• Journal of Chest Surgery
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• v.42 no.5
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• pp.597-603
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• 2009

Background: Atrioventricular valve regurgitation in pediatric patients with a functional single ventricles (FSV) - has been known as one of the important risk factors for death and unfavorable long-term results after a Fontan operation. We evaluated early and mid-term results of bivalvation valvuloplasty in FSV patients. Material and Method: We retrospectively evaluated 11 patients with a functional single ventricle who underwent bivalvationvalvuloplasty between 1999 and 2007. The degree of common atrioventricular valve regurgitation (CAVVR) was determined by color Doppler echocardiography (regurgitation grade scoring, trivial; 1, mild; 2, moderate; 3, severe; 4). Mean age at valve surgery was $6.9{\pm}7.0$ months (median 4 months, 24 days$\sim$21 months)and mean body weight was $6.2{\pm}2.8\;kg$ ($3.1{\sim}11.3\;kg$). Nine patients had isomerism heart and two of them had TAPVC. The concomitant procedures were performed in all but one patient. Additional commissural closure was performed in 3 patients and commissural annuloplasty in another 3 patients. Result: There was one hospital death after. surgery. A 32-day old patient who had been preoperatively dependent on a ventilator died of air way and lung problems 4.3 months after pulmonary artery banding and bivalvation valvuloplasty. Mean follow-up duration was 40 months ($4.3{\sim}114$ months). Mean preoperative CAVVR score was $3.3{\pm}0.6$, which decreased to $1.9{\pm}0.7$ postoperatively (p<0.0001). This residual regurgitation slightly increased to $2.2{\pm}0.4$ (no statistical significance) after a mean follow-up of 1.4.3 months. Six patients (60%) required re-operations for residual regurgitation at a subsequent bidirectionalcavopulmonary shunt or Fontan operation. One patient with Ebsteinoid malformation of the right sided atrioventricular valve required valve replacement due to stenoinsufficiency. Another patient required edge-to-edge repair at the right sided AV valve (between the right mural leaflet and the bridging leaflets). The remaining 4 patients required additional suture placements between bridging leaflets with or without commissural annuloplasty. All survivor had trivial or mild CAVVR at the latest follow-up. Conclusion: Bivalvation valvuloplasty for CAVVR in FSV patients is. an effective and safe procedure. However, significant numbers of the patients have small residual regurgitation and require additional valve procedures at subsequent operations. Long-term observations to monitor progression of the CAVVR is mandatory.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.46-52
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• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.4
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• pp.753-768
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• 1995

For accurate impression taking of dental patient and esthetic denture treatment of ednetulous patient, measuring between intraoral anatomic landmarks is useful.In this study the subjects selected at a random were two-jundred forty persons with a mean age 22.5(range 21-24) and were taken impression of by irreversible hydrocolloid impression material(Alginate). On the study model made by dental stone, each individual tray was made and final impresion was taken by border moilding. On final model measurings were performed with 3-dimensional measuring device and the values were analyzed by t-test The results is following : ABOUT THE MEASURED VALUES. 1. The width between maxillary right and left canine cusp tip was average 36.44mm(s.d. 2.48), man 36.67mm, woman 35.83mm(p<0.05). 2. The width between labial height of contour of maxillary right and left canine was average 40.08mm(s.d. 2.42), man 40.29mm, woman 39.52mm(p<0.05). 3. The width between mesio-lingual cusps of maxillary first molar was average 43.14mm(s.d. 3.33), man 43.56mm, woman 42.05mm(p<0.05). 4. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary first molar was average 64.89mm(s.d. 3.88), man 65.58mm, woman 62.92mm(p<0.05). 5. The width between buccal alveolar ridge on axis of mesiolingual cusp of right and left maxillary second molar was average 68.58mm(s.d. 3.91), man 69.29mm, woman 66.30mm (p<0.05). 6. The width between right and left hamular notch was average 49.80mm(s.d. 3.96), man 50.70mm, woman 48.20mm(p<0.05). 7. The length from labial heigth of contour of maxillary central incisor to center of incisive papilla was average 9.52mm(s.d. 1.18), man 9.46mm, woman 9.63mm(p>0.05). 8. The length from labial heigth of contour of maxillary central incisor to palatine fovea was average 53.27mm(s.d. 2.93), man 53.93mm, woman 52.08mm(p<0.05). 9. The center of incisive papilla ws located posterior to intercanine line at 0.40mm(s.d. 1.16), man 0.51mm, woman 0.11mm(p<0.05). 10. The height from incisal edge of maxillary central incisor to the labial vestibule was average 21.84mm(s.d. 1.38), man 22.01mm, woman 21.00mm(p<0.05). 11. The height from mesiolingual cusp of maxillary first molar to buccalvestible was average 17.45mm(s.d. 1.42), man 17.56mm, woman 17.08mm(p>0.05). 12. The height from hamular notch to standard occlusal plane was average 6.84mm(s.d. 1.06), man 6.91mm, woman 6.70mm(p>0.05). 13. The height from the deepest point of palatal vault to standard occlsalplane was average 19.95 mm(s.d. 2.03), man 20.19mm, woman 19.12mm(p<0.05). ABOUT THE ARCH FORM 1. The arch form was able to classify into four typr by the rate of the measured values. Each arch form distribution was that the 1 group had 32.46% the 2 group 2.19%, the 3 group 52.83%, the 4 group 12.72%. The sexual composition was that in 1 group man had 73.5%, woman 26.5%, in 2 group man had 40.0%, woman 60.0%, in 3 group man had 83.3%, woman 16.7%, and in 4 group man had 55.17%, woman 44.83%. 2. When canine cusp tip was marked as point O, the intersection point between labial height of contour of maxillary central incisor and intermaxillary suture as point A, height of contour of maxillary second molar buccal alveolar ridge as B point, ${\angle}$AOB was measured $133.8^{\circ}$for the 1 group, $133.0^{\circ}$for the 2 group, $132.3^{\circ}$for the 3 group, $128.9^{\circ}$for the 4 group.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.20-26
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• 2011

Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.237-243
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• 2010

Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

• Journal of Chest Surgery
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• v.38 no.7 s.252
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• pp.461-467
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• 2005

Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line of tracheal transplantation, lung transplantation and pulmonary resection. The purpose of the present study is to compare the influence of the pleura, diaphragm and omentum in survival of isolated tracheal segments in the experimental animals. Material and Method: Sprague-Dawley rats weighing 250- 350g were used. The animals were divided in three groups; the pleura, omentum and diaphragm. Following intraperitoneal anesthesia, endotracheal intubation was performed. Then the trachea was exposed. A three-ring sec- tion of cervical trachea was excised. The resected trachea was implanted at each sites. After 2 weeks, rats were sacrificed. Histopathological examination of the tracheal segments was performed. For comparison of each groups, histopathological viability of resected tracheal segment was scored by three tissue layers; epithelium, submucosa, and cartilage. The results were presented as average score. Result: In histopathological examination, submucosa and cartilage using tracheal segment necrosis scoring system. The pleural group showed well preserved tissue. There was minimal necrosis and inflammation compared with other groups. In the pleural group, tracheal necrosis scores were $2.17\pm0.983$at epithelium, $1.67\pm0.516$ at submucosa and $2.17\pm0.753$ at cartilage. At the omental group, scores were $1.00\pm0.00,\;1.60\pm0.548\;and\;1.80\m0.447$. In the diaphragmatic group, scores were $1.40:\pm0.894,\;2.40\pm0.547\;and\;2.20\pm0.447$. Total necrosis score were $6.00\pm1.789$ in the pleural group, $4.40\pm0.894$ in the omental group and $6.00\pm1.414$ in the diaphragmatic group. Conclusion: There were no significant viability differences in terms of total necrosis score for the viability of resected tracheal segment. But the best result was achieved in the omental group. Therefore, omental wrapping on tracheal graft site will be beneficial for the prevention of graft necrosis.

• Journal of Chest Surgery
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• v.36 no.2
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• pp.63-72
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• 2003

Although a variety of synthetic vascular grafts are available in modern vascular surgery, no ideal prosthesis ha,4 yet been developed. Small-caliber vascular grafts with low flow, as used in the lower extremity, continue to become thrombosed at unacceptable rates. We have developed and evaluated the new antithrombogenic blood contacting surfaces in canine model. Material and Method: Two now antithrombogenic blood contacting surfaces(Polyvinylalcohol -Polyurethane(PVA-PU) blend and natural Graphite-polyurethane(G-PU) blend) have been developed and evaluated in canine model, using vascular grafts and patches. The luminal surfaces of the test vascular grafts(5 mm ID) were fabricated by dipping a glass rod in PVA-PU blend solution(50 % PVA) using phase separation method. Mongrel dogs of either sex weighing 18-22 kg were anesthetized by endotracheal intubation using halothane and their lungs were ventilated with a volume-cycled ventilator, Maintenance anesthesia with 0.5-1.0% halothane and supplemental oxygen was used. Two pairs were used for comparison in the bilateral femoral arteries for both vascular grafts(PVA-PU vs. PU) and vascular patches(G-PU vs. PU). Bilateral groin incisions were made and the arteries were exposed and clamped. After an excision of 1 cm of the artery between clamps, a grail of 2.5 cm in length was implanted end-to-end using 6-0 polypropylene suture. The vascular patch was implanted as a form of on-lay patch. Animals were sacrificed at 1, 2, 4, 6, 8 and 16 weeks for vascular grafts and 1, 2. 4 and 6 weeks for vascular patches. Result The vascular grafts of PVA-PU blends showed patent lumina in the 2 and 16 weeks animals, while those of PU showed a patent lumen in 2 weeks animal. PVA-PU graft of 16 weeks showed a fairly clean luminal surface. A light microscopic finding of this graft demonstrated good tissue infiltration through porosity, The animals with vascular patches showed patent arteries in both groups except 2 weeks animal. Scanning electron microscopy of the luminal surfaces of G-PU patches in 4 and 6 weeks animals showed endothelial cell covering with microvilli. PU patches showed qualitatively less endothelial cell covering. Conclusion: In conclusion, PVA-PU and G-PU blends can be a promising blood contacting surfaces for application in a synthetic vascualr graft. However, further animal study is needed to determine the real long-term effects of these methods of surface modifications.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.115-120
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• 2012

Purpose: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond$^{TM}$) as a topical skin adhesive for pediatric urologic open surgery. Methods: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond$^{TM}$ for skin closure. Results: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. Conclusion: Dermabond$^{TM}$ is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

• Economic and Environmental Geology
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• v.44 no.4
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• pp.273-288
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• 2011

Chon-Ashuu copper mining claim area is located, in terms of the geotectonic setting, in the northern part of the suture line which is bounded with the marginal part of Issik-kul micro-continent on the southern part of North Tien-Shan terrane. The geological blocks of Chon-Ashuu districts belong to the southern tip of Kazakhstan orocline. The rock formation of this area are composed of the continental crust or/and arc collage and the paleo-continental fragments-accretionary wedge complex of pre-Altaid orogenic materials. ASI(Alumina Saturation Index) of Paleozoic plutonic rocks in Chon-Ashuu area belong to the peraluminous and metaluminous rocks which were generated from fractional crystallization of Island and volcanic arc crusts in syn-post collisional plate. The geology of the ChonAshuu area consists of upper Proterozoic and Paleozoic rock formations. According to Harker variation diagrams for Chon-Ashuu arenaceous sedimentary rocks, the silty sandstone of Chon-Ashuu area showing the mineralogical immaturity were derived from Island arc or the marginal environments of active continent in Cambro-Carboniferous period. Numerous intrusive rocks of Chon-Ashuu area are distributed along north east trending tectonic structures and are bounded on four sides by the conjugate pattern. The most common type of the plutonic rocks are granodiorite and monzodiorite. According to the molecular normative An-Ab-Or composition (Barker, 1979), the plutonic rocks in Chon-Ashuu area are classified into tonalite - trondhjemite - granodiorite (TTG) series which are an aggregation of rocks which is the country rock of copper mineralization, that are formed by melting of hydrous mafic crust at high pressure.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.177-184
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• 1996

Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.