Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.
Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Yie, Kil-Soo;Baek, Man-Jong;Na, Chan-Young
Journal of Chest Surgery
/
v.40
no.4
s.273
/
pp.288-291
/
2007
Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.
Kim, Hyeong-Ryul;Cho, Jeong-Su;Jang, Hee-Jin;Lee, Sang-Cheol;Choi, Eun-Suk;Jheon, Sang-Hoon;Sung, Soak-Whan
Journal of Chest Surgery
/
v.42
no.5
/
pp.615-623
/
2009
Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.
Background: Video-assisted thoracic sympathicotomy is a definitive minimally invasive treatment for axillary hyperhidrosis. Different techniques exist for controlling axillary hyperhidrosis, but they are temporary and expensive. We compared the results after using two different levels of sympathicotomy for treating axillary hyperhidrosis: T3-T4 and T4. Material and Method: Between June 2002 and May 2007, 30 patients with isolated axillary hyperhidrosis underwent either T3-T4 or T4 thoracoscopic sympathicotomy in the Department of Thoracic & Cardiovascular Surgery at Wonkwang University Hospital. The patients were divided into two groups. Group I (n=15) was composed of patients who underwent T3-T4 sympathicotomy (thermal ablation), and Group II (n=15) was composed of patients who underwent T4 sympathicotomy (thermal ablation). The procedures were bilateral and simultaneous, involving the use of two 2-mm trocars and a 0-degree 2-mm thoracoscope under general anesthesia with single endotracheal intubation. Outcome parameters included satisfaction rate of treatment, degree of compensatory sweating, and postoperative complications. Patients were interviewed by telephone regarding satisfaction and compensatory hyperhidrosis. Result: There were no differences in age between group I and group II. The mean follow-up for the T3-T4 group was $38.7{\pm}2.3$ months, and the mean follow-up for the T4 group was $18.7{\pm}3.6$ months. The immediate therapeutic success rate (within 2 weeks postoperative) was 100% in both groups, and there were no recurrences in either group during the long-term follow-up period. The satisfaction rate was higher (93.3%) in the T4 group than in the T3-T4 group (53.3%), and the incidence of compensatory hyperhidrosis was lower in the T4 group (6.7%) than in the T3-T4 group (46.7%). Postoperative complications included one mild pneumothorax and two instances of intercostal neuralgia. Digital infrared thermographic imaging (DITI) correlated well with postoperative satisfaction. Conclusion: Both techniques proved effective for controlling isolated axillary hyperhidrosis. The T4 group had a higher satisfaction rate and lower severity of compensatory hyperhidrosis. Hence, thermal ablation of the lower interganglionic fibers of the third thoracic sympathetic ganglion on the fourth rib is a more practical and minimally invasive treatment than is the T3-T4 surgical method, according to the degree of compensatory sweating in isolated axillary hyperhidrosis.
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.
Kim, Ji Dong;Park, Go Eun;Lim, Jong-Hwan;Yun, Chung Weon
Journal of Korean Society of Forest Science
/
v.106
no.2
/
pp.130-149
/
2017
The subalpine zone which is vulnerable to climate change could be functioning as a habitat for northern plant species especially in the Korean peninsula. In this study, classification of phytosociological community type and investigation on flora of vascular plants of Daecheongbong area in Mt. Seorak were carried out in order to provide a basic information for an ecological restoration and management of the vegetation through community ecological approach. Vegetation data were collected from 31 of quadrates from May to October, 2016. We analyzed vegetation types with phytosociological method, importance value with Curtis & McIntosh method, CCA using PC-ORD program tool, and flora of vascular plants. As a result, the forest vegetation was classified into Abies nephrolepis community. The community was divided 3 groups such as Pinus pumila group, Rhododendron brachycarpum group and Angelica decursiva group. Therefore, the vegetation had 3 kinds of units. The differential species group, it was classified into total of 7 species group units including Thuja koraiensis and Smilacina bicolor differential species group. The mean importance percentage (MIP) in VU 1 was shown Pinus koraiensis (24.1), A. nephrolepis (23.6) and Betula ermanii (10.5), and in VU 2, it was P. koraiensis (26.2), A. nephrolepis (20.8) and B. ermanii (10.5), and in VU 3, it was P. koraiensis (22.2), A. nephrolepis (16.4), B. ermanii (13.5) in the order, respectively. As for importance values of P. koraiensis and A. nephrolepis representative competition species, were different at each layers. The former (46.7) was higher than the latter (26.1) in tree layer, but the latter was higher than the former in subtree and, shrub and herb layers of VU 1. VU 2 and VU 3 also indicated the same tendency. P. pumila group and A. decursiva group were shown to have positive correlation with altitude and present species, respectively. The designated as the endemic plant was 11 taxa and, as the rare plant 24 taxa and 62.5% of vascular plant was northern plant species. It is necessary to continue further long-term monitoring of 3 vegetation units, IV of main competition species (P. koraiensis and A. nephrolepis) with stratum and main specific species (rare plants and endemic plants) considering vegetation science and, population and community ecology approaches.
Background: A diagnosis of chronic myeloid leukemia (CML) is made on discovery of the presence of a Philadelphia (Ph) chromosome. The success of the treatment of this form of leukemia with tyrosine kinase inhibitor (TKI) is monitored by reduction of the Ph chromosome. Objective: To compare the role of conventional cytogenetic (CC) methods with a real time quantitative polymerase chain reaction (RQ-PCR) and fluorescence in situ hybridization (FISH) for diagnosis and treatment monitoring of CML patients. The secondary outcome was to analyze the treatment responses to TKI in CML patients. Materials and Methods: This was a retrospective study of CML patients who attended the Hematology clinic at Chiang Mai University Hospital from 2005-2010. Medical records were reviewed for demographic data, risk score, treatment response and the results of CC methods, FISH and RQ-PCR. Results: One hundred and twenty three cases were included in the study, 57.7% of whom were male with a mean age of 46.9 years. Most of the patients registered as intermediate to high risk on the Sokal score. At diagnosis, 121 patients were tested using the CC method and 118 (95.9%) were identified as positive. Five patients failed to be diagnosed by CC methods but were positive for BCR-ABL1 using the FISH method. Imatinib was the first-line treatment used in 120 patients (97.6%). In most patients (108 out of 122, 88.5%), a complete cytogenetic response (CCyR) was achieved after TKI therapy and in 86 patients (70.5%) CCyR was achieved long term by the CC method. Five out of the 35 analyzed patients in which CCyR was achieved by the CC method had a positive FISH result. Out of the 76 patients in which CCyR was achieved, RQ-PCR classified patients to only CCyR in 17 patients (22.4%) with a deeper major molecular response (MMR) in 4 patients (5.3%) and complete molecular response (CMR) in 55 patients (72.4%). In the case of initial therapy, CCyR was achieved in 95 patients (79.1%) who received imatinib and in both patients who received dasatinib (100%). For the second line treatment, nilotinib were used in 30 patients and in 19 of them (63.3%) CCyR was achieved. In half of the 6 patients (50%) who received dasatinib as second line or third line treatment CCyR was also achieved. Conclusions: CML patients had a good response to TKI treatment. FISH could be useful for diagnosis in cases where CC analysis failed to detect the Ph chromosome. RQ-PCR was helpful in detecting any residual disease and determining the depth of the treatment response at levels greater than the CC methods.
Journal of the Korean Applied Science and Technology
/
v.37
no.5
/
pp.1285-1297
/
2020
In this study, we report the results of a study on the clinical evaluation of wrinkle improvement by developing a method for liposome of high-purity Centella asiatica extract used in pharmaceuticals and cosmetics, and a cream using the same. In order to make Centellasome-10EX stabilizing centella asiatica extract in liposome lamella vesicle, it could be completed using 5% hydrogenated lecithin and 2% sucrose distearate. The appearance of Centellasome-10EX was a creamy form of low viscosity, the color was pale yellow, and the odor had the inherent odor of the raw material. The pH was about 6.12, the specific gravity was 1.09, and the acid value was about 0.35. The content of the main constituents of centella asiatica extract contained in the liposome vesicle contains 10,800 ppm of asiatic acid, 10,900 ppm of asiaticoside, 6,000 ppm of madecasic acid, and 1,600 ppm of madecassoside, and long-term storage. There was no discoloration even at the time, and it was found that the main component remained stable thermodynamically. To mechanistically analyze the structure of the liposome vesicle of Centellasome-10EX, as a result of observation with a transmission electron microscope (Cryo-TEM), the multilayer vesicles are formed and filled with moisture, and there are 10 to 60 multilayers around it. It was confirmed that the liposome lamella vesicle was formed. As a clinical trial (in-vivo) test, the moisturizing effect of centellasome cream after application for 5 weeks was 28.3%, which was significantly increased compared to placebo. The skin elasticity effect was 13.6%, which significantly increased the moisturizing power than the placebo. The effect of improving fine wrinkles around the eyes was improved by 23.52% compared to placebo cream. Through the results of this study, it was possible to study the formulation and manufacturing method for encapsulation and stabilization of the developed Centellasome-10EX in the liposome vesicle. It is expected that the results obtained through clinical research on the wrinkle improvement effect of the cream using this can be widely used to study skin science in the cosmetic industry and to develop high-quality cosmetics with high efficacy.
Kim, Young-Kyu;Moon, Sung-Hoon;Cho, Seung-Hyun;Oh, Won-Seok
Journal of the Korean Arthroscopy Society
/
v.16
no.1
/
pp.40-46
/
2012
Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.
Journal of the Korea Academia-Industrial cooperation Society
/
v.17
no.8
/
pp.215-225
/
2016
This study seeks to find an alternative to the requirement for proving the competitiveness of Korean performing arts before entering into the overseas market by deriving the factors causing entry into the market to be delayed based on an analysis of the current status. Between 2007 to 2014, the overseas revenues from Korean performing arts increased by 16.4% compared to the total amount of financial support, as the number of free performances given overseas and the average guaranteed number of performances overseas are both at a standstill. Also, the size of the audience increased by a mere 3.3 times, which is an even lower growth rate than that for the number of performances, 3.8 times, during the same period. Furthermore, the audience size per unit is suffering from long-term stagnation. The main causes are as follows: 1) applying one-dimensional methods to performing arts exchanges and expanding the overseas market, 2) the existing confused concepts between profit and non-profit contents, 3) the weaknesses of the market expansion strategy, because of programming practices focusing on providers, such as presenters and producers, rather than consumers. As a result, the necessary basic research, including consumer surveys, has not been done yet. In order to understand the implications of this analysis and solve the problem of the delayed overseas expansion of Korean performing arts, the Korean wave industry was examined as a representative example. Consumer surveys for the performing arts, possibly benchmarked to the "Korean Wave Consumer Survey Index (KWCSI)", are expected to be done in the near future. In addition, through the development of a specific consumer index of the performing arts, customized marketing strategies by continent and country need to be established. This empirical study of the overseas expansion of performing arts can be utilized as a bridge between the academic and real worlds. This work may also enable a variety of strategies to be established for the overseas expansion of the performing arts.
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