• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.183-189
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• 2009

Purpose : To evaluate the usefulness of three-dimensional (3D) maximal intensity projection (MIP) reconstruction method in breast MRI. Materials and Methods : Total 54 breasts of consecutive 27 patients were examined by breast MRI. Breast MRI was performed using GE Signa Excite Twin speed (GE medical system, Wisconsin, USA) 1.5T. We obtained routine breast MR images including axial T2WI, T1WI, sagittal T1FS, dynamic contrast-enhanced T1FS, and subtraction images. 3D MIP reconstruction images were obtained as follows; subtraction images were obtained using TIPS and early stage of contrast-enhanced TIPS images. And then 3D MIP images were obtained using the subtraction images through advantage workstation (GE Medical system). We detected and analyzed the lesions in the 3D MIP and routine MRI images according to ACR $BIRADS^{(R)}$ MRI lexicon. And then we compared the findings of 3D MIP and those of routine breast MR images and evaluated whether 3D MIP had additional information comparing to routine MR images. Results : 3D MIP images detect the 43 of 56 masses found on routine MR images (76.8%). In non-mass like enhancement, 3D MIP detected 17 of 20 lesions (85 %). And there were one hundred sixty nine foci at 3D MIP images and one hundred nine foci at routine MR images. 3D MIP images detected 14 of 23 category 3 lesions (60.9%), 11 of 16 category 4 lesions (68.87%), 28 of 28 Category 5 lesions (100%). In analyzing the enhancing lesions at 3D MIP images, assessment categories of the lesions were correlated as the results at routine MR images (p-value < 0.0001). 3D MIP detected additional two daughter nodules that were descriped foci at routine MR images and additional one nodule that was not detected at routine MR images. Conclusion : 3D MIP image has some limitations but is useful as additional image of routine breast MR Images.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.825-830
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• 2007

Background: Minimally invasive cardiac surgery appears to offer certain advantages such as earlier postoperative recovery and a greater cosmetic effect than that achieved through conventional sternotomy. However, this approach has not yet been widely adopted in Korea to replace complex open heart surgery such as mitral valve reconstruction. This study compared the results of robot assisted minimally invasive mitral valve repair with those results of conventional sternotomy. Material and Method: From December 1993 to December 2005, 520 consecutive patients underwent mitral valve reconstruction for mitral regurgitation in our institution. These patients were subdivided according to those whose surgery used the conventional sternotomy approach (Group S, n=432) and those who underwent minimally invasive right anterior thoracotomy (Group M, n=88); we then compared the clinical results of both groups. When we performed minimally invasive right thoracotomy, we used a robot (AESOP 3000) and made an incision less than 5 cm. Result: Our study patients in both groups were similar for their age, gender and preoperative ejection fraction. There were two hospital mortalities in group S. but there was no mortality in the group M patients. Significant reductions in the ICU stay and the postoperative hospital stay were observed in the group M patients compared with the group S patients. However, both the bypass time and the aortic cross-clamp time were significantly longer in the group M patients. In spite of the confined incision in the group M patients, there were no limitations on the mitral valve repair techniques. There was a similar frequency of postoperative significant residual mitral regurgitation in both groups. Conclusion: In this study, the minimally invasive mitral valve repair showed comparable early results with the conventional sternotomy patients. We will now need long-term follow-up of these patients who underwent minimally invasive mitral valve repair, but we anticipate that based on the results of this study, we will begin to routinely perform minimally invasive cardiac surgery as out primary approach for mitral valve reconstruction.

• Korean Journal of Heritage: History & Science
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• v.42 no.2
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• pp.62-85
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• 2009

The Nam-Hae Sin-sa, the South Sea shrine in Yeong-Am, Korea was a national institution for public peace and bliss, was excavated in 2000, and the shrine and the 3-way-gate were reconstructed in 2001. Hae Sin-sa, the Sea shrine is a place for religious service separated into the Nam-Hae Sin-sa, the Dong-Hae Myo, and the Seo-Hae Dan. The Dong-Hae Myo was reconstructed, but restored shrine and 3-way-gate of the Nam-Hae Sin-sa is not perfect in comparison with excavation plan in 2000, therefore new reconstruction was researched through the related literature, the analysis of historical maps and excavation results, the interview with the concerned people and the case study. This research defines the analysis of the Plan of the Nam-Hae Sin-sa Reconstruction as follows. 1. The Nam-Hae Sin-sa was the institution for religious service operated by national direct management, represents the shrine for public peace and bliss on the Mountain, the Sea, and the River. Especially the Nam-Hae Sin-sa had an important position on the pivot of international trade with China and Japan, and had a role of main shrine with another one in the Mt. Ji-ri San. 2. The name of the Sea shrine was called as Nam-Hae Sin-sa(the South Sea shrine), Dong-Hae Myo(the East Sea shrine), Seo-Hae Dan(the West Sea shrine). But the name of the South Sea shrine had changed in the early period of Chosun as Nam-Hae Sin-sa to the later Chosun as Nam-Hae Dang through the research of related literature and historical map. Such as the Seo-Hae Dan, it was constructed for the Dan, the flat raised-floor without buildings, and changed to the type of Sa-Dang with addition of buildings. 3. The historical map of Hae Sin-sa informs the types of the roof, the Mat-bae roof was used in the Dong-Hae Myo, but the Pal-jak roof was showed in the Seo-Hae Dan and the Nam-Hae Sin-sa. 4. According to the analysis of Yong-Ch'uck the unit length, Nam-Hae Sin-sa was reconstructed in the period of Koryo on large scale, but it was restored in the Chosun on middle scale. And the Unit of Yong Ch'uck was changed into Yeong-jo Ch'uck in the period of Chosun. 5. As the results, The Plan of the Nam-Hae Sin-sa Reconstruction designed the new shrine into the 3 Kan front and the 2 Kan side with 3:2 scale. An-ch'o-gong with Yong-du and Yong Mi the ornaments represents head and tail of dragon, the Un-gong and the ornament of Pa-ryun-dae-gong in the building, and the Ch'ung-ryang of the Yong-du show the image of the institution for religious service for the god of the sea who look like dragon. The inner gate building and the main entrance were designed as same plan and scale as Hyang-gyo, the Korean Traditional School and Shrine of Confucianism, on the basis of results of excavation. Raise the 3-tall gate of the main entrance with harmony of the scale and the shape, because the side of gate building has the Mat-bae roof. 6. This research shows that Plan of the Nam-Hae Sin-sa Reconstruction is composed into shrine space and reservation space from the main entrance to inner gate and shrine like Jung-ak Dan in the Mt. Gye-ryong San, and it also informs the well in the west side of Sin-sa is an important factor of the plan of shrine architecture.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.161-166
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• 2006

Purpose: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. Materials and Methods: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. Results: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was $5.3{\pm}2.9\;mm(range,\;0{\sim}23\;mm)$. The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001). Conclusion: These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.

• Journal of Chest Surgery
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• v.38 no.4 s.249
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• pp.271-276
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• 2005

We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.

• 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 the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.140-149
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• 2007

Cleft lip and palate are congenital craniofacial malformation. Reconstruction of dental arch in patient with alveolo-palatal clefts is very important, because they have many problems in functions and esthetics. Malnutrition, poor oral hygiene, respiratory infections, speech malfunctions, maxillofacial deformity, and psychological problems may be occured without proper treatment during the long period of management of the cleft lip and palate. So the treatment should be managed with a multidisciplinary approach. Bone grafting is a consequential step in the dental rehabilitation of the cleft lip and palate patient A complete alveolar arch should be achieyed of the teeth to erupt in and to form a stable dentition. And the presence of the cleft complicate the orthodontic treatment. Therefore bone grafting in patients with cleft lip and palate is a widely adopted surgical procedure. Grafted bone stabilizes the alveolar process and allows the canine or incisor to move into the graft site. After the bone grafting, orthodontic closure of the maxillary arch has become a common practice for achieving dental reconstruction without any prosthodontic treatment. Various grafting materials have been used in alveolar clefts. Iliac bone is most widely fovoured, but tibia, rib, cranial bone, mandible have also been used. And according to its time of occurrence, the bone graft may be divided into primary, early secondary, secondary, late secondary. Bone grafting is called secondary when performed later, at the end of the mixed dentition. It is the most accepted procedure and has become part of treatment of protocol A secondary bone graft is performed preferably before the eruption of the permanent canine in order to provide adequate periodontal support for the eruption and preservation of the teeth adjacent to the cleft. In this report, we report here on a patient with unilateral cleft lip and palate, who underwent iliac bone graft. The cleft was fully obliterated by grafted bone in the region of the alveolar process. The presence of bone permitted physiologic tooth movement and the orthodontic movement of adjacent tooth into the former cleft area. Satisfactory arch alignment could be achieved in by subsequent orthodontic treatment.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.505-512
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• 2018

Purpose: Many reconstruction methods have been attempted after an en-bloc resection of the proximal humerus. In particular, the introduction of reverse shoulder arthroplasty (RSA) has made a breakthrough in the functional recovery of the shoulder. Nevertheless, RSA has limitations when the humeral bone stock loss is significant. In addition, it is unclear if RSA is effective in patients showing failure with non-operative treatment of a proximal humeral tumor. Materials and Methods: A reconstruction was performed using an overlapping allograft-RSA composite for 11 patients with a failed proximal humeral construct. Delayed RSA was performed on 6 patients with failed non-operative treatment. The pre- and postoperative Musculoskeletal Tumor Society (MSTS) score and the complications were addressed. Results: Overlapping allograft-RSA composite afforded a stable construct in 11 failed proximal humeral reconstructions and the patient's chief complaints were resolved. The mean time to the union of overlapped allograft-host junction was 5.5 months. Average preoperative MSTS score of 20.3 point increased to 25.7 point, postoperatively. Four of the six patients who had RSA within 4 years from the index operation showed arm elevation of more than $90^{\circ}$ whereas the remaining 5 patients showed some disability. The complications include one case each of dislocation and aseptic infection, which were resolved by changing the polyethylene liner and scar revision, respectively. None of the 6 patients who underwent delayed RSA after the failure of non-operative treatment showed arm elevation more than $90^{\circ}$. Conclusion: An overlapping allograft-RSA composite is a simple and reliable reconstructive modality in patients with massive bone loss. In patients with metastatic cancer necessitating a surgical resection at presentation, early conversion to RSA is recommended to secure functional recovery.

• Sim-seong Yeon-gu
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• v.38 no.2
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• pp.269-304
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• 2023

The purpose of this paper is to present the psychological meaning of the creation myths by utilizing related myths, analysand's dreams, active imagination, and artwork to reveal the creative function of the unconscious. The creation myth is the phenomenon of projection when a new order is demanded in the chaotic phase of personal and human history. Depending on the attitude of the ego, it can be a sign of a reconstruction/alteration of consciousness or an invasion. Related literature such as Jung, von Franz, Neumann, Harding, and Edinger, domestic papers, and case reports are introduced to identify the background for this research. The psychological meaning of 'darkness' in creation myths is regarded as unconscious that is too dark to see. The Eskimo creation myth and an analysand's dreams of being blind and wandering in darkness are discussed in relation to nigredo in Alchemy. The psychological meaning of 'massa confusa' regards Uroboros, pleroma, early childhood experience, and a psychological womb in which everything is contained in one. With related myths and unconscious materials, a discussion is followed on how this realm can be a precursor of creation but also be trapped in an abyss. The psychological meaning of 'separation of world parent' is related to splitting one into two when unconscious contexts were touched before it became consciousness. Related myths, 'the world created between heaven and earth,' 'celestial being descending to the earth,' and 'the legend of relocation of a mountain,' as well as clinical material, are examined. Then this paper discusses the clinical implications of the separation of heaven and earth occurring on its own, that the creator's emotional aspects, such as loneliness and anxiety, are involved, and that delayed separation leads to the death of creatura and sudden separation leads to the death of the chaos. Then, the meaning of 'separation of world parent' is discussed in relation with separatio, the alchemical process of acquiring light/consciousness from darkness/unconsciousness. The psychological meaning of the creation of 'land/island' refers to the emergence of consciousness, the contents of the unconscious material into the realm of the ego. Related myths, such as the 'body of the monster/dragon becoming land' and analysand's dreams, are introduced, referring to the embodiment of Mercurius. This is followed by discussing related myths in creating the land to coagulatio in alchemy and utilizing creative work such as active imagination, art, music, and dance that can coagulate or concretize unconscious material in clinical approaches. Finally, myths of resurfaced land after the Flood or the complete destruction of the world in relation to the reconstruction of ego are discussed with related clinical material to show the importance of the analyst/therapist/supervisor's mental stability and capacity.

• Journal of the Korean GEO-environmental Society
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• v.21 no.12
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• pp.35-41
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• 2020

Recently, underground spaces have been developed variously due to the concentration of the building structure in downtown area and reconstruction of the apartment. However, various problems such as differential settlement are occurring in the waterproof and reinforcement construction. In grouting method, which is frequently used for the ground reinforcement, quality control was performed by measuring the injection quantity of grouting materials and performing laboratory tests using boring samples, but it is difficult to determine whether the ground reinforcement has been performed properly during the construction stage. In order to solve this problem, a research is needed to carry out quality control by measuring electric resistivity after grouting is performed using grouting materials mixed with conductive materials. In this research, as a basic study of the new grouting method using conductive materials, uniaxial compression tests were performed using cement specimen with 0, 3, 5, 7% of carbon fiber to evaluate the effect of conductive material on the performance of grouting material. Based on the test results, the uniaxial compressive strength is increased with the mixed proportion of the carbon fiber increase. Furthermore, the carbon fiber can also affect on the early-strength of the grouting materials.