• Journal of Chest Surgery
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• v.40 no.8
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• pp.558-563
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• 2007

Background: Traumatic aortic rupture is a highly fatal condition in which a patient's outcome is strongly affected by other associated injuries. Selection of the appropriate surgical timing and the management plan is important. Material and Method: The medical records of the 15 traumatic descending thoracic aortic rupture patients who underwent the clamp & sew technique were retrospectively reviewed and checked for the presence of associated injuries and the postoperative course. Result: The hospital mortality was 6.07% (one patient). This patient died intra-operatively and the cause of the death was delayed hemoperitoneum. The mean operative time and aortic clamp time were $231{\pm}53.1$ and $13.1{\pm}5.3$ minutes, respectively. One patient complained the bowel obstructive symptoms at postoperative 10 days. We found the mechanical bowel obstruction on computed tomography of the abdomen, and segmental bowel resection was done. Conclusion: Although several surgical strategies may be appropriate for managing traumatic aortic rupture, the clamp & sew technique is a safe and effective method for the treatment of traumatic aortic injury.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.21-27
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• 2008

Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.664-668
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• 1996

Malignant mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. However, a multimodality approach toward therapy may Increase the length of palliation when a maximal resection of tumor is achieved. Recently we have experienced a 49 years-old male patient who had d ffuse malignant mesothelioma. The patient has complained of blood-tinged sputum and right chest pain for several months. Chest x-rays and CT scans showed compact haziness in the right entire thorax with massive bloody elusion, diffuse pleural thickening and collapsed underlying lung. We performed extrapleural pneumonectomy, and postoperative chemotherapy with cisplatin and mltomycin (Memorial Sloan-fettering Cancer Center method) was done. We are observing him for months now and there is no evidence of local recurrence.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.281-286
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• 1985

Small bowel malignancy consists 1~2 % of overall gastrointestinal tract cancer and leiomyosarcomas of small intestine are 10~20% of small bowel malignancy. Small bowel leiomyosarcomas are rare in incidence and have no specific symptoms, signs or definite radiologic findings, so it is not easy to diagnose at early stage of disease. They are found occasionally by unknown origined gastrointestinal bleeding, abdominal pain, intestinal obstruction, perforation and palpable mass, and diagnosed mostly by operation. Recently annual case reports are increasing trend in Korea. We experienced two cases of small bowel leiomyosarcoma which was diagnosed finally by pathologic findings, so we report them With literatural review.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.154-163
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• 2010

Purpose: Colonic polyposis is less common in children than in adults. The clinical data pertaining to colonic polyposis in children are limited. Children with colonic polyposis have complications associated with numerous polyps, malignant transformation of the polyps, and extraintestinal neoplasms. We studied the clinical spectrum, endoscopic characteristics, and histologic findings of colonic polyposis in Korean children. Methods: We reviewed the clinical data of 37 children with multiple colonic polyps between 1987 and 2009. The mean age at the time of diagnosis of colonic polyposis was 8.0${\pm}$3.2 years. Results: Peutz-Jeghers syndrome, juvenile polyposis syndrome, familial adenomatous polyposis (FAP), and lymphoid polyposis was diagnosed in 22, 7, 6, and 2 children, respectively. The most common clinical presentation in children with colonic polyposis was hematochezia. A family history of colonic polyposis was noted in 7 children. The colonoscopic findings of colonic polyposis varied with the size and number of polyps. The majority of polyps were multi-lobulatd and pedunculated in children with Peutz-Jeghers syndrome. The polyps in children with juvenile polyposis syndrome were primarily round and pedunculated. For the children with FAP, the colon was carpeted with small, sessile polyps. There were multiple sessile polyps in the patients with lymphoid polyposis. Surgical polypectomy was performed in 14 children (38%). Intestinal segmental resection was performed in 13 children (35%). Four patients with FAP underwent total colectomy. Four children with Peutz-Jeghers syndrome had extraintestinal neoplasms. No malignant transformation of polyp was identified. Conclusion: Children with colonic polyposis should undergo a careful initial evaluation and require periodic re-evaluation.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.449-453
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• 1996

A successful resection of dissecting thoracoabdominal aortic aneurysm is presented in a patient who had undergone kidney transplantation 20 months previously. Because the transplanted kidney is more sensitive to ischemia than the normal kidney, a femoro-femoral bypass with a pump oxygenator was used for perfusion of the transplanted kidney during crossclamping. During the clamping time of 1)8 minutes, kidney perfusion was maintai ed with a perfusion pressure of (19 to 31) 27mmHg and the flow was 0.53 to 0.81 L/min. 32mm sized Hemashield (22 Cm in length) was interposed. The postoperative course was uncomplicated. We believe that performing the femoro- femoral bypass with a pump oxygenator is an effective and simple method for renal and spinal protection in such operations.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.583-588
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• 2005

Congenital tracheal stenosis can be a life-threatening disease, especially in cases involving the long-segment of the trachea. When patients are symptomatic immediately after birth or develop an accompanying complex cardiac anomaly, surgical repair can be a considerable challenge. We experienced a tracheoplasty in one early infant weighing 2.6 kg and one neonate who had ventilator dependency from long-segment congenital tracheal stenosis and congenital cardiac anomaly. One early infant, who had diffuse stenosis of distal trachea after ventricular septal defect closure, underwent resection and extended end to end anastomosis. One neonate who had diffuse stenosis of proximal trachea with tetralogy of Fallot (TOF), underwent slide tracheoplasty with total correction for TOF Postoperative chest computed tomography showed widely patent trachea. Both infants are now well without symptoms.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.89-94
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• 2008

Background: Thoracoscopic R3 sympathicotomy can effectively treat palmar hyperhidrosis. Here, we evaluated post-operative outcomes of patients receiving a thoracoscopic R3 sympathicotomy due to palmar hyperhidrosis. Material and Method: From January 2001 to December 2006, 225 patients were treated with a R3 sympathicotomy, and follow up was completed for 200 patients, with an average follow up period of 51.7 ($11{\sim}80$) months. We measured postoperative hand sweating according to four grades; dry (grade 1), proper (grade 2), light sweating (grade 3), heavy sweating (grade 4) and evaluated patient satisfaction using 4 grades: very good (grade 0), good (grade1), regular (grade 2), and deficient (grade 3). Result: There were no differences in clinical parameters between the compensatory sweating group and the non-compensatory sweating group. There was a 83.5% compensatory sweating rate. The degree of compensatory sweating related to the patient's body mass index and was influenced by the season, environmental temperature, and emotional stress. Conclusion: The satisfaction rate was 61.5%, and the degree of satisfaction related to the development of compensatory sweating. Therefore, reducing compensatory sweating would increase patient satisfaction with R3 sympathicotomies.

• Proceedings of the Korean Society of Propulsion Engineers Conference
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• 2000.04a
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• pp.5-5
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• 2000

액체 추진 로켓 엔진의 고주파 연소 불안정 관련 이론은 대체로 연소기 내부의 음향 공명 모드와 분무 연소 과정의 상호 작용을 구동 메커니즘으로 전제하며 Rayleigh Criterion의 재해석에 기초하여 불안정성 평가를 위한 매개변수를 도입하고 연소 불안정성을 예측한다. 여기에는 음향장 분석 이론, 음향 불안정 이론, 연소응답 및 기화반응 이론 등이 포함된다. 본 연구에서는 LOX/RPl 추진제 조합의 액체 추진 로켓 엔진 연소기를 대상으로 다차원 순수 음향장 해석과 연소-음향장 분석을 통해 대상 엔진의 고주파 연소 불안정 특성을 예측하였다. 수동 제어 기기인 음향공 설치에 따른 연소기의 음향장 및 연소-음향장의 특성 변화를 고찰하고 위 결과를 종합하여 음향공의 연소 불안정 억제 성능 및 대상 엔진의 연소 불안정성을 평가하였다. 연소기 형상 및 음향공 설치에 따른 다차원 순수 음향장 해석은 상용코드인 ANSYS를 사용하여 수행하였다. 내부 유체는 압축성, 비점성 유체로 유체의 평균 유동은 무시하며 위치에 관계없이 균일한 물성치를 부여하였다. 정상상태 연소과정을 가정하고 평형 화학을 이용한 분석 결과로부터 연소 기체의 관련 물성치를 결정하였다. 연소기 길이 방향, 반경 방향, 원주 방향 격자점들의 음향 특성을 주파수 영역에 대해 해석하고 3차원 음향 모드 형상을 토대로 음향장을 분석하였다. 연소-음향장 해석은 음향 불안정 이론 중 n- $\tau$ 2 매개변수 기법을 사용하였다. 연료 액적의 분무 연소 과정을 1차원적으로 가정하고 정상상태의 평형 화학 계산 결과를 이용하여 엔진의 연소면을 1차원적으로 설정하였다. 상류 연소응답과 중립 안정 곡선을 토대로 대상 엔진의 연소 불안정 특성을 분석하였다.구 분석 결과 기술적 문제점으로는 배기 가스온도가 낮은데 따른 출구 부분의 Bearing, Sealing이 문제가 될 수 있다고 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)

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.108-111
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• 2006

We present a case of double medial plica that developed on right knee joint. There has been no documented case of double medial plica of the knee joint. In a general way, double medial plica syndrome is very difficult to diagnose because it does rarely develop and symptoms are non-specific or not present. It is difficult to distinguish between pain originating from the medial plica and from other internal derangement of the knee. This patient had symptoms including aggravating right knee pain with sitting position or knee flexion for 3 months. We performed MRI and arthroscopy for more accurate diagnosis. MRI T1, T2 images showed typical double medial plica and we had performed arthroscopic excision of symptomatic medial plica in right knee joint. Arthroscopic resection provided satisfactory relief of symptom.lasting and satisfactory relieve of symptom.