, regardless of pre-implantation processes of acelluarization or freezing, can be acceptably implanted in goats, although short duration of observation in a small number of animals may limit this study.

• 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.43 no.5
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• pp.482-489
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• 2010

Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP ($\geq$0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.405-416
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• 2008

Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.430-438
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• 2008

Background: All the patients with mechanical valves require warfarin therapy in order to prevent them from developing thromboembolic complications. According to the ACC/AHA practice guidelines, after AVR with bileaflet mechanical prostheses in patients with no risk factors, warfarin is indicated to achieve an INR of 2.0 to 3.0. After MVR with any mechanical valve, warfarin is indicated to achieve an INR of 2.5 to 3.5. But in our clinical experience, bleeding complications (epistaxis, hematuria, uterine bleeding, intracerebral hemorrhage etc.) frequently developed in patients who maintained their INR within this value. So, we retrospectively reviewed the patients with bileaflet mechanical heart valve prosthesis and we determined the optimal anticoagulation value. Material and Method: From January 1984 to February 2007, 311 patients have been followed up at a national medical center. We classified the AVR patients (n=60) into three groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II and an INR from 2.5 to 3.0 in Group III. We classified the MVR (n=171) and DVR (n=80) patients into four groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II, an INR from 2.5 to 3.0 in Group III and an INR from 3.0 to 3.5 in Group III. We compared the groups for their thromboembolic and bleeding complications by means of the Kaplan Meier method. Result: In the AVR patients, 2 thromboembolic complications and 4 bleeding complications occurred and the log rank test failed to identify any statistical significance between the groups for thethromboembolic complication rate, but groups I and II had lower bleeding complication rates than did group III. Thirteen thromboembolic complication and 15 bleeding complication occurred in the MVR and DVR patients, and the log rank test also failed to identify statistical significance between the groups for the thromboembolic complication rate, but groups I and II had lower bleeding complication rates that did groups III and IV. Conclusion: The thromboembolic complication rate was not statistically different between groups I and II and groups III and IV, but the bleeding complication rates of groups I and II were lower than those of groups III and IV. So this outcome encouraged us to continue using our low intensive anticoagulation regime, that is, an INR of 1.5 to 2.5.

• Food Science of Animal Resources
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• v.31 no.5
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• pp.731-740
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• 2011

This study was conducted to evaluate a quality comparison between Chuncheon Dakgalbi made from Korean native chickens (KNC) and that made from commercial broilers. Two Korean native chickens including Woorimatdag (KNCWoori) and Hanhyup3 (KNC-Hanhyup), and two commercial broilers including grades of 18 (Broiler-18) and 13 (Broiler-13) were slaughtered at 110, 70, 38, and 31 d of ages. Chuncheon dalkalbi was prepared by mixing/dipping the meat in chili pepper sauce; it was then packed with air-packaging (Air-P) and 30% $CO_2$-MAP (0% $O_2$/30% $CO_2$/70% $N_2$), and stored at $5^{\circ}C$ for 10 d. The results showed that the KNC group had a lower pH but a higher cooking loss compared with the broiler group (p<0.05). In a texture analysis, KNC-Woori had the highest shear force value among the breeds (p<0.05). For the fatty acid composition of the thigh, the KNC-Woori contained more total saturated acids, myristic acid, palmitic acid and stearic acid, but less total unsaturated fatty acids, linoleic acid and linolenic acid than other breeds (p<0.05). Also, the n6/n3 ratios of the KNC group (19.24 and 16.77) were higher than those of the broiler group (14.02 and 14.77) (p<0.05). The total acceptability scores of Dakgalbi made from the KNC group were decreased by sensory panelists. The Dakgalbi with 30% $CO_2$-MAP delayed the protein deterioration (Volatile basic nitrogen) and lipid oxidation during storage. However, no clear evidence was observed of $CO_2$-MAP on the effect of different chicken materials. It is suggested that 30% $CO_2$-MAP instead of Air-P is used for methods for Chuncheon Dakgalbi. Furthermore, it might be unfavorable to use Korean native chickens as raw material for Chuncheon Dakgalbi from a practical quality point of view.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.455-469
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• 2008

Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.504-511
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• 2001

Preventive resin restoration, extended concept of occlusal pit and fissure sealing, is procedure composed of as follows. Cavity preparation is limited to areas of initial caries The cavity is then restored with composite resin, while other sound pits and fissures are sealed with pit and fissure sealant. If pit and assure sealant with which microrestoration is possible is used, it may be of great benefit to both patient and operator in case of difficult-to-control children s treatment. However study on preventive resin restoration using this kind of materials have been scarce. The purpose of this study was to compare the microleakage of four different modes of preventive resin restoration. Restoration using only composite resin was compared together Fifty-five bicuspids were prepared with small class I cavity preparation on the occlusal surface, divided into the following groups and restored accordingly. Group 1 : Cavity was restored with Z-100 composite resin Group 2 : Cavity was restored with Z-100 composite resin. Pits and fissures were then sealed with Teethmate F-1 Group 3 : Cavity was restored with Z-100 composite resin Pits and fissures were then sealed with Ultraseal XT-plus Group 4 : Cavity and pits and fissures were restored with Ultraseal XT-plus altogrether Group 5 : Cavity was restored with Ultraseal XT-plus. Pits and fissures were then sealed with the same material. After restoration, the samples were thermocycled 500 times between $5^{\circ}C$ and $55^{\circ}C$ with a dwell time of 30 seconds. After thermocycling, the samples were dipped into 1% methylene blue solution for 24 hours, then rinsed with tap water. The teeth were then embedded in resin and cut buccolingually along the tooth axis and observed with a stereomicroscope to determine the degree of microleakage. The results were as follows : 1. Group 4 showed the greatest microleakage, while group 3, showed the least. The mean microleakage decreased in the following order:4>1>5>2>3. 2. There was no stastically significant difference between group 1 and group 5(p>0.05). However, group 1 showed significantly greater microleakage compared to group 2 and 3(p<0.05) Group 1 showed significantly less microleakage compared to group 4(p<0.05). 3. Group 2 showed no statistically significant difference compared to group 3(p>0.05). However group 2 showed significantly less microleakage compared to group 4 and 5(p<0.05) 4. Group 3 showed significantly less microleakage compared to group 4 and 5(p<0.05). 5. Group 5 showed significantly less microleakage than group 4(p<0.05).

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.274-282
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• 2000

Stainless steel crowns are widely used for restoration for primary molars. The material used for the crowns is an alloy of $70\sim80%$ nickel and $5\sim15%$ chromium. Nickel has been known to cause allergic reaction, cancer and cell toxicity. Little is known about nickel with respect to the relationship between Ni-contained SS crown and graining of Ni-resistance in oral microorganisms. The purpose of this study is to examine whether use of Ni-contained SS crown leads to occurrence of Ni-resistant microorganism, especially enterococci. The gingival crevicular fluid of two different groups was taken. Experimental group included patients wearing SS crown, and control group comprised individuals without SS crown. The samples were plated in BHI agar, BHI agar supplemented with nickel chloride at the concentration of 3mM and bile esculin azide (BEA) agar. The cultured enterococci on BEA agar medium were tested their Ni-resistance in nickel-containing media increasing concentrations from 3mM to 50mM. The results were as follows: 1. In experimental group, a total of 507,350 strains were isolated on BHI agar, of which 53,864(10.62%) strains were found to be resistant to 3mM nickel. In control group, of 414,590 isolates on BHI agar, 37,523 isolates were resistant to 3mM nickel. 2. A total of 95 enterococci were isolated on BEA agar in experimental group, while 20 were isolated in control group. of the enterococci, 68 and 12 isolates were found to be nickel-resistant in experimental and control group, respectively. 3. Of 68 nickel-resistant isolates in experimental group, one survived 50mM nickel. In contrast, none of the isolates in control group was observed to grow at the concentrations over 30mM nickel.