• Clinical Endoscopy
• /
• v.56 no.3
• /
• pp.375-380
• /
• 2023

Cholecystectomy is the best method for treating gallstone diseases. However, 10%-30% of patients who undergo a cholecystectomy continue to complain of upper abdominal pain, dyspepsia, or jaundice-this is referred to as postcholecystectomy syndrome. Cystic duct stump stones are a troublesome cause of postcholecystectomy syndrome. Conventionally, surgery is mainly performed to remove cystic duct stump stones. However, repeated surgery can cause complications, such as postoperative bleeding, biliary injury, and wound infection. As an alternative method of surgery, endoscopic retrograde cholangiopancreatography is sometimes used to remove cystic duct stump stones, although the success rate is not high due to technical difficulties. Recently, peroral cholangioscopy, which can directly observe the bile duct, has been suggested as an alternative method. We report two cases in which a cystic duct stump stone was successfully removed via a single-operator cholangioscopy, after failure with an endoscopic retrograde cholangiopancreatography.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.26 no.4
• /
• pp.412-416
• /
• 2022

Although a pancreaticojejunostomy (PJ) is not required after a distal pancreatectomy in most cases, it needs to be performed to prevent atrophy of the remnant pancreas when the proximal duct is obstructed by a tumor, stone, or etc. In these conditions, the critical postoperative pancreatic fistula (POPF) gives surgeons cause to hesitate before performing a PJ. We previously presented the modified technique of Mattress PJ named "inverted mattress PJ" (IM-PJ) and published improved outcomes in the aspects of POPF after a pancreaticoduodenectomy and a central pancreatectomy. Recently, we had a case of a patient who has chronic pancreatitis with a proximal pancreatic duct obstruction, requiring a distal pancreatectomy and PJ. Based on the previous report, we decided to apply the "inverted mattress PJ" (IM-PJ) technique for a Roux-en Y PJ after a distal pancreatectomy. The patient was discharged after surgery without complications. We reviewed a case of a patient requiring PJ following a distal pancreatectomy and discussed the safety of our technique.

• Childhood Kidney Diseases
• /
• v.3 no.2
• /
• pp.170-179
• /
• 1999

Purpose: To evaluate whether or not sodium restriction had its own beneficial effect and increased the efficiency of the anti-hypertensive drugs on the progression of renal failure. Methods: We studied using the excision remnant kidney model. Treatment groups were as follows: 5/6 nephrectomy and a 0.49% (normal-high) sodium diet (NN); 5/6 nephrectomy and a 0.25% (normal-low) sodium diet (LN); 5/6 nephrectomy, a 0.49% sodium diet and enalapril (NNE); 5/6 nephrectomy, a 0.49% sodium diet and nicardipine (NNN); 5/6 nephrectomy, a 0.25% sodium diet and enalapril (LNE); 5/6 nephrectomy, a 0.25% sodium diet and nicardipine (LNN). Both diets were isocaloric and had the same content of protein, phosphorus and calcium. Proteinuria, remnant kidney weight, mesangial expansion scores, and glomerular volume were assessed. Results: Blood pressure tended to be lower in LN compared to NN (P<0.05). NN developed progressive hypertension. LNE, LU, NNE, and NNN reduced blood pressure. LNE, LNN, NNE, NNN, and LN had significantly less proteinuria than NN at 16 weeks (P<0.05). At 24 weeks, LN developed proteinuria (82 mg/day), which were lessened in LNE (54 mg/day) and not lessened in LNN (76 mg/day). Mesangial expansion scores were significantly less in LN rats compared to those in NN rats. Glomerular volumes at 24 weeks in LN rats were significantly less compared to those at 16 weeks in NN rats. Mesangial expansion scores and glomerular volumes at 4, weeks, 12 weeks, and 24 weeks were not different among LN, LNE, and LNN groups. Conclusion: Dietary salt restriction lessens renal damage, at least in part, by inhibiting compensatory renal growth and reducing blood pressure. Enalapril was particularly successful in reducing proteinuria and glomerular injury when combined with dietary salt restriction.

• The korean journal of orthodontics
• /
• v.32 no.4 s.93
• /
• pp.293-300
• /
• 2002

The purpose of this study was to evaluate the clinical effectiveness of hydrophilic primer, which claim to retain adequate bond strength on moistened enamel resulting from moisture or saliva contamination, by comparing the shear bond strength and adhesive failure patterns of brackets bonded using hydrophilic primer and conventional hydrophobic primer. Brackets were bonded to human premolars embedded in metal cylinders utilizing light cured adhesive, primed with either a hydrophilic primer(Transbond fm primer) or a conventional hydrophobic primer(Transbond XT primer). Each sample was exposed to varying degrees of artificial saliva contamination during the priming process. The shear bond strength was measured using a universal testing machine, and the adhesive failure patterns after debonding were visually examined by strereomicroscope and assessed using the adhesive remnant index(ARI). The results were as follows 1. In dry conditions, no significant differences in shear bond strength between Transbond W and Transbond XT primers were found. 2. Transbond MIP primer exhibited a significantly higher shear bond strength than Transbond XT primer in saliva-contaminated conditions, regardless of the degree of contamination. 3. When contaminated with one coat of saliva, Transbond MIP primer did not exhibit significant differences in shear bond strength compared to the dry condition. When contaminated with two coats of saliva, Transbond MIP primer exhibited a singnificantly lower shear bond strength compared to the dry condition. 4. The adhesive remnant index of the adhesive failure pattern had a tendency to decrease, as the degree of saliva contamination increased. Bracket-adhesive interface failure was observed in more than half of the saliva contaminated samples utilizing Transbond MIP primer, whereas the bond failure sites of the Transbond XT primer samples occurred almost exclusively at the adhesive-enamel interface in saliva-contaminated conditions. The results of this study suggest that in cases where moisture control is difficult, Transbond MIP primer is an effective alternative to conventional hydrophobic primers.

• The korean journal of orthodontics
• /
• v.31 no.2 s.85
• /
• pp.261-270
• /
• 2001

The purpose of this study was to evaluate the clinical usefulness of plasma arc light which can reduce the curing time dramatically compared by shear bond strengths and failure patterns of the brackets bonded with visible light in direct bracket bonding. Some kinds of brackets were bonded with the Transbond$^{\circledR}$ to the human premolars which were embedded in the resin blocks according to the various conditions. After bonding, the shear bond strength was tested by Instron universal testing machine and in addition , the amount of residual adhesive remaining on the tooth after debonding was measured by the stereoscope and assessed with adhesive remnant index(ARI). The results were as follows : 1. When plasma arc light was used for bonding the brackets, the shear bond strength was clinically sufficient in both metal and ceramic brackets, but resin brackets showed significantly lower bond strength but which was clinically useful. 2. When metal brackets were bonded using visible light, there was no significant difference in shear bond strength due to the light-curing time and the bond strength was clinically sufficient. 3. When the adhesive failure patterns of brackets bonded with plasma arc light were observed by using the adhesive remnant index, the bond failure of the metal and resin bracket occurred more frequently at bracket-adhesive interface but the failure of the ceramic bracket occurred more frequently at enamel-adhesive interface. 4. There was no statistically significant difference of the shear bond strength and adhesive failure pattern between metal bracket bonded for 2 seconds by curing with plasma arc light and 10 seconds by curing with visible light. 6. When metal brackets were bonded using plasma arc light, the shear bond strength decreased as the distance from the light source increased. The above results suggest that plasma arc light can be clinically useful for bonding the brackets without fear of the decrease of the shear bond strength.

• The korean journal of orthodontics
• /
• v.34 no.4 s.105
• /
• pp.325-332
• /
• 2004

A self-etching primer that combines the etchant and primer in one chemical compound saves time and should be mote cost-effective to the clinician and patient. The purpose of this study was to evaluate the clinical effectiveness of a self-etching primer by measuring shear bond strengths according to various conditions and observing adhesive failure patterns. For this Investigation, 120 upper and lower premolars extracted for orthodontic purposes were used and randomly divided into six groups of twenty teeth each. Human premolars were embedded in a metal cylinder with orthodontic resin. Metal brackets and ceramic brackets were bonded with XT primer and self-etching primer by means of XT adhesive. Upon curing, plasma arc light and visible light were used. After bonding, the shear bond strength was tested by Instron universal testing machine, and the amount of residual adhesive that remained on the tooth after debonding was measured by stereoscope and assessed with an adhesive remnant index. The results were as fellows: 1. When brackets were bonded, if other conditions remained the same, there was no significant difference in shear bond strength due to the type of primer - either self-etching primer or XT primer. 2. When metal brackets were bonded, there was no significant difference in shear bond strength according to the source of light - plasma arc light or visible light - and type of primer. 3. There was a very significant difference in shear bond strength according to the type of brackets - metal or ceramic brackets. The shear bond strength of ceramic brackets was stronger than metal brackets. 4. When the adhesive failure patterns of metal brackets bonded with self-etching primer were observed by using the adhesive remnant index, the bond failure of the metal bracket occurred more frequently at the bracket-adhesive. The failure of the ceramic bracket, however, occurred more frequently at the enamel-adhesive interface. The adhesive failure patterns of metal brackets bonded with XT primer observed the same patterns. The above results suggest that self-etching primer can be clinically useful for bonding the brackets without fear of a decrease in shear bond strength.

• Journal of the Korean Arthroscopy Society
• /
• v.17 no.1
• /
• pp.24-30
• /
• 2013

Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

• Journal of the Korean Ceramic Society
• /
• v.40 no.2
• /
• pp.206-211
• /
• 2003

Effects of substrates and buffer layer upon the formation of crystalline phases and ferroelectricity of $YMnO_3$ thin films were investigated. The hexagonal $YMnO_3$ was easily formed on Si(100) while the mixed phases, hexagonal and orthorhombic $YMnO_3$, on $Pt(111)/TiO_2/SiO_2/Si$ substrate. When the $Y_2O_3$ buffer layer of 70 nm thick was inserted between the substrates and the $YMnO_3,$ the c-axis oriented hexagonal single phase formed on both substrates, Si(100) and $Pt(111)/TiO_2/SiO_2/Si$. The leakage current density of the hexagonal $YMnO_3$ thin films was lower than that consisting of mixed phases, hexagonal and orthorhombic. Furthermore the hexagonal $YMnO_3$ with c-axis preferred orientation showed the lowest leakage current density. The remnant polarization from a P-E hysteresis curve for the $YMnO_3$ formed on Si(100) was 0.14 without buffer layer and $0.24_{mu}C/cm^2$ for that with buffer layer. For the $Pt(111)/TiO_3/SiO_3/Si$ substrates, the specimen without $Y_2O_3$buffer layer did not show the hysteresis curve, while the buffer-layered has the remnant polarization of $1.14_{mu}C/cm^2$. It was concluded that the leakage current density and the ferroelectricity for the $YMnO_3$ thin films could be controlled by varying crystalline phases and their preferred orientation which depend on the kind of substrates and whether the $Y_2O_3$buffer layer exist or not.

• Radiation Oncology Journal
• /
• v.16 no.3
• /
• pp.259-264
• /
• 1998

Purpose : This study was to evaluate the effectiveness of preoperative radiotherapy in maxillary sinus cancer. Materials and Methods : A retrospective analysis was done for 42 patients with maxillary sinus cancer who were treated with radiation with or without surgery from April 1986 to September 1996. There were 27 male and 15 female patients. Patients' age ranged from 24 to 75 years (median 56 years). Stage distribution showed 2 in T2, 19 in T3, and 21 in T4 lesions The histologic type was squamous cell carcinoma in 38, undifferentiated carcinoma in 1, transitional cell carcinoma in 1, and adenoid cystic carcinoma in 2 patients. All patients were treated with radiation initially with a dosage range of 50.4-70.2 Gy (median 70.2 Gy) before further evaluation of remnant disease. Eleven patients were given induction chemotherapy (2cycles of 5-fluorouracil and cisplatin) concurrently with radiotherapy. Six to eight weeks after radiotherapy with or without chemotherapy computerized tomography (CT) of paranasal sinus was taken to evaluate remnant disease. If the CT finding showed remnant disease, a Caldwell-Luc procedure was done to get the specimen of suspicious lesions. A radical maxillectomy was done if the specimen was proven to contain malignancy. In contrast periodic follow-up examination was done without any radical surgery if the tissue showed only granulation tissue. Follow-up period ranged from 3 to 92 months with a median 16 months. Results : Nine (21.4$\%$) patients showed complete response (CR) and 33 patients (78.6$\%$) showed persistent disease (PER) to initial radiotherapy. Among the 9 CR patients, 7 patients had no evidence of disease (NED), 1 patient had local failure, and 1 patient had regional failure. Among 33 PER patients, salvage total maxillectomy was done in 10 patients, and the surgery was not feasible or refused in 23 patients. Following the salvage radical surgery, 2 patients were NED and 8 patients were PER status. Overall and disease- free survival rate at 5 years was 23.1$\%$ and 16.7$\%$, respectively. The only factors associated with the overall survival rate was the response to radiotherapy (P<0.01). Conclusion : The only factors associated with the overall survival rate was the response to radiotherapy. We could omit a radical mutilating surgery by preoperative irradiation in 7 of 42 patients (21.4$\%$) so as to preserve their facial integrity.

• Journal of the Korean earth science society
• /
• v.23 no.4
• /
• pp.357-368
• /
• 2002

In this study we have tried to explain the barrel-shaped morphology for young supernova remnants considering the dynamical effects of the ejecta. We consider the magnetic field amplification resulting from the Rayleigh-Taylor instability near the contact discontinuity. We can generate the synthetic radio image assuming the cosmic-ray pressure and calculate the azimuthal intensity ratio (A) to enable a quantitative comparison with observations. The postshock magnetic field are amplified by shearing, stretching, and compressing at the R-T finger boundary. The evolution of the instability strongly depends on the deceleration of the ejecta and the evolutionary stage of the remnant. the strength of the magnetic field increases in the initial phase and decreases after the reverse shock passes the constant density region of the ejecta. However, some memory of the earlier phases of amplification is retained in the interior even when the outer regions turn into a blast wave. The ratio of the averaged magnetic field strength at the equator to the one at the pole in the turbulent region can amount to 7.5 at the peak. The magnetic field amplification can make the large azimuthal intensity ratio (A=15). The magnitude of the amplification is sensitive to numerical resolution. This mens the magnetic field amplification can explain the barrel-shaped morphology of young supernova remnant without the dependence of the efficiency of the cosmic-ray acceleration on the magnetic field configuration. In order for this mechanism to be effective, the surrounding magnetic field must be well-ordered. The small number of barrel-shaped remnants may indicate that this condition rarely occurs.