• Journal of Chest Surgery
• /
• v.49 no.3
• /
• pp.165-170
• /
• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• Advances in pediatric surgery
• /
• v.17 no.2
• /
• pp.133-138
• /
• 2011

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

• Journal of Chest Surgery
• /
• v.37 no.7
• /
• pp.578-584
• /
• 2004

Sinus of Valsalva aneurysm is a rare cardiac anomaly and a long-term survival after surgical treatment has not been well established. This study was designed to evaluate the long-term surgical results after the repair of sinus Valsalva aneurysm. Material and Method: From April 1991 to November 2003, 35 patients (23 male, 12 female, mean age 35.2 years, range 11∼64) underwent operation for sinus of Valsalva aneurysm. Twenty six patients (74.3%) were in the New York Heart Association (NYHA) class III∼IV before surgery. In preoperative echocardiogram, mean EF was 63.32 $\pm$ 11.43% and nine patients (25.7%) were in AR grade III∼IV. Direct closure, patch closure of ruptured sinus Valsalva were performed in fourteen patients (46.7%), sixteen patients (53.3%) respectively. Aortic valve replacement, valvuloplasty were performed in five patients (14.3%), three patients (8.6%) respectively. Three patients (8.6%) underwent the Bentall procedure. Concomitant procedures were performed in 15 patients (42.9%), which were closure of VSD and ASD. Mean CPB time and ACC time were 116.79 $\pm$ 38.79 and 81.2 $\pm$ 28.97 minutes. Result: There was no operative mortality. One patient (2.9%) developed complete heart block that required a permanent pacemaker implantation. Three patients (8.6%) required reoperation due to a recurred rupture of the sinus Valsalva aneurysm and developed aortic insufficiency. Mean follow-up time was 58.55 $\pm$ 38.38 months. There was one late death. Actuarial 5 year freedom rate from reoperation was 87.1 $\pm$ 7%. Conclusion: Surgical treatment for sinus of Valsalva aneurysm is safe and has satisfactory long-term results.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.2
• /
• pp.126-133
• /
• 2005

Purpose: to know the treatment result of squamous cell carcinoma in extremity had poor prognosis with risk factor including burn scar and chronic osteomyelitis. Material and Methods: Between Octorber 1993 and September 2002, 20 patients with squamous cell carcinoma in extremity had no distant metastasis was got operation and followed over 36 months. Amputation was done when it was hard to get enough wide margin or neurovascular structure was involved instead of wide excision. Mean age of patients was 57.2 years old and male to female was 16 to 4. TMN staging and histologic grading were performed. Results: There were 6 metastasis (30%) in 20 cases for mean 48.3 months (36-84 months). 3 metastasis to local lymph node and 3 distant metastasis were happened at lung (in 3 cases) and thorasic vertebra (in 1 case). Survival was 18 cases at last look. 5-year survival rate was 50%. 3 local recurrence was developed at average 11 months (4-18 months). Complication was focal skin defect after wide excision and skin graft in 2 cases. The patients by wide excision got average 1.9 time operation and by amputation got average 1.3 time. Conclusion: Squamous cell carcinoma at extremity in Korea had high metastasis rate due to burn scar and chronic osteomyelitis, and it showed equal treatment result which treated by wide excision compared with amputation.

• Journal of the Korea Organic Resources Recycling Association
• /
• v.5 no.2
• /
• pp.39-45
• /
• 1997

This study was performed to investigate the growth response of earthworm (Eisenia foetida) in cow manure added Cadmium (Cd) and therefore, to estimate the toxic threshold level of Cadmium and the levels of Cadmium in cow manure for obtain-ing the maximum Cadmium-concentration enable to accumulate in earthworm tis-sue. Seven different concentrations of Cadmium added in cow manure were 0 (control), 50, 100, 200, 400, 800, 1600 mg/kg, respectively. Survival rate (SR), mean fresh weight of adult worm at final time ($FW_2$), increasing rate (IR), number of cocoon (NC), number of young worm (NY) and residual matter (RW) were not significantly different among Cadmium concentrations in cow manure. Of the measured growth-characteristics, survival rate (SR) had a significantly positive correlation (p<0.001) with number of cocoon (NC). But mean fresh weight of adult worm at final time ($FW_2$) had a significantly negative correlation (p<0.05) with residual matter of cow manure. The maximum Cadmium concentration accumulated in tissue was ranged from 283.8 mg/kg to 396.2 mg/kg. It was obtained at the level of 956.5 mg/kg and 1116.6 mg/kg in cow manure added Cadmium, respectively.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.24 no.2
• /
• pp.272-277
• /
• 2010

This experimental study was performed to investigate the antitumor effect of Egg white combined-Chalcanthite (InSan 4, IS4) in xenografted nude mice with NCI-H460 human lung cancer cell. We cultured NCI-H460 cell lines and xenografted them on nude mice. These mice were divided into 3 groups; group with dose of 45 mg/kg IS4 orally, group with dose of 90 mg/kg IS4 orally, and the control group. They had been raised and treated for 28 days. We checked their body weight, tumor weight and volume twice a week, and their absolute organ weight, microhistological observation and biochemical blood analysis at the final day by sacrificing them. We also calculated their tumor inhibition rate (IR), mean survival time and percent increase in life span (% ILS). In this study, we observed that all of the IS4 treated mice have tumor regression, dosage-dependently, compared to the control group. Tumor weight and volume of high dose treated mice were smallest. IR increased in IS4 in a dose-dependent manner. Mean survival time and percent increase in life span (% ILS) in high-dose IS4 treatment group were the highest of the three groups. There was no significant difference in biochemical blood analysis, alanine phopsphatase (ALP), Calcium, creatinine (CRE), alanine transferase (ALT), and aspartate transaminase (AST) levels. The urea nitrogen (UN) level results significantly decreased by IS4 45 and 90 mg/kg (IS4 45 mg/kg, IS4 90 mg/kg, p<0.01). IS4 may have potential anti-tumor effect in a solid tumor induced by NCI-H460 without remarkable side effects.

• The Journal of Korean Medicine
• /
• v.31 no.3
• /
• pp.34-46
• /
• 2010

Objective: This experimental study was performed to examine if Hang-Am-Dan non-boiled water extracts (HAD-N) induce apoptosis in human lung carcinoma NCI-H460 cells in vitro and inhibits the growth of NCI-H460 cell-transplanted solid tumor in vivo. Materials and Methods: We cultured NCI-H460 cell lines and xenografted them to nude mice. The mice were divided into 3 groups, NCI-H460 cell alone, NCI-H460 + 90 mg/kg HAD-N treated group, and NCI-H460 + 180 mg/kg HAD-N treated group, with seven mice per group. HAD-N was orally administrated every day for four weeks. We checked their body weight and tumor weight and volumes two times a week and their absolute organ weight and biochemical blood analysis at the final day by sacrificing them. We also calculated their tumor inhibition rate (IR), mean survival time and percent increase in life span (% ILS). Results: In this study, we observed that all of the HAD-N treated mice got smaller tumors. The more doses of HAD-N used, the less IR showed at the 8th day after starting this experiment. Tumor weight and volume of HAD-N treatment groups also decreased. Mean survival time and percent increase in life span (% ILS) in the high-dose HAD-N treatment groups were higher than those of other groups. The test substances in the blood level UN results showed reduction in the significance in both HAD-N 90 mg/kg and HAD-N 180 mg/kg (p<0.01). The blood level phosphatase results in HAD-N 90 mg/kg group compared to NCI-H460 cell alone group showed a reduction in significance (p<0.05). AST levels HAD-N 180 mg/kg group compared to NCI-H460 cell alone group significance as well (p<0.05). Conclusion: We suggest that the results of the in vivo study showed that HAD-N may have potential as a growth inhibitor of tumor-induced NCI-H460 of nude mice in spite of the shortcomings of this study. More studies to overcome those shortcomings and to find out significant antitumor mechanism will be needed.

• The Journal of the Korean bone and joint tumor society
• /
• v.7 no.4
• /
• pp.133-138
• /
• 2001

Purpose : To analyze the clinical behaviors and survivorship of metastatic bone tumors. Materials and Methods : One hundred and ninty-eight metastatic bone tumors had been diagnosed from January 1982 to December 1998. Age and sex distribution, primary cancer types. metastatic sites, duration from diagnosed of primary tumors to bony metastases and survivorship were analysed. Results : Mean age was 57(24~86) years old. Lung(32.3%) and breast(16.2%) cancers were two most common primary foci. The spines was the most common site of metastases especially lumbar region(38%). Survivorship analysis was done in one hundred and fifteen patients who had been followed up. The mean survival period was 15.3 months. The survivorship of hepatoma(7.1 Mons), lung(8.72 Mons) and renal cell(4.8 Mons)cancers was relatively shorter and breast cancer(54.1 Mons) longest. Conclusion : The mean age of metastatic bone tumors of this study was older than the past reports. The axial skeletons especially spine was predominant metastatic site. The survivorship of metastatic bone tumor decreased sharply as time goes by, so early diagnosis is clue for longer survival after bony metastases.

• The Journal of the Korean dental association
• /
• v.50 no.6
• /
• pp.329-338
• /
• 2012

Introduction: The purpose of this study is to evaluate the clinical results of vertical alveolar ridge augmentation using autogenous block bone graft, especially resorption rate, and outcomes of dental implants placed in the grafted site. Patients and Methods: Medical records and radiographs were reviewed. Twenty-seven patients who have been received the autogenous block bone graft which harvested from chin, ramus, and ilium, and the implant installation on 31 areas(22 maxillas and 9 mandibles) were included. Eight implants were installed simultaneously at the time of bone graft in 4 patients, and 65 implants were installed after 4.9 months(range 2~18 months) of autogenous block bone graft in 23 patients. The resorption amount and rate of augmented bone, and the success and survival rates implants were evaluated. Results: Mean height of the augmented block bone was $5.9{\pm}2.3mm$(range from 2.5 to 13.0 mm). Mean follow-up period after block bone graft was 30.4 months(range from 16 to 55 months). Mean resorption of the augmented block bone was $2.0{\pm}1.5mm$ (range from 0.5 to 7.24 mm). The success and survival rates of the implants were 78.1 % and 98.6%, respectively. Conclusion: This study indicates that the autogenous block bone graft is a useful and stable method for alveolar ridge augmentation for dental implant. And more augmentation is needed to compensate the resorption of the grafted bone.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.4
• /
• pp.258-265
• /
• 2015

Objective : The purposes of this article are to present 5 cases of intracranial meningioma with leptomeningeal dissemination (LD) and investigate the characteristics of this disease. Methods : We present a retrospective case series of 5 females at our institutions (age ranged 21-72 years, mean 54.6 years) diagnosed with LD of an intracranial meningioma after surgery between 1998 and 2013. A database search revealed 45 cases with LD of meningioma in the English literature. Characteristic features were analyzed and compared. Results : The incidence rate at our institutions of LD of meningioma was 0.9% (5/534). World Health Organization (WHO) grade was distributed as follows: I : 2, II : 2, and III : 1. Time to LD ranged from 2.5 months to 6.9 years; the patient with WHO grade III had the shortest interval to LD. The patient with an intraventricular meningioma (WHO grade II) had the second shortest interval to LD (1.7 years), and simultaneously revealed both LD and extraneuronal metastases. Four of 5 patients showed a disease progression, with the survival ranging from 1 month to 3.8 years after LD. Based on the literature, the initial tumor was an intraventricular meningioma in 9 patients, and their time to LD was shorter on average (mean 1.9 years). Histologically, 26 of 45 (58%) were initially diagnosed with a WHO grade II or III meningioma, and 6 of 19 patients (32%) with WHO grade I revealed malignant transformation. Conclusion : This study shows that intraventricular location and histologically aggressive features seem to increase the chance of LD of meningioma.