• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.236-239
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• 2011

A 10 month-old female (intact) Maltese dog was presented due to continuous heart murmur. The dog was diagnosed with patent ductus arteriosus (PDA) based on two-dimensional echocardiography, computed tomography (CT) and angiography. Transarterial coil embolization was used for transcatheter occlusion of the PDA. A single coil was placed successfully and effectively occluded the blood flow through the ductus. Continuous heart murmur disappeared immediately the coil placement and no residual flow was detected. Complications and safety following the procedure were evaluated regularly based on clinical signs, cardiac examinations and serum troponin-I concentrations. This is the first clinical application of coil embolization for transcatheter closure of PDA in a dog in Korea.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.37-41
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• 2010

Background and Objectives : Transient minor voice changes after thyroidectomy are not infrequent complaints even in cases without any evidence of recurrent laryngeal nerve damage. However, clinical course, diagnosis and management of such voice changes are not fully understood. This study aimed to evaluate the clinical characteristics of minor voice changes after thyroidectomy. We also tried to assess the significance and feasibility of superior laryngeal nerve monitoring and to find out the optimal evaluation tools for such voice changes after thyroidectomy. Materials and Method : Nine adult patients who received total thyroidectomy without evidence of recurrent laryngeal nerve injury were enrolled for this prospective study. Voice evaluations were performed preoperatively and 3 months postoperatively ; acoustic analyses including voice range profile, aerodynamic study, stroboscopic evaluation and subjective voice assessment with questionnaires. The external branch of superior laryngeal nerve was monitored by nerve stimulator after ligation of superior thyroidal vessels. Results: Four of nine patients complained their voice change at 3 months after the surgery. Three of them reported complete recovery of their voice at 6 months after the surgery. Acoustic analysis revealed significant decrease in their phonatory range especially with high tone loss. Questionnaires related to singing was more sensitive than previously well-known "voice handicap index". Stimulation of the superior laryngeal nerve was feasible in most of the cases (94.4%), but it failed to show any correlation with minor voice changes after thyroidectomy. Conclusion : Minor voice changes were not rare events during the first 6 month after thyroidectomy. Decrease in phonatory range with high tone loss and therefore, discomfort in singing was the most common finding. Superior laryngeal monitoring was feasible but it was not a sensitive tool for the prediction of minor voice change after thyroidectomy.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.280-292
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• 2016

Purpose: The purpose of this study was to compare the long-term survival rate and peri-implant marginal bone loss related to multiple risk factors including the clinician's experience. Materials and Methods: Four hundred twenty implants in 146 patients, who had involved a supportive periodontal therapy program every 3 to 6 months and had follow up data for at least 5 years, were selected as the study group. Peri-implant marginal bone loss, data of demographic, implant and surgical characteristics were collected from peri-apical radiographs and chart review. Implant survival was regarded as the remaining with radiographic marginal bone level in excess of 50% of the fixture length for any reason. Results: The cumulative survival rate after 5 years of loading was 94.9%. In binary logistic regression analysis, smoking status (P = 0.033) and presence of spontaneous cover screw exposure (P < 0.001) were significantly related to 5-year survival of implants. In stepwise multiple regression analysis, smoking status (P < 0.001), type of abutment connection (P < 0.001) and implant surface (P = 0.033) were significantly related to peri-implant marginal bone level. And the year of resident was not statistically related to 5-year implant survival in simple logistic regression analysis (P = 0.171). Conclusion: Smoking status, spontaneous cover screw exposure, type of abutment connection and implant surface might influence the implant success. There was no significant correlation between the year of resident and implant failure.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.13.3-14
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• 1983

A clinical study was done on 24 cases with foreign body in the air passage, who were treated at the department of otolaryngology of Kyung Hee university hospital during the period from Apr. 1973 to Feb. 1983. The obtained results were as follows : 1) The incidence of sex was much higher in male than female and children under 4 years old were predominant. 2) Almost of all patients came in the hospital within 3 days after onset. However one patient came in hospital 5 months later. 3) The variety of foreign body was numerous, among which vegetables and plastic materials were most frequently found. 4) The most common sites of lodgement were trachea and right main bronchus. 5) The common clinical manifestations were dyspnea, decreasing breathing sound and cough. Negative X-ray findings did not exclude a foreign body in the air passage. 6) The important pulmonary complications due to foreign body were atelectasis, emphysema and pneumonia. 7) Foreign body was successfully removed by use of peroral or inferior endoscopy in all cases except one case, on whom thorachotomy was done. 8) The important complications due to the surgical procedure were decannulation difficulty and pneumothorax.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.82-93
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• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2000.04a
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• pp.10-10
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• 2000

램제트 엔진은 비추력이 높고 추력 레벨은 낮으므로, 2단 추진기관에 적합한 추진 시스템이다. 1단-추진기관의 작동이 끝나고, 2단 램제트 엔진이 점화 후 안정된 연소에 도달되기까지 비행체의 속도는 항력에 의하여, 초당 약 마하수 0.1 정도씩 감소된다. 1단 연소 후 2단 램제트로 전환되는 지연시간이 길수록 1단에서 요구되는 종말 가속도는 증가되므로, 1단이 차지하게되는 부피는 증가되고 비행체의 크기 또한 늘어나게 된다. 따라서 1단에서 2단 램제트로 천이되는데 소요되는 시간을 가능한 짧게 하는 것이 효과적이다. 그러나 램제트 엔진의 특성상 선결되어야할 다음과 같은 여러 문제들이 있다. 첫째, 1단 작동 시 공기 흡입구와 연소실은 차단벽으로 분리되어 있다가, 1단 연소후 차단막이 제거되어 외부공기가 램제트 연소실로 흡입된다. 흡입되는 공기는 흡입구의 형상에 의하여 램 압축되지만 초음속으로 연소실을 통과하게된다. 연료 주입 구에서 공급되는 연료는 연소실에서 유동의 흐름방향(streamline)에 따라서 연소실로 확산되는데, 연소되기 전에는 유속이 빠르게 노즐로 빠져 나가므로 램제트 연료가 재순환 구역(recirculation zone)으로 침투하는데 쉽지가 않다. 둘째, 연소실 입구에서 발생되는 와류 (ring vortex)는 1단 연료의 고온 연소 가스를 연소실로 확산시키는데, 비 균일한 온도 분포를 유발하여 램제트 연료의 점화에너지가 공급되는 시간이 적당하지 않을 경우 균일한 화염 전파에 악영향을 준다. 셋째, 연소실에서의 빠른 유동 조건은 연료가 연소실에 머무를 수 있는 시간을 감소시키며, 연소실 입구에서 강한 전단 응력이 발생되어 화염이 안정화되는데 악 영향을 미치게된다. 본 논문은 공기 흡입구, 연소실 및 노즐을 통합하여 수치해석을 하였으며 열유동/점화/연소등의 미케니즘을 이해하고, 주요 인자들 중 와류의 영향에 초점을 맞추었다.다고 판단되며 배기 가스 자체에 대기 공기중에 함유되어 있던 습기가 얼어붙는(Icing화) 문제가 발생하기 때문에 배기가스의 Icing을 방지하기 위하여 압축기 끝단에서 공기를 추출하여 배기부분에 송출할 필요성이 있는 것으로 판단되었다. 출구가스의 기체 유동속도가 매우 빠르므로 (100-l10m.sec) 이를 완화하기 위한 디퓨저의 설계가 요구된다고 판단된다. 또 연소기 후방에 물을 주입하는 경우 열교환기 및 기타 부분품에 발생할 수 있는 부식 및 열교환 효율 저하도 간과할 수 없는 문제로 파악되었다. 이러한 기술적 문제가 적절히 해결되는 경우 비활성 가스 제너레이터는 민수용으로는 대형 빌딩, 산림, 유조선 등의 화재에 매우 적절히 사용되어 질 수 있을 뿐 아니라 군사적으로도 군사작전 중 및 공군 기지의 화재 그리고 지하벙커에 설치되어 있는 고급 첨단 군사 장비 등의 화재 뿐 아니라 대간첩작전 등에 효과적으로 활용될 수 있을 것으로 판단된다.가 작으며, 본 연소관에 충전된 RDX/AP계 추진제의 경우 추진제의 습기투과에 의한 추진제 물성 변화는 미미한 것으로 나타났다.의 향상으로, 음성개선에 효과적이라고 사료되었으며, 이 방법이 편측 성대마비 환자의 효과적인 음성개선의 치료방법의 하나로 응용될 수 있으리라 생각된다..7%), 혈액투석, 식도부분절제술 및 위루술·위회장문합술을 시행한 경우가 각 1례(2.9%)씩이었다. 13) 심각한 합병증은 9례(26.5%)에서 보였는데 그중 식도협착증이 6례(17.6%), 급성신부전증 1례(2.9%), 종격동기흉과 폐염이 병발한 경우와 폐염이 각 1례(2.9%)였다. 14) 식도경 시행회수는 1회가 17례(54.8%), 2회가 9례(29.0%), 3회 이상이 5례(16.1%)였다.EX>$IC_{50}$/ 값이 210 $\mu\textrm{g}$/$m\ell$로서 효과적

• Journal of Chest Surgery
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• v.30 no.5
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• pp.501-505
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• 1997

It was reported that use of aprotinin in elderly patients undergoing hypothermic circulatory arrest was associated with an increased risk of renal dysfunction, and myocardial infarction as a result of intravascular coagulation. We reviewed 20 patients who received high-dose aprotinin under deep hypothermic circulatory arrest with(NP group, n= 11) or without selective cerebral perfusion(SP group, n=9). The activated clotting time was exceeded 750 seconds in all but 1 patient. After opening aortic arch, retrograde low flow perfusion was maintained through femoral artery to prevent air embolization to the visceral arteries. Four patients among 20 died during hospitalization'due to bleeding, coronary artery dissection pulmonary hemorrhage and multiple cerebral infarction. Postoperatively, cerebrovascular accidents occurred in two patients; one with preoperative carotid artery dissection and the other with unknown multiple cerebral infarction. In conclusion, use of aprotinin in young patients undergoing hypothermic circulatory arrest did not increase the risk of renal dysfunction or intravascular coagulation if ACT during circulatory arrest is maintained to exceed 750 seconds with low-flow perfusion.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1056-1062
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• 1998

Background: We prospectively investigated types, incidences, and risk factors for arrhythmias after open heart surgery in adults. Materials and methods: From June 1994 to May 1995, we performed 302 cases of adult cardiac surgery at our department. This study group consisted of 150 men and 152 women, with a mean age of 43.9±28.0(range 16 to 75)years. We included all the patients irrespective of their operative types or disease entities. Results: The overall incidence of arrhythmias after open heart surgery in adults was 58.3%. The incidence of postoperative arrhythmias for redo-valvular heart surgery was 77.8%, and those for simple valvular procedure, coronary artery bypass surgery, aortic surgery, and congenital heart disease were 70.8%, 45.3%, 40.0%, and 29.5%, respectively. Eight out of twelve risk factors showed statistical significance for the development of postoperative arrhythmias. They were preoperative history of arrhythmias, antiarrhythmic drug medication, previous cardiac surgery, larger left ventricular end-diastolic, end-systolic dimension, left atrial dimension on preoperative echocardiogram, longer cardiopulmonary bypass time and aortic cross clamping time. Univariated analyses for age and types of cardioplegic solution did not show statistical significance. Conclusions: Prospective study on postoperative arrhythmias occurrence, treatment and prevention of is warrauted to draw more clear conclusion.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.266-270
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• 1998

The management of malignant pleural effusion is a difficult problem. Tetracycline was probably the most commonly used sclerosing agent, but parenteral tetracycline is no longer available. This prospective study was designed to determine the efficacy of insufflated talc in producing plerodesisin patients with malignant pleural effusions. Fifteen patients managed between March 1995 and March 1997 underwent thoracoscopy and had 4 gm sterile asbestos-free talc insufflation throughout the pleural space. The mean interval between the procedure and last follow-up was 101 days(range: 25-233 days). The results of treatment were clinically and radiologically compared with pre-operative status. The results were as follows: 1. The patients were 6 men and 9 women with a mean age of 55.1 years(range: 31-74 years). The primary tumors were lung cancer in 10 patients, breast cancer in two, hepatoma in one, stomach cancer in one, and adenocarcinoma of unkown origin in one. 2. Cancer cell positive ratio was 36% in sputum cytology study and 100% in thoracoscopic biopsy. 3. Symptoms improved in 94% of patients treated by talc pleurodesis. 4. After 30 days of the procedure, there was radiologically no recurrence of plural fluid in 94% patients. 5. There were wound infection in one, respiratory failure in one. In conclusion, the insufflation of 4 gm sterile asbestos-free talc in the pleural space is an effective method to control malignant pleural effusions and patients selection is important factor for reexpansion the lung.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.783-787
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• 2005

Eight patients underwvnt reoperation after valve replacement surgery with a mechanical valve from January, 1992 to December, 2003. Among the various indications for reoperation, there were 4 patients with paravalvular leakage; 3 patients underwent resuturing of the area of leakage and one patient underwent redo valve replacement. Among the three patients with stenosis due to thrombosis of the valve, 2 patients underwent redo valve replacement and one patient underwent thrombectomy. In one patient, the valve functioned normally, but stenosis was caused by overgrowth of the patient and redo valve replacement was done 123 months later. There was no postoperative mortality or morbidity. After an average of 51 months ($2\~134$ months) of postoperative follow up, the patients were in good condition and were able to maintain a NYHA functional class of I or II. The operative method used, whether it be a redo valve replacement or valve sparing method, depends upon the type of lesion and the anatomic structure.