• Journal of the Korean Society of Radiology
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• v.11 no.5
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• pp.387-392
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• 2017

When an infant has visited a hospital due to skull fracture, the rupture of a blood vessel, or skin wounds on the head resulted from an incident, accident, traffic accident, or disease, he/she becomes to undergo anterior/posterior and lateral skull imaging, which is a head test at the department of radiology. In the head test, if the adult skull imaging grid is applied to the imaging, the secondary radiation will be removed to enhance the contrast of the image. However, among the radiation exposure conditions, the tube voltage should be enhanced by 8~10 kVp leading to an increase in the patient exposure. The present study was conducted under assumption that if the same images can be obtained from infant skull imaging without using the skull imaging grid, the exposure dose will be reduced and the artifacts due to grid cut off can be prevented. The researcher measured the radiation dosage using a radiation meter and conducted the subjective evaluation (ROC, receiver operating characteristic) among medical image evaluation methods. Based on the results, when the images were taken without using the grid, the exposure dose was reduced by 0.019 mGy in the anterior/posterior imaging and by 0.02 mGy in the lateral imaging and the image evaluation score was higher by 4 points. In conclusion, if the images of the skulls of infants that visited the hospital are taken with out using the grid, the exposure dose can be reduced, the image artifacts due to grid cut off can be prevented, and the lifespan of the X-ray tube will be extended.

• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.88-93
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• 2015

Objective : Elevated cellular retinoic acid binding protein-I (CRABP-I) is thought to be related to the abnormal proliferation and migration of smooth muscle cells (SMCs). Accordingly, a higher CRABP-I level could cause disorganized vessel walls by causing immature SMC phenotypes and altering extracellular matrix proteins which could result in vulnerable arterial walls with inadequate responses to hemodynamic stress. We hypothesized that elevated CRABP-I level in the cerebrospinal fluid (CSF) could be related to subarachnoid hemorrhage (SAH). Moreover, we also extended this hypothesis in patients with vascular malformation according to the presence of hemorrhage. Methods : We investigated the CSF of 26 patients : SAH, n=7; unruptured intracranial aneurysm (UIA), n=7; arteriovenous malformation (AVM), n=4; cavernous malformation (CM), n=3; control group, n=5. The optical density of CRABP-I was confirmed by Western blotting and presented as mean${\pm}$standard error of the measurement. Results : CRABP-I in SAH ($0.33{\pm}0.09$) was significantly higher than that in the UIA ($0.12{\pm}0.01$, p=0.033) or control group ($0.10{\pm}0.01$, p=0.012). Hemorrhage presenting AVM (mean 0.45, ranged 0.30-0.59) had a higher CRABP-I level than that in AVM without hemorrhage presentation (mean 0.16, ranged 0.14-0.17). The CRABP-I intensity in CM with hemorrhage was 0.21 and 0.31, and for CM without hemorrhage 0.14. Overall, the hemorrhage presenting group (n=11, $0.34{\pm}0.06$) showed a significantly higher CRABP-I intensity than that of the non-hemorrhage presenting group (n= 10, $0.13{\pm}0.01$, p=0.001). Conclusion : The results suggest that elevated CRABP-I in the CSF could be related with aneurysm rupture. Additionally, a higher CRABP-I level seems to be associated with hemorrhage development in vascular malformation.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.419-429
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• 1998

This study was carried out in order to study early histologic changes and repair reaction appling to extrusive force for 3rd premolar of adult dogs. After 1 week of extrusive force with elastic chain, one of dogs was sacrified and after 3 weeks retention period, another dog was sacrified. The paraffin sections of samples were stained with Hematoxylin - Eosin and Masson's Trichrome and were examed by light microscopy . The obtained results as follows 1. In Hematoxylin - Eosin and Masson Trichrome stain of control group , the periodontal ligament width was constant from apical third to cervical third of the root and periodontal fiber arrangement was horizontal or oblique in cervical third. oblique in middle third, oblique in apical third of root. in alveolar bone, smooth appearance was shown 2. In Group 1, all periodontal fiber arrangement was oblique toward tooth, and the periodontal ligament width increased Partially PDL was ruptured in apex. In MT stain, immature bone formation was seen at alveolar crest area. Active bone formation was observed along the one side of alveolus, and apical portion of pulp was involved with blood vessel rupture , vacuolization of pulp tissue and hyperemia 3. In Group 2, most periodontal ligament arrangement and PDL width was repaired and fiber density increased. In MT stain, mineralization of immature bone on the alveolar crest was progressed. In pulp, vacuole and hyperemia was diminished and fibrotic change was diminished 4. After 3 week periodontal ligament has more repair ability than pulp tissue. pulp was involved with vacuolization and fibrosis, so it takes more time for repair.

• Journal of the Korean Institute of Gas
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• v.16 no.1
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• pp.15-21
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• 2012

An analysis was completed of the hazards distance of hydrogen accidents such as jet release, jet fire, and vapor cloud explosion(VCE) of hydrogen gas, and simplified equations have been proposed to predict the hazard distances to set up safety distance by the gas dispersion, fire, and explosion following hydrogen gas release. For a small release rate of hydrogen gas, such as from a pine-hole, the hazard distance from jet dispersion is longer than that from jet fire. The hazard distance is directly proportional to the pressure raised to a half power and to the diameter of hole and up to several tens meters. For a large release rate, such as from full bore rupture of a pipeline or a large hole of storage vessel, the hazard distance from a large jet fire is longer than that from unconfined vapor cloud explosion. The hazard distance from the fire may be up to several hundred meters. Hydrogen filling station in urban area is difficult to compliance with the safety distance criterion, if the accident scenario of large hydrogen gas release is basis for setting up the safety distance, which is minimum separation distance between the station and building. Therefore, the accident of large hydrogen gas release must be prevented by using safety devices and the safety distance may be set based on the small release rate of hydrogen gas. But if there are any possibility of large release, populated building, such as school, hospital etc, should be separated several hundred meters.

• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.163-171
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• 1999

Purpose: Liquid beta emitter filled in angioplasty balloon could be used to perform endovascular balloon brachytherapy to prevent coronary artery restenosis. We investigated the dosimetry for Re-188-DTPA liquid-filled balloon and medical internal radiation dosimetry in case of balloon leakage. Materials and Methods: We estimated radiation dose from an angioplasty balloon (20 mm length, 3 mm diameter cylinder) to the adjacent vessel wall using Monte Carlo EGS4 code. We obtained time-activity curves of kidneys in normal dog and calculated $T_{max},\;T_{1/2}$. Using MIRDOSE3 program, we estimated absorbed doses to the major organs (kidneys, bladder) and the whole body when we assumed that balloon leaked all the isotope contained. Results: The radiation dose was 17.5 Gy at the balloon surface when we applied 3,700 MBq/ml of Re-188 for 100 seconds, Fifty percent of the energy deposited within 1 mm from the balloon surface. The estimated internal dose to the whole body was 0.005 mGy/MBq and 18.5 mGy for the spillage of 3,700 MBq of Re-188. Conclusion: We suggest that Re-188-DTPA can be used for endovascular balloon brachytherapy to inhibit coronary artery restenosis after angioplasty with tolerable whole body radiation dose in case of balloon rupture.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.277-280
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• 2008

Tuberculous aortitis is a very rare disease. Furthermore, it is all the more rare for it to be complicated by the development of an aortic aneurysm or the formation of aorto-bronchial fistula. If it is complicated by rupture of the aorta, mortality is very high. If the patient didn't contract tuberculosis, but was expectorating blood, we would have to carry out a chest CT promptly, in order to make a rapid and accurate diagnosis of this disease. A 46-year-old male patient was admitted due to the sudden onset of intermittent hemoptysis and chest discomfort. CT scans of the chest showed an aneurysmal change to the descending thoracic aorta, and the formation of an aorto-bronchial fistula, which originated from this aneurysm and communicated with its left lower lobe. We operated with an artificial vessel graft interposition of the descending thoracic aorta and a left lower lobectomy. Because the diagnosis was of tuberculosis, we started anti-Tbc medication and long term anti-Tbc medication was recommended.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Journal of the Korean Wood Science and Technology
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• v.13 no.3
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• pp.49-53
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• 1985

The effects of pre-treatments, the hot water extraction of wood meal and the addition of chemical ($CaCl_2$) to wood-cement water system on the properties of wood-cement composite such as modulus of rupture (MOR), modulus of elasticity (MOE), water sorption ratio and swelling ratio of resulting boards were studied in this experiment. The wood meals through 0.83mm(20 mesh) and retained on 0.42mm(35 mesh) screen were prepared from Pinus densiflora S. at Z. and Larix leptolepsis G. For hot water extraction, 500 grams of wood meal for each species were heated to boiling with 1,500ml of distilled water in 2-liter beaker for 6 hours. Every 2 hours, the wood meals were washed with boiling distil1ed water and reheated to boiling again. After 6 hours boiling, the boiled wood particles were collected by pouring this particles on 200 mesh screen. The collected particles then washed twice with hot distilled water and dried for 24 hours in an oven at $109{\pm}20^{\circ}C$. A mixture of 663.4 grams of cement with 331.7 grams of wood meal based on oven-dry weight were dry-mixed in a plastic vessel. The mixture was kneaded with 497.6ml of distilled water in the ratio of 1.5ml of water to a gram of wood meal. To add calcium chloride to the mixture as an accelerator, $CaCl_2$ 4% solution by weight per volume, was added to pine-or larch-cement board in the ratio of 3% to cement weight. To set wood-cement board, this mixture was clamped at 30cm ${\times}$ 30cm, in thickness of 1.5cm for 3 days at room temperature, declamped and then placed at open condition for 17 days. The target density was 1.0. The four specimens sized to 5cm in width and 28cm in length were used for MOR and MOE test for each treatment. After MOR test, the tested specimens were cut to the size of 5cm ${\times}$ 5cm for water sorption and swelling test. The twenty specimens used to measure the water sorption ratio (soaking 24 hours) and ten of these were used for swelling ratio measurement The results obtained were as follows: 1) Larch was not suitable for wood-cement boards because larch-cement board developed no strength, but pine showed 97.9kg/$cm^2$ by hot water extraction. 2) To increase MOR, hot water extraction was more effective than the addition of $CaCl_2$ in pine and larch because the $CaCl_2$ addition was seemed to speed up the ratio of cement hydration without reacting with the wood substances. 3) The water sorption ratio was lowered by the addition of $CaCl_2$ to wood-cement system because the chemical additive accelerated the rate of cement hydration. 4) In pine-cement board, the swelling ratio from 0.37 to 0.42 percent was observed in length and the swelling ratio from 0.88 to 2.0 percent in thickness. As a rule, the swelling ratio of wood-cement board was very low and the swelling ratio in thickness was higher than in length.

• 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 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.