• Journal of Chest Surgery
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• v.19 no.2
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• pp.273-279
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• 1986

Total anomalous pulmonary venous return is a cardiac malformation in which there is no direct connection between any pulmonary vein and the left atrium but, rather all the pulmonary veins connect to the right atrium or one of its tributaries. TAPVC is a relatively uncommon anomaly, accounting for only about 1.5-3% of cases of congenital heart disease. Recently improvement in intraoperative techniques did eventually bring substantial improvements in the results in infants. 4 cases of TAPVC was successfully treated with one-stage operation, in the Dept. of Thoracic and Cardiovascular Surgery, National Medical Center in which 2 cases are supracardiac types and the other 2 cases are cardiac types. Sex ratio was 1:1, and the range of age was 2 years-18 years. The common pulmonary venous sinus was connected to the left vertical vein and innominate vein: in 2 supracardiac types and coronary sinus in 2 cardiac types. All cases are operated with standard cardiopulmonary bypass, and the hospital mortality was 0%.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.202-205
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• 2006

Osteomas of the paranasal sinuses rarely lead to intracranial manifestations. The authors report an unusual case of a frontal sinus osteoma leading to subdural emyema formation. A 19-year-old man presented with headache and fever one month after minor facial trauma. Neuroradiological studies revealed subdural empyema in left frontal lobe with moderate cerebral edema and a osteoma in the left frontal sinus with sinusitis of maxillary sinus. The patient was surgically treated in one stage operation of decompressive craniectomy, removal of subdural empyema with frontal sinus osteoma, and endoscopic sinus surgery via cranial and nasal route. The patient recovered very well after surgery and postoperative antibiotic therapy. The etiology of intracranial infection and the treatment strategy are to be discussed.

• Journal of Chest Surgery
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• v.27 no.7
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• pp.634-638
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• 1994

Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.

• Journal of Chest Surgery
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• v.26 no.6
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• pp.496-500
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• 1993

Takaysu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries. The end stage pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch, left common carotid artery and left subclavian artery. The patient was 27 year-old female and she was admitted because of headache and neck pain. Aortogram revealed fusiform dilatation of left common carotid artery with focal narrowing on it`s distal portion. The patient underwent surgical resection and replacement of Dacron tube graft between distal and proximal left common carotid artery. 3 months after operation, she was readmitted because of shoulder pain and headache. Aortogram revealed focal narrowing of proximal left common carotid artery and total obstruction of left subclavian artery which caused subclavian steel syndrome. Aorto-left common carotid and aorto-left subclavian bypass graft replacement were done.

• Archives of Plastic Surgery
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• v.43 no.2
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• pp.197-203
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• 2016

Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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• 2003.05a
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• pp.802-807
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• 2003

International Convention Center Jeju(ICCJ) was planed and built for accommodating a variety of conventional and exhibitional activities. For a better flexibility of operation, almost all rooms in ICCJ are designed to be subdivided Into a couple of small rooms with installation of movable partition walls. Architectural and acoustical design should be deliberatively and cooperatively undertaken to cope with such a complex condition. Conference hall, the largest room in ICCJ, has a capacity of 5000 seats who:1 used as a whole. It could be divided into 3 halls, one with 2000 pre-installed seats on slanted floor, up/down removable stage and its settings above, and the other 2 flat rooms with no seats installed. A devided hall with pre-installed seats and stage is designed for a multi-use auditorium. Almost all surfaces except ceilings adjacent to the stage are sound absorptively treated, in regard to extensive use of sound reinforcement systems. Its reverberation time 1.65 sec without audience, which is roughly correspond to 1.50 sec with fully occupied audience. When there is a need for a larger room, all the partition wail Is removed and the hall could be used as a whole. Exhibition hall is located in the first floor of ICCJ. Absorption and softness are needed for the hat 1 because exhibition behavior has something noisy features. Perforated MDF panels with porous materials and air space in the back groundare adopted for the walls. There are one large, two medium, and several small convention rooms in ICJJ. The room are also acoustically designed for maximum flexibility with no defects soundwisely.

• Korean Journal of Community Nutrition
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• v.3 no.4
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• pp.655-667
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• 1998

The Computer-assisted Hazard Analysis and Critical Control Point(HACCP) program has been developed for a systematic implementation of HACCP principles in identifying, assessing and controlling hazards in institutional foodservics operations. The HACCP-based sanitation evaluation tool has been developed, based on the results of the computerized assisted HACCP program in 4 service sites of C contracted foodservice company, including 2 general hospitals with 650-beds, one office operation of 400 meals per day, and one factory foodservice of 1,000 meals per day. All database files and processing programs were created by using Unify Vision tool with Windows 95 of user environments. The results of this study can be summarized as follows : 1. This program consists of the pre-stage for HACCP study and the implementation stage of the HACCP system. 1) The pre-stage for HACCP study includes the selection of menu items, the development of the HACCP recipe, the construction of product flow diagrams, and printing the HACCP recipes and product flow diagrams. 2) The implementation of the HACCP system includes the identification of microbiological hazards, the determination of critical control points based on the decision tree base files. 3) The HACCP-based sanitation evaluation tool consisted of 3 dimensions of time-temperature relationship, personal hygiene, and equipment-facility sanitation. The Cronbach's alphas calculation indicated that the tool was reliable. The results showed that the focus groups rated the mean of importance in time-temperature relationship, personal hygiene, and equipment-facility sanitation as 4.57, 4.59 and 4.55 respectively. Based on the results, this HACCP-based sanitation evaluation tool was considered as an effective tool for assuring product quality. This program will assist foodservice managers to encourage a standardized approach in the HACCP study and to maintain a systematic approach for ensuring that the HACCP principles are applied correctly.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1241-1247
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• 1996

From January 1989 to March 1996, we have operated on 102 cases of non-small cell lung cancer at the department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine. They were clinically evaluated. The results are as follows; 1. The peak incidence of age of primary lung cancer was 5th decade(34.3%) and 6th decade(38.2%). Male to female ratio was 2.5:1. 2. Most of symptoms were respiratory, which were cough(61.8%), sputum(43.l%), chest discomfort and pain(30.4%), dyspnea(27.5%), and hemoptysis(9.8%). Asymptomatic cases were 1.9% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy(59.8%), sputum cytology(17.6%), percutaneous needle aspiration(11.8%) and open biopsy(10.8%). 4. Histopathologic classifications were squamous cell carcinoma(55.9%), adenocarcinoma(30.5%), adenosquamous cell carcinoma(6.9%), large cell carcinoma(4.9%), bronchioalveolar cell carcinoma(0.9%), and mixed cell carcinoma(0.9%). 5. Methods of operation were pneumonectony(47.1%), lobectomy(38.2%), bilobectomy(5.9%), wedge resection(1.9%), exploration(6.9%), and overall resectability was 93.1%. 6. Postoperative staging classifications were Stage I (13.7%), Stage II(31.4%), Stage IIIa(38.3%), Stage IIIb(14.7%), and Stage IV(1.9%). 7. The postoperative complications developed in 9.8%, and operative mortality was 1.9 %. 8. One year survival rate was 81.7%, 3 year 49.7% and 5 year 21.8%. According to stage, 5 year survival rate was 39% in stage I, 24.3% in stage II, 23.9% in stage IIIa.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.531-543
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• 2007

Backgrounds : Gastric cancer is one of the most frequent causes of cancer-related deaths worldwide. Gastric cancer patients frequently exhibit distant metastasis at the time of diagnosis and at present, there is no standard regimen after operation or chemotherapy to prevent metastasis and recurrences. Aims : The objective of the study was to compare the overall survival and disease free survival in patients treated with wheel balance therapy (WBT) with patients treated with WBT alone or the combination of WBT and conventional therapy and see if there were any significant improvements in survival between the two groups. Setting & Design : East-West Cancer Center at Daejeon University: retrospective study. Materials & Methods : We retrospectively analyzed 62 patients with stage III (40 patients) and stage IV (22 patients) gastric cancer who have received operation or chemotherapy 2 months prior to beginning WBT. The patients followed the WBT protocol which includes herbal medicine such as PSM capsules, OnePlus syrup, or HAD capsules which prevent metastasis and recurrences. Overall survival and disease free survival were analyzed and the patients were treated for 89.55 weeks and 49.27 weeks (median value) for stages III and IV, respectively. Statistical analysis used : Overall survival and disease free survival were estimated using the Kaplan-Meier method and the WBT and combination treatment arms were compared using the log rank test. Results : For stage III, the 3 year overall survival was 78.5% and disease free survival was 78.3%. Metastasis and recurrence occurred in 13 of 40 patients (32.5%). For stage IV, the 2 year overall survival was 18.2% and disease free survival was also 18.2%. Metastasis and recurrence occurred in 19 of 22 patients (86.4%). No significant difference was found statistically between the WBT alone and combination treatment arms though the combination regimen showed superiority (overall survival p=0.5093, disease free survival p=0.5175). Conclusions : WBT yielded satisfactory results in prolonging survival and preventing metastasis and recurrence in gastric cancer patients. The major treatment unit of WBT is composed of herbal medications (HAD, PSM capsules, OnePlus syrup) and a randomized, prospective study should be carried out using only this treatment unit in the future.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.21-24
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• 2002

Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.