• Journal of Chest Surgery
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• 제8권2호
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• pp.149-152
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• 1975

In spite of great advances in surgical treatment during past several decades, surgery of the trachea failed to develop correspondingly, partly because of relative rarity of the tracheal lesions and partly because of difficulties in surgical technique and anesthesia. Surgical diseases of the trachea are largely obstructions due to neoplasm or cicatrical stenosis and tracheal malacia. The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tubes, has produced, apparently with increasing frequency, tracheal stenosis, tracheomalized tracheal erosion. Surgery is presently the only reasonable way to treat stenotic lesions of the tracheobronchial tree. In the case of tumors, the current trend has been that of radical excision. Primary end-to--end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, for decades it was believed that a maximum of four tracheal rings only might be excised and primary healing achieved with safety. A great variety of procedures, developed by numerous investigations and directed at tracheal substitution, have almost invariably met with discouraging results. A meticulous study done by Grillo and associates on autopsy specimens has shown that an average 6.4cm of mediastinal trachea can be safely resected by full mobilization of the right lung and transplantation of the left main bronchus into the bronchus intermedius. Recently, we experienced a case of successful resection of a tumor of the tracheal carina and primary tracheo-left main bronchial anastomosis at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul. The patient, a 29-year-old man, was admitted to the hospital with complaints of dyspnea and cough. On admission, chest film showed hydropneumothorax on the right. After closed thoracostomy, hydropneumothorax disappeared, but hazy densities, developed in the right middle and lower lung fields, resisted to treatment. Bronchoscopy uncovered irregular tumor covering the carina and the right main bronchus, and biopsy indicated well differentiated squamous Cell carcinoma. Operation was performed on July 2, 1975. A right postero-lateral thoracotomy was used. Excision involved the lower trachea, the carina, the left main bronchus and the right lung. This was followed by direct anastomosis between the trachea and the left main bronchus. Bronchography was done on 17th postoperative day revealed good result of operation without stricture at the site ofanastomosis. About one month after the operation symptoms and signs of bronchial irritation with dyspnea developed, and these responded to respiratory care. On 82nd postoperative day, sudden dyspnea developed at night and the patient expired several hours later. Autopsy was not done and the cause of death was uncertain.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.112-119
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• 2011

Purpose: Collagen membranes are used extensively as bioabsorbable barriers in guided bone regeneration. However, collagen has different effects on tissue restoration depending on the type, structure, degree of cross-linking and chemical treatment. The purpose of this study was to evaluate the inflammatory reaction, bone formation, and degradation of dehydrothermal treated porcine type I atelocollagen (CollaGuide$^{(R)}$) compared to of the non-crosslinked porcine type I, III collagen (BioGide$^{(R)}$) and the glutaldehyde cross-linked bovine type I collagen (BioMend$^{(R)}$) in surgically created bone defects in rat mandible. Methods: Bone defect model was based upon 3 mm sized full-thickness transcortical bone defects in the mandibular ramus of Sprague-Dawley rats. The defects were covered bucolingually with CollaGuide$^{(R)}$, BioMend$^{(R)}$, or BioGide$^{(R)}$ (n=12). For control, the defects were not covered by any membrane. Lymphocyte, multinucleated giant cell infiltration, bone formation over the defect area and membrane absorption were evaluated at 4 weeks postimplantation. For comparison of the membrane effect over the bone augmentation, rats received a bone graft plus different covering of membrane. A $3{\times}4$ mm sized block graft was harvested from the mandibular angle and was laid and stabilized with a microscrew on the naturally existing curvature of mandibular inferior border. After 10 weeks postimplantation, same histologic analysis were done. Results: In the defect model at 4 weeks post-implantation, the amount of new bone formed in defects was similar for all types of membrane. Bio-Gide$^{(R)}$ membranes induced significantly greater inflammatory response and membrane resorption than other two membranes; characterized by lymphocytes and multinucleated giant cells. At 10 weeks postoperatively, all membranes were completely resorbed. Conclusion: Dehydrotheramal treated cross-linked collagen was safe and effective in guiding bone regeneration in alveolar ridge defects and bone augmentation in rats, similar to BioGide$^{(R)}$ and BioMend$^{(R)}$, thus, could be clinically useful.

• Asian-Australasian Journal of Animal Sciences
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• 제24권9호
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• pp.1268-1273
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• 2011

The present study was conducted to determine a feasible method of protein concentrate extraction from rice bran (RBPC) and its effect as a substitution for skim milk in early weaning pig diets. An investigation to extract protein concentrate from full fat rice bran was undertaken to determine the best ratio of water and rice bran, the amount of NaOH and a HCl solvent to use in a simple paddle-type mixer with modified spinning to produce RBPC. The results stated that the best ratio for water mixing in the RBPC extraction process was 1:5 with 20 g NaOH and 30 min in a paddle-type mixer at 300 rpm. A mix of 250 ml 0.2 N HCl was optimum for neutralization and protein precipitation. After the fluid was spun out with a washing machine, the sediment was left for 12-14 hours to complete the filtration. One kilogram of rice bran could produce an average of 324.5 gram RBPC and it contained 3.40% ash, 496.48 kcal of GE/100 gram, 1.94% crude fiber, 28.20% ether extract, 7.64% moisture and 16.66% crude protein, respectively. A total of 45 crossbred piglets, weaned at 3 weeks of age were allotted into control diet (A) and dietary treatments formulated with a four different rates of RBPC substitution for skim milk at a percentage of 25 (B), 50 (C), 77 (D) and 100 (E) respectively, in a randomized complete block (RCB) design. All piglets had free access to feed and water until 8 week of age when the experiment ended. Feed intake, average daily gain, growth rate and feed efficiency were not affected by dietary treatments. Blood test parameters after completion of the growth trial indicated normal health. Even though the mean of cell hemoglobin concentration was significantly different between treatments (p<0.05) it was still within the normal range. The cost difference for BW gain of 100% RBPC substituted for skim milk in the weaning diet was approximately 35% lower than that of the control and the relative cost of production was 96.67, 92.85, 70.75 and 64.48% lower for the replacement of 25, 50, 75 and 100% of skim milk respectively. These results implied that this technology is feasible for use by small scale farmers to improve their self-reliance.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.92-100
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• 2006

Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis ($Terudermis^{(R)}$) or acellular dermal matrix ($AlloDerm^{(R)}$), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an $AlloDerm^{(R)}$. Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying $AlloDerm^{(R)}$ in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of $AlloDerm^{(R)}$ application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

• 대한골관절종양학회지
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• 제1권2호
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• pp.133-144
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• 1995

고관절 제거후 재건을 위한 방법으로서의 안장형 인공 고관절 치환술은 동종골 이식술후 고관절 전치환술, 열처리한 자가골 재삽입 후 고관절 전치환술, 좌골 대퇴골간 유합술, 가동 관절로 그대로 두는 방법 등에 비해서 수술 시간의 단축에 의한 감염율 및 기타 이환율의 감소, 술후 조기 보행 가능, 좌식 생활을 하는 한국인의 생활에 편리한 이점이 있다. 이 방법은 Modular system으로 다리 정렬 상태를 잘 보존시킬 수 있으며 필요하다면 추후 골 재건술도 할 수 있는 장점이 있다. 저자들은 비구를 침범한 악성 골 종양을 제거 고관절의 재건을 위해 3예에서 안장형 인공 고관절 치환술을 시행하였다. 이중 1예에서 가역성 서혜부 탈장이 관찰되었으나 12개월, 19개월(사망), 27개월의 추시 관찰 결과 자가 보행, 계단 오르내리기가 가능하고, 쪼그려 앉기와 방바닥에 앉을 수 있으며, 통증없이 일상적인 생활을 할 수 있었다. 따라서, 비구를 침범한 골 종양 제거후의 고관절 재건술의 좋은 방법으로 판단되어 이에 문헌 고찰과 함께 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.53-57
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• 2010

연부조직만으로 경구개를 재건하는데 있어서는 환자군을 적절히 선택하는 것이 중요하며 골재건이 필요하지 않은 Okay 분류 Ia와 Ib가 주요한 적응증이 된다. 하악이나 구강저부 결손을 재건하는 것과는 다르게 경구개 결손은 구강과 비강 점막층을 동시에 수복할 수 있는 피판이 이상적이다. 이중 저자들은 전완유리피판에 전상판화 방법을 좀 더 안정적으로 시행, 경구개 전층을 성공적으로 재건하였으며, 특히 저작과 연하 등 기능적 측면뿐 아니라 경구개 및 비강의 점막을 함께 복원할 수 있는 해부학적인 장점이 있는 피판임을 확인하여 문헌고찰과 함께 보고하는 바이다.

• Applied Microscopy
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• 제30권1호
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• pp.89-100
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• 2000

아프리카 왕달팽이 (Achatina fulica) 및 산민달팽이(Incilaria fruhstorferi)의 타액을 분비하는 관들을 전자현미경을 통해 관찰한 결과 다음과 같은 결론을 얻었다. Achatina fulica의 소엽내관과 소엽간관은 대부분 원형또는 타원형의 도우넛(dough-nut)형태로서 관을 구성하는 내강세포는 세포의 경계가 불분명하며 세포질은 손가락 마주끼기와 같은 많은 주름들로 구성되어 있었다. 이들의 세포상단에는 미세융모가 잘 발달해 있었다. 반면 Incilaria fruhstorfer의 소엽내관과 소엽간관은 불규칙한 단층원주상피로 구성되어 있고, 전자밀도가 높은 세포질 속에는 다소 불규칙한 구형의 과립들로 가득차 있었다. 세포의 상단에는 미세융모의 발달이 미진하였다. Achatina fulica의 타액관은 내강이 비교적 좁은 긴 관상구조를 하고 있었다. 내강상피세포들은 세포의 경계가 불분명하고, 세포질 속에는 많은 공포와 전자밀도가 낮은 투명과립들로 가득 차 있었고 이들 상피세포의 상단에는 길이가 짧고 가늘은 미세융모가 발달해 있었다. 반면 Incilaria fruhstorfer의 타액관은 Achatiana fulica의 타액관 보다 그 직경이 $65\times250{\mu}m$정도로 더 넓었으며 같은 구조의 내강상피로 구성되어 있었고 상피세포의 상단에는 치밀반과 같은 연접장치가 자주 관찰되는 특징도 보였다. Achatina fulica와 Incilaria fruhstorferi 타액선내 혈관들은 타액선 세포사이에 있는 결합조직에서 주로 관찰되었으며 내피세포들은 대부분 불규칙한 구조이고 전자밀도는 높아서 어둡게 관찰되었다. 이들은 사상족을 내어 포식현상을 보였다.

• 한국패류학회지
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• 제27권4호
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• pp.337-343
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• 2011

일본(기수)재첩 유생사육을 위한 최적조건을 파악하기 위하여 수온, 염분, 유생 수용밀도, 먹이생물 종류 및 공급량, 채묘방법에 따른 성장과 생존율을 조사하였다. 일본(기수)재첩의 부유유생은 $24^{\circ}C$와 $27^{\circ}C$에서 빠른 성장을 보였으며, $18^{\circ}C$와 $21^{\circ}C$에서 50% 이상의 높은 생존율을 보임으로서 유생 사육을 위한 적정 수온은 $21-24^{\circ}C$이며, 최적수온은 $24^{\circ}C$ 이었다. 또한 염분 3 psu 이상에서 성장과 생존이 가능하였으나 적정 염분은 6-9 psu 이었다. 유생밀도별 사육시험에서 1 ml당 1-10 개체에서 높은 성장과 생존율을 보였으나 경제성을 고려한 적정 유생사육 밀도는 1 ml당 10 개체였다. 먹이생물에 따른 유생의 성장과 생존율은 Isochrysis galbana, Pavlova lutheri 및 Chaetoceros calcitrans를 혼합하여 10,000-20,000 cells/ml의 밀도로 공급하는 것이 가장 효과적이었다. 성숙유생의 채묘는 모래저질에서 성장과 생존율이 유의하게 효과적이었으며, 특히 0.25 mm 이하의 미세사질에서 높은 생존율을 보였다.

• 한국패류학회지
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• 제27권4호
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• pp.307-315
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• 2011

유생의 발달크기에 따라 미세조류 12종에 대하여 섭취 가능성을 조사한 결과 유생의 크기에 따라 섭취 가능한 미세조류는 많은 차이를 보였다. 전체 유생크기에서 I. galban, I. aff. galbana, P. lutheri, C. ellipsoidea, N. oculata는 94.2-99.7%의 섭취율를 보였고, C. calcitrans, C. gracilis, C. simplex는 평균 각장 $189.3{\pm}13.8{\mu}m$ 크기인 중형 각 정기 이후 90.0% 이상의 섭취율을 보였다. P. triconutum, D. tertiolecta, T. tetrathele는 평균 각장 $65.0-100.0{\mu}m$의 D형 유생은 섭취가 관찰되지 않았지만, 이후 유생에서는 각각 97.3-99.7%, 43.3-99.3%, 48.5-99.3% 섭취하였다. 그러나 T. weissflogii는 평균 각장 $306.2{\pm}14.7{\mu}m$ 이상에서 1.0-1.7%의 섭취율을 보였지만, 전체 유생기동안 그의 섭취가 되지 않았다. 이상의 결과를 이용해 전체 50.0% 이상 섭취 가능한 먹이생물의 세포크기를 조사한 결과, 평균 각장 $102.3{\mu}m$ 이하의 D형 단계는 장축과 단축 모두 $4.6{\mu}m$ 이하, $158.3{\mu}m$ 미만에서는 장축기준으로 $9.3{\mu}m$ 미만까지 섭취가 가능하고, $158.3{\mu}m$ 이상 크기는 단축 기준 $9.3{\mu}m$까지 섭취가 가능한 것으로 나타났다. 전제 유생기 동안 장축과 단축을 포함해서 $10.0{\mu}m$ 이상은 섭취가 되지 않았다.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.334-341
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• 2001

Objective : We have currently changed treatment strategies to methotrexate(MTX)-based preirradiation chemotherapy with subsequent planned radiation for the initial therapy of primary central nervous system lymphoma (PCNSL). The aim of this study was to evaluate the results of treating PCNSL with chemotherapy plus radiotherapy (CRT) or radiotherapy(RT) alone. Method and Material : This study involved 10 females and 3 males patients with a mean age of 54.2 years. All patients underwent surgery, open(8 cases) or stereotactic biopsy(5 cases) for histological diagnosis. Eleven tumors were diffuse large B-cell lymphomas. Tumor volume change in the follow-up images and survival time were evaluated in patients treated with CRT and RT alone. In the beginning, two patients received ProMACE-Cytabom chemotherapeutic regimen, but did not complete the course and died of progressive tumor 8 and 9 months after diagnosis, respectively. One patient died at 6 months before chemotherapy. These three were excluded from the survival analysis. Five patients(RT group) completed full courses of cranial irradiation with or without boost. For the current combined modality treatment, high-dose MTXbased chemotherapy(systemic and intrathecal MTX, IV vincristine, and oral procarbazine) followed by whole brain irrdiation to 45Gy to tumor was introduced in 5 patients of CRT group. Result : A complete response was achieved in three of five who received RT only and in all of five who received CRT. All patients in CRT groups are in disease free status at a mean 23 months following therapy. The RT group patients refused any additional salvage therapy at tumor relapse and survived at mean 20 months from diagnosis. The Karnofsky performance status improved in eight of ten patients with treatment. The treatment toxicity included leukoencephalopathy in RT group and severe leukopenia, transient hepatitis, avascular necrosis of femoral head, hearing loss, and amenorrhea in CRT group, respectively. Conclusion : The combined modality therapy of MTX-based chemotherapy plus radiotherapy for PCNSL may enhance tumor response and improve patient survival. The patients who received CRT should be carefully followed up because of the higher risk of treatment-induced late neurotoxicity.