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Clinical Experiences of Cardiac Surgery Using Minimal Incision (소절개선을 이용한 심장수술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Joung-Taek;Lee, Seo-Won;Kim, Hae-Sook;Lim, Hyun-Kung;Lee, Choon-Soo;Sun, Kyung
    • 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.

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Comparison of Inflammatory Markers Changes in Patients Who Used Postoperative Prophylactic Antibiotics within 24 Hours after Spine Surgery and 5 Days after Spine Surgery

  • Youn, Gun;Choi, Man Kyu;Kim, Sung Bum
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.834-840
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    • 2022
  • Objective : C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count are inflammatory markers used to evaluate postoperative infections. Although these markers are non-specific, understanding their normal kinetics after surgery may be helpful in the early detection of postoperative infections. To compliment the recent trend of reducing the duration of antibiotic use, this retrospective study investigated the inflammatory markers of patients who had received antibiotics within 24 hours after surgery according to the Health Insurance Review & Assessment Service guidelines and compared them with those of patients who had received antibiotics for 5 days, which was proven to be non-infectious. Methods : We enrolled 74 patients, divided into two groups. Patients underwent posterior lumbar interbody fusion (PLIF) at a single institution between 2019 and 2020. Group A included 37 patients who received antibiotics within 24 hours after the PLIF procedure, and group B comprised 37 patients who had used antibiotics for 5 days. A 1 : 1 nearest-neighbor propensity-matched analysis was used. The clinical variables included age, sex, medical history, body mass index, estimated blood loss, and operation time. Laboratory data included CRP, ESR, and WBC, which were measured preoperatively and on postoperative days (POD) 1, 3, 5, and 7. Results : CRP dynamics tended to decrease after peaking on POD 3, with a similar trend in both groups. The average CRP level in group B was slightly higher than that in group A; however, the difference was not statistically significant. Multiple linear regression analysis revealed operation time, number of fused levels, and estimated blood loss as significant predictors of a greater CRP peak value (r2=0.473, p<0.001) in patients. No trend (a tendency to decrease from the peak value) could be determined for ESR and WBC count on POD 7. Conclusion : Although slight differences were observed in numerical values and kinetics, sequential changes in inflammatory markers according to the duration of antibiotic administration showed similar patterns. Knowledge of CRP kinetics allows the assessment of the degree of difference between the clinical and expected values.

Comparison of Agronomic Characteristics and Activity Variation of ADP-Glucose Pyrophosphorylase at Different Growth Stages in Soybean Cultivars (콩 품종의 생육특성 및 생육단계별 ADP-Glucose Pyrophosphorylase의 활성변화 비교)

  • Kim, Young-Jin;Lee, Si-Myeong;Cho, Sang-Kyun;Oh, Young-Jin;Kim, Hag-Sin
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.55 no.2
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    • pp.139-143
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    • 2010
  • The relationship between ADP-glucose pyrophosphorylase (AGP) activity and the characteristics of related pod setting in developing seed of soybean cv. Pungsannamulkong, Iksannamulkong, Geumjeongkong #1 and Danpaheuk was studied. AGP activity during the accumulate of the majority of dry matter in all cultivars suggested that this enzyme might be associated with this process. At the Vn and R1 stages, AGP activity of full-grown leaves of Pungsannamulkong, Iksannamulkong, Geumjeongkong #1 was the highest and then decreased progressively. However AGP activity of Danpaheuk was the lowest and also had lower seed weight. So regulation of matter accumulation in developing soybean seeds may also depend on AGP activity. AGP capacities as expressed by AGP activity seem to have a good predicting value for the dry matter of leaf and seed at R1 to R5 stages in our series of R3 stage genotypes. Western blots probed with antibody specific to the subunit of potato AGP revealed a single 60KD immunoreactive band that changed in intensity during the growth cycle in association with changes in total AGP activity.

Impact of Climate Change on Yield and Canopy Photosynthesis of Soybean (RCP 8.5 기후변화 조건에서 콩의 군락 광합성 및 수량 반응 평가)

  • Wan-Gyu, Sang;Jae-Kyeong, Baek;Dongwon, Kwon;Jung-Il, Cho
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.24 no.4
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    • pp.275-284
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    • 2022
  • Changes in air temperature, CO2 concentration and precipitation due to climate change are expected to have a significant impact on soybean productivity. This study was conducted to evaluate the climate change impact on growth and development of determinate soybean cultivar in the southern parts of Korea. The high temperature during vegetative period, which does not accompany the increase of CO2 concentration, increased the canopy photosynthetic rate in soybean, but after flowering, the high temperature above the optimal ranges interrupts the photosynthetic metabolism. In yield and yield components, high temperature reduced both the pod and seed number and single seed weight, resulting in a reduction of total seed yield. On the other hand, the increase in CO2 concentration dramatically increased the canopy photosynthetic rate over the whole growth period. In addition, high CO2 concentration increased the number of pods and seeds, which had a positive effect on total seed yield. Under concurrent elevation of air temperature and CO2 concentration, canopy photosynthesis increased significantly, but enhanced canopy photosynthesis did not lead to an increase in soybean seed yield. The increase in biomass and branch by enhanced canopy photosynthesis seems to be attributed to an increase in the total number of pods and seeds per plant, which compensates for the negative effects of high temperature on pod development. However, Single seed weight tended to decrease rapidly by high temperature, regardless of CO2 concentration level. Elevated CO2 concentration did not compensate for the poor distribution of assimilations from source to sink caused by high temperature. These results show that the damage of future soybean yield and quality is closely related to high temperature stress during seed filling period.

Development of the Seasonal Korean Aviation Turbulence Guidance (KTG) System Using the Regional Unified Model of the Korea Meteorological Administration (KMA) (기상청 통합지역모델을 이용한 계절 한국형 항공난류 예측시스템(계절-KTG) 개발)

  • Lee, Dan-Bi;Chun, Hye-Yeong
    • Atmosphere
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    • v.24 no.2
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    • pp.235-243
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    • 2014
  • Sources of aviation turbulence vary through the seasons, especially in the East Asia including Korean peninsula, associated primarily with the changes in the jet/front system and convective activities. For this reason, a seasonal Korean aviation Turbulence Guidance (KTG) system (seasonal-KTG) is developed in the present study by using pilot reports (PIREPs) and analysis data of the operational Unified Model (UM) of the Korea Meteorological Administration (KMA) for two years between June 2011 and May 2013. Twenty best diagnostics of aviation turbulence in each season are selected by the method of probability of detection (POD) using the PIREPs and UM data. After calculating a weighting value of each selected diagnostics using their area under curve (AUC), the 20 best diagnostics are combined with the weighting scores into a single ensemble-averaged index by season. Compared with the current operational-KTG system that is based on the diagnostics applying all seasons, the performances of the seasonal-KTG system are better in all seasons, except in fall.

Experimental investigation on flow field around a flapping plate with single degree of freedom

  • Hanyu Wang;Chuan Lu;Wenhai Qu;Jinbiao Xiong
    • Nuclear Engineering and Technology
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    • v.55 no.6
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    • pp.1999-2010
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    • 2023
  • Undesirable flapping motion of discs can cause the failure of swing check valves in nuclear passive safety systems. Time-resolved particle image velocimetry (PIV) was employed to investigate the flow characteristics around a free-to-rotate plate and the motion response, with the Reynolds numbers, based on the hydraulic diameter of the channel, from 1.32 × 104 to 3.95 × 104. Appreciable flapping motion (±3.52°) appeared at the Reynolds number of 2.6 × 104 with the frequency of 5.08 Hz. In the low-Reynolds-number case, the plate showed negligible flapping. In the high-Reynolds-number case, the deflection angle increased with reduced flapping amplitude. The torque from the fluid determined the flapping amplitude. In the low-Reynolds-number case, Karman vortices were absent. With increasing Reynolds numbers, Karman vortices developed behind the plate with larger deflection angles. Strong interaction between the wake flow from the leading and trailing edge of the plate was observed. Based on power spectrum density (PSD) analysis, the vortex shedding frequency coincided with the flapping frequency, and the amplitude was positively correlated to the strength of the vortices. Proper orthogonal decomposition (POD) modes evince that, in the case of appreciable motion, coherent structures exhibited a larger spatial scale, enhancing the magnitude of the external torque on the plate.

Development of Single Board Computer (SBC) for Nano/Pico Small Satellites (초소형위성용 단일보드 탑재컴퓨터의 개발)

  • Kim, Young-Hyun;Moon, Byoung-Young;Lee, Bo-Ra;Chang, Young-Keun
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.32 no.4
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    • pp.101-110
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    • 2004
  • Flight and Qualification Models of Single Board Computer (SBC), called On-Board Computer (OBC), for HAUSAT-l picosatellite, which is scheduled to launch on September, 2004 by Russian "Dnepr" launch vehicle, have been developed. The OBC of HAUSAT-1 has been designed with some improved features compared to other picosatellites. A multifunctional controller and up-to-date SPI (Serial Peripheral Interface) and 1-Wire interface are implemented to simplify the harness routing and to minimize the mass and size of OBC. The improved fault-tolerant architecture design methodology is incorporated in the HAUSAT-1 OBC to protect against space radiation environment. The functions of the OBC were fully tested and verified by the Electrical Test Bed (ETB) model. This paper is also addressing the environmental test results, such as random vibration and thermal vacuum tests.

Preemptive application of QX-314 attenuates trigeminal neuropathic mechanical allodynia in rats

  • Yoon, Jeong-Ho;Son, Jo-Young;Kim, Min-Ji;Kang, Song-Hee;Ju, Jin-Sook;Bae, Yong-Chul;Ahn, Dong-Kuk
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.3
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    • pp.331-341
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    • 2018
  • The aim of the present study was to examine the effects of preemptive analgesia on the development of trigeminal neuropathic pain. For this purpose, mechanical allodynia was evaluated in male Sprague-Dawley rats using chronic constriction injury of the infraorbital nerve (CCI-ION) and perineural application of 2% QX-314 to the infraorbital nerve. CCI-ION produced severe mechanical allodynia, which was maintained until postoperative day (POD) 30. An immediate single application of 2% QX-314 to the infraorbital nerve following CCI-ION significantly reduced neuropathic mechanical allodynia. Immediate double application of QX-314 produced a greater attenuation of mechanical allodynia than a single application of QX-314. Immediate double application of 2% QX-314 reduced the CCI-ION-induced upregulation of GFAP and p-p38 expression in the trigeminal ganglion. The upregulated p-p38 expression was co-localized with NeuN, a neuronal cell marker. We also investigated the role of voltage-gated sodium channels (Navs) in the antinociception produced by preemptive application of QX-314 through analysis of the changes in Nav expression in the trigeminal ganglion following CCI-ION. Preemptive application of QX-314 significantly reduced the upregulation of Nav1.3, 1.7, and 1.9 produced by CCI-ION. These results suggest that long-lasting blockade of the transmission of pain signaling inhibits the development of neuropathic pain through the regulation of Nav isoform expression in the trigeminal ganglion. Importantly, these results provide a potential preemptive therapeutic strategy for the treatment of neuropathic pain after nerve injury.

Transgastric Endoscopic Cholecystectomy in a Dog : Natural Orifice Transluminal Endoscopic Surgery (개에서 내시경을 이용한 경위장관 담낭절제술 1예 : 자연개구부 내시경수술)

  • Jeong, Seong-Mok;Kim, Young-Ill;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Ji-Young;Park, Jong-Heon;Kim, Ji-Yeon;Lee, Sang-Il;Kim, Myung-Cheol;Shin, Sang-Tae;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.315-319
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    • 2007
  • Transgastric endoscopic cholecystectomy was successfully accomplished in a 1-year-old, 15 kg, female, mongrel dog. Single-working channel flexible gastric endoscope was used with the aid of one abdominal laparoscopic port. Gastrotomy was performed using endoscopic needle knife at the ventral antral region. Through the gastric incision endoscope was advanced and retroflexed for the visualization of gallbladder. For the better exposure of surgical field, gentle traction was applied at the fundus of the gallbladder using laparoscopic grasping forceps. Cystic duct and artery was ligated using endoclips. After transecting the duct and artery, gallbladder was dissected using endoscopic coagulating grasping forceps and needle knife. Resected gallbladder was retrieved through the mouth and gastric incision site was sutured using endoclips. There was no evidence of bile leakage or stomach leakage on postoperative day (POD) 3. On POD 16, gastric endoscopy and laparoscopy was performed. Gastric endoscopy revealed complete adhesion of incision site. The content of the peritoneum appeared healthy, with no sign of infection, bile staining, or organ injury. The omentum was adhered over resected gallbladder fossa and the serosal surface of gastrotomy site. This is the first report of NOTES cholecystectomy in the dog and provides new concept of cholecystectomy of the dog.

Performance Evaluation of Snow Detection Using Himawari-8 AHI Data (Himawari-8 AHI 적설 탐지의 성능 평가)

  • Jin, Donghyun;Lee, Kyeong-sang;Seo, Minji;Choi, Sungwon;Seong, Noh-hun;Lee, Eunkyung;Han, Hyeon-gyeong;Han, Kyung-soo
    • Korean Journal of Remote Sensing
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    • v.34 no.6_1
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    • pp.1025-1032
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    • 2018
  • Snow Cover is a form of precipitation that is defined by snow on the surface and is the single largest component of the cryosphere that plays an important role in maintaining the energy balance between the earth's surface and the atmosphere. It affects the regulation of the Earth's surface temperature. However, since snow cover is mainly distributed in area where human access is difficult, snow cover detection using satellites is actively performed, and snow cover detection in forest area is an important process as well as distinguishing between cloud and snow. In this study, we applied the Normalized Difference Snow Index (NDSI) and the Normalized Difference Vegetation Index (NDVI) to the geostationary satellites for the snow detection of forest area in existing polar orbit satellites. On the rest of the forest area, the snow cover detection using $R_{1.61{\mu}m}$ anomaly technique and NDSI was performed. As a result of the indirect validation using the snow cover data and the Visible Infrared Imaging Radiometer (VIIRS) snow cover data, the probability of detection (POD) was 99.95 % and the False Alarm Ratio (FAR) was 16.63 %. We also performed qualitative validation using the Himawari-8 Advanced Himawari Imager (AHI) RGB image. The result showed that the areas detected by the VIIRS Snow Cover miss pixel are mixed with the area detected by the research false pixel.