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Evaluating the Capping Effects of Dredged Materials on the Contaminated Sediment for Remediation and Restoration of the West Sea-Byeong Dumping Site (서해병 폐기물 배출해역 오염퇴적물의 정화·복원을 위한 준설토 피복 효과 평가)

  • Kang, Dong Won;Lee, Kwang Sup;Kim, Young Ryun;Choi, Ki-young;Kim, Chang-joon
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.2
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    • pp.212-223
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    • 2022
  • For the remediation and restoration of contaminated sediment at the West Sea-Byeong dumping site, dredged materials was dumped in 2013, 2014, 2016, and 2017. The physicochemical properties and benthic fauna in surface sediments of the capping area (5 stations) and natural recovery area (2 stations) were analyzed annually from 2014 to 2020 to evaluate the capping effect of the dredged materials. The natural recovery area had a finer sediment with a mean particle size of 5.91-7.64 Φ, while the sediment in the capping area consisted of coarse-grained particles with a mean particle size of 1.47-3.01 Φ owing to the capping effect of dredged materials. Considering that the contents of organic matters (COD, TOC, and TN) and heavy metals in the capping area are approximately 50 % lower (p<0.05) than that in the natural recovery area, it is judged that there is a capping effect of dredged materials. As a result of analyzing macrobenthic assemblages, the number of species and ecological indices of the capping area were significantly lower than that of the natural recovery area (p<0.05). The number of species and ecological indices at the capping area were increased for the first four years after the capping in 2013 and 2014 and then tended to decrease thereafter. It is presumed that opportunistic species, which have rapid growth and short lifetime, appeared dominantly during the initial phase of capping, and the additory capping in 2016 and 2017 caused re-disturbance in the habitat environment. In the natural recovery and capping areas, Azti's Marine Biotic Index (AMBI) was evaluated as a fine healthy status because it maintained the level of 2nd grades (Good), whereas Benthic Pollution Index (BPI) remained at the 1st and 2nd grade. Therefore, capping of dredged materials for remediation of contaminated sediment in the dumping site has the effect of reducing the pollution level. However, in terms of the benthic ecosystem, it is recommended that the recovery trend should be monitored long-term. Additionally, it is necessary to introduce an adaptive management strategy when expanding the project to remediate the contaminated sediment at the dumping area in the future.

A Study on Estimating Shear Strength of Continuum Rock Slope (연속체 암반비탈면의 강도정수 산정 연구)

  • Kim, Hyung-Min;Lee, Su-gon;Lee, Byok-Kyu;Woo, Jae-Gyung;Hur, Ik;Lee, Jun-Ki
    • Journal of the Korean Geotechnical Society
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    • v.35 no.5
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    • pp.5-19
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    • 2019
  • Considering the natural phenomenon in which steep slopes ($65^{\circ}{\sim}85^{\circ}$) consisting of rock mass remain stable for decades, slopes steeper than 1:0.5 (the standard of slope angle for blast rock) may be applied in geotechnical conditions which are similar to those above at the design and initial construction stages. In the process of analysing the stability of a good to fair continuum rock slope that can be designed as a steep slope, a general method of estimating rock mass strength properties from design practice perspective was required. Practical and genealized engineering methods of determining the properties of a rock mass are important for a good continuum rock slope that can be designed as a steep slope. The Genealized Hoek-Brown (H-B) failure criterion and GSI (Geological Strength Index), which were revised and supplemented by Hoek et al. (2002), were assessed as rock mass characterization systems fully taking into account the effects of discontinuities, and were widely utilized as a method for calculating equivalent Mohr-Coulomb shear strength (balancing the areas) according to stress changes. The concept of calculating equivalent M-C shear strength according to the change of confining stress range was proposed, and on a slope, the equivalent shear strength changes sensitively with changes in the maximum confining stress (${{\sigma}^{\prime}}_{3max}$ or normal stress), making it difficult to use it in practical design. In this study, the method of estimating the strength properties (an iso-angle division method) that can be applied universally within the maximum confining stress range for a good to fair continuum rock mass slope is proposed by applying the H-B failure criterion. In order to assess the validity and applicability of the proposed method of estimating the shear strength (A), the rock slope, which is a study object, was selected as the type of rock (igneous, metamorphic, sedimentary) on the steep slope near the existing working design site. It is compared and analyzed with the equivalent M-C shear strength (balancing the areas) proposed by Hoek. The equivalent M-C shear strength of the balancing the areas method and iso-angle division method was estimated using the RocLab program (geotechnical properties calculation software based on the H-B failure criterion (2002)) by using the basic data of the laboratory rock triaxial compression test at the existing working design site and the face mapping of discontinuities on the rock slope of study area. The calculated equivalent M-C shear strength of the balancing the areas method was interlinked to show very large or small cohesion and internal friction angles (generally, greater than $45^{\circ}$). The equivalent M-C shear strength of the iso-angle division is in-between the equivalent M-C shear properties of the balancing the areas, and the internal friction angles show a range of $30^{\circ}$ to $42^{\circ}$. We compared and analyzed the shear strength (A) of the iso-angle division method at the study area with the shear strength (B) of the existing working design site with similar or the same grade RMR each other. The application of the proposed iso-angle division method was indirectly evaluated through the results of the stability analysis (limit equilibrium analysis and finite element analysis) applied with these the strength properties. The difference between A and B of the shear strength is about 10%. LEM results (in wet condition) showed that Fs (A) = 14.08~58.22 (average 32.9) and Fs (B) = 18.39~60.04 (average 32.2), which were similar in accordance with the same rock types. As a result of FEM, displacement (A) = 0.13~0.65 mm (average 0.27 mm) and displacement (B) = 0.14~1.07 mm (average 0.37 mm). Using the GSI and Hoek-Brown failure criterion, the significant result could be identified in the application evaluation. Therefore, the strength properties of rock mass estimated by the iso-angle division method could be applied with practical shear strength.

Effects of Sesame Meal on Growth Performances and Fatty acid Composition, Free Amino Acid Contents, and Panel Tests of Loin of Hanwoo Steers (참깻묵이 거세 한우의 비육성적과 등심의 지방산 조성, 유리 아미노산 함량 및 관능평가에 미치는 영향)

  • Kim, Sung Il;Cho, Bong Rae;Choi, Chang Bon
    • Journal of Animal Science and Technology
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    • v.55 no.5
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    • pp.451-460
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    • 2013
  • The feed value of sesame meal, a main agricultural by-product from the northern area of Gyeongsangbuk-do province, was assessed in Hanwoo steers. A total of twelve Hanwoo steers (average BW = 412.08 kg) were allocated into a Control (fed no sesame meal) or Treatment (fed sesame meal from 14.6 months of age) group, considering BW and ages, and the animals were fed for a total of 480 days. The final BW, total gain and ADG for the Control and Treatment groups were 741.17 kg and 762.67 kg, 331.84 kg and 347.84 kg, and 0.69 kg and 0.72 kg, respectively, showing better performances in sesame meal-fed animals. Feed requirements during the whole experimental period improved by feeding sesame meal (15.31 and 14.87 for Control and Treatment group, respectively). Hanwoo steers fed sesame meal also showed a 22.83 kg heavier cold carcass weight (424.17 kg and 447.00 kg in the Control and Treatment group, respectively), and 2.41% improved dressing percentages (58.60% and 57.22% for the Control and Treatment group, respectively). The area of the M. longissimus dorsi was $91.83cm^2$ and $88.33cm^2$ in the Control and Treatment group, respectively. The final yield of A and B grade meat were 50 : 50% and 33.3 : 66.7% from the Control and Treatment group, respectively. The average marbling score was 4.83 and 5.50, and the numeric values for quality grade was 2.17 and 2.67 for the Control and Treatment group, respectively, showing better beef quality in sesame meal-fed Hanwoo steers. In fact, there were two animals with beef quality $1^{{+}{+}}$ in the sesame meal-fed group. The melting point of lipid extracted from the M. longissimus dorsi of Hanwoo steers was significantly (p<0.05) lower in the Treatment group ($28.28^{\circ}C$) compared to the Control group ($30.65^{\circ}C$). The composition of saturated fatty acids, $C_{14:0}$ (myristic acid) and $C_{16:0}$ (palmitic acid), were significantly lower in sesame meal-fed animals, 4.70% and 2.20% for myristic acid, and 30.55% and 27.12% for palmitic acid, in the Control and Treatment group, respectively. In contrast, there were no significant differences in C18:0 (stearic acid) composition between the groups. The composition of a representative unsaturated fatty acid, $C_{18:1}$ (oleic acid), was significantly higher in Treatment animals (49.89%) than Control animals (44.29%) (p<0.05). The ratio of total monounsaturated fatty acids / saturated fatty acids; M/S) was 1.10 and 1.36 for the Control and Treatment groups, respectively, showing remarkably higher ratios in sesame meal-fed group. The content of glutamic acid, related to beef flavor, was significantly higher in the Treatment group (3.35 mg/100 g) compared to the Control group (1.88 mg/100g) (p<0.05). The tenderness score, evaluated by an eight-point scale in the panel test, and overall palatability (based on juiciness, flavor, oiliness, and umami) were significantly higher in the Treatment group (5.67 and 5.23, respectively) than the Control group (3.83 and 4.60, respectively) (p<0.05). In conclusion, the current results imply that sesame meal could serve as a good supplement for Hanwoo steers for producing high quality beef.

Prevalence of Enteyobius vermiculuris infection and preventive effects of masts treatment among children in rural and urban areas, and children in orphanages (농촌, 도시 및 집단생활 아동의 요충 감염과 집단 구충에 의한 예방 효과)

  • Kim, Jong-Su;Lee, Hae-Yong;An, Yeong-Gyeom
    • Parasites, Hosts and Diseases
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    • v.29 no.3
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    • pp.235-244
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    • 1991
  • An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg Positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1, 262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11 9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2~32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4~5 days interval were higher (70.8%) than those from single anal swabs (50.0~59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%) . 5. A total of 2, 609 (male : female=1 : 12.4) worms were collected from 17 egg-positive cases treated with anthelinintics. The mean number of worms per child was 153 (range: 4-824) . 6. The egg-positive cases in several studied groups (180 children) were treated with anthelmintics 6 times at 3-week intervals. In this case, the overall positive rate was decreased from 54.8% to 2.2% at 15 weeks after the treatments, but no complete negative conversion was experienced. However, in a group of children (154 children) including egg Positive and negative cases who were both treated with anthelmintics at 3-week interval, a complete egg-negative conversion was observed in the 9th week after treatments. 7. The egg-detection rate in the brothers or sisters of egg Positive children was 70.0% (28 out of 40 examined), and the egg-positive rate according to the family unit was 69.7%. In summarizing the above results, it is concluded that Enterobius vermicularis infection is still highly prevalent among children in Korea, and that repeated mass treatments of more than 3 times will be effective for control of this infection.

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The Effects of Autologous Blood Pleurodesis in the Pneumothorax with Persistent Air Leak (지속성 기흉에서 자가혈액을 이용한 흉막유착술의 효과)

  • Yoon, Su-Mi;Shin, Sung-Joon;Kim, Young-Chan;Shon, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Chung, Won-Sang;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.724-732
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    • 2000
  • Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

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Concurrent Chemoradiation with Weekly Paclitaxel in Locally Advanced Non-small Cell Lung Cancer (국소진행성 비소세포폐암에서 Paclitaxel 매주투여 및 방사선치료 동시요법)

  • Bae, Kang Woo;Song, Tak Ho;Yang, Joo Yeon;Kim, Yun Seup;Park, Jae Seok;Jee, Young Koo;Lee, Kye Young
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.351-357
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    • 2004
  • Background : Paclitaxel is highly beneficial anticancer drug for the treatment of non-small cell lung cancer and has shown remarkable radiosensitizing effect in vitro. We evaluated whether concurrent chemoradiation therapy with weekly paclitaxel (60 $mg/m^2$) could be tolerated and effective in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods : Twenty-two stage III (IIIA:6, IIIB:16) NSCLC patients were treated with weekly administration of paclitaxel (60 $mg/m^2$) on days 1, 8, 15, 22, 29, and 36 in addition to concurrent radiation therapy of 54 Gy. After the initial phase of concurrent chemoradiation, patients received additional two cycles of consolidation chemotherapy with paclitaxel (175 $mg/m^2$)/cisplatin (75 $mg/m^2$) or paclitaxel (175 $mg/m^2$)/carboplatin (6AUC) every 3 weeks. Results : Overall response rate was 81.8% (18/22) with 9.1% (2/22) of complete response and 72.7% (16/22) of partial response rate. Two patients (9.1%) died of chemoradiation-induced pneumonitis after completion of therapy. In total, grade 3 toxicities included pneumonitis (22.7%), esophagitis (22.7%), neuropathy (13.6%), and neutropenia (13.6%). The median survival time was 15 months and 2-year overall survival were 31.8%. Conclusion : Concurrent chemoradiation therapy with weekly paclitaxel in locally advanced NSCLC showed good local response, but survival rate was not completely satisfactory due to potentially fatal chemoradiation-induced pneumonitis.

The Study of Effect and Safety related to Dong-gi Acupuncture(DGA) and Complex therapy on Lumbago due to blood stasis and sprain (좌섬(挫閃)·어혈(瘀血) 요통(腰痛)에 동기침법(動氣鍼法) 및 복합치료(複合治療)의 유효성(有效性) 및 안정성(安定性) 연구(硏究))

  • Kim, Kee-Hyun;Lim, Hyung-Ho;Hwang, Hyeon-Seo;Song, Ho-Sueb;Song, Young-Sang;Kwon, Soon-Jung;Kim, Kyung-Nam;Ahn, Koang-Hyun;Lee, Seong-No;Kang, Mi-Suk;Gyun, Im-Jung
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.107-114
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    • 2002
  • Objective : This study was designed to find the most effective and safest way to overcome Lumbago due to blood stasis and sprain involved in a few Meridian Tendino-musculatures by evaluating the effect of two kinds of Dong-gi(Dong-qi) Acupuncture(DGA) and by reporting their side effects. Material : 97 patients of out and admission patients were selected, who were diagnosed with lumbar sprain caused by repetitive bending, heavy weight lifting, unsuitable posture, concussion and falling down and whose Lumbago due to blood stasis and sprain in the concept of oriental medicine. Methods : 97 patients were divided into three groups. One is exclusive DGA group to which DGA and the method retaining needles on the acupoints for about 20 minutes were applied, the other is DGA combined active exercise group in which patients stretched their Meridian Tendino-muscuIatures with their hips moving up and downward repeatedly during DGA, the third is DGA combined passive exercise group in which patients were made to flex or extend their bodies on the auto flexion-distraction table in a prone position, from 10 to 20 degree, during DGA. In each group, bed rest, physical therapy and herbal medicine were used according to symptoms, in addition to DGA. In DGA method, "Su(Shu)" points of the meridian related to the involved Meridian Tendino-musculature were mainly chosen, that is, Sokkol(Shugu, B65), Hugye(Houxi, SI3), ChungJo(Zhongzhu, TE3) were used, for most LBP belonged to Bladder and Gallbladder Meridian Tendino-musculature disorders. Pyong-Bo-Pyong-Sa(Ping-Bu-Ping-Xie) such as Dong-Gi and Yeom-Jeon(Nian-Zhuan) was applied as Bo-Sa method. For evaluation of effectiveness, new score system was devised by severity of pain and range of movement. the score was given twice at patients' first and last visit and the difference between first and last score was regarded as a evaluation scale, the effectiveness was classified into four grade by evaluation scale.(scale : 12-15; excellent, 8-11; good, 4-7; fair, 0-3; bad) Results : 1. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed 97, 87 and 89% in effectiveness. 2. Exclusive DGA, DGA combined active exercise and DGA combined passive exercise group showed no aggravation of pain, range of movement. 3. In blood test of 34 patients, only one patient showed abnormal rise of sGOT, sGPT and $\gamma$-GTP at his first visit and the others didn't show any detrimental change. DGA had no bad influence upon BUN and creatinine of patients. Conclusion : For complex theraphy combining DGA, exercise, physical therapy and Herbal medicine proved to be highly effective on treating lumbago due to blood stasis and sprain, this is expected to be available for clinical use.

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Radiofrequency thermal Shrinkage for Elongated Anterior Cruciate Ligament after Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술 이후 이완된 전방십자인대에 시행한 고주파 에너지 열 수축)

  • Kim, Yeung-Jin;Chun, Churl-Hong;Kim, Tae-Kyun;Yang, Hwan-Deok;Kim, Hyoung-Joon;Kim, Young-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.27-32
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    • 2008
  • Purpose: To evaluate the clinical results of the patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity after ACL reconstruction. Material and Methods: From October 1999 to March 2006, we performed 133 cases of ACL reconstruction. Among them we experienced 16 patients who had the laxity of reconstructed ACL in second look arthroscopy. Mean follow-up was 20.4 months. Mean age was 33.5 years. 12 cases were male and 4 cases were female. The elongated ACL were treated by bipolar radiofrequency energy with an output of grade II. Subjective and objective parameters were utilized in analyses, such as: the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test, IKDC score. Wilcoxon signed-rank test was used to perform the data analysis. P<0.05 was considered to be statistically significant. Results: Postoperative mean Lysholm knee score (preop: $82.2{\pm}5.2(77{\sim}85))$ (P=0.04), postop: $85.2{\pm}4.8$(82-90)) and anterior displacement by the Telos stress test (preop: $5.4{\pm}4.6(3{\sim}10)mm$, postop: $2.1{\pm}1.9(0{\sim}4)mm)$ (P=0.02), Lachman's test, and IKDC scores (P=0.04) demonstrated significant differences statistically compared to the preoperative. There were no statistical differences in mean range of motion, Tegner activity scale. Conclusions: Arthroscopic shrinkage for the ACL laxity after ACL reconstruction with radiofrequency device showed good clinical results and was applicable operative technique.

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Survival Difference of Combination Chemotherapy versus Supportive Care in the Patients with Stage Ⅳ Non-Small Cell Lung Cancer (4기 비소세포폐암 환자에서 복합화학요법군과 보존적치료군의 생존율 비교연구)

  • Kim, Byeong Hun;Lee, Kyung Hee;Doh, Gab Suk;Lee, Eun Jung;Kim, Seong Mok;Chung, Jin Hong;Lee, Kwan Ho;Hyun, Myung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.536-546
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    • 1996
  • Background : The survival benefit of combination chemotherapy comparing supportive care to patients with advanced non-small cell lung cancel, especially stage IV non-small cell lung cancer patients with metastatic disease, is controversial. The main goal of this study was to evaluate the difference in survival between patients treated with chemotherapy and those who were not and to identify prognostic factors in the patients with stage IV non-small cell lung cancer. Methods : From January 1989 to December 1994, total 67 patients including 20 patients treated with combination chemotherapy and 47 patients treated with only supportive care in stage IV non-small cell lung cancer patients with metastatic disease were enrolled in this study. Combination chemotherapy consisted of etoposide $120mg/m^2$ iv for 3 days and cis-platin iv day 1 every 4 weeks. The treatment groups were retrospectively analyzed by age, sex, histologic cell type, weight loss, serum LDH level, ECOG performance status and major organ metastasis. Results : The significant prognostic factors influencing survival on this study were ECOG performance status and histologic subtype. Overall response rate by combination chemotherapy was 30%(complete response 0%, partial response 30%). Median survival of overall patients was 13.6 weeks and median survival of Chemotherapy group, 20 weeks, was significantly longer than that of supportive care group, 11.7 week(p<0.01). Median survival of responded in patients receiving chemotherapy, 45.5 weeks, was significantly longer than that of non-responder, 17.3 weeks(p<0.05). 1 year-survival rate of chemotherapy group and supportive care group was 15N and 8%, respectively. Nausea or vomiting, alopecia and anemia were seen in nearly most cases after this combination chemotherapy. Toxicities above grade 3 included neutropenia, anemia, thrombocytopenia, infection, fever, nausea, vomiting and alopecia. But this combination chemotherapy was relatively well tolerated except one treatment-related death from sepsis associated with severe granulocytopenia. Conclusion : These results suggest that systemic chemotherapy might be helpful to the stage IV non-small cell lung cancer patients with good performance status and large scale randomized prospective trials should be performed.

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Reduction Aortoplasty with Suture Plication Technique for Dilatation of the Ascending Aorta associated with Aortic Valve Disease (대동맥판막 질환과 동반된 상행대동맥 확장에 대한 봉합봉축법에 의한 대동맥 축소성형술)

  • Na Chan-Young;Oh Sam-Sae;Lee Chang-Ha;Whang Seong Wook;Lee Cheol;Lim Hong Gook;Kim Jae Hyun;Seo Hong Ju;Kim Gun Gyk;Baek Man-Jong
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.221-228
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    • 2005
  • Reduction aortoplasty has been advocated for dilatation of the ascending aorta associated with aortic valve disease in older, high-risk patients. We report our results with modification of reduction aortoplasty and aortic valve replacement. Material and Method: Between July 2001 and December 2002, 14 consecutive patients who underwent modification of reduction aortoplasty, suture plication technique without excision of the dilated aortic wall, were reviewed. The mean age was 63.7$\pm$6.7 (50 to 75) years. Ten patients had congenital bicuspid aortic valve, Twelve patients had severe aortic valve stenosis and 6 had regurgitation of grade III$\~$IV. The diameter of the ascending aorta was measured before and immediately after surgery and 6 and 12 months postoperatively using echocardiography or computed tomography. Follow-up was complete in an average of 14.7$\~$5.4 (7 to 24) months. Result: There were no early postoperative deaths and no bleeding complications. Reduction aortoplasty with suture plication technique decreased the diameter of ascending aorta from 49.4$\pm$3.5 mm preoperatively to 33.2$\pm$3.4 mm postoperatively (p <0.001). During follow-up, there were no late deaths and no aneurysm recurrence on the ascending aorta. Conclusion: Suture plication technique of reduction aortoplasty without excision of the dilated aortic wall offers good early and short-term results in older, high-risk patients with dilatation of the ascending aorta associated with aortic valve disease. Surgical long-term results of our technique should be evaluated in further studies.