• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.142-147
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• 2021

Background: This study was performed to investigate the association between cystographic anastomotic urinary leakage (UL) after retropubic radical prostatectomy (RRP) and early urinary incontinence (UI). Methods: The medical records of 53 patients who had undergone cystography after RRP at our institution between January 2015 and December 2018 were retrospectively analyzed. Cystography was performed 7 to 10 days after surgery. The duration of catheterization depended on the degree of UL, which was classified as mild, moderate, or severe. The study subjects were divided into the non-UL group and the UL group. Continence was defined as the use of no pads. The prostate was dissected in an antegrade fashion, and urethrovesical anastomosis was performed with a continuous suture. Results: Incontinence rates at 1 and 3 months postoperatively were significantly higher in the UL group than the non-UL group (83.3% vs. 52.2%, p=0.014 and 76.7% vs. 47.8%, p=0.030, respectively); however, those at 6 and 12 months were not significantly different (23.3% vs. 17.4%, p=0.597 and 4.3% vs. 10.0%, p=0.440, respectively). The severity of UL was not found to influence the duration of incontinence. The presence of cystographic anastomotic UL was found to be predictive of UI during the first 3 postoperative months (odds ratio, 3.3; p=0.045). Conclusion: The presence of anastomotic UL on cystography was associated with higher rates of UI in the early postoperative periods. However, incontinence rates in patients with or without anastomotic UL immediately after RRP equalized at 6 months and the severity of UL did not affect the duration of postoperative UI.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.152-159
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• 2024

Background: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment. Methods: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA). Results: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT. Conclusion: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.770-774
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• 2006

Background: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leak-age and observed the effects and efficiency of treatment. Material and Method: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. Results: Continuous air leakages disappeared in all f6 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complications were transient and disappeared without specific treatment. Conclusion: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.625-629
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• 2008

Background: When it comes to esophageal cancer operations, the prevalence of anastomotic complications that adversely affect quality of life is related to the type of anastomotic procedure and the operative site. We studied outcomes related to a safe anastomotic method used in Ivor Lewis esophagogastrectomy for preventing anastomotic leakage and stricture formation. Material and Method: Between May 2003 and April 2007, 18 patients with esophageal cancer underwent this type of esophagogastrectomy. Four people were lost to follow-up. There were 17 men (94.4%) and 1 woman. The mean patient age was 61 years (range, $46{\sim}73$ years). Result: The mean follow-up period was 17.2 months (range, $1{\sim}45$ months). There was no anastomotic leakage. There was one benign anastomotic stricture (5.6%) requiring esophageal balloon dilatation, which was accomplished with a 25 mm circular stapler. Conclusion: We experienced relatively good postoperative results using a safe anastomotic method in the Ivor lewis operation for preventing anastomotic complications. These results suggest that this anastomotic method is effective in reducing the incidence of benign anastomotic complications.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.310-315
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• 2000

Background: A retrospectiye study was done for understanding morbidity and mortality after major lung resection. Material and Method: From June 1994 to August 1998, 203 patients received major lung resections for various causes. There were 142 males and 62 females with a mean age of 47.5 years. Initial complains were cough in 47.8%, sputum in 33.0%, hemoptysis or blood-tinged sputum in 23.2%, dyspnea in 18.2%, chest pain in 15.3%, weight loss in 10.8%, fever and chill in 4.9%. There were no complaints in 5.9% of the total patients. The underlying diseases were lung tumor(102 cases/50.2%), bronchectasis(28 cases/13.8%), aspergillosis(24 cases/1.8%), tuberculosis(20 cases/9.9%) and others (29 cases/66.5%) and pneumonectomy(68 cases/33.5%). The postoperative complications were classified as : empyema, BPF, respiratory problem, persistent air leakage over 7 days, arrhythmia, ventilator applied over 24 hours, bleeding, wound infection and chylothorax. The postlobectomy complications were revealed as follow: empyema(3.7%), BPF(2.2%), respiratory problem(5.2%), persistent air leakage over 7days(8.9%), arrhythmia(2.2%), ventilator applied over 24 hours(2.2%), bleeding(1.5%), wound infection(2.9%), chylothorax(0.7%). The postpneumonectomy complications were revealed as follow : empyema(5.9%), BPF (5.9%), respiratory problem(17.6%), persistent air leakage over 7days(0%), arrhythmia(5.4%), ventialtor apply over 24 hours(7.4%), bleeding (7.4%), wound infection(2.9%) and chylothorax(1.5%). Reoperation was done in 8 cases (4.0%). There were 5.8% operative mortalities in pneumonectomy and 0.7% in lobectomy.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.503-516
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• 2001

Background : The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. Method : In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. Results : In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. Conclusion : A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.

• Journal of Cardiovascular Imaging
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• v.30 no.4
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• pp.292-304
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• 2022

BACKGROUND: Calcium is a determinant of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI). This is based on a fixed contrast attenuation value while X-ray attenuation is patient-dependent and without considering frame expansion and PVL location. We examined the role of calcium in (site-specific) PVL after TAVI using a patient-specific contrast attenuation coefficient combined with frame expansion. METHODS: 57 patients were included with baseline CT, post-TAVI transthoracic echocardiography and rotational angiography (R-angio). Calcium load was assessed using a patient-specific contrast attenuation coefficient. Baseline CT and post-TAVI R-angio were fused to assess frame expansion. PVL was assessed by a core lab. RESULTS: Overall, the highest calcium load was at the non-coronary-cusp-region (NCR, 436 mm³) vs. the right-coronary-cusp-region (RCR, 233 mm³) and the left-coronary-cusp-region (LCR, 244 mm³), p < 0.001. Calcium load was higher in patients with vs. without PVL (1,137 vs. 742 mm³, p = 0.012) and was an independent predictor of PVL (odds ratio, 4.83, p = 0.004). PVL was seen most often in the LCR (39% vs. 21% [RCR] and 19% [NCR]). The degree of frame expansion was 71% at the NCR, 70% at the RCR and 74% at the LCR without difference between patients with or without PVL. CONCLUSIONS: Calcium load was higher in patients with PVL and was an independent predictor of PVL. While calcium was predominantly seen at the NCR, PVL was most often at the LCR. These findings indicate that in addition to calcium, specific anatomic features play a role in PVL after TAVI.

• Korean Journal of Bronchoesophagology
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• v.15 no.1
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• pp.35-40
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• 2009

Background: Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients raBackground Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients ranging from 29 to 69 years of age. The complication was two anastomosis site leakage, one gastric necrosis and one mortality due to bowel strangulation and sepsis. Conclusion: Transhiatal esophagectomy and intracervical esophagogastrostomy is safety and useful method at selection case even though corrosive esophageal resection is debated.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.26 no.11
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• pp.1644-1652
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• 2022

In the case of safety training where practical training is impossible due to risk problems, training contents using realistic media such as virtual reality or augmented reality are becoming a new alternative. In this paper, we propose a smoke modeling method that can be applied to safety-training contents implemented with realistic media technology. When an accident occurs in a hazardous area such as a petrochemical plant, visibility is not secured due to gas leakage and fire. In order to create such a situation, it is important to realistically express smoke. The proposed method is a smoke model implementation technique that can be effectively applied to the background of complex passages and devices such as petrochemical plants. In the proposed method, the smoke is expressed using volumetric rendering in the post-processing stage for the resulting image of scene rendering. Implementation results in the background of the factory show that the proposed method produces models that can express the smoke realistically.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.205-212
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• 2001

Background : The information on nasal transport and the metabolism of peptides have been obtained from pharmacokinetic investigations in experimental animals. However, there are no transport and metabolic studies of human nasal epithelial cells. In this study, the permeability characteristics and the metabolic properties of in vitro human nasal cell monolayers were investigated. Material and Methods : Normal human inferior nasal conchal tissue samples were obtained from patients undergoing endoscopic nasal cavitary surgery. The specimens were cultured in a transwell using an air-liquid Interface (ALI) culture, and the transepithelial electrical resistance (TEER) value of the blank filter and confluent cell monolayers were measured. To determine the % leakage of mannitol, $4{\mu}mol%$ $^{14}C$-labelled mannitol was added and the % leakage was measured every 10 minute for 1 hour. Result : Human nasal epithelial cells in the primary culture grew to a confluent monolayer within 7 days and expressed microvilli. The tight junction between the cells was confirmed by transmission electron microscopy. The TEER value of the blank filter, fifth day and seventh day reached $108.5\;ohm.cm^2$, $141\;ohm.cm^2$ and $177.5\;ohm.cm^2$, respectively. Transcellular % leakage of the $^{14}$-mannitol at 10, 20, 30, 40, 50 and 60 minutes was $35.67{\pm}5.43$, $34.42{\pm}5.60$, $32.75{\pm}5.71$, $31.76{\pm}4.22$, $30.96{\pm}3.49$ and $29.60{\pm}3.68\;%$, respectively. Conclusion : The human nasal epithelial monolayer using ALI culture techniques is suitable for a transcellular permeability study. The data suggests that human nasal epithelial cells In an ALI culture technique shows some promise for a nasal transport and metabolism study.