• Title/Summary/Keyword: Operation using

Search Result 18,995, Processing Time 0.06 seconds

Aortic and Mitral Valve Replacement with Reconstruction of the Intervalvular Fibrous Skeleton in Prosthetic Valve Endocarditis (인공판막 심내막염에서 판막간 섬유체 재건을 이용한 대동맥판 및 승모판 치환술)

  • Baek, Man-Jong;Kim, Wook-Sung;Oh, Sam-Se;Jeon, Yang-Bin;Ryu, Jae-Wook;Kong, Joon-Hyuk;Lim, Cheong;Kim, Soo-Cheol;Kim, Woong-Han;Na, Chan-Young;Lee, Seong-Ki;Lee, Chang-Ha;Lee, Young-Tak;Yoon, Youg-Woong;Park, Young-Kwang;Kim, Chong-Whan
    • Journal of Chest Surgery
    • /
    • v.34 no.7
    • /
    • pp.561-565
    • /
    • 2001
  • Patients who have complex endocarditis with involvement of both the aortic and mitral valves and intervalvular fibrous skeleton are among the most difficult to treat and still have the highest surgical mortality and morbidity rates. We report one case of aortic and mitral valve replacement with reconstruction of the fibrous skeleton performed in a 55-year-old female patient who had an aortic annular abscess and both the aortic and mitral prosthetic valve endocarditis with destruction of the fibrous skeleton. Previously, she had undergone redo double valve replacement\`, Transesophageal echocardiogram showed the paravalvular defect at the noncoronary aortic sinus and abnormal sinus tract along the fibrous skeleton. Emergent operation was performed due to positive blood cultures of staphylococcus epidermidis and persistent sepsis despite appropriate antibiotic therapy. After aortotomy extended to the roof of left atrium, both prosthetic valves and destroyed fibrous skeleton were completely resected and the aortic annular abscess was debrided and closed with a bovine pericardial patch. Reconstructions of both aortic and mitral annuli and the fibrous skeleton were done by using two separate bovine pericardial patches in triangular shape and mechanical valves were implanted. Postoperatively, adequate antibiotic therapies were continued and the patient was discharged at the postoperative 72 days without evidence of recurrence of endocarditis. Transthoracic echocardiogram of the postoperative 8 months shows no paravalvular leakage or recurrence of endocarditis and the patient has been followed up with no symptom.

  • PDF

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • Lee, Sub;Kim, Han-Woong;Kang, Hyoung-Seok;Bae, Chi-Hoon;Jheon, Sang-Hoon;Kwon, Oh-Choon;Ahn, Wook-Su
    • Journal of Chest Surgery
    • /
    • v.34 no.9
    • /
    • pp.672-679
    • /
    • 2001
  • Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

  • PDF

Comparative Study of 2 mm Video-thoracoscopic Examination and High-resolution Computed Tomography for Spontaneous Pneumothoarx Patients (자연기흉에서 고해상 전산화단층촬영술과 2 mm 비디오 흉강경검사의 비교 연구)

  • Lee, Song-Am;Chee, Hyun-Keun;Hwang, Jae-Joon;Cho, Seong-Joon;Lee, Sung-Ho;Kim, Kwang-Taik
    • Journal of Chest Surgery
    • /
    • v.40 no.5 s.274
    • /
    • pp.362-368
    • /
    • 2007
  • Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.

Early and Midterm Results of Hybrid Endovascular Repair for Thoracic Aortic Disease (흉부대동맥 질환에서 시행된 하이브리드 혈관내 성형술의 중단기 성적)

  • Youn, Young-Nam;Kim, Kwan-Wook;Hong, Soon-Chang;Lee, Sak;Chang, Byung-Chul;Song, Seung-Jun
    • Journal of Chest Surgery
    • /
    • v.43 no.5
    • /
    • pp.490-498
    • /
    • 2010
  • Background: A hybrid procedure using an open surgical extra-anatomic bypass of aortic arch vessels and thoracic endovascular aortic repair (TEVAR) is less invasive than open surgery, and provides a suitable proximal landing zone. Here we report our experience with a hybrid TEVAR procedure at a single center. Material and Method: We retrospectively reviewed consecutive patients with thoracic aortic disease who received a hybrid TEVAR procedure between August 2008 and January 2010. Patients' data were prospectively collected and mean follow-up was $10.8{\pm}5.5$ months (range 3~20). Result: Nine patients (7 males and 2 females) with a mean age of $63.8{\pm}15.8$ years (range 38~84) underwent a hybrid procedure. Five patients had an arch or a proximal descending aortic aneurysm, two had a dissecting aneurysm of the descending aorta, and two had an aneurysm of the ascending arch and descending aorta. Mean expected mortality calculated by logistic EuroSCORE was 21%. Six patients underwent debranching and rerouting from ascending aorta to arch vessels, 2 had carotid-carotid bypass grafting, and 1 underwent carotid-axillary bypass grafting. Mean operation time was $221.4{\pm}84.0$ min (range 94~364). Deployment success of endovascular stent grafting was 100% with no endoleak on completion angiography. There was no mortality, and a small embolism in the branch of the right opthalmic artery in one patient. During follow-up, one intervention was required for the endoleak. Actuarial survival at 20 months was 100%. Conclusion: Early and mid-term results are encouraging and suggest that hybrid TEVAR procedures are less invasive and safer and represent an effective technique for treating thoracic aortic disease.

Reproducibility of Regional Pulse Wave Velocity in Healthy Subjects

  • Im Jae-Joong;Lee, Nak-Bum;Rhee Moo-Yong;Na Sang-Hun;Kim, Young-Kwon;Lee, Myoung-Mook;Cockcroft John R.
    • International Journal of Vascular Biomedical Engineering
    • /
    • v.4 no.2
    • /
    • pp.19-24
    • /
    • 2006
  • Background: Pulse wave velocity (PWV), which is inversely related to the distensibility of an arterial wall, offers a simple and potentially useful approach for an evaluation of cardiovascular diseases. In spite of the clinical importance and widespread use of PWV, there exist no standard either for pulse sensors or for system requirements for accurate pulse wave measurement. Objective of this study was to assess the reproducibility of PWV values using a newly developed PWV measurement system in healthy subjects prior to a large-scale clinical study. Methods: System used for the study was the PP-1000 (Hanbyul Meditech Co., Korea), which provides regional PWV values based on the measurements of electrocardiography (ECG), phonocardiography (PCG), and pulse waves from four different sites of arteries (carotid, femoral, radial, and dorsalis pedis) simultaneously. Seventeen healthy male subjects with a mean age of 33 years (ranges 22 to 52 years) without any cardiovascular disease were participated for the experiment. Two observers (observer A and B) performed two consecutive measurements from the same subject in a random order. For an evaluation of system reproducibility, two analyses (within-observer and between-observer) were performed, and expressed in terms of mean difference ${\pm}2SD$, as described by Bland and Altman plots. Results: Mean and SD of PWVs for aorta, arm, and leg were $7.07{\pm}1.48m/sec,\;8.43{\pm}1.14m/sec,\;and\;8.09{\pm}0.98m/sec$ measured from observer A and $6.76{\pm}1.00m/sec,\;7.97{\pm}0.80m/sec,\;and\;\7.97{\pm}0.72m/sec$ from observer B, respectively. Between-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.14{\pm\}0.62m/sec,\;0.18{\pm\}0.84m/sec,\;and\;0.07{\pm}0.86m/sec$, and the correlation coefficients were high especially 0.93 for aortic PWV. Within-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.01{\pm}0.26m/sec,\;0.02{\pm}0.26m/sec,\;and\;0.08{\pm}0.32m/sec$ from observer A and $0.01{\pm}0.24m/sec,\;0.04{\pm}0.28m/sec,\;and\;0.01{\pm}0.20m/sec$ from observer B, respectively. All the measurements showed significantly high correlation coefficients ranges from 0.94 to 0.99. Conclusion: PWV measurement system used for the study offers comfortable and simple operation and provides accurate analysis results with high reproducibility. Since the reproducibility of the measurement is critical for the diagnosis in clinical use, it is necessary to provide an accurate algorithm for the detection of additional features such as flow wave, reflection wave, and dicrotic notch from a pulse waveform. This study will be extended for the comparison of PWV values from patients with various vascular risks for clinical application. Data acquired from the study could be used for the determination of the appropriate sample size for further studies relating various types of arteriosclerosis-related vascular disease.

  • PDF

Comparison of Inhalation Scan and Perfusion Scan for the Prediction of Postoperative Pulmonary Function (수술후 폐기능 변화의 예측에 대한 연무 흡입스캔과 관류스캔의 비교)

  • Cheon, Young-Kug;Kwak, Young-Im;Yun, Jong-Gil;Zo, Jae-Ill;Shim, Young-Mog;Lim, Sang-Moo;Hong, Sung-Woon;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
    • /
    • v.41 no.2
    • /
    • pp.111-119
    • /
    • 1994
  • Background: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. $^{99m}Tc$-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared $^{99m}Tc$-DTPA radioaerosol inhalation scan with $^{99m}Tc$-MAA perfusion scan in predicting postoperative lung function. Method: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneurnonectomy $FEV_1$=Preop $FEV_1x%$ of total function of lung to remain Postlobectomy $FEV_1$=Preop $FEV_1{\times}$(% of total 1-function of affected lung${\times}$$\frac{Number\;of\;segments\;to\;be\;resected}{Number\;of\;segments\;of\;affected\;lung})$ Results: 1) The inhalation scan showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.86, 0.72, 0.87 respectively). 3) Among three parameters, $FEV_1$ showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. Conclusion: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function a1though the former showed a better correlation in FVC.

  • PDF

Empirical Research on the R&D Investment and Performance of Venture Businesses (벤처기업의 R&D 투자와 성과에 관한 실증연구)

  • Lee, D.K.;Lee, C.K.;Kim, J.H.
    • 한국벤처창업학회:학술대회논문집
    • /
    • 2008.04a
    • /
    • pp.179-208
    • /
    • 2008
  • In this research, an empirical analysis was performed to determine the correlation between management performance and R&D investment for domestic venture businesses in each industry. Specifically, an empirical analysis for each industry was attempted not only to clarify the general hypothesis on the relationship between management performance and R&D investment for venture businesses but also to demonstrate that differences exist for each industry. Empirical analysis was conducted for eight industries with respect to the $2002{\sim}2006$ panel data extracted as investigative results from the "Investigation Report on Science and Technology R&D Activities" published by the Ministry of Science and Technology. Industrial classification was limited to the middle-level classification (2-digit) in the Korea Standard Industry Code (KSIC) owing to the limited number of panels. Although this research only verified the overall positive effect of R&D activities and funds for existing research on corporate value or productivity and management performance, it was able to document the difference for each individual industry and each business size unlike existing research.Furthermore, the reliability of the research results was enhanced by targeting companies that have been continuously conducting R&D and management activities using consistent 5-year panel data in the analysis. Again, this was something that existing research did not have. Finally, through the use of recent data from 2002 after the IMF economic crisis up to 2006 in the empirical analysis, this research proposed the problems due to the prevailing circumstances at the time of entering the advanced nation stage based on an empirical analysis; the prevailing problems during the pursuit of advanced nation status before the IMF crisis broke out were not tackled. The key empirical analysis yielded several results. First, capital and size of the labor force have a positive correlation with the management performance for the entire company or the venture business. This applies to all eight industries as the subjects of the analysis. Second, although the number of years since a company has been established can have positive or negative correlation with management performance for the entire company or venture business in specific industries, a definite overall trend cannot be identified. Third, R&D investment can be said to have an overall positive effect on corporate management performance. Fourth, the size of the research staff cannot be said to be a factor unilaterally affecting the management performance of the entire company or the venture business. Fifth, the number of years a research institute has been in operation, which was assumed to have a positive effect on the management performance of a company because of the accumulated R&D know-how -- definitely acts as a positive factor contributing to the management performance of a company.

  • PDF

Effect of Whalakyuoleyng-dan plus Yinsamyangwui-tang on Anti-angionesis (활락효영단합인삼양위탕(活絡效靈丹合人蔘養胃湯)이 혈관신생(血管新生) 억제(抑制)에 미치는 영향(影響))

  • Ko, Ki-Wan;Park, Joon-Hyuk;Kang, Hee;Kim, Sung-Hoon;Yu, Young-Beob;Shim, Bum-Sang;Choi, Seung-Hoon;Ahn, Koo-Seok
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
    • /
    • v.7 no.1
    • /
    • pp.77-97
    • /
    • 2001
  • Anti-angiogenesis is one of therapies which have been high-lightened on the research of cancer treatment. Anti-angiogenesis means that new blood vessels are created from a existing capillary tube and it is a important process on metastasis and permeation when cancer is created or formed. Since angiogenesis have been under research, a complete recovery oriented treatment against cancer have been suggested blocking metastasis, delaying the growth of cancer cell, and blocking the supply of oxygen and nutritive substance through the web of blood vessels. Until now, there are several anti-angiogenesis, which have been known to the public, such as thalidomide, angiostatin, endostatin, 2-methoxyestradiol, TNP-470, and marimastat, etc. Additionally, 17 clinical testing projects about anti-angiogenesis are on the process in NCI(National Cancer Institute). Especially, TNP-470 showed effectiveness against cancer on clinical testing after finishing animal testing. Based on existing researches showing that Yinsamyangwui-tang is effective to strengthening body resistance and Whallakhyolenyng-dan effects cells on the inside of blood vessel because Whallakhyolenyng- dan restrains cell adhesion during the restraining period of a blood vessel, I tried to research the effect of Whalakhyolenyng-dan plus Yinsamyangwui-tang on angiogenesis. I made a conclusion putting into operation through using SK-Hep-1 (KCLB 30052), A549(KCLB 10185), AGS(KCLB 21739), and BCE(Bovine Capillary Endothelial Cell). Followings are the results of my experimental research: 1. According to the researching results of anti-cancer activation against cancer cell, Whallkhyoleyng dan plus Yinsamyangwui-tang decreased the number of cancer cells -- While injecting $600{\mu}g/ml$, injected groups decreased 3.1% more comparing with the contrastive group of SK-Hep-1, 49.7% more comparing with the contrastive group of A549, and 31.0% more comparing with the contrastive group of AGS. 2. According to the researching results of DNA composition effect between BCE and cancer cell, Whallakhyoleyng-dan plus Yinsamyangwui-tang reduced the rate of SK-Hep-1 synthesis inhibition by 59.1% at $600{\mu}g/ml$ intensity comparing with contrastive group; for A549, 72.6%; for AGS, 6.1%, for BCE, 28.9%. 3. According to the researching results about the effect of BCE cell to angiogenesis, angiogenesis was restrained at $400{\mu}g/ml$ intensity during 18 hours observation. 4. In the case of aortic ring assay, the half level of angiogenesis was reduced comparing with the contrastive group while injecting with $400{\mu}g/ml$ intensity; with $800{\mu}g/ml$, under 10% comparing with contrastive group; and with $1600{\mu}g/ml$, complete restrain. According to the above results, Whallakhyoleyng-dan plus Yinsamyangwui-tang was proved to have an anti-angiogenetic effects.

  • PDF

EMERGY Analysis of Korean Fisheries (한국수산업의 EMERGY 분석)

  • SOHN Ji-Ho;SHIN Sung-Kyo;CHO Eun-Il;LEE Suk-Mo
    • Korean Journal of Fisheries and Aquatic Sciences
    • /
    • v.29 no.5
    • /
    • pp.689-700
    • /
    • 1996
  • Fisheries products have to be produced and maintained by work processes from the environment, sometimes helped by people. In Korean fisheries both environmental production and its economic use are included within the windows of system approach. EMERGY is the sum of all inputs expressed as one form of solar energy required directly and indirectly to make a product. Calculating EMERGY flows into Korean fisheries evaluates the real wealth contributed by environmental production and its economic use. Several indices calculated from EMERGY analysis table and a three-arm diagram give perspective on the type and efficiency of the environmental uses. Net EMERGY yield ratio is a measure of its net contribution to the economy beyond its own operation. For adjacent waters fisheries in Korea, the net contribution to the economy is 11.85 or higher, which is a stimulus to the economy that is able to purchase it. EMERGY investment ratio measures the intensity of the economic development and the loading of the environment. The ratio for Korean fisheries as a whole is 0.50, for the adjacent waters fisheries 0.09 and for the shallow-sea cultures 1.28, which is lower than the same index for the industry of the developed country (7.0). The component of environment drawn into production are large compared to purchased investment in Korean fisheries. Much more EMERGY is contained in fisheries products than in the paid services used to process the products. The EMERGY exchange ratio for Korean fisheries as a whole is 6.98, for the adjacent waters fisheries is 10.69 and for the shallow-sea cultures is 1.25. Using market values to evaluate wealth of environment resources is found to be many times too small. Money is paid only to people for their contribution, and never to the environment for its contribution. Macroeconomic value is the appropriate measure for discussing large-scale considerations of an economy, including environment and human goods & services.

  • PDF

A Study on the Filtration of Swine Anaerobic Digestate Using Multi-Layered Compost Beds (다층구조의 퇴비단을 이용한 돈분뇨 슬러리 혐기소화액의 여과효과에 대한 연구)

  • Han, Deug-Woo;Lee, Dong-Hyun;Kim, Jung-Gon;Yang, Seung-Hak;Bae, Jin-Woo;Kwag, Jung-Hoon;Choi, Dong-Yoon;Jeong, Kwang-Hwa
    • Journal of the Korea Organic Resources Recycling Association
    • /
    • v.21 no.4
    • /
    • pp.72-81
    • /
    • 2013
  • The objective of this study was to verify whether SCB(Slurry Composting & Bio-filtration) system can be applied for the treatment of anaerobic digestion(AD) wastewater and also, to identify the most effective set among three filtration compost beds tested. Results can be summarized as these; (a) When AD wastewater was sprayed on the top of beds which were mainly composed of sawdust and/or other media and, subsequently, filtrates collected and analyzed, there were large drop in the values of Electric Conductivity(EC), Total Suspended Solid(TSS), Biochemical Oxygen Demand(BOD), and Chemical Oxygen Demand(COD). In contrast, Total Nitrgen(T-N) and Total Phosphorus(T-P) were progressively elevated. We consider these changes as positive if the filtrate are to be utilized as liquid fertilizer. (b) When three sets of filtration beds (T1, T2, T3) were compared for their effectiveness, no significant difference was found among them. These indicate that expensive sawdust can be replaced in part with cheaper media such as woodchip, rice husks, or others. (c) At early stage of operation (within 20 days), BOD in filtrates were maintained at high level probably due to the lack of microbial activity. During the same stage, T-N, T-P was at low level but, were elevated to higher levels thereafter. These data, when combined, indicate that the filtration system needs at least a couple of weeks for the optimized microbial functioning. (d) The temperatures of the experimental beds were progressively dropped as the experiment continued through the fall season, although filtration effectiveness was not noticeably influenced.