• Journal of Chest Surgery
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• v.32 no.5
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• pp.413-421
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• 1999

Background: Ischemia reperfusion injury is known to contribute to the major causes of the early graft failure in lung transplantation. Triiodothyronine (T3) has been suggested to ameliorate ischemia reperfusion injury from both in vivo and in vitro experiments of various organs. Prospecting its beneficial effect for pulmonary allograft preservation, we made a new solution by adding T3 into the extracellular type dextran solution. Material and Method: Twelve adult mongrel dogs underwent left lung allotransplantation. Six donor dogs were flushed with the new solution(Group 1, n=6), and the remaining six were flushed with Euro-Collins solution to serve as controls(Group 2, n=6). Allografts were stored in each preservation solution for 20 hours at 4$^{\circ}C$. Left single lung transplantations were performed. The right pulmonary artery and the right main bronchus were clamped at 15 minutes after the reperfusion and maintained throughout the experiment to evaluate the transplanted left lung function. Result: Arterial carbon dioxide tension was better in group 1 than in group 2 throughout the experiment period and the difference was statistically significant at 2 hours after reperfusion(28.0${\pm}$3.0 mmHg and 53.1${\pm}$17.4 mmHg, p<0.05). The differences of arterial oxygen partial pressure, peak airway pressure and pulmonary vascular resistance showed no statistical significance. The malondialdehyde(MDA) level, measured from tissue obtained at 120 minutes after reperfusion showed no statistically significant difference. The tissue wet/dry ratio of group 1(649${\pm}$27 %) was significantly lower than that of group 2(686${\pm}$71 %, p<0.05). The microscopic examination revealed varying degrees of injury represented mainly by findings such as perivascular neutrophil infiltration, capillary hemorrhage and interstitial congestion. These findings were less severe in group 1 than those in group 2. Conclusion: The new solution demonstrated superior allograft preservation after 20 hour ischemia compared to Euro-Collins solution in canine single left lung transplantation model, these results suggest that T3 might be a promising agent for pulmonary allograft preservation.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.728-733
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• 2003

Background: The aim of the current study was to assess the effects of total arterial myocardial revascularization (TAMR) with bilateral internal mammary arteries. Material and Method: 139 consecutive patients who underwent off pump coronary artery bypass surgery from January 2000 to December 2001 were included in the current retrospective study. Patients were divided into those receiving bilateral internal mammary artery, BITA (n=85) and those receiving single internal mammary artery, SITA (n=54). Result: There was only one death in each group. No significant differences were noted in the total ICU and hospital stay; 2.4$\pm$1.7 and 11.2$\pm$17.7 days, in the BITA group, respectively and 2.8$\pm$2.7 and 9.7$\pm$7.1 days in the SITA group, respectively (P>0.05). The mean number of distal anastomosis of 3.9$\pm$0.7 was slightly higher in the SITA group compared to the SITA group, which was 3.1$\pm$0.8. Myocardial infarction occurred in 7 patients (BITA group: 2, SITA group: 5) and deep sternal infection necessitating reoperation occurred in 4 patients (BITA group: 3, SITA group: 1). Coronary angiogram was performed in the immediate postoperative period in 104 patients (BITA group: 64/85, SITA group: 40/54). Of these patients, stenosis in the LAD anastomosis site occurred in 4 patients (BITA group: 2, SITA group: 2). A total of 8 anastomotic sites were stenotic in the entire series of which percutaneous intervention was performed in 3 patients and none required reoperative coronary artery bypass. Conclusion: The results of the current data did not show a significant difference in patiency rate with bilateral internal mammary artery use for CABG supporting the feasibility of its use as a viable alternative method for TAMR.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.222-231
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• 2005

Purpose: This article describes a double-bundle ACL reconstruction technique using a five-strand hamstring tendon autograft with conventional anteromedial bundle reconstruction and additional posterolateral bundle reconstruction. Operative technique: For the tibial tunnel, the conventional single tunnel technique is performed and for the femoral tunnel, the double tunnel technique is performed with the anteromedial and posterolateral bundle. After minimal notchplasty, the anteromedial femoral tunnel is prepared with leaving one milimeter of posterior femoral cortex within the over-the-top, which if positioned at the 11-o'clock orientation for the right knee or at the 1-o'clock position for the left knee. The posterolateral femoral tunnel that is located 5 to 7 mm superior to the inner margin of the lateral meniscus anterior horn at $90^{\circ}$ of flexion is prepared with tile outside-in technique using a 4.5 cannulated reamer. The graft material for the double bundle reconstruction is made of the conventional four-strand hamstring autograft in the anteromedial bundle and of a single-strand semitendinosus tendon in the posterolateral bundle. The anteromedial bundle is fixed with using a rigid fix system on the femoral side and the posterolateral bundle is fixed to tie with the miniplate from the outside femur. Then, with the knee in $10^{\circ}\;to\;20^{\circ}$ of flexion, a bioabsorbable screw is simultaneously applied to achieve tibial fixation with tensioning of both bundles. Conclusion: A double bundle reconstruction with five-strand hamstring autograft, which is designed with a favorable conventional anteromedial bundle and an additional posterolateral bundle to restore rotation stability, seems to be a very effective method for the treatment for ACL instabilities.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.550-562
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• 2008

Background: We attempted to reproduce a previously reported method that is known to be effective for decellularization, and we sought to find the optimal condition for decellularization by introducing some modifications to this method. Material and Method: Porcine semilunar valves, arterial walls and pericardium were processed for decellularization with using a variety of combinations and concentrations of decellularizing agents under different conditions of temperature, osmolarity and incubation time. The degree of decellularization and the preservation of the extracellular matrix were evaluated by staining with hematoxylin and eosin and with alpha-Gal and DAPI in some of the decellularized tissues. Result: Decellularization was achieved in the specimens that were treated with sodium deoxycholate, sodium dodesyl sulfate, Triton X-100 and sodium dodesyl sulfate with Triton X-100 as single-step methods, and this was also achieved in the specimens that were treated with hypotonic solution ${\rightarrow}$ Triton X-100 ${\rightarrow}$ sodium dodesyl sulfate, sodium deoxycholate ${\rightarrow}$ hypotonic solution ${\rightarrow}$ sodium dodesyl sulfate, and hypotonic solution sodium dodesyl sulfate as multi-step methods. Conclusion: Considering the number and the amount of the chemicals that were used, the incubation time and the degree of damage to the extracellular matrix, a single-step method with sodium dodesyl sulfate and Triton X-100 and a multi-step method with hypotonic solution followed by sodium dodesyl sulfate were both relatively optimal methods for decellularization in this study.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1183-1194
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• 1998

Background: From Sept. 1985 to Sept. 1997, 2,000 cases of open heart surgery(OHS) were performed in the Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University. Material and Method: Among the total of 2,000 cases of OHS, 1532 cases were congenital heart disease(CHD) and 468 cases were acquired heart disease(AHD). The age distribution was 9 days(4.0kg) to 68 years in CHD and 11 to 66 years in AHD. In 1532 cases of CHD, there were 1403 acyanotic cases and 129 cyanotic cases. Result: The CHD cases consisted of 940 ventricular septal defects(61.4%), 324 atrial septal defects(21.1%), 112 tetralogy of Fallot(7.3%), 46 pulmonary stenosis(3%), 38 endocardial cushion defects(2.5%), 15 valsalva sinus ruptures(1%), 4 transposition of great arteries (0.3%), 4 double outlet right ventricles(0.3%), and etc. Corrective operations were applied for congenital heart disease with a result of 3.1% hospital mortality. Of 468 AHD, 381 cases were valvular heart diseases, 48 ischemic heart diseases, 12 cardiac tumors, 8 annuloaortic ectasias, 16 dissecting aortic aneurysms and etc. In the 381 valvular heart diseases, there were 226 single valve replacements(36 aortic valve replacements(AVR), 188 mitral valve replacements(MVR), and 2 tricuspid valve replacements(TVR), among these were 71 cases of double valve replacements(AVR & MVR), 54 cases of MVR with tricuspid valve annuloplasty(TVA), and 18 cases of AVR, MVR with TVA. The total implanted prosthetic valves were 466. In MVR, 123 St. Jude Medical valves, 90 Carpentier-Edwards valves, 65 CarboMedics valves, 42 Sorin valves and 16 other valves were used. In AVR, 68 St. Jude Medical valves, 36 CarboMedics valves, 14 Carpentier-Edwards valves and 9 other valves were used. Coronary Artery Bypass Surgery(CABG) were performed in 48 cases. The patterns of bypass graft were 14 patients of single vessel graft, 21 patients of two vessels graft, 10 patients of three vessels graft and 3 patients of four vessels graft. Conclusion: The hospital operation mortality rate of congenital acyanotic, cyanotic and acquired heart diseases were 2.0%, 15.5%, and 5.1% respectively. The overall mortality rate was 3.6%(72/2,000).

• Journal of the Mineralogical Society of Korea
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• v.20 no.3
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• pp.147-153
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• 2007

Kaolinite [$Al_2Si_2O_5(OH)_4$] was successfully synthesized by a hydrothermal process from amorphous $Al(OH)_3$ and $SiO_2$ at $230^{\circ}C$ under the pressure of $30 kg/cm^2$. The experiments were performed varying temperatures ($180{\sim}280^{\circ}C$), pressure ($10{\sim}60kg/cm^2$), chemistry ($Al_2O_3/SiO_2 = 0.5{\sim}0.38$) and pH ($0.3{\sim}9.5$) of the solution. The autoclaving was carried out in a closed stainless steel vessel. Kaolinite appears from the starting composition of $Al_2O_3/SiO_2= 0.5$ with boehmite and was stable as a single phase with the composition of $Al_2O_3/SiO_2=0.45$. Boehmite was a stable phase below $200^{\circ}C$ for the 240 h period of autoclaving, but kaolinite appeared even in 20 h at $230^{\circ}C$. The single kaolinite phase of a good crystallinity was observed at pH ranging 2 to 6. That indicates that pH is one of the most critical parameters for the successful formation of kaolinite. The optimal molar ratio of $Al_2O_3$ to $SiO_2$ was determined to be 0.45. The XRD pattern of the synthesized kaolinite coincided with that of natural one and its morphology was the cluster type of the kaolinite crystals (diameter = ${\sim}3{\mu}m$), irrespective of starting material, composition and temperature.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.619-627
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• 2008

The objective of this study was to compare the microleakage of five adhesive systems in the enamel and dentin of permanent teeth. Class V cavity preparations with occlusal margins in enamel and gingival margins in dentin were prepared on both buccal and lingual surfaces of 25 extracted human molar teeth. The tested adhesives were: Adper Scotchbond Multi-purpose Plus Adhesive (SM), Adper Single bond 2 (SB), Clearfil SE Bond (SE), Adper Prompt L-Pop (PL) and G-Bond (GB). The results were as follows: 1. At the enamel margins, PL showed the highest leakage value(0.85), and others showed values of SB(0.55), GB(0.50), SM(0.35) and SE(0.25) in decreasing order. There were statistically significant differences in PL vs. SM and PL vs. SE(p<0.05). 2. At the dentin margins, GB showed the highest leakage value(2.10), and others showed values of SE(1.45), PL(1.40), SB(1.05), SM(0.70) in decreasing order. There were statistically significant differences in GB vs. SB and GB vs. SM(p<0.05). 3. Dentin margins showed high dye penetration rate than enamel margins in all material tested groups and there were statistically significant differences for SE, PL and GB.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.373-378
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• 1999

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.135-142
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• 2010

Purpose: This study was aimed to compare the margin and internal fitness of single anterior all-ceramic crown zirconia core made by three deferent CAD/CAM systems. Material and methods: Five single zirconia cores were manufactured by three deferent CAD/CAM systems($Cerasys^{(R)}$system, KaVo $Everest^{(R)}$system, $LAVA^{TM}$system). The manufactured zirconia cores were duplicated through the use of replica technique, and a replicated sample was sectioned in the center of bucolingual and mesiodistal direction to measure the marginal and internal gap. Measurement was carried out by using measuring microscope ($AXIO^{(R)}$) and $I-Solution^{(R)}$ and analysed through the use of ANOVA. Results: As for the mean marginal fitness of the zirconia core, it was $84.74{\pm}27.57{\mu}m$, in $Cerasys^{(R)}$, $80.23{\pm}21.07{\mu}m$ in KaVo $Everest^{(R)}$ and $96.37 {\pm}11.45{\mu}m$ in $LAVA^{TM}$, and as for the mean internal gap, it was $94.11{\pm}30.07{\mu}m$ in $Cerasys^{(R)}$, $92.31{\pm}25.18{\mu}m$ in KaVo $Everest^{(R)}$, and $94.99{\pm}18.74 {\mu}m$ in $LAVA^{TM}$. There was no significant statistically deference among the total average gap of three systems. The internal gap in KaVo $Everest^{(R)}$ seemed to be smaller than $LAVA^{TM}$ (P < .05). The internal gap in the incisal area was larger in all of the three systems. Conclusion: There was no difference in marginal fitness in $Cerasys^{(R)}$, KaVo $Everest^{(R)}$ and $LAVA^{TM}$. As for the internal fitness, it was smaller in KaVo $Everest^{(R)}$ system than $LAVA^{TM}$ system. In all of the three systems, there was a larger gap in incisal area. The marginal and internal gap was within the clinically allowed range in all of the three systems.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.520-527
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• 2008

Purpose: This study was conducted to evaluate the shear bond strength of composite resin to dentin when etched with laser instead of phosphoric acid. Material and methods: Recently extracted forty molars, completely free of dental caries, were embedded into acrylic resin. After exposing dentin with diamond saw, teeth surface were polished with a series of SiC paper. The teeth were divided into four groups composed of 10 specimens each; 1) no surface treated group as a control 2) acid-etched with 35%-phosphoric acid 3) Er:YAG laser treated 4) Er,Cr:YSGG laser treated. A dentin bonding agent (Adapter Single Bond2, 3M/ESPE) was applied to the specimens and then transparent plastic tubes (3 mm of height and diameter) were placed on each dentin. The composite resin was inserted into the tubes and cured. All the specimens were stored in distilled water at $37^{\circ}C$ for 24 hours and the shear bond strength was measured using a universal testing machine (Z020, Zwick, Germany). The data of tensile bond strength were statistically analyzed by one-way ANOVA and Duncan's test at ${\alpha}$= 0.05. Results: The bond strengths of Er:YAG laser-treated group was $3.98{\pm}0.88$ MPa and Er,Cr:YSGG laser-treated group showed $3.70{\pm}1.55$ MPa. There were no significant differences between two laser groups. The control group showed the lowest bond strength, $1.52{\pm}0.42$ MPa and the highest shear bond strength was presented in acid-etched group, $7.10{\pm}1.86$ MPa (P < .05). Conclusion: Laser-etched group exhibited significantly higer bond strength than that of control group, while still weaker than that of the phosphoric acid-etched group.