• Title/Summary/Keyword: Medical Procedures

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Regression of Left Ventricular Hypertrophy after AVR in Aortic Valvular Stenosis (대동맥판막협착증 환자에서 판막치환 후 좌심실심근비후의 변화)

  • 이재원;최강주;송명근
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.586-590
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    • 1998
  • Background: The regression of the left ventricular hypertrophy after prosthetic valve replacement in patients with aortic valvular stenosis is an important factor to determine the appropriateness of the replaced prosthetic valvular size. Methods: To assess the regression of myocardial hypertrophy, a retrospective analysis of Doppler echocardiographic and electrocardiographic data was undertaken before, soon after(7.5$\pm$2.1 day), and late after(10.7$\pm$1.8 months) surgery in 36 patients(22 males, 14 female, mean age 54$\pm$12.1 years, mean BSA 1.61$\pm$0.15m2) with predominant aortic valvular stenosis. The patients underwent St. Jude Medical aortic valve replacement. By the size of the valves used, the patients were divided into three groups(19, 21 and 23+). Results: The mean body surface area(1.48$\pm$0.13) in the patients with the 19 mm valve was smaller than that in the other groups(1.63$\pm$0.12)(p<0.05). No significant changes of ejection fraction were detected in all groups over time. Left ventricular muscle mass index(gm/m2) was reduced significantly in the 21 and 23+ groups over time(p<0.05), but there were no significant changes in the 19 mm valve group. The electric voltage height on EKG at the period of late after surgery was reduced significantly in all groups(p<0.05). Conclusion: Despite clinical improvement, the LVH was not reduced significantly in 19 mm valve group. Thus we suggest that more attention and additional procedures such as annular enlargement should be taken in patients who will undergo the replacement of 19 mm prosthetic valve.

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An experimental study on the biological safety and compatability of P.V.C. made in Korea (한국산 P.V.C.의 생물학적 안정도 및 적합성에 대한 실험적 고찰)

  • Sun, Kyung
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.157-166
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    • 1984
  • These biologic test procedures are designed to test the suitability of P.V.C. made in Korea intended for parenteral preparation, which were based on the U.S. Pharmacopeia XIX "Biologic Test-Plastic Container", Official from July 1, 1975. Healthy adult human blood and rabbits weighing 2\ulcorner.2Kg were used for test materials. Sample P.V.C. were sampled from the medical equipments made in Korea randomly and Control P.V.C. were sampled from the standardized Cobe and Polystan P.V.C. tubes. P.V.C. extract was prepared from a homogeneous P.V.C. samples by incubating 60 square centimeters of the sample per 20 millimeters of sterile pyrogen-free saline at 70\ulcorner for 72 hours or autoclaving at 120\ulcorner for 1 hour. The Implantation Test was designed to evaluate the reaction of living tissue to the plastic by the method of the implantation of the Sample itself into animal tissue. The Systemic Injection Test, the Intracutaneous Test, and the remainders were designed to determine the biological response of animals to plastics by the single-dose injection of specific extracts prepared from a Sample. The results are as follows; 1.Implantation Test - No significant difference for reactions was noted between the Sample treated animal and the Control after 72 hours of implantation. 2.Systemic Toxicity Injection Test - No sign of toxicity and/or death immediately after injection and at 4, 24, 48 hours respectfully after injection. 3.Intracutaneous Test - None of the animals treated with the Sample showed a significantly greater reaction than the observed in the animals treated with Blank. 4.Pyrogen Assay-Only one animal treated with the Sample showed the maximal rise of rectal temperature about 0.2\ulcorner after 3 hours of injection, but remainders showed no change. 5.Hemolytic Index - The positive Control tube of distilled water exhibited complete hemolysis while the negative Control tube and P.V.C. extract were negative demonstrating no hemolysis. 6.Cell Morphology of Erythrocytes and Leukocytes on Stored, Heparinized Human Blood -- There was no significant difference in the morphology of either the Control or Sample extract. 7.Clotting Mechanism of Human Blood in vitro - After allowing to the P.V.C. extract at room temperature for 5 Hours and at 10\ulcorner for 24 hours, there was no appreciable difference in Prothrombin Time under these conditions. 8.Clotting Mechanism of Rabbit in vivo - At the termination of 5 days after intraperitoneal injection of the P.V.C. extract, no significant changes in Clotting Time were observed. According to the above results, it could be concluded that the P.V.C. made in Korea was acceptable for parenteral preparation, especially treated with physiologic saline and/or human blood.man blood.

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Primary neurofibroma of the Diaphragm (횡격막에 발생한 신경섬유종 1례)

  • 유회성
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.149-152
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    • 1975
  • In spite of great advances in surgical treatment during past several decades, surgery of the trachea failed to develop correspondingly, partly because of relative rarity of the tracheal lesions and partly because of difficulties in surgical technique and anesthesia. Surgical diseases of the trachea are largely obstructions due to neoplasm or cicatrical stenosis and tracheal malacia. The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tubes, has produced, apparently with increasing frequency, tracheal stenosis, tracheomalized tracheal erosion. Surgery is presently the only reasonable way to treat stenotic lesions of the tracheobronchial tree. In the case of tumors, the current trend has been that of radical excision. Primary end-to--end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, for decades it was believed that a maximum of four tracheal rings only might be excised and primary healing achieved with safety. A great variety of procedures, developed by numerous investigations and directed at tracheal substitution, have almost invariably met with discouraging results. A meticulous study done by Grillo and associates on autopsy specimens has shown that an average 6.4cm of mediastinal trachea can be safely resected by full mobilization of the right lung and transplantation of the left main bronchus into the bronchus intermedius. Recently, we experienced a case of successful resection of a tumor of the tracheal carina and primary tracheo-left main bronchial anastomosis at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul. The patient, a 29-year-old man, was admitted to the hospital with complaints of dyspnea and cough. On admission, chest film showed hydropneumothorax on the right. After closed thoracostomy, hydropneumothorax disappeared, but hazy densities, developed in the right middle and lower lung fields, resisted to treatment. Bronchoscopy uncovered irregular tumor covering the carina and the right main bronchus, and biopsy indicated well differentiated squamous Cell carcinoma. Operation was performed on July 2, 1975. A right postero-lateral thoracotomy was used. Excision involved the lower trachea, the carina, the left main bronchus and the right lung. This was followed by direct anastomosis between the trachea and the left main bronchus. Bronchography was done on 17th postoperative day revealed good result of operation without stricture at the site ofanastomosis. About one month after the operation symptoms and signs of bronchial irritation with dyspnea developed, and these responded to respiratory care. On 82nd postoperative day, sudden dyspnea developed at night and the patient expired several hours later. Autopsy was not done and the cause of death was uncertain.

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IDENTIFICATION OF FUSOBACTERIUM NUCLEATUM AND FUSOBACTERIUM NECROPHORUM USING POLYMERASE CHAIN REACTION(PCR) (중합효소연쇄반응(Polymerase Chain Reaction)을 이용한 Fusobacterium nucleatum 및 Fusobacterium necrophorum의 동점에 관한 연구)

  • Kang, Chang-Woo;Park, Dong-Sung;Yoon, Soo-Han
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.40-48
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    • 1999
  • This study was designed to examine the specificities of the designed primers for F. nucleatum and F. necrophorum and to compare the PCR results using clinical samples with those of the anaerobic culture method. F. nucleatum and F. necrophorum spp. are frequently isolated in infected root canals, and they are related to periapical diseases. F. nucleatum(VPI 10197) and F. necrophorum(ATCC 25286) were used as references for PCR reaction, and thirty five teeth with one canal and periapical lesion were used. The samples were cultured anaerobically and identified using Rapid ID 32A(BioMerieux Vitek, Inc., France) as biochemical battery. In the GenBank database, species-specific PCR primers(nuc1/nuc2 primers for F. nucleatum and nec1/nec2 primers for F. necrophorum) were designed from the 16S ribosomal DNA(rDNA) sequences of F. nucleatum(accession number M58683) and F. necrophorum(accession number AF044948). PCR procedures of F. nucleatum(VPI 10197) and F. necrophorum (ATCC 25286) were simulated on a computer software. Amplify(v.1.2${\beta}$ for Macintosh). 820 bps and 817 bps of nucleotides were expected, respectively. Using extracted DNAs with QiaAmp tissue kit(Qiagen co., Germany), PCR was done. The results were as follows : 1. The nuc1/nuc2 primers produced an amplicon of 820 bps and the nec1/nec2 primers produced an amplicon of 817 bps. 2. The nuc1/nuc2 primers and the nec1/nec2 primers were specific and did not react with species other than the designated ones(i.e. nuc1/nuc2 primers did not produce amplicons for F. necrophorum, and vice versa.). And the PCR products of Porphyromonas endodontalis(ATCC 35406), Porphyromonas gingivalis(ATCC 33277), Prevotella intermedia(ATCC 25611), and Prevotella nigrescens(ATCC 33563), frequently isolated in infected root canals and periapical lesions, were not amplified by the primers specific for Fusobacterium nucleatum and Fusobacterium necrophorum. 3. This method utilizing PCR could detect F. nucleatum and F. necrophorum in clinical samples, while anaerobic culture method could detect neither.

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Changes of Surface Electromyography on Frontalis Muscle during Electro-Acupuncture Stimulation of Abdomen or Legs - A Pilot Study for Clinical Approach to Autonomic Nervous System Changes - (복부 및 사지 부위의 전기침 자극이 전두근에서 측정한 SEMG 변화에 미치는 영향 - 자율신경계의 변화에 대한 임상적 접근을 위한 사전 연구 -)

  • Je, Jun-Tae;Choi, San-Ho;Shin, Sun-Ho;Lim, Jin-Young;Lee, Sang-Kwan
    • The Journal of Internal Korean Medicine
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    • v.33 no.1
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    • pp.14-25
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    • 2012
  • Objectives : To observe physiological changes during clinical acupuncture treatment. Methods : We recruited 40 healthy volunteers who had experienced an acupuncture treatment at least once within the past three years. The experimental group was divided into four groups according to the needling site and frequency of electrical stimulation. Sites consisted of abdomen and legs. Frequencies consisted of 100 Hz and 2 Hz. The procedures of experimental treatment consisted of seven phases, Resting I phase (Resting I), Needle insertion phase (Insertion), Maintenance of needle insertion I phase (Maintain I), Electrical stimulation phase (ES), Maintenance of needle insertion II phase (Maintain II), Needle removal phase (Removal) and Resting II phase (Resting II). We measured the surface electromygraphy (SEMG) through an electrode on the frontalis muscle during all phases consecutively. Results : When SEMGs of all seven phases were analyzed, they significantly increased or decreased according to phases. SEMGs of Insertion, Maintain I, ES and Maintain II phase significantly increased more than RestingI in abdomen and legs groups. SEMGs of the abdomen group were measured as being $4.78{\pm}0.74{\mu}V$ on Resting I, $16.48{\pm}3.97{\mu}V$ on Insertion, $46.31{\pm}10.56{\mu}V$ on Maintain I, $45.88{\pm}9.72{\mu}V$ on ES, $45.56{\pm}9.69{\mu}V$ on Maintain II, $18.76{\pm}3.05{\mu}V$ on Removal, and $3.75{\pm}0.65{\mu}V$ on Resting II. SEMGs of the legs group were measured as being $3.34{\pm}0.35{\mu}V$ on Resting I, $12.11{\pm}1.76{\mu}V$ on Insertion, $36.74{\pm}6.99{\mu}V$ on Maintain I, $33.57{\pm}6.30{\mu}V$ on ES, $32.66{\pm}6.03{\mu}V$ on Maintain II, $14.08{\pm}2.15{\mu}V$ on Removal, and $2.88{\pm}0.32{\mu}V$ on Resting II. Conclusions : SEMG changed differently according to processes of acupuncture. Electrical stimulation showed different change of SEMG. Thus, acupuncture treatment may change the status of the autonomic nervous system.

Surgical Treatment of Peripheral Artery Occlusive Disease (말초동맥 폐쇄질환에 대한 외과적 고찰)

  • 김해균;윤용한;이두연;문동석;이택연;홍윤주
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.262-265
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    • 1998
  • A retrospective analysis was performed on the 72 cases of peripheral artery occlusive disease treated at Yonsei Medical School Yongdong Severance Hospital, from March 1, 1990, through July 31, 1992, focusing on the operative procedures, surgical results and perioperative complications. The etiologic causes of vascular obstruction were atherosclerosis in 28 cases, Buerger's disease in 31, traumatic orgin in 7, operative complications in 4, and malignancy and arteritis in one case each. Treatment modalities, actually performed include bypass graft.(27), infusion of PGE1 (23), Embolectomy (16), Sympathectomy (4) and end-to-end anastomosis (2). There were 21 satisfactory cases and 9 unsatisfactory cases of atherosclerotive occlusive disease, defining the operative outcome as“satisfactory”if the obstructive symptoms disappeared completely and “unsatisfactory”if they did not. The patients of TAO induced Buerger's disease with preoperative Foutain class III or IV were surgically converted to class 0 in 14 cases, class I in 12 and class II in 3.

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Retrograde Study on Thoracic Percutaneous Vertebroplasty and Kyphoplasty Done by Transpedicular Approach (흉추에서의 경척추경 접근법을 통한 경피적 척추체성형술 및 척추체 후만변형 복원술에 관한 후향성 연구)

  • Joh, Ju Yeon;Bae, Young Gon;Kim, Yang Hyun;Lee, Eun Hyung;Lee, Chul Joong;Lee, Sang Chul;Kim, Yongn Lak
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.204-207
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    • 2005
  • Background: Transpedicular percutaneous vertebroplasty, along with kyphoplasty of the thoracic vertebrae, is technically more difficult than those of the lumbar vertebrae due to the anatomical differences. During the last four years, all the percutaneous vertebroplasty and kyphoplasty of the thoracic vertebrae carried out at our institution were performed using a transpedicular approach; therefore, we tried to find if there were any problems or complications associated with the process. Methods: The medical records of all the patients who had undergone thoracic percutaneous vertebroplasty or kyphoplasty were retrospectively reviewed. The following were looked up: the procedure name, unipedicular or bipedicular, the level of the thoracic vertebrae treated, and the pre- and postoperative changes in the Visual Analog Scales (VAS), the volume of cement injected and complications. Results: In the last four years, 58 vertebral bodies in 58 patients were treated. Twelve and 46 vertebral bodies were treated by kyphoplasty and vertebroplasty, respectively. A total of 58 mid and lower thoracic levels were treated: T5 (n=1), T6 (n=1), T7 (n=3), T8 (n=4), T9 (n=1), T10 (n=4), T11 (n=14) and T12 (n=30). The mean preoperative and postoperative VAS scores were $8.1{\pm}1.4$ and $5.2{\pm}1.7$, respectively. The mean volume of cement injected was $4.01{\pm}1.85ml$; $3.18{\pm}0.60ml$ at T5-8 and $4.22{\pm}2.27ml$ at T9-12. There were no clinical complications, such as pedicular fracture or cement leakage. Conclusions: Although transpedicular vertebroplasty and kyphoplasty at the mid to lower thoracic vertebral bodies is technically difficult compared to that at the lumbar region, the procedures can be performed safely.

The Effect of Oocyte Donor Age and Micromainpulation Medium on the Development of Mouse Cloned Embryos (생쥐 복제수정란 발달에 있어서 난자공여 생쥐 연령과 미세조작 배양액의 영향)

  • Kim, Dong-Hoon;Lee, Youn-Su;Oh, Keon-Bong;Hwang, Seong-Soo;Im, Gi-Sun;Park, Jin-Ki
    • Reproductive and Developmental Biology
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    • v.35 no.3
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    • pp.313-317
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    • 2011
  • This study was conducted to examine the effect of oocyte donor age and micromanipulation medium on the development of mouse cloned embryos receiving cumulus cells. Mouse oocytes were obtained from 6 to 11 week-old mice BDF1 female mice(experiment 1) and cumulus cells were used as donor cells. Micromanipulation procedures for nuclear transfer(NT) were performed in FHM, M2 or Hepes-buffered TCM199(TCM199) medium(experiment 2). After nuclear transfer, the reconstructed oocytes were activated by 10 mM $SrCl_2$ in Ca-free CZB medium in the presence of 5 II ${\mu}$g/ml cytochalasin B for 5 h and cultured in KSOM medium for 4 days. In experiment 1, the survival rate of oocytes after injection of cumulus cells were significantly(p<0.05) lower in oocytes from 6~7 week-old mice(53.3%) than in oocytes from 8~9(80.9%) and 10~11 week-old mice(77.1%). In experiment 2, the survival rate of oocytes after cell injection were significantly(p<0.05) higher in FHM and M2 medium(71.7% and 76.9%) than in TCM199 medium(51.2%). The activation rates of cloned embryos were not different among the micromanipulation media. However, the embryos developed to blastocyst stage were significantly(p<0.05) higher in FHM medium(13.9%) than in M2 and TCM199 medium(0.0% and 0.0%). In conclusion, the present study suggest that oocytes from above 8 week-old mice are superior to oocytes from 6~7 week-old mice as a source of recipient cytoplasm and FHM is superior to M2 and TCM199 as a micromanipulation medium for mouse somatic cell cloning.

Clinical Study of Empyema Thoracis (농흉에 대한 임상적 고찰)

  • Kim, Tae-Nyeun;Lee, Young-Hyun;Chung, Jae-Chun;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.87-94
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    • 1986
  • Empyema thoracis following pneumonia, intra-abdominal pathology, trauma, and surgical procedure continues to be a source of major morbidity and mortality. Thirty seven adult and eleven pediatric patients with empyema thoracis were treated at the University of Yeungnam Medical Center from May 1983 to November 1986. Age distribution ranged from 6 months to 72 years and showed a double-peaked curve with the highest incidence between 36 and 65 years and below 15 years of age. There were male predominence in patients above 16 years of age. The most common predisposing factors was impaired consciousness due to either alcoholism or head injury. The causes of empyema were as follows: pneumonia 64.6%, lung abscess 6.4%, intraabdominal pathology 6.4%, and surgical procedure 6.4%. The cardinal symptoms were fever, cough, chest pain, dyspnea, sputum, weight loss, anorexia, and night sweat in orders. Culture of empyema fluid were positive in 50% of patients. The isolated organisms were Gram-negative bacilli 33.3%, staphylococcus aureus 25%, and streptococcus 25%. The patients received antibiotics in conjunction with various invasive procedures : chest tube drainage 77.1%, decortication 6.3%, and repeated thoracentesis 10.3%. There were 4 deaths, 1 child and 3 adults, with a overall mortality of 8.3%.

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Thiopental Prevents A Beta-Endorphin Response to Cardiopulmonary Bypass (체외순환전 투여된 Thiopental이 Beta-endorphin치 변화에 미치는 영향)

  • Song, Sun-Ok;Carr, Daniel B.;Park, Dae-Pal;Jee, Dae-Lim;Kim, Sae-Yeon
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.350-358
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    • 1997
  • We studied the effects of adding a single bolus(500 mg) of sodium thiopental to a continuous infusion of low-dose fentanyl on plasma beta-endorphin immunoreactivity(iBE) responses to cardiopulmonary bypass(CPB) in 28 patients undergoing elective coronary artery bypass grafting or valve procedures. Thiopental was injected just prior to the initiation of CPB. The iBE levels and the hemodynamic indices such, as mean arterial pressure, cardiac output and systemic vascular resistance were measured before CPB, at 30 min and again at 60 min after the initiation of the bypass. The results were as follows. After the initiation of CPB, iBE levels increased at 30 min and 60 min(P=0.006, P=0.004 respectively) in the control group, but not in the thiopental group. There were significant differences in the changes of iBE levels between the groups(F=8.7, G-G=0.002, P=0.001). The hemodynamic indices were similar in both groups. In conclusion, pretreatment with thiopental just before the initiation of CPB prevents the stress-induced beta-endorphin response to CPB.

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