Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.
Background: Current vascular prostheses are still inadequate for reconstruction of small-diameter vessels. Autologous pericardium can be a good alternative for this purpose as it already possesses good blood compatibility and shows a mechanical behavior similar to that of natural arteries. However, the clinical use of autologous pericardial tissue as a small-diameter vascular graft has limitations due to mixed outcomes from uncertain biological behavior and difficulty to gain reliable patency results in animal experiments. To study this issue, we implanted fresh and glutaraldehyde-treated autologous pericardium as small-diameter arterial grafts in dogs, and compared their time-related changes histologically. Material and Method: As a form of 5mm-diameter arterial graft, one pair of autologous pericardial tissue was used for comparison between the glutaraldehyde-treated and the glutaraldehyde-untreated grafts in the bilateral carotid arteries in the same dog. The patency of the grafts were evaluated at regular intervals with Doppler ultrasonography. After the predetermined periods of 3 days, 2 weeks, 1 month, 3 months and 6 months, the grafts in each animal were explanted. The retrieved grafts were processed for light and electron microscopic analyses following gross observation. Result: Of 7 animals, 2 were excluded from the study because one died postoperatively due to bleeding and the other was documented as one side of the grafts being obstructed. All 10 grafts in the remaining 5 dogs were patent. Grossly, a variable degree of thromboses were observed in the luminal surfaces of the grafts at 3 days and 2 weeks, despite good patency. Pseudointimal smooth blood-contacting surfaces were developed in the grafts at f month and later. By light microscopy, mesothelial cell layers of the pericardial tissue were absent in all explanted grafts. Newly formed endothelial cell layers on the blood-contacting surface were observed in both the glutaraldehyde-treated and fresh grafts at 3 months and later. The collagen fibers became degraded by fragmentation in the fresh graft at 1 month and In the glutaraldehyde-treated graft at 3 months. At 6 months, the collagen layers were no longer visible in either the glutaraldehyde-treated or fresh grafts. By electron microscopy, a greater amount of coarse fibrin fibers were observed in the fresh grafts than in the glutaraldehyde-treated grafts and, more compact and well-arrayed layers were observed in the glutaraldehyde-treated grafts than in the fresh grafts. Conclusion: The glutaraldehyde-treated small-diameter pericardial arterial grafts showed a better endothelialization of the blood-contacting surface and a slower fragmentation of the collagen layers than the fresh grafts, although it has yet to be proven whether these differences are so significant as to affect the patency results between the groups.
The purpose of this study was to investigate the initial tissue change, to repair on the teeth & surrounding tissue under the intrusive orthodontic forces by use of elastic chain, through the microscopic findings. For this study, three young adult mongrel dogs were used, and were divied into three group : the control group was deliveried only casting crown and the experimental group 1 was equipped with energy chain during 1 week and experimental 2 group was deliveried using energy chain during 1 week and 3 weeks observation. All experimental groups and control groups were sacrificed to make the samples for microscopic findings on premolar teeth. All samples were examed and compared the histologic changes through the microscopic with H-E stain. The obtained results were as follows. 1. In hematoxylin-eosin stain of the control group, the periodontal ligament was constant width from apical third to cervical third of the root, and the periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle and apical third of the root. 2. In Masson Trichrome stain of the control group, osteoblast and osteoclast appeared in cervical third of root, and bone resorption and new bone formation was observed in middle and apical third of the root. 3. In experimental 1, osteoclasts were increased highly, and hyperemia of blood vessels and new bone formation and bone resorption by reversal line in apical third of the root were seen. PDL width was increased apprarently from crest to apex of the root and more in apical third. 4. In experimental 2, osteoclasts and hyperemia of blood vessels were more increased than control material in apical third of the root. PDL width was increased more than control group in root apex, and was seen less than experimental 1. PDL arrangement was similar to experimental 1 and was mixed only in root apex. Therefore, in premolar intrusion of the young adult dog, there were increased osteoclast, hyperemia and dilation of blood vessel, resorption of alveolar bone and cementum and different arrangement of PDL in initial tissue change. There was not observed complete repair after remove intrusive force.
Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Journal of the Korean Society of Fisheries and Ocean Technology
/
v.39
no.1
/
pp.8-18
/
2003
In order to investigate the oceanic condition of fishing ground in the adjacent sea of Naro Island, the oceanographic observation were carried out by the training vessel of Yosu National University on winter, spring, summer, and autumn in 2000. Main features in the observation are as follows; 1) the ranges of temperature, salinity, and chlorophyll-a were from 4.$3\circ_C$ to 10.$1\circ_C$, from 33.1 psu to 34.9 psu, and from 0.1 $ug$/$\Omega$ to 26.2 $ug$/$\Omega$ in winter, from 8.$1\circ_C$ to 13.$7\circ_C$, from 33.1 psu to 34.3 psu, and from 0.1 $ug$/$\Omega$ to 24.4 $ug$/$\Omega$ in spring, from 14.$5\circ_C$ to 24.$2\circ_C$, from 30.5 psu to 34.1 psu, and from 0.1 $ug$/$\Omega$ to 30.0 $ug$/$\Omega$ in summer, and from 14.$8\circ_C$ to 18.$6\circ_C$, from 30.1 psu to 34.0 psu, and from 0.1 $ug$/$\Omega$ to 19.1 $ug$/$\Omega$ in autumn, respectively, 2) the temperature in the coastal region was higher than that in the open ocean while salinity was lower, and the convection was identified between the surface and the bottom during in winter and autumn, and the thermocline were made between surface and 20m layer with vertical gradients of 4.$0\circ_C$/7m in summer, 3) the chlorophyll-a in the this region was varied in each season, being highly distributed in spring, on bottom and coastal region, and 4) an evidence of sea water intrusion toward Sori Island was observed, and of inner water intrusion from Yeoja Bay was observed.
Journal of the Korean Society of Fisheries and Ocean Technology
/
v.39
no.1
/
pp.19-26
/
2003
In order to investigate the seasonal variation of watermass in the adjacent sea of Naro Island, oceanographic observation on the fishing grounds were carried out by the training vessel of Yosu National University on winter, spring, summer, and autumn in 2000. The results obtained are summarized as follows ; 1) the watermass in the fishing ground were divided into the coastal water (30.0∼31.4psu), mixing water (31.5∼32.9psu) and the offshore water (33.0∼35.0psu) according to the distribution of salinity from T-S diagram plotted all salinity data observed on winter, spring, summer, and autumn in 2000. 2) the ranges of temperature and salinity were from 4.$3\circ_C$ to 10.1$^{\circ}C$ and from 33.1psu to 34.9psu in winter, from 8.$1\circ_C$ to 13.$7\circ_C$ and from 33.1psu to 34.3psu in spring, from 14.5$^{\circ}C$ to 24.$2\circ_C$ and from 30.5psu to 34.1psu in summer, and from 14.$5\circ_C$ to 18.$6\circ_C$ and from 30.1psu to 34.0psu in autumn, respectively. 3) the distribution of watermass in the fishing ground varied largely each seasons, but a general tendency on the distribution was obtained. That is, in winter and spring the offshore water was distributed most widely and in summer the coastal and mixing water occupied the fishing ground but in autumn the mixing water prevailed. 4) variation of temperature and salinity were appeared between the surface and 20m layer in the sea aduacent to Naro Island. Therefore, in the summer the thermocline were made between surface and 20m layer with vertical gradients of 4.$0\circ_C$/7m.
The effects of pre-treatments, the hot water extraction of wood meal and the addition of chemical ($CaCl_2$) to wood-cement water system on the properties of wood-cement composite such as modulus of rupture (MOR), modulus of elasticity (MOE), water sorption ratio and swelling ratio of resulting boards were studied in this experiment. The wood meals through 0.83mm(20 mesh) and retained on 0.42mm(35 mesh) screen were prepared from Pinus densiflora S. at Z. and Larix leptolepsis G. For hot water extraction, 500 grams of wood meal for each species were heated to boiling with 1,500ml of distilled water in 2-liter beaker for 6 hours. Every 2 hours, the wood meals were washed with boiling distil1ed water and reheated to boiling again. After 6 hours boiling, the boiled wood particles were collected by pouring this particles on 200 mesh screen. The collected particles then washed twice with hot distilled water and dried for 24 hours in an oven at $109{\pm}20^{\circ}C$. A mixture of 663.4 grams of cement with 331.7 grams of wood meal based on oven-dry weight were dry-mixed in a plastic vessel. The mixture was kneaded with 497.6ml of distilled water in the ratio of 1.5ml of water to a gram of wood meal. To add calcium chloride to the mixture as an accelerator, $CaCl_2$ 4% solution by weight per volume, was added to pine-or larch-cement board in the ratio of 3% to cement weight. To set wood-cement board, this mixture was clamped at 30cm ${\times}$ 30cm, in thickness of 1.5cm for 3 days at room temperature, declamped and then placed at open condition for 17 days. The target density was 1.0. The four specimens sized to 5cm in width and 28cm in length were used for MOR and MOE test for each treatment. After MOR test, the tested specimens were cut to the size of 5cm ${\times}$ 5cm for water sorption and swelling test. The twenty specimens used to measure the water sorption ratio (soaking 24 hours) and ten of these were used for swelling ratio measurement The results obtained were as follows: 1) Larch was not suitable for wood-cement boards because larch-cement board developed no strength, but pine showed 97.9kg/$cm^2$ by hot water extraction. 2) To increase MOR, hot water extraction was more effective than the addition of $CaCl_2$ in pine and larch because the $CaCl_2$ addition was seemed to speed up the ratio of cement hydration without reacting with the wood substances. 3) The water sorption ratio was lowered by the addition of $CaCl_2$ to wood-cement system because the chemical additive accelerated the rate of cement hydration. 4) In pine-cement board, the swelling ratio from 0.37 to 0.42 percent was observed in length and the swelling ratio from 0.88 to 2.0 percent in thickness. As a rule, the swelling ratio of wood-cement board was very low and the swelling ratio in thickness was higher than in length.
Kim, Yeonchun;Ji, Yeonghun;Han, Hyangsun;Lee, Joohan;Lee, Hoonyol
Korean Journal of Remote Sensing
/
v.30
no.5
/
pp.677-686
/
2014
Sea ice covers wide area in Terra Nova Bay in East Antarctica where the Jangbogo Antarctic Research Station was built in 2014, which affects greatly on the sailing of an icebreaker research vessel. In this study, we analyzed the optimum sea route and sailable period of the icebreaker to visit the Jangbogo Antarctic Research Station by using sea ice concentration data observed by passive microwave sensors such as Special Sensor Microwave/Imager (SSM/I) and Special Sensor Microwave Imager/Sounder (SSMIS) for the last decade, and by using sea route of the Araon, an icebreaker of Republic of Korea, from 2010 to 2012. It is found that Araon sailed in the route of sea ice concentration up to 78%. Sailing speed of the Araon decreased due to increasing sea ice concentration. However, Araon maintained the speed close to the average speed for the entire sailing period (~11 kn) in the route of sea ice concentration up to 70%. Therefore, we confirm that the Araon can sail typically in the route which shows sea ice concentration below 70%. We derived annually available sailing period in recent 10 years for the sea route of the Araon in 2010, 2011 and 2012, which is defined as the period showing sea ice concentration below 70% through the route. Maximum sailable period was analyzed to be 61 and 62 days for the route of the Araon in 2010 and 2011, respectively. However, the typical sailing in the routes was unavailable in some years because sea ice concentration was higher than 70% through the routes. Meanwhile, the sailable period for the routes of the Araon in 2012 was observed in every year, which was a minimum of 15 days and is a maximum of 89 days. Therefore, we could suggest that optimum route of icebreaker to visit the Jangbogo Antarctic Research Station is the route of the Araon in 2012. High resolution images from SAR or optical sensors are necessary to investigate sea ice condition near shoreline of Jangbogo research station due to several kilometers of low resolution of sea ice concentration.
Kang Joon Kyu;Kim Hyung Tai;Park In Duk;Chung Young Mi;Lee Cheol Joo
Journal of Chest Surgery
/
v.38
no.6
s.251
/
pp.410-414
/
2005
There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.
Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
Journal of Chest Surgery
/
v.32
no.4
/
pp.373-378
/
1999
Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.
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