• Journal of Chest Surgery
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• 제20권1호
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• pp.106-111
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• 1987

Twenty eight patients with atrial septal defect operated on from May, 1983, to July, 1986 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, were analyzed retrospectively. Among the 28 patients of atrial septal defect, 8 were male and 20 were female. Their ages ranged from 4.6 years to 52.5 years old with the mean of 15.3 years. The main clinical symptoms on admission were exertional dyspnea [82%], frequent respiratory infection [75%], palpitation [54%] and easy fatigability [25%]. Electrocardiographic findings were as follows: Regular sinus rhythm [100%], RVH [54%], RBBB [25%] and first degree of A-V block [4%]. Hemodynamic studies were performed in all cases and mean pulmonary systolic arterial pressure was 34.1*11.8mmHg. and mean Qp/Qs was 2.6*0.9. All 28 patients were operated under direct vision using extracorporeal circulation. 23 cases were secundum type defect and a single hole was found in 22 cases. The associated cardiovascular anomalies were found in 11 patients: ventricular septal defect in 3, patent ductus arteriosus in 1, partial anomalous pulmonary venous drainage in 2, mitral regurgitation in 2, tricuspid regurgitation in 1, anomalous left atrial septation in 1 and valvular pulmonary stenosis in 1. The defect closed directly in 22 cases and with patches in 6 cases. Postoperative complications were wound infection, arrhythmia bleeding, intracardiac patch detachment, pneumothorax and urethral injury. But there was no operative mortality.

• Journal of Chest Surgery
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• 제20권3호
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• pp.520-527
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• 1987

Clinical analysis was performed of 89 secundum type atrial septal defect patients operated on during the period from July, 15th, 1981 to March, 1987 in the Thoracic and Cardiovascular Surgery Department of Pusan National University Hospital. Secundum type ASD was 2`I.0% among all of congenital heart diseases operated in the same period. The age distribution of patients ranged from 3 to 41 years and sex ratio, male to female was 1.23 to 1.0. Common symptoms were exertional dyspnea 64.0%, frequent upper respiratory infection 43.8%, cyanosis 10.1% and fatigue 7.9%. The mean value of cardiac catheterization data of the group of ASD combined with another cardiovascular anomalies was compared with that of only ASD group. The amount of shunt showed not statistically significant difference between two groups [P>0.05] but pulmonary arterial pressure and pulmonary vascular resistance of combined group was significantly higher than that of only ASD group [P<0.02, P<0.01]. The difference of mean hemodynamic data between the age group below 20 years and above 21 years was not statistically significant [P>0.05]. All cases were operated under cardiopulmonary bypass. Among these 51 were closed directly and 38 were applied Dacron patch. Two most common associated cardiac anomalies were pulmonary stenosis [8 cases, 9.0%] and VSD [8 cases, 9.0%]. The most frequent postoperative complication was wound infection, One patient died of low cardiac output on 10th postoperative day and the overall operative mortality was 1.1%

• Journal of Chest Surgery
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• 제16권3호
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• pp.289-294
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• 1983

The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

• Journal of Chest Surgery
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• 제9권1호
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• pp.1-9
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• 1976

The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

• The Korean Journal of Physiology and Pharmacology
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• 제21권3호
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• pp.309-316
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• 2017

Transient receptor potential vanilloid 3 (TRPV3) is a non-selective cation channel with modest permeability to calcium ions. It is involved in intracellular calcium signaling and is therefore important in processes such as thermal sensation, skin barrier formation, and wound healing. TRPV3 was initially proposed as a warm temperature sensor. It is activated by synthetic small-molecule chemicals and plant-derived natural compounds such as camphor and eugenol. Schisandra chinensis (Turcz.) Baill (SC) has diverse pharmacological properties including antiallergic, anti-inflammatory, and wound healing activities. It is extensively used as an oriental herbal medicine for the treatment of various diseases. In this study, we investigated whether SC fruit extracts and seed oil, as well as four compounds isolated from the fruit can activate the TRPV3 channel. By performing whole-cell patch clamp recording in HEK293T cells overexpressing TRPV3, we found that the methanolic extract of SC fruit has an agonistic effect on the TRPV3 channel. Furthermore, electrophysiological analysis revealed that ${\gamma}$-schisandrin, one of the isolated compounds, activated TRPV3 at a concentration of $30{\mu}M$. In addition, ${\gamma}$-schisandrin (${\sim}100{\mu}M$) increased cytoplasmic $Ca^{2+}$ concentrations by approximately 20% in response to TRPV3 activation. This is the first report to indicate that SC extract and ${\gamma}$-schisandrin can modulate the TRPV3 channel. This report also suggests a mechanism by which ${\gamma}$-schisandrin acts as a therapeutic agent against TRPV3-related diseases.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• 대한두경부종양학회지
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• 제16권1호
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8917-8921
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• 2014

Objective: To observe and compare the effects of multi-patch biopsy under conventional white light imaging endoscopy (C-WLI) and precise targeted biopsy under magnifying narrow-band imaging endoscopy (M-NBI) on the endoscopic submucosal dissection (ESD) of early gastric cancers and intraepithelial neoplasias. Methods: According to the way of selecting biopsy specimens, patients were divided into C-WLI and M-NBI groups, 20 cases. The ESD operations of the 2 groups were compared quantitively. Results: The mean frequency of biopsy in M-NBI group was ($1.00{\pm}0.00$), obviously lower than in the C-WLI group ($4.78{\pm}1.02$) (P<0.01).The average total number of selected biopsy specimens was also fewer ($1.45{\pm}0.12$ and $7.82{\pm}2.22$, respectively, P<0.01). There was no significant difference in the time of determining excision extension, marking time and the time of specimen excision of 2 groups during the ESD (P>0.05), whereas submucosal injection time, mucosal dissection time, stopping bleeding time, wound processing time in the M-NBI group were significantly shorter than in the C-WLI group (P<0.01). Conclusion: Precise targeted biopsy under M-NBI can obviously shorten the time of ESD operation, with small quantity of tissues but high pathological positive rate.

• Journal of Chest Surgery
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• 제31권7호
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• pp.674-678
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• 1998

좌주관상동맥 협착증은 관상동맥 협착증 환자의 약 7%에서 발생될 정도로 관상동맥 협착증 중에서는 드문 질환이며, 특히 좌주관상동맥 협착증이 독립적으로 나타나는 경우는 1% 미만으로 매우 드물다. 그러나 독립된 좌주관상동맥 협착증이 있는 경우에 보편적인 관상동맥 우회로조성술로는 완전한 재관류를 기대할 수 없다. 따라서 이를 극복하기 위해 좌주관상동맥 혈관성형술이 새로이 시도되고 있다. 연세대학교 심장혈관센터에서는 1994년 5월부터 1996년 2월까지 독립된 좌주관상동맥 협착증을 가진 11명에게 혈관성형술을 시행하여 얻은 결과를 평가하고자 한다. 대상환자의 연령은 34세에서 62세 사이로 평균 44.1 $\pm$ 9.3세였다. 이중 남자가 3명, 여자가 8명 (73%)으로 대부분이 여자였다. 수술전 관상동맥 협착증의 위험요소는 당뇨가 1례, 고혈압이 3례, 흡연이 2례, 과체중이 3례 및 가족력이 1례 있었다. 평균 콜레스테롤 치는 196.5 $\pm$ 33.6 mg/dL였으며, 이중 4례에서 200 mg/dL가 넘었다. 수술전 흉통의 정도는 Class II가 6명, Class III가 5명이었으며, 심전도상에서 T inversion이나, ST elevation이 있으면서 심초음파검사에서 좌심실 운동장애를 보인 예가 4례 있었으나 심근경색증을 보인 예는 없었다. 수술전 좌심실 박출계수는 61.1 $\pm$ 5.9%였다. 수술후 좌심실 박출계수는 65.2 $\pm$ 9.1이었고, 좌심실 운동장애를 보인 예는 없었다. 진단은 좌주관상동맥 입구의 협착증이 8명, 근위부 협착이 3명이었으며, 협착정도는 전례에서 60% 이상이었고 이중 5례는 80% 이상이었다. 수술시 접근방법은 모든 예에서 좌주관상동맥의 전방접근을 시도하였으며, 혈관성형술에 사용한 첨포는 소심낭 (bovine pericardium) 을 사용하였다. 동반수술은 전례에서 좌전하행지에 우회로조성술을 시행하였다 (10례 : 좌내유동맥, 1례 : 대복재정맥). 수술시 측정한 협착부위의 직경은 1례가 1 mm, 나머지 10례는 2 mm였으며, 혈관성형술 후에 측정한 직경은 9례가 4 mm, 2례가 5 mm 였다. 수술후 합병증은 하지의 창상감염이 1례 있었으며, 수술사망은 없었다. 추적조사는 100%가 가능하였으며, 추적조사 기간은 평균 15.5$\pm$5.8 개월이었다. 이 기간 중 흉통이 발생한 예는 없었으며, 심전도상 이상소견을 보인 예도 없었다. 수술후 평균 14.4$\pm$3.3 개월에 관상동맥 조영술을 5례에서 시행하였으며, 5례 모두 좌주관상동맥 혈관성형술 부위는 광범위한 개통이 있었으나, 좌전하행지에 이식한 이식편 중 2례에서 중등도의 협착이 있었으며, 나머지 3례도 혈류량이 상당히 줄어든 소견을 보였다. 이상과 같은 결과로 미루어 독립된 좌주관상동맥 협착증이 있는 경우에 비적응증이 되지 않는다면 혈관성형술이 완전한 재관류를 위하여 이상적인 방법으로 생각되며, 단지 좌전하행지에 시행하는 우회로술은 의미가 없을 것으로 생각된다.

• 한국융합학회논문지
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• 제8권1호
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• pp.35-42
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• 2017

보름달 물해파리 유래 펩타이드인 LVH는 주름개선에 효과가 있는 기능성 소재로서 보고되어 있다. 본 연구에서는 LVH의 피부 침투 효율을 증가시키기 위하여 LVH와 팔미트산을 이용하여 pal-LVH를 합성하였고, 합성된 pal-LVH의 기능성 소재로서의 효과를 조사하였다. 이를 위해서 우리는 두 펩타이드의 세포독성, 항노화, 주름 개선 그리고 피부 자극에 대한 효능을 비교 평가하였다. Pal-LVH는 LVH와 마찬가지로 세포독성은 보이지 않았다. 그리고 고농도에서는 LVH와 비슷한 우수한 상처 치유와 항노화 능력을 보였고, 주름개선 효과 또한 저농도에서는 LVH와 거의 유사하게 나타났다. 이들 결과는 pal-LVH 펩타이드는 피부 침투율을 증가시키면서, LVH 펩타이드가 가지고 있는 우수한 효능에는 영향을 주지 않는다는 것을 지시한다. 따라서 pal-LVH는 주름개선 효과 및 안티에이징 물질 등의 기능성 신소재로서 가능성을 제시하며, 다양한 융합 연구를 통하여 의약품 개발에 응용되어 질 수 있다.