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EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

Effect of Plowing Frequency and Sowing Dates on the Agronomic Characteristics, Feed Value, Weed Yield and Palatability of Silage Corn (경운횟수와 파종기 이동이 사일리지용 옥수수의 생육특성, 사료가치, 잡초발생 및 가축의 기호성에 미치는 영향)

  • Lee, Sang-Moo;Kim, Byoung-Tae;Hwang, Joo-Hwan;Jeon, Byoung-Tae;Moon, Sang-Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.27 no.3
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    • pp.209-218
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    • 2007
  • This experiment was conducted to investigate effect of plowing frequency and sowing dates on the agronomic characteristics, feed value, weed yield and palatability of silage corn. Treatments were a basal treatment(C: May 5 seeding, plowing once, weeding control once), T1(May 12 seeding, plowing twice, weeding control 0 time), T2(May 19 seeding, plowing three times, weeding control 0 time, T3(May 26 seeding, plowing four times, weeding control 0 time) and T4(June 2 seeding, plowing five times, weeding control 0 time). The experiment was performed at the College of Life and Natural Sciences of Sangju University in Sangju in 2006. The plant height and ear height showed highly in order to C > T1 > T2 > T3 > T4 treatment, leaf length was the highest at T2 (96.0cm). Leaf width and number of dead leaf were the highest at C and T3 (11.2cm), C, C and T1 (4.6), respectively. Stem diameter was the highest at T3 as 31mm, while T2 was the lowest as 25mm (p<0.05). Ear circle showed highly in order of C > T1 > T4 > T3 > T4 (p<0.05), and tip filling degree was the highest at C treatment as 8.8, while T4 treatment was the lowest as 6.0 (p<0.05). The stem hardness and grain hardness were C < T1 < T2 < T3 < T4 (p<0.05). Stem saccharinity was T1(6.1%) was the highest, while T2(3.0%) was the lowest(P<0.05). Fresh yield of weed was the lowest at C treatment as 500 kg/ha, but T1 treatment was the highest as 44,100 kg/ha (p<0.05). Weed coverage rate showed highly in order of T1 > T2 > T3 > T4 > C treatment (p<0.05). Fresh yield of corn was the highest at C treatment as T3,550 kg/ha, but T4 treatment was the lowest as 65,500 kg/ha (p<0.05). Dry matter yield of corn showed highly in order of C(26,978 kg/ha) > T1(26,130 kg/ha) > T2(20,255 kg/ha) > T3(20,255 kg/ha) > T4(17,508 kg/ha) treatment (p<0.05). Crude protein content was T1(7.69%) > T4(7.42%) > T2(6.34%) > T3(5.99%) > C(5.91%) treatment (p<0.05), and Crude fat content showed highly in order of C (2.13%) > T1(2.04%) > T2(1.96%) > T3(1.95%) > T4(1.84%) treatment. Relative palatability of Holstein, Korean native goat and spotted deer was the highest at C treatment, but Korean native cattle was the highest at T1 treatment.

Modified Thoracoscopic Bullectomy (흉강경하 기낭절제술의 변형 술식)

  • Park, Chan-Beom;Cho, Min-Seob;Sa, Young-Jo;Lee, Jong-Ho;Jin, Ung;Kwon, Jong-Bum;Cho, Deog-Gon;Park, Kuhn;Cho, Kyu-Do;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.937-942
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    • 2003
  • Morbidity, the use of analgesics, the amount of postoperative drainage and the postoperative hospital stay were reduced in VATS for pneumothorax. However, some authors preferred minithoracotomy to VATS because the rate of recurrence after VATS were between 5% and 10%. Therefore, we present a modified thoracoscopic bullectomy (MTB) which we believe has the advantages of conventional VATS and minithoracotomy. Material and Method: Sixty-six patients who received the operation from January 2002 to December 2002 were divided into 3 groups. Twenty-six patients were treated by axillary minithoracotomy and thirteen by conventional VATS and 18 by modified thoracoscopic bullectomy, The mean age was 21.9 years (range, 16∼35 years) for minithoracotomy group, 20.6 years (range, 17∼28 years) for conventional VATS group and 22.6 years (range, 16∼39 years) for MTB group. The mean follow-ups were 11.4 months for minithoracotomy group, 9.5 months for conventional VATS group and 4.7 months for MTB group. Result: The mean duration of operation was 55.79$\pm$23.35 minutes in MTB and 44.23$\pm$19.24 minutes in conventional VATS (p=0.333). The number of staplers being used was 1.63 $\pm$0.76 in MTB, 1.41$\pm$0.64 in minithoracotomy (p=0.663), and 2.92$\pm$1.19 in conventional VATS (p<0.001). The duration of indwelling chest tube was 1.63$\pm$0.76 day in MTB, 4.07$\pm$ 1.41 day in minithoracotomy (p<0.001) and 4.46$\pm$2.33day in conventional VATS (p<0.001). Hospital length of stay was 3.26$\pm$0.81 day in MTB, 6.04$\pm$2.21 day in minithoracotomy (p<0.001) and 6.69$\pm$3.33 day in conventional VATS (p<0.001). The number of postoperative complication and recurrence were 2 in minithoracotomy (7.4%), 5 in conventional VATS (38.5%) and 1 in MTB (5.6%). Conclusion: Modified thoracoscopic bullectomy is an effective procedure in the treatment of spontaneous pneumothorax.

Effects of Evaporative Water-loss from Cultural Pots on Growth of Pot-grown Ornamental Plants (화분(花盆)의 수분증발(水分蒸發)이 분식화훼류(盆植花卉類)의 생육(生育)에 미치는 영향(影響))

  • Suh, Youn-gkyo
    • Korean Journal of Agricultural Science
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    • v.4 no.2
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    • pp.317-343
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    • 1977
  • This study was carried out to obtain the informations about evaporation from pot, soil temperature and soil atmosphere composition in pot, and the effect on the growth of nine ornamental species using seven different containers. The investigated containers were clay pot(CP), clay pot painted in green(CP-P), varnished clay pot(CP-V), polyethylene film inserting in clay pot(CP-PI), clay pot mulched with black polyethylene film(CP-PM), porcelain pot(POP), and plastic pot(PLP). Nine ornamental species were balsam(Impatiens balsamina), chrysanthemum(Chrysanthemum morifolium), cosmos(Cosmos bipinatus), English ivy(Hedera helix), geranium(Pelargonium zonale), kochia(Kochia scoparia var. trichophila), marigold(Tagetes patula), ornamental kale(Brassica oleraceae var. acephala), and salvia (Salvia splendens). The results obtained are summarized as follows: 1. Dry weight of all tested species grown in PLP, POP, CP-P, CP-V and CP-PI was heavier than that of CP. 2. Plant height in nine tested species grown in PLP, POP, CP-P, CP-V, and CP-PI was taller than that of CP. 3. Geranium grown in PLP, POP, CP-P, and CP-V gave more number of leaf than that of CP. 4. The number of flower in balsam grown in PLP, POP, CP-P, CP-V and CP-PI was more than that of CP. The result from marigold was very similar to this tendency. Spike length and floret number in salvia gave the same tendency, but its spike number was not different among containers used. 5. The average diurnal evaporation from PLP and POP was about 43% of that of CP. About two third of total evaporation from CP was through pot wall. 6. The evaporation rate from the slowest to the highest was PLP, POP, CP-P, CP-V, CP-PI, CP-PM and CP. Containers inhibiting evaporation through pot wall hold more soil moisture than CP from one day after water supply. 7. The more evaporative water-loss from containers gave the lower soil temperature. The variation of soil temperature among containers was higher during the day than the night. 8. The $O_2$ concentration of soil atmosphere in CP was higher than that of nonporous containers, and the difference between them was 0.40-1.12%. The range of the $O_2$ concentration 17.95~19.62%. The $CO_2$ concentration of soil atmosphere in CP was lower than that of nonporous containers, and its range was 0.59-1.76%. This deviation in soil atmosphere composition did not influenced on the growth of plants. 9. There was a possitive correlation between the amount of soil water and the plant growth. 10. Plant grown on CP gave more total nitrogen content in top growth than that on PLP. C/N ratio was somewhat low in plant on CP. From the above results, $O_2$ and $CO_2$ concentration in soil atmosphere did not gave enough deviation to the extent which affect the plant growth. The effect of soil moisture on the plant growth using different containers was the far-most significant factor from this investigation. Therefore, it was obious that the utilization of the nonporous container might save the cost for water supply and reduce the production cost of the pot-grown ornamental plant in Korea eventually.

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Growth and Yield Characteristics of Foxtail Millet, Comon Millet Cereal Crops on Marginal Agricultural Lands (조건 불리 한계농경지에서의 조, 수수, 기장의 생육 및 수량)

  • Yoon, Seong-Tak;Lee, Myung-Cheol;Kim, Jeong-Soon;Zhang, Qingyu;Xu, Zhen-Yu;Kim, Young-Bok;Kim, Tae-Ho;Nam, Jung-Chang;Nam, Min-Hee;Lee, Young-Hawn;Hwang, Jae-Bok;Shim, Sang-In;Kim, Seong-Min
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.55 no.4
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    • pp.350-356
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    • 2010
  • This experiment was conducted to select optimum minor cereal crop and variety for the marginal agricultural lands so that they would be used to increase the agricultural land use rate in mountainous areas. This experiment used three different marginal agricultural lands, that is, slope land, barren land and gravelly land. Soil pH of control field was 7.85, slightly alkali, whereas gravelly land showed strong acid(pH 5.1). EC of marginal agricultural lands was generally lower compared to the control, especially barren land showed 0.05dS $m^{-1}$ which was the lowest among marginal agricultural lands. Foxtail millet showed no significant difference of heading and ripening date among marginal agricultural lands. Foxtail millet of slope land showed the highest culm length(169.5 cm) and grains per ear(4913.9 grains) among marginal agricultural lands except control field. Growth duration of three varieties was varied from 112 to 113days, which was not different statistically. In grains per ear of common millet, slope land showed 787.1 grains which was the highest among marginal agricultural lands except control field. Among varieties, Byorukgijang showed the highest grains per ear(827.2 g/ear), whereas 1000 grain weight was 5.5 g which was lower compared to that of Hwanggijang(6.2 g). In sorghum, slope land showed the highest grains(2563.8 grains) per ear and ears per 3.3 $m^2$(26.0 ears) except control field. Growth duration of three sorghum varieties almost the same from 122 to 123 days, whereas the highest grains per ear was obtained from Moktaksusu(2357.6 grains). Jangmoksusu showed the highest 1000 grain weight(23.8 g) among three sorghum varieties. In yield of three foxtail millets, the highest yield was obtained from slope land(282.0 kg/10a) among marginal agricultural lands and Mongdangjo showed the highest yield(252.3 kg/10a) among three varieties. In yield of three common millets, the highest yield was obtained from slope land(196.0 kg/10a) among marginal agricultural lands and Byorukgijang showed the highest yield(173.8 kg/10a) in three varieties. In three sorghum varieties, the highest yield was obtained from slope land(301.7 kg/10a) among marginal agricultural lands and Moktaksusu showed the highest yield(236.5 kg/10a) among three varieties.

The Irradiated Lung Volume in Tangential Fields for the Treatment of a Breast (유방암의 접선 조사시 피폭 폐용적)

  • Oh Young Taek;Kim Juree;Kang Haejin;Sohn Jeong Hye;Kang Seung Hee;Chun Mison
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.137-143
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    • 1997
  • Purpose : Radiation pneumonitis is one of the complications caused by radiation therapy that includes a Portion of the lung tissue. The severity of radiation induced pulmonary dysfunction depends on the irradiated lung volume, total dose, dose rate and underlying Pulmonary function. It also depends on whether chemotherapy is done or not. The irradiated lung volume is the most important factor to predict the pulmonary dysfunction in breast cancer Patients following radiation therapy. There are some data that show the irradiated lung volume measured from CT scans as a part of treatment Planning with the tangential beams. But such data have not been reported in Korea. We planned to evaluate the irradiated lung volume quantitatively using CT scans for the breast tangential field and search for useful factors that could Predict the irradiated lung volume Materials and Methods : The lung volume was measured for 25 patients with breast cancer irradiated with tangential field from Jan.1995 to Aug.1996. Parameters that can predict the irradiated lung volume included; (1) the peruendicular distance from the Posterior tangential edge to the posterior part of the anterior chest wall at the center of the field (CLD) ; (2) the maximum perpendicular distance from the posterior tangential field edge to the posterior Part of the anterior chest wall (MLD) ; (3) the greatest perpendicular distance from the Posterior tangential edge to the posterior part of anterior chest wall on CT image at the center of the longitudinal field (GPD) ; (4) the length of the longitudinal field (L). The irradiated lung volume(RV), the entire both lung volume(EV) and the ipsilateral lung volume(IV) were measured using dose volume histogram. The relationship between the irradiated lung volume and predictors was evaluated by regression analysis. Results :The RV is 61-279cc (mean 170cc), the RV/EV is $2.9-13.0\%\;(mean\;5.8\%)$ and the RV/IV is $4.9-29.0\%\;(mean\;12.2\%)$. The CLD, the MLD and the GPD ave 1.9-3.3cm, 1.9-3.3cm and 1.4-3.1cm respectively. The significant relations between the irradiated lung volume such as RV. RV/EV, RV/IV and parameters such as CLD, MLD, GPO, L. $CLD\timesL,\;MLD\timesL\;and\;GPD\timesL$ are not found with little variances in parameters. The RV/IV of the left breast irradiation is significantly larger than that of the right but the RV/EVS do not show the differences. There is no symptomatic radiation pneumonitis at least during 6 months follow up. Conclusion : The significant relationship between the irradiated lung volume and predictors is not found with little variation on parameters. The irradiated lung volume in the tangential held is liss than $10\%$ of entire lung volume when CLO is less than 3cm. The RV/IV of the left tangential field is larger than that of the right but there was no significant differences in RV/EVS. Symptomatic radiation pneumonitis has not occurred during minimum 6 months follow up.

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Clinical Characteristics of Childhood Henoch-Sch$\"{o}$nlein Purpura with Duodenal Involvement by Upper Gastrointestinal Endoscopy (내시경상 십이지장을 침범한 Henoch-Sch$\"{o}$nlein Purpura 환아의 임상적 특징)

  • Park, Sun-Hee;Nam, Yoo-Nee;Park, Sang-Hui;Sim, So-Yeon;Eun, Byung-Wook;Choi, Deok-Young;Sun, Yong-Han;Cho, Kang-Ho;Ryoo, Eell;Son, Dong-Woo;Jeon, In-Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.156-162
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    • 2009
  • Purpose: The aim of this study was to investigate the clinical usefulness of upper gastrointestinal (GI) endoscopy in children with Henoch-Sch$\"{o}$nlein purpura (HSP). Methods: We retrospectively analyzed the clinical, endoscopic, and histopathologic records of children with HSP who had been admitted to the Department of Pediatrics of Gil Hospital and underwent upper GI endoscopy between January 2002 and June 2009. Patients were classified into the following two groups for statistical analysis: duodenal involvement (+) and duodenal involvement (-). Results: Fifty-one children with HSP underwent upper GI endoscopy; the mean age was 7.2${\pm}$2.9 years. The upper GI endoscopy showed abnormalities of the duodenum in 38 cases (74.5%), 22 of which had duodenal ulcers. Among the biopsy specimens obtained from the duodenum of 37 cases, 13 cases (35.1%) had leukocytoclastic vasculitis, neutrophil debri, and/or extravasation of RBCs. Steroid use was more frequent in the duodenal involvement (+) group (86.8%) than the duodenal involvement (-) group (53.8%; p=0.02). The mean length of hospitalization was 13.9${\pm}$8.43 days in the duodenal involvement (+) group and 8.1${\pm}$4.62 days in the duodenal involvement (-) group (p=0.003). The recurrence rate was significantly higher in the duodenal involvement (-) group than the duodenal involvement (+) group (p=0.027), whereas none of the other study parameters, such as the age of onset, renal involvement, and steroid use, led to significantly higher or lower recurrence rates. Conclusion: These results suggest that duodenal involvement can influence the clinical course and prognosis of HSP in children.

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Nutritional Effects of Paper Board Sludge on the Soybean(Glycine max. L.) (대두(大豆)에 대(對)한 제지(製紙) Sludge의 영양학적(營養學的) 연구(昭究))

  • Kim, Moon Kyu;Chang, Ki Woon;Choi, Woo Young;Ham, Suon Kyu;Nam, Yun Kyu;Lee, Chang Jun
    • Korean Journal of Agricultural Science
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    • v.17 no.1
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    • pp.1-8
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    • 1990
  • The paper board sludge(PBS) itself and compost sludge manure(CSM) mixed with sawdust, fowl droppings and urea to the PBS were treated to soybean plants to find the effects of growing characters, yield components, and nutritional compounds in the plant tissues. 1. Percentages of missing plants were 5-9% and 3.6-4.1% in the treatments of PBS and CSM, respectively. After that, the plants were restored to normal conditions. Anyway it is not desirable to use the paper board sludge and immature compost sludge manure in seeding time or to young seedlings. 2. Growth of the plant height was retarded in early growing phase, but it was normal in later stages. And the width and length of the largest leaf, numbers of main stem nodes and pods were not significant among the treatments. 3. The yield intends to increase through the treatments of 1,200, 1,600, and 2,000Kg PBS per 10a. In the CSM treatments with high rate of sawdust, fowl droppings and urea, the numbers of pods and grains were higher than the treatment of high content of PBS. 100-grain and one liter weights were opposite intention. It was suggested that the excess nitrogen amounts from the compost sludge manure than conventional fertilization affected to the yield components. 4. The contents of the main chemical compounds such as N, $P_2O_5$, $K_2O$, Ca, Mg were determined. The concentrations of nitrogen were higher in the treatment of PBS and CSM than none and control. 5. In conclusion, the nutritional effects of PBS were in evidence. To use the sludges, it should be fermented with adequate additives to improve the aeration, C/N ratio, activity of microbial, and other conditions. The sludges could be used to crops as a fertilizers effectively.

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The Recovery of Left Ventricular Function after Coronary Artery Bypass Grafting in Patients with Severe Ischemic Left Ventricular Dysfunction: Off-pump Versus On-pump (심한 허혈성 좌심실 기능부전 환자에서 관상동맥우회술시 체외순환 여부에 따른 좌심실 기능 회복력 비교)

  • Kim Jae Hyun;Kim Gun Gyk;Baek Man Jong;Oh Sam Sae;Kim Chong Whan;Na Chan-Young
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.116-122
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    • 2005
  • Background: Adverse effects of cardiopulmonary bypass can be avoided by 'Off-pump' coronary artery bypass (OPCAB) surgery. Recent studies have reported that OPCAB had the most beneficial impact on patients at highest risk by reducing bypass-related complications. The purpose of this study is to compare the outcome of OPCAB and conventional coronary artery bypass grafting (CCAB) in patients with poor left ventricular (LV) function. Material and Method: From March 1997 to February 2004, seventy five patients with left ventricular ejection fraction (LVEF) of $35\%$ or less underwent isolated coronary artery bypass grafting at our institute. Of these patients, 33 patients underwent OPCAB and 42 underwent CCAB. Preoperative risk factors, operative and postoperative outcomes, including LV functional change, were compared and analysed. Result: Patients undergoing CCAB were more likely to have unstable angina, three vessel disease and acute myocardial infarction among the preoperative factors. OPCAB group had significantly lower mean operation time, less numbers of total distal anastomoses per patient and less numbers of distal anastomoses per patient in the circumflex territory than the CCAB group. There was no difference between the groups in regard to in-hospital mortality $(OPCAB\; 9.1\%\;(n=3)\;Vs.\;CCAB\;9.5\%\;(n=4)),$ intubation time, the length of stay in intensive care unit and in hospital postoperatively. Postoperative complication occurred more in CCAB group but did not show statistical difference. On follow-up echocardiography, OPCAB group showed $9.1\%$ improvement in mean LVEF, 4.3 mm decrease in mean left ventricular end-diastolic dimension (LVEDD) and 4.2 mm decrease in mean left ventricular end-systolic dimension (LVESD). CCAB group showed $11.0\%$ improvement in mean LVEF, 5.1 mm decrease in mean LVEDD and 5.5 mm decrease in mean LVESD. But there was no statistically significant difference between the two groups. Conclusion: This study showed that LV function improves postoperatively in patients with severe ischemic LV dysfunction, but failed to show any difference in the degree of improvement between OPCAB and CCAB. In terms of operative mortality rate and LV functional recovery, the results of OPCAB were as good as those of CCAB in patients with poor LV function. But, OPCAB procedure was advantageous in shortening of operative time and in decrease of complications. We recommend OPCAB as the first surgical option for patients with severe LV dysfunction.