• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.3
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• pp.197-205
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• 2007

Angiogenesis is a essential part for bone formation and bone fracture healing. Vascular endothelial growth factor (VEGF), one of the most important molecules among many angiogenic factors, is a specific mitogen for vascular endothelial cells. VEGF-mediated angiogenesis is required for bone formation and repair. However, the effect of VEGF on osteoblastic cells during osteogenesis is still controversial. In recent days, substantial progress have been made toward developing tissue-engineered alternatives to autologous bone grafting for maxillofacial bony defects. Periosteum has received considerable interest as a better source of adult stem cells. Periosteum has the advantage of easy harvest and contains various cell types and progenitor cells that are able to differentiate into a several mesenchymal lineages, including bone. Several studies have reported the bone formation potential of periosteal cells, however, the correlation between VEGF signaling and cultured human periosteal cell-derived osteogenesis has not been fully investigated yet. The purpose of this study was to examine the correlation between VEGF signaling and cultured human periosteal-derived cells osteogenesis. Periosteal tissues of $5\;{\times}\;20\;mm$ were obtained from mandible during surgical extraction of lower impacted third molar from 3 patients. Periosteal-derived cells were introduced into the cell culture and were subcultured once they reached confluence. After passage 3, the periosteal-derived cells were further cultured for 42 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and ${\beta}-glycerophosphate$. We evaluated the alkaline phosphatase (ALP) activity, the expression of Runx2 and VEGF, alizarin red S staining, and the quantification of osteocalcin and VEGF secretion in the periosteal-derived cells. The ALP activity increased rapidly up to day 14, followed by decrease in activity to day 35. Runx2 was expressed strongly at day 7, followed by decreased expression at day 14, and its expression was not observed thereafter. Both VEGF 165 and VEGF 121 were expressed strongly at day 35 and 42 of culture, particularly during the later stages of differentiation. Alizarin red S-positive nodules were first observed on day 14 and then increased in number during the entire culture period. Osteocalcin and VEGF were first detected in the culture medium on day 14, and their levels increased thereafter in a time-dependent manner. These results suggest that VEGF secretion from cultured human periosteal-derived cells increases along with mineralization process of the extracellular matrix. The level of VEGF secretion from periosteal-derived cells might depend on the extent of osteoblastic differentiation.

• Journal of Chest Surgery
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• v.36 no.2
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• pp.73-78
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• 2003

The Fontan operation has undergone a number of major modifications and clinical results have been improving over time. Nevertheless, during the follow-up period, life-threatening complications develop and affect the long-term outcomes. Surgical interventions for these complications are needed and are increasing. Material and Method: From April 1988 to January 2000, 16 patients underwent reoperations for complications after Fontan operation. The mean age at reoperation was 8.8 :-5.5 years. Initial Fontan operations were atriopulmonary connections in 8 and total cavopulmonary connections in 8. Total cavopulmonary connections were accomplished with intracardiac lateral tunnel in 5 and extracardiac epicardial lateral tunnel in 3. Five patients had variable sized fenestrations. The reasons for reoperations included residual shunt in 6, pulmonary venous obstruction in 3, atrial flutter in 3, atrioventricular valve regurgitation in 2, Fontan pathway stenosis in 1, and protein-losing enteropathy in 1 Result: There were 3 early and late deaths respectively Patients who had residual shunts underwent primary closure of shunt site (n=2), atrial reseptation for separation between systemic and pulmonary vein (n=2), conversion to lateral tunnel (n=1), and conversion to one and a half ventricular repair (n=1). Four patients who had stenotic lesion of pulmonary vein or Fontan pathway underwent widening of the lesion (n=3) and left pneumonectomy (n=1) In cases of atrial flutter, conversion to lateral tunnel after revision of atriopulmonary connections was performed (n=3). For the atrioventricular valve regurgitation (n=2), we performed a replacement with mechanical valve. In one patient who had developed protein-losing enteropathy, aorto-pulmonary collateral arteries were obliterated via thoracotomy. Cryoablation was performed concomitantly in 4 patients as an additional treatment modality of atrial arrhythmia. Conclusion: Complications after Fontan operation are difficult to manage and have a considerable morbidity and mortality. However, more accurate understanding of Fontan physiology and technical advancement increased the possibility of treatment for such complications as well as Fontan operation itself. Appropriate surgical treatment for these patients relieved the symptoms and improved the functional class, Although the results were not satisfactory enough in all patients.

• Journal of Chest Surgery
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• v.40 no.10
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• pp.659-666
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• 2007

Background: Preserving the subvalvular apparatus after mitral valve replacement (MVR) results in better ventricular function and a better outcome. In conjunction, mitral valve repair (MVr) is associated with a better outcome, yet little is known about the hemodynamics and outcomes between patients undergoing MVr and MVR with chordal preservation. We prospectively evaluated the hemodynamic changes and outcomes of patients undergoing MVr and MVR with chordal preservation. Material and Method: Fifty-four patients with mitral regurgitation (MR) who under-went MVR with chordal preservation (n=21) or MVr (n=33) were studied. The patients' characteristics, the intra-and postoperative hemodynamics and the use of cardiac medications, the postoperative outcome and the complications were recorded during the hospital stay. All the patients were followed up for at least 6 months post-operatively for determining their morbidity and mortality. Result: The patients' characteristics were similar between the groups, except for the presence of atrial fibrillation and congestive heart failure which was more frequent in the MVR group. Also, the preoperative left ventricular ejection fraction was lower in the MVR group than in the MVr group ($64{\pm}9%$ versus $69{\pm}5%$, respectively, p=0.043). There were no significant differences of the hemodynamics between the groups. The use of inotropic drugs and pacemakers during the 12hrs postoperatively was more common in the MVR group than in the MVr group (48% versus 24%, p=0.025 and 52% versus 24%, p=0.035, respectively). The other postoperative outcomes were similar in both groups for at least the 6 months follow-up period. Conclusion: MVR with chordal preservation was comparable with regard to the hemodynamics and clinical outcomes, supporting the beneficial effect of preserving the subvalvular apparatus after MVR.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.294-301
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• 2003

This study was performed to compare the effects of hydrocolloid(Duoderm$\circledR$, HC in this study) and hydrogel (Nu-Gel$\circledR$, HG in this study) occlusive dressing materials on degree of exudate, wound contraction, epithelialization, and healing of full-thickness skin wound in dogs. Three wounds measuring 2${\times}$2 cm in size were created bilaterally(6 wounds/dog) on the dorsolateral aspect of the trunk of 12 dogs. In each dog, the wounds were treated with HC, HG, and normal saline, respectively. For a 4 week period, the wounds were evaluated gross aspects and histopathological aspects. There were no statistically significant differences between treatment groups in percentage of wound contraction, percentage of epithelialization, and percentage of wound total healing during the first week. Significant differences were first detected on day 14. On day l4(P < 0.01) and 21 (P < 0.05), mean percentage of epithelialization of HG-treated wound was significantly greater than those in HC- and normal saline-treated wound. Mean percentage of wound contraction of HG-treated wound was significantly greater than that in HC- and control wounds on day 21(P< 0.05). On day 21, mean percentage of wound healing of HG-treated wound was significantly greater than that in HC- and control wounds(P < 0.02). On day 1, 4, and 7 after wound creation, although severe infiltration of PMN (polymorphonuclear leukocyte) cells in HC- and control wounds were observed in the subcutis and moderate infiltration of PMN cells in HG-treated wound were observed in the subcutis, we did not detect significant differences. On day 14 after wounding creation, in the wounds treated with HG dressing, epithelial cells were found over the surface, and edema further decreased in the tissue under the wounds, and the granulation tissue was replaced with collagen fibers. On day 21 after wound creation, in HG-treated wound compared with other experimental material-treated wounds, regenerated epidermis covered most of the wound surface, and the granulation tissue was more replaced with collagen fibers than that on day 14. Overall results indicated that the use of hydrogel dressing materials(Nu-Gel$\circledR$) as hydrocolloid dressing (Duoderm$\circledR$) materials and normal saline treatment on full-thickness skin wounds in dogs increased the rate of healing at repair stage.

• Korean Journal of Heritage: History & Science
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• v.52 no.4
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• pp.38-55
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• 2019

At Otani University in Kyoto, Japan, there is a rubbed copy of Tripitaka Koreana, presumably printed in 1381. According to the postscript of the copy, written by Saek Lee himself, the rubbed copy was made at Haeinsa temple in 1381 and was kept at Sinluksa temple in Yeuju. The copy was delivered as a gift to Japan in 1414 and now is kept at the Library of Otani University. Although an approximate summary of the content of the copy was reported in the early 2000s after a basic survey, details of the copy, including the concrete format and packaging paper, are not known yet. In this paper a detailed survey of the copy is conducted on the 109 pages. The copy is divided into two parts: the wrapping and the inner pages. The wrapping paper is divided into yellow and brown colors depending on the material of the paper. The yellow colorwrapping paper was possibly made in 1381 at the time of the rubbed printing, and the brown wrapping paper was repaired after being moved to Japan. Using funds collected in February 1380, the copy of Gyeong(經), Yul(律), and Ron(論) chapters was printed in April 1381. Binding of the copy was completed in September, and the wrapping paper with the title in gold was made in October 1380. The box for keeping Buddhist scriptures was manufactured in November 1380. The copy was moved to Sinluksa temple in April 1382 and delivered to Japan in 1414. At Otani University, the copy is stored in separate rectangular boxes 32.1×25.3cm in size with a height of 23.6cm. The rectangular plate on the four sides is red in external color but black colorinside. The box for keeping Buddhist scriptures was probably made in 1381, but a partial repair was made later. Because of the difficulty of executing a detailed survey of the box for Buddhist scriptures, it is hard to find out its nation and period of production. We look forward to studying the copy as well as the box for Buddhist scriptures in future.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.522-532
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• 2010

The aims of the present study were to characterize the effect of glucocorticosteroids (GCs) on the normal canine skin and to evaluate the effect of a lipid mixture (LM), containing cholesterol, pseudoceramide, and free fatty acid, on the steroid-induced damaged skin of dogs. Five beagles were involved and the skin of the back of each dog was topically applied with four kinds of GCs twice daily for 28 days. LM was applied after that period of GCs application. Transepidermal water loss (TEWL), skin hydration, and skin pH were assessed during experimental periods and histopathological evaluation was performed. TEWL was significantly increased, with a maximum increase obtained on day 28 (p < 0.01). Skin pH was significantly decreased, with a maximum decrease obtained on day 28 (p < 0.01). Skin surface hydration was significantly increased on day 3, but values of skin hydration were progressively decreased and finally reached those of baseline. In histology, as results of steroid application, losses of keratin layers in the stratum corneum and edematous changes in the upper parts of dermis, and consequently, thickness of the epidermis and the stratum corneum were decreased. In addition, the numbers of hair follicles were markedly decreased in steroid control as compared to intact control. However, these skin atrophic changes were markedly inhibited by treatment of LM as compared with steroid control in the present study. Moreover, all biophysical parameters were reached to the baseline after LM treatment. These results showed that the topically applied GCs induced skin barrier impairment and a LM should be effective on repair of disturbed skin barrier function in dogs. Therefore, it is concluded that a LM tested in the present study is expected to treat the steroid-induced skin damages.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.189-198
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• 2009

Purpose: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. Materials and Methods: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. Results: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of $8^{\circ}$ and $16^{\circ}$ less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. Conclusion: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.180-188
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• 2009

Purpose: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. Materials and Methods: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. Results: Postoperative UCLA scores improved from 16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. Conclusion: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.901-908
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• 2001

Background : Coronary artery bypass graft(CABG) in patients with advanced left ventricular dysfunction has often been regarded as having high mortality rate, despite the great improvement in operative result of CABG. With recent advances in surgical technique and myocardial protection, surgical revascularization improved the symptom and long-term survival of these high risk patients more than the medical conservative treatment. Material and Methold : Clinical data of 31(4.1％) patients with preoperative ejection fraction less than 30% among 864 CABGs performed between January 1995 and March 1999 were retrospectively analyzed and pre- and postoperative changes of the ejection fraction on echocardiography were analyzed. There were 26 men and 5 women. The mean age was 60.7 years(range 41 to 72 years). History of myocardial infarction(30 cases, 98％) was the most common preoperative risk factor. There were seven irreversible myocardial infarction on thallium scan. Most patients had triple vessel diseases(26 cases, 84％) and first degree of Rentrop classification(16 cases, 52％) on coronary angiography. The mean number of distal anastomosis during CABG was per patient was 4.9${\pm}$0.8 sites in each patient. In addition to long saphenous veins, the internal mammary artery was used in 20 patients. Total bypass time was 244.7${\pm}$3.7 minutes(range, 117 to 567 minutes), and mean aortic cross-clamp time was 77.9 ${\pm}$ 1.6 minutes(range, 30 to 178 minutes). There were five other reparative procedures such as two left ventricular aneurysrmectomy, two mitral repair, and one aortic valve replacement. There were twelve postoperative complications such as three cardiac arrhythmia, two bleeding(re-operation), one delayed sternal closure, eleven usage of intra-aortic balloon counterpulsation for low cardiac output. Two patients died, postoperative mortality was 6.5% . Twenty-nine patients were relieved of chest pain and left ventricular ejection fraction after operation was significantly higher(38.5${\pm}$11.6%, p 0.001) as compared with preoperative left ventricular ejection fraction(25.3${\pm}$2.3%). The follow up period of out patient was 25. 3 months. Conclusion: In patients with coronary artery disease and advanced left ventricular dysfunction, coronary artery bypass grafting can be performed relatively safely with improvement in left ventricular function, but it will be necessary to study long term results.

• Korean Journal of Environment and Ecology
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• v.36 no.4
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• pp.390-401
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• 2022

This study investigated the characteristics of fish communities and inhabiting status of endangered species in the Bukcheon (Stream) of Seoraksan National Park, Korea from April to September 2020. A total of 4,356 fish of 7 families and 22 species were collected from 17 survey stations during the survey period. The dominant species was Zacco koreanus (relative abundance, 41.8%), and subdominant species was Rhynchocypris kumgangensis (relative abundance, 15.1%), followed by Pungtungia herzi (10.1%), Pseudopungtungia tenuicorpa (5.0%), Coreoleuciscus splendidus (4.1%), Zacco platypus (3.8%), Microphysogobio longidorsalis (3.5%), and Hemibarbus mylodon (2.2%). Among the fish species collected, 14 species (63.6%) were identified as Korean endemic species. There was one natural monument species (Hemibarbus mylodon), and four species of class II endangered wildlife that were designated by the Ministry of Environment (Acheilognathus signifer, Pseudopungtungi tenuicorpa, Gobiobotia brevibarba, and Brachymystax lenok tsinlingensis). Among the four species of class II endangered wildlife, B. lenok tsinlingensis inhabited in the upper stream, and A. signifer, P. tenuicorpa and G. brevibarba inhabited mainly in the middle-lower stream. Also, P. tenuicorpa, H. mylodon, and B. lenok tsinlingensis were inhabited in large numbers. Additionally, two cold-water fish species (R. kumgangensis and B. lenok tsinlingensis) and one landlocked species (B. lenok tsinlingensis) were collected. According to the results of cluster analysis, the dominance index decreased from upstream to downstream, but the diversity, evenness, and richness index increased; the cluster structure was divided into the uppermost, upstream, midstream, and downstream. The water quality of Bukcheon was evaluated as good overall since the river health (index of biological integrity) evaluated using fish was evaluated as very good (11 stations), good (2 stations), and normal (4 stations). However, river repair work was being carried out in some areas and some wastewater was flowing in from the midstream, therefore, supplementary measures to preserve fish habitats are required.