• Title/Summary/Keyword: Gore-Tex

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Trial of a Synthetic Absorbable Staple Line Reinforcement for Preventing Recurrence after Performing Video-assisted Thoracoscopic Bullectomy for the Treatment of Primary Pneumothorax (일차성 기흉 치료에서 흉강경 기포 절제술 시 재발 방지를 위한 Staple Line 보강재 사용)

  • Park, Jae-Hong;Yoo, Byung-Ha;Kim, Han-Yong;Hwang, Sang-Won;Kim, Myoung-Young
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.337-343
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    • 2009
  • Background: Postoperative recurrence is a major problem after performing video-assisted thoracic surgery for the treatment of primary pneumothorax. This study was designed to evaluate the efficacy and safety of a bioabsorbable staple line reinforcement (GORE $SEAMGUARD^{(R)}$) for preventing recurrence after bullectomy. Material and Method: From January 2000 to December 2004, 300 patients underwent video assisted thoracoscopic surgery for the treatment of primary penumothorax. 143 patients were treated with bioabsorbable staple line reinforcement (Group A) and 142 patients were treated with stapling of the bullae (Group B). Mechanical pleural abrasion was performed in all the patients. The operating time, the duration of the indwelling chest tube, the length of the hospital stay and the number of recurrences after operation were compared between the groups. Result: No operative deaths occurred. The conversion rate to an open procedure was 5% (15/300). Comparison with these groups (Group A versus Group B) showed the following results: the operating time ($49.6{\pm}25.6$ vs $51.8{\pm}30.4$ minutes, respectively, p=0.514), the duration of an indwelling chest tube ($5.8{\pm}2.5$ vs $7.2{\pm}3.3$ days, respectively, p<0.005), the hospital stay ($10.9{\pm}4.3$ vs $12.5{\pm}4.3$ days, respectively, p<0.005) and the number of recurrences (14 (9.8%) vs 10 (7.0%), respectively, the over all rate: 8.4% p=0.523), and the mean follow up period. ($48.1{\pm}36.6$ vs $36.5{\pm}24.4$ months, respectively). Conclusion: There were advantages to use synthetic absorbable staple line reinforcement over the usual method for the treatment of primary pneumothorax in regard to the duration of an indwelling chest tube and the hospital stay, but here was no significant difference between the groups for postoperative recurrence.

Oriental and Western Medical Study on the cause and treatment of Obesity (비만의 원인과 치료에 대한 동서의학적 고찰)

  • Lee, Sang-Bong;Keum, Dong-Ho;Lee, Myeong-Jong
    • The Journal of Dong Guk Oriental Medicine
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    • v.5
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    • pp.33-52
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    • 1996
  • The purpose of this study was to investigate efficient treatment in obesity. In order to help clinical application in obesity treatment, this study was performed to investigate the cause and treatment in obesity. The main finding of this study were as follows. 1. In the cause of oriental medicine in obesity, that were moisture(濕), phlegm(痰), gore(瘀), the productive heat(積熱), overeating, supemutrition, underaction, heredity and habitude, psychologic factor(stress) etc. 2. In the western medicine, the cause of obesity were genetic cause, endocrine disorder, hypothalamic extraodinary and secondary effect of drug. But simple obesity is the greater part. Also there were psychologicai and environmental causes. 3. Ear acupuncture of wide application were Naebunbi, Sinmun, Taejang, $ij{\check{o}}m$, $Pyej{\check{o}}m$, $Bij{\check{o}}m$ etc. 4. Body acupuncture of application were $Naej{\check{o}}ng$, $Sangg{\check{o}}h{\check{o}}$, Pungnyung, Kokchi, $Sam{\check{o}}mgyo$, $Umn{\check{o}}ngch{\check{o}}n$ etc. 5. In oriental medical treatment of obesity, Bangpungtongs ngsan(防風通聖散), Daesihotang(大柴胡湯), Seungkitang(承氣湯), Bangkihwangkitang(防己黃?湯), Richulsaryeungtang(二朮四笭湯), Taeksatang(澤瀉湯), Opieum(五皮飮), Gongyundan(控涎丹) etc were wide applicated. 6. The western medical treatment in obesity encourage the dietary cure, exercise cure and behavior adjustment than medical therapy or operation. In treatment of obesity, the dietary cure and herb-drug therapy, ear acupuncture and body acupuncture are effective. But weight maintenance after treating is more important. After all the continuous dietary cure, behavior adjusting cure and exercise cure are necessary.

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Outcomes of Open Repair of Mycotic Aortic Aneurysms with In Situ Replacement

  • Kim, Hyo-Hyun;Kim, Do Jung;Joo, Hyun-Chel
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.430-435
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    • 2017
  • Background: Mycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy. Methods: From 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue. We recorded the clinical findings, anatomic location of the aneurysm, bacteriology results, antibiotic therapy, morbidity, and mortality for these cases. Results: The median age was $62{\pm}7.2years$ (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was $44.5{\pm}4.9mm$. The mean time from onset of illness to surgery was $14.5{\pm}2.4days$. Aortic continuity was restored in situ with a Dacron prosthesis (79%), homograft (16%), or Gore-Tex graft (5%). Soft-tissue coverage of the prosthesis was performed in 8 patients. The mean follow-up time was $43.2{\pm}11.7months$. The early mortality rate was 10.5%, and the 5-year survival rate was $74.9%{\pm}11.5%$. Conclusion: This study showed acceptable early and midterm outcomes of open repair of mycotic aneurysms. We emphasize that aggressive intraoperative debridement with soft-tissue coverage results in a high rate of success in these high-risk patients.

Twenty-one Year Experience with Right Ventricle to Pulmonary Artery Conduit Interposition (우심실-폐동맥 간 도관 이식술의 21년간의 경험)

  • Kwak, Jae-Gun;Yoo, Jae-Suk;Kim, Yong-Jin;Kim, Woong-Han;Lee, Jeong-Ryul
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.417-422
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    • 2008
  • Background: The aim of this study is to evaluate the long term results of creating various right ventricle to pulmonary artery conduits for treating complex congenital heart disease. Material and Method: Between June 1986 and July 2006, we retrospectively reviewed 245 patients who underwent reconstruction of the right ventricular outflow tract with various kinds of conduits. 410 operations were done in 245 patients, the mean age at operation was $3.2{\pm}4.9$ years (range: 7 days$\sim$45 years) and the mean body weight was $12.5{\pm}8.7\;kg$ (range: $2.4\sim76.3\;kg$). Result: We used the following conduits: Polystan conduit, Shelhigh conduit, Carpenter-Edward conduit, Dacron graft with an artificial valve, valveless Gore Tex vascular graft, homograft and hand-made bovine or autologous pericardial conduit. The mean follow up duration was $6.3{\pm}5.2$ years. Redo operation for RV-PA conduit dysfunction was performed in 131 patients, a second redo was done in 31 and a third redo was done in 3. The reoperation free rates were 67.3%, 48.5% and 39.4% for 5 years, 10 years and 15 years, respectively. The homograft showed the best durability, followed by the Dacron graft with artificial valve and the Carpentier-Edward conduit. The larger sized conduit showed better durability. Conclusion: The homograft showed lowest reoperation rate and a smaller size of conduit showed the highest reoperation rate. The reoperation rate for the RV-PA conduit was about 35% at 5 years, so it is mandatory to develop the more durable conduit for RV outflow.

Fontan Operation in a Case of Single Functional Pulmonary Artery (심한 좌폐동맥 형성부전을 동반한 단심실 환아의 폰탄 수술 증례)

  • Kim Joon Bum;Park Jeong-Jun;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.308-311
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    • 2005
  • The status of pulmonary circulation is regarded with utmost importance for the successful Fontan operation. The absence of unilateral pulmonary artery leads to decreased pulmonary vascular bed and elevated pulmonary vascular resistance which are the risk factors for Fontan operation. A 9-year-8-month-old female patient diagnosed as tricuspid atresia, pulmonary atresia with absent left pulmonary artery flow, received extracardiac conduit Fontan operation using 18 mm Gore-Tex graft. She was discharged on twenty sixth postoperative day with arterial $O_2$ saturation of $70\%$ on room air. On last follow up at 14 months after the operation, she was clinically well with $O_2$ saturation of $91\%$.

Surgical Outcomes of Congenital Atrial Septal Defect Using da VinciTM Surgical Robot System

  • Kim, Ji Eon;Jung, Sung-Ho;Kim, Gwan Sic;Kim, Joon Bum;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.93-97
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    • 2013
  • Background: Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. Materials and Methods: This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was $16.9{\pm}10.4$ months. Results: No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were $74.1{\pm}32.2$ and $157.6{\pm}49.7$ minutes, respectively. The postoperative hospital stay was $5.5{\pm}3.3$ days. Conclusion: The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.

Clinical and histopathological study on the effect of Nonresorbable membrane with Demineralized freeze dried bone graft for Guided Bone Regeneration in Implant Dehiscence Defects (매식체 주위 열개형 골결손부에서 차단막과 골 이식술의 사용이 골 형성에 미치는 영향에 대한 임상 및 조직병리학적 연구)

  • Kwon, Chil-Sung;Hong, Ki-Seok;Lim, Sung-Bin;Chung, Chin-Hyung;Lee, Chong-Heon
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.687-702
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    • 2005
  • The purpose of this study is to examine the effect of non-resorbable membrane such as e-PTFE which was used with DFDB in bone regeneration on dehiscence defect in peri-implant area. Amomg the patients, who have recieved an implant surgery at the department of Periodontics in Dan Kook University Dental Hospital, 12 patients showed implant exposure due to the dehiscence defect and 15 implants of these 22 patients were the target of the treatment. Periodontists randomly applied $Gore-Tex^{(R)}$ to the patients and treated them with antibiotics for five days both preoperatively and postoperatively. Reentry period was 26 weeks on average in maxilla and 14 weeks on average in mandible. The results were as follows : 1. Dehiscence bone defect frequently appeared in premolar in mandible and anterior teeth in maxilla respectively. 2. Among 15 cases, 1 membrane exposure was observed and in this case, regenerated area was decreased. 3. In non-resorbable membrane, bone surface area $9.25{\pm}4.84$ preoperatively and significantly increased to $11.48{\pm}7.52$ postoperatively(0.05). 4. The increase of bone surface area in non-resorbable membrane was $2.23{\pm}3.38$. 5. As a result of histopathological finding, DFDB surrounded by new bone formation and lamellate bone, resorption of DFDB and bone mineralization was found. Also, fibrosis of connective tissue beneath the membrane was found. This study shows that the surgical method using DFDB and non-resorbable membrane on dehiscence defect in peri-implant area is effective in bone regeneration.

Characteristics of Woman's Jogori through the costumes excavated from ChangRyung Jo's family(1721~1742) grave and preserved in Yeoju Museum Gyeounggi Province, Korea (여주박물관 소장 창녕조씨(1721~1742)묘 복식을 통해 본 여자저고리의 조형적 특성)

  • Song, Mi-Kyung
    • Journal of the Korean Society of Costume
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    • v.62 no.6
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    • pp.218-230
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    • 2012
  • The 25 pieces of women's jogori worn by ChangRyung Jo's family(1721~1742) that are preserved in Yeoju Museum, Gyeounggi Province, Korea were examined in this study. The aim of this study is to analyze women's jogori that were excavated from the grave of Changryung Jo's family, and to characterize women's costumes around the middle $18^{th}$ Century. The size of the jogori was divided into two groups. The garment length of the first group ranged from 31cm to 34cm and the bigger size ranged from 36.5cm to 40cm. The number of jogori in the group with the smaller size was twenty-five pieces and five pieces for the group with the bigger size. Changryung Jo's jogori was composed of two pieces of padded jogori, four pieces of quilted jogori and nineteen pieces of double layer jogori. Even though the direction of the margin located on back seemed point toward the right hand side, the gorum, the string for the tie, and the Sup, the outer gore of the jogori located on the other side of the margin had no pattern of direction. The line of jogori from the armhole gets narrower toward the edge of sleeves which could be recognized as a typical pattern of the middle $18^{th}$ Century jugori. The bigger group of jogori seemed to be worn by people other than ChangRyung Jo's relatives and used to be a gifts to aid in funerals. Major characteristics of jogori is could be categorized into the Dangko Mokpan collar jogori and Samhaejang jogori. The results of this study helps set the relative dating for the women's jogori of middle $18^{th}$ Century where not much excavations have been made.

Long-Term Results of Arteriovenous Fistula for Hemodialysis in Chronic Renal Failure (혈액투석을 위한 동정맥루의 장기관찰 성적)

  • 김인광
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.764-769
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    • 1994
  • From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

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Surgical correction in annuloaortic ectasia associated with ascending aortic aneurysm: one case report (거대상행핵대동맥루를 동반한 대동맥륜확장증 수술 치험: Cabrol씨 수술 1례 보)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.753-761
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    • 1984
  • Most patients having annuloaortic ectasia are associated with marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. A 19 year old male patient complaining of tightness on left posterior chest wall underwent cardiac angiography in which demonstrated annuloaortic ectasia with ascending aortic aneurysm and aortic insufficiency. The patient had corrective operation replacing the ascending aorta and aortic valve with a composite graft[Dacron prosthesis containing a Bjork-Shiley aortic valve] within the aneurysmal sac. The coronary orifices were anastomosed to the tubular Dacron prosthesis [30 mm in diameter] by means of a second smaller Gore-Tex tube [8mm in diameter]. The aneurysmal sac was trimmed by removing the redundant wall and then wrapped outer wall of the Dacron prosthesis. Postoperatively, mediastinal bleeding was temporarily observed in the operative day and satisfactory blood pressure was maintained with small dose of dopamine. One week later, large amount of serous effusion was drained out of the retrosternal space making partial disruption of the skin which was healed well by daily local dressing. The patient discharged in good condition on postoperative 29th day with no residual complications and is doing very well on the 4 months follow-up.

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