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Clinical Experiences of redo-CABG (관상동맥우회 재수술의 임상적 고찰)

  • Lim, Sang-Hyun;Kwak, Young-Tae;Lee, Sak;Chang, Byung-Chul;Kang, Meyun-Shick;Cho, Bum-Koo;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.779-784
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    • 2002
  • Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F=12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results (심폐바이패스 없이 시행하는 관상동맥우회술과 경피적 관상동맥중재술의 병합요법 : 적응증 및 조기성적)

  • Hwang Ho Young;Kim Jin Hyun;Cho Kwang Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.733-738
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    • 2005
  • Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

Mid-Term Results of Mitral Valve Repair Using a Partial Flexible Band and a Completely Rigid Ring in Patients with Degenerative Mitral Regurgitation (퇴행성 승모판막역류 환자에서 Partial Flexible Band와 Complete Rigid Ring을 이용한 승모판막 성형술의 중기 결과 비교)

  • Kim, Kyung-Hwan;Ahn, Hyuk;Hwang, Ho-Young;Choi, Jin-Ho;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.475-481
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    • 2010
  • Background: We evaluated mid-term results of mitral annuloplasty using a flexible band and a completely rigid ring for mitral valve repair in patients with degenerative mitral regurgitation (MR). Material and Method: From January 2004 to September 2008, 71 patients (M:F=36:35, $55{\pm}13$ years) underwent mitral valve repair with mitral annuloplasty for degenerative MR. Ring annuloplasty was done using a Cosgrove-Edwards flexible band (Group I, n=43) or a Carpentier-Edwards classic ring (Group II, n=28). There were no differences in preoperative characteristics of the participants. Average duration of follow-up was 36 months (range: 2~69 mos). Result: There was no in-hospital mortality. Postoperative morbidity, which included atrial fibrillation (n=7) and low cardiac output syndrome (n=5) in groups I and II were similar. There was one late death in group II. The proportion exhibiting freedom from recurrent mitral regurgitation ($\geq$moderate) at 4 years in Groups I and II were, respectively, 94.5 and 91.8%, (p=0.695). Left ventricular ejection fraction decreased in the early postoperative period ($7{\pm}2$ days) and recovered by last follow-up ($25{\pm}16$ mos; p=0.002). The pattern was similar in groups I and II (p=0.905). Re-operation was performed in 3 patients (1 in Group I and 2 in Group II, p=0.316). Four-year event-free survival (free of adverse valve-related events) was 95.2% for Group I and 92.6% for Group II; this difference was not significant, p=0.646). Conclusion: The type of technique used in mitral annuloplasty to repair the mitral valve repair after degenerative MR did not affect mid-term clinical and functional results.

Monitoring of Sulfur Dioxide Residue in Commercial Medicinal Herbs in Seoul (2010) (2010년 서울지역 유통 한약재의 잔류이산화황 함량 모니터링)

  • Jung, Sam-Ju;Lee, Sung-Deuk;Kim, Su-Jin;Jo, Sung-Ae;Kim, Nam-Hoon;Jung, Hee-Jung;Kim, Hwa-Soon;Han, Ki-Young
    • Journal of Food Hygiene and Safety
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    • v.26 no.4
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    • pp.435-447
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    • 2011
  • This study was investigated to determine the contents of sulfur dioxide residues in medicinal herbs in Seoul Yang Nyoung Shi in 2010 (1,522 samples of 189 kinds). Samples were measured by modified Monier-Williams method. of the total samples, 618 samples (84 kinds) were domestic, and 904 samples (158 kinds) were imported. The content of sulfur dioxide in the domestics showed the range of 0.0 to 1,298.0 mg/kg (average 12.7 mg/kg), while those in imported samples were the range of 0.0 to 3,982.2 mg/kg (average 42.4 mg/kg). The average (mg/kg) amount of sulfur dioxide by parts in medicinal herbs was as follows; Tuber 122.3, Radix 69.3, Rhizoma 37.4, Cortex 33.3, Fructus 8.8, Ramulus 4.9, Semen 4.6, Folium 3.4, Flos 2.7, Perithecium 1.4. of the total samples (1,522), 52 samples (3.4%) were violated the KFDA regulatory guidance of sulfur dioxide. Among these 52 unsuitable samples, 16 samples (7 kinds) were domestic, and 36 samples (23 kinds) were imported. Approximately 88.1% of the total samples was less than 10 mg/kg of sulfur dioxide and 6.3% of the total samples showed more than 30 mg/kg of sulfur dioxide.

Growth Potential of Escherichia coli O157:H7 in Lettuce Leaf Extract and on Lettuce Leaf Surface (상추잎 즙액과 표면에서 Escherichia coli O157:H7의 생장 가능성)

  • Kim, Won-Il;Jung, Hyang-Mi;Kim, Se-Ri;Park, Kyeong-Hun;Kim, Byung-Seok;Yun, Hye-Jung;Yun, Jong-Chul;Ryu, Kyoung-Yul
    • Journal of Food Hygiene and Safety
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    • v.26 no.4
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    • pp.296-301
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    • 2011
  • This study was to evaluate the growth potential of E. coli O157:H7 in lettuce leaf extracts and on lettuce leaf surface at various temperatures. The pathogen can survive and multiply in the extracts and leaf surface of lettuce. The population of E. coli O157:H7 in the lettuce extracts reached to 4.79 log CFU/mL at $37^{\circ}C$. The multiplication of pathogen in lettuce extracts initiated within 10 hours of inoculation over $15^{\circ}C$ conditions. And it can survive in the lettuce leaf extracts at $4^{\circ}C$ for 100 hours at least. And this pathogen can multiply on lettuce leaf surface and the population of pathogen on the lettuce leaf surface increased to 1.82 log CFU/g at $25^{\circ}C$. At $37^{\circ}C$, the pathogen density increased to 1.53 CFU/g within 3 days after inoculation. At all temperature, irrespective of the inoculation level, similar trends in growth of E. coli O157:H7 were observed. These results emphasize the growth potential of E. coli O157:H7 in lettuce leaf extract and on lettuce leaf surface. To reduce the risk of outbreak, it is important to maintain the cold chain system during storage before the consumption.

An Analysis on the Sinking Resistance of Purse Seine - 2. In the Case of the Model Purse Seine with Different Netting Material and Sinkers - (旋網의 沈降 抵抗 解析 - 2. 網地材料와 沈子量 다른 模型網의 경우 -)

  • Kim, Suk-Jong
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.40 no.1
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    • pp.29-36
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    • 2004
  • This study deals with an analysis on the sinking resistance for the model purse seine, in the case of different netting material and sinkers. The experiment was carried out using rune simplified model seines of knotless nettings. Dimension of model seines 420cm for corkline and 85cm for seine depth, three groups of models rigged 25, 45 and 60g with the same weighted sinkers in water were used. These were named PP-25, PA-25, PES-25, PP-45, PA-45, PES-45, PP-60, PA-60 and PES-60 seine. The densitie($\rho$) of netting materials were 0.91g/cm$cm^3$, 1.14g/cm$cm^3$ and 1.38g/cm$m^3$. Experiments carried out in the observation channel in a flume tank under still water conditions. Sinking motion was recorded by the one set of TV-camera for VTR, and reading coordinate carried out by the video digitization system. Differential equations were derived from the conservation of momenta of the model purse seines and used to determine the sinking speeds of the depths of leadline and the other portions of the seines. An analysis carried out by simultaneous differential equations for numerical method by sub-routine Runge-Kutta-Gill The results obtained were as follows : 1. Average sinking speed of leadline for the model seines rigged 60g with the same weighted sinkers in water was fastest for 12.2cm/sec of PES seine, followed by 11.4cm/sec of PA and 10.7cm/sec of PP seines. 2. The coefficient of resistance for netting of seine was estimated to be $K_D=0.09(\frac{\rho}{\rho_w})^4$ 3. The coefficient of resistance for netting bundle of seine was estimated to be $C_R=0.91(\frac{\rho}{\rho_w})$ 4. In all seines, the calculated depths of leadline closely agreed with the measured ones, each 25g, 45g, 60g of weighted sinkers were put into formulas meas.=1.04cal., meas.=0.99cal. and meas.=0.98 cal.

Study on the Anchovy Boat Seine - II - On The Hydrodynamic Resistance and Performance of Patti-net (기선권현망의 연구 II - 파치망의 유체저항과 그물꼴에 관하여 -)

  • Lee, Byoung-Gee;Su, Young-Tae;Han, Hi-Soo
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.14 no.2
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    • pp.63-68
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    • 1978
  • A boat seine has been used as a major fishing gear for catching anchovy (Engraulis japonica) in the southern coastal waters of Korea since the 1920s. Since the 1950s some improvement from the original seine has been made; powered boats equipped with net hauler has been used instead of rowing boats with hand-driven capstan, and the seining method has been changed into the trawling method. But even now, there are many problems to be solved in the view point of decreasing man power without decreasing catching efficiency. For the purpose, patti-net has been introduced from Japan and experimented on the commercial base since 1972, and it was known that the patti-net could be operated with man power as half as needed in the coventional net, but catching efficiency was not so desirable. Therefore, the study on the characteristics of it were required. The authors carried out a model experiment with a Qne-twentieth scale model net towed by a powered boat on the sea. The obtained results run as follows: 1. Hydrodynamic resistance of the model net can be explained as $R_p=69.6 V_{I.66}$ $R_h=37 v^2$ where $R_p$ and $R_b$ denote the resistance of the whole gear and the cod end in kg respectively, and v the towing speed in mlsec. 2. Performance of wing and cod end showed no deformation such as observed at the conventional net. 3. The ratio of opening at the entrance of bag net to that of cod end showed about 2: 1. Therefore, when we intend to enlarge the net to be able to operate in the deep fishing ground, the cod end should be enlarged in the same proportion and increased towing power is needed .. Then, it will be better to increase the ratio for increasing fishing efficiency without increasing towing power.

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The Effect of Knowledge about Foods on the Foods Purchasing (식품에 대한 지식이 식품선택에 미치는 영향에 관한 조사연구)

  • 박윤정;조신호;이효지
    • Korean journal of food and cookery science
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    • v.5 no.2
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    • pp.63-73
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    • 1989
  • Family meals are very important for physical and mental health of family mebers. The purpose of this study is to contribute to change the habitual and unconscious cooking methods of housewives into more scientific moth(Ids. In order to achieve this purpose, this study tried to find out the degree to which housewives applied their knowledge of nutition and foods to actual behavior in purchasing. A special form of questionaire was prepared and distributed to 502 housewives in Seoul from Feb.8th to 22nd in 1989. The results were as follows: 1. Mean (score) of their nutritional knowledge was 14 7; if seems to be comparatively higher. 2. When they purchased food materials, their husbands' favor was the first consideration. Particularly, freshness was the first considered in purchasing meat, fishes, fruits, and vegetables. And Nutrition was so in case of seaweeds, oil, and fat. 3. For the most part, they cook three or four Subsidiary dishes for a meal. If they cooked one or two they chose to cook vegetables. If three or four they added meat and fishes. If more than four, they used various food materials.

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Optimization of Compound K Production from Ginseng Extract by Enzymatic Bioconversion of Trichoderma reesei (Trichoderma reesei 유래 산업효소를 이용한 인삼추출물로부터 Compound K 생산 최적화)

  • Han, Gang;Lee, Nam-Keun;Lee, Yu-Ri;Jeong, Eun-Jeong;Jeong, Yong-Seob
    • The Korean Journal of Food And Nutrition
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    • v.25 no.3
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    • pp.570-578
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    • 2012
  • Compound K(ginsenoside M1) is one of saponin metabolites and has many benefits for human health. This study was to investigate Compound K produced from ginseng crude saponin extract with commercial cellulolytic complex enzyme(cellulase, ${\beta}$-glucanase, and hemicellulase) obtained from Trichoderma reesei. The effect factors(temperature, pH, ginseng crude saponin extract and enzyme concentration, and reaction time) on production of Compound K from ginseng crude saponin extract were determined by one factor at a time method. The selected major factor variables were ginseng crude saponin extract of 2%(w/v), enzyme of 7%(v/v), reaction time of 48 hr. Based on the effect factors, response surface method was proceeded to optimize the enzymatic bioconversion conditions for the desirable Compound K production under the fixed condition of pH 5.0 and $50^{\circ}C$. The optimal reaction condition from RSM was ginseng crude saponin extract of 2.38%, enzyme of 6.06%, and reaction time of 64.04 hr. The expected concentration of Compound K produced from that reaction was 840.77 mg/100 g. Production of Compound K was 1,017.93 mg/100 g and 862.31 mg/100 g, by flask and bench-scale bioreactor($2.5{\ell}$) system, respectively.

Effect of Feeding Rye Silage on Growth Performance, Blood and Carcass Characteristics in Finishing Pigs (호맥 사일리지의 급여가 비육돈의 생산성, 혈액 성상 및 도체 특성에 미치는 효과)

  • Cho Jin-Ho;Han Young-Geun;Min Byoung-Joon;Chen Ying-Jie;Kim Hea-Jin;Yoo Jong-Sang;Kim Jung-Woo;Kim In-Ho
    • Food Science of Animal Resources
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    • v.25 no.4
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    • pp.449-457
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    • 2005
  • This study was conducted to evaluate the effects of feeding rye silage on growth performance, blood and carcass characteristics in finishing pigs. The total of eighteen $(Landrace{\times}Yorkshire{\times}Duroc)$ pigs $(94.03\pm0.71kg)$ were used in a 28-days assay. Dietary treatments included 1) CON(commercial diet ME 3,350 kcal/kg and crude fiber $2.84\%$), 2) T1(ME 3,294kcal/kg and crude fiber $2.99\%$ diet with rye silage $1.66\%$) and 3) T2(ME 3,237kcal/kg and crude fiber $3.15\%$ with rye silage $3.32\%$). In growth performance, total feed intake, basal feed intake and average daily feed intake were significantly higher in T1 and T2 treatments than CON treatment(P<0.05). Cortisol concentration in blood of pigs fed rye silage was significantly decreased compare to pigs fed CON diet(p<0.05). In meat quality characteristics, the hunter's $L^*$ value and marbling of pork were the highest in T2 treatment among treatments (P<0.05). Fatty acid composition in lean meat, the composition of palmitic and arachidic acid were significantly Higher in CON than others(P<0.05), also, palmitoleic acid was highest in T2 treatment among treatments(P<0.05). In fats those, palmitic and arachidic acid were the highest in CON treatment than those of other treatments(P<0.05). Digestibility of dry matter and nitrogen in pigs fed T1 and T2 diets were greater than that of pigs fed CON diet(p<0.05). Propionic acid concentration of fecal was the highest in T1 treatment among treatments(P<0.05). In conclusion, feed intake, the hunter's $L^*$ value, meat color of sensory evaluation and marbling of pork were affected by $3.32\%$ rye silage feeding.