• Journal of Chest Surgery
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• v.56 no.4
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• pp.255-261
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• 2023

Background: The surgical threshold for bicuspid aortic valve (BAV)-related aortopathy is a matter of debate due to its uncertain etiology and prognosis. This study investigated the prognosis of unrepaired BAV aortopathy in patients undergoing surgical aortic valve replacement (SAVR). Methods: We retrospectively analyzed data from 720 patients (age, 60.8±11.5 years; 246 women) who underwent SAVR for BAV disease without aortic repair between 2005 and 2020 at Asan Medical Center. The clinical endpoints were defined as occurrences of sudden death, aortic dissection or rupture, and elective aortic repair. To estimate postoperative changes in the dimensions of the unrepaired aorta, the individual annual aortic expansion rate was calculated. Multiple linear regression models were used to evaluate the risk of aortic expansion. Results: The mean ascending aortic diameter was 39.5±4.6 mm, and 299 patients (41.5%) had a baseline ascending aorta diameter >40 mm. During 70.0±68.3 months of follow-up, the mean annual aortic expansion rate was 0.39±1.96 mm/yr, no aortic dissection or rupture was observed, and sudden deaths were reported in 12 patients (0.34% per person-year). Linear regression analysis revealed no significant correlation between the baseline ascending aortic diameter and postoperative aortic expansion (R²=0.004, β=-0.84, p=0.082). Conclusion: In selected patients undergoing SAVR for a BAV (<55 mm), the risk of adverse aortic events was very low. As this observation contradicts current practice guidelines advocating for proactive aortic replacement in dilated ascending aortas measuring >45 mm, the study results need further validation by studies involving larger populations or randomized controlled trials.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.484-488
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• 1999

Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

• Journal of the Korean Society of Fashion and Beauty
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• v.4 no.3 s.9
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• pp.40-44
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• 2006

This study is on the brassiere of reduce clothing pressure. To set the measurements of bras for women in their 20s, considering the comfortableness in wearing and tightness, this paper conducted a questionnaire survey concerning breasts and bras as well as measurements of body and contact surface pressure. As a result of comparing the discrepancies between the lower chest circumferences of the body and the bra, it was revealed that 67.0% were wearing one that was bigger than the body size. Most of them mentioned 'feeling of tightness' as a reason(60.4%), which suggests there are problems of the total length and elasticity in the process of making bras. The favorite bra types are wire type(57.9%), mold type(24.3%), and strapless type(10.4%).it is recommended that the total length of lower chest circumference be increased. The result and the recommendations of this study are as follows: First, the total length of brassiere be increased by 5cm from the current patterns in the process of manufacturing. Second, elasticity of the lower-side tapes be extended from 120% to 170%.

• Journal of Chest Surgery
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• v.27 no.3
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• pp.177-186
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• 1994

Pentastarch is a hydroxyethyl starch similar to hetastarch, but lower average molecular weight and fewer hydroxyethyl groups which result in enhanced enzymatic hydrolysis and faster renal elimination.This report was performed to compare the clinical efficacy and safety of 10 % pentastarch[Pentaspan , group I] for plasma volume expansion after open heart surgery with that of 5% albumin[Plasmanate, group II]. There were no statistically significant differences between the group I [n=18] and group II [n:19] in the preoperative parameters [age, sex, body weight] and operative parameters[bypass time, aorta cross clamping time]. During the first 24 hours after arrival of the patient in the surgical intensive care unit, colloid solution [500--1000 ml] was infused to maintain left atrial pressure of more than 8 mmHg, or cardiac index of 2.0 L/min/M2 of more. In results, there were 3 complications of hypotension immediately after infusion of 5 % albumin solution and 2 among the 3 patients were excluded for the study. However there was no complication after infusion of 10 % pentastarch solution. Hemodynamic responses to infusion was similar for both groups, although in group I a greater increase in both left atrial pressure[mean 1.8 versus 0.7 mmHg, p< 0.05] and right atrial pressure [mean 2.2 versus 1.7 mmHg, p < 0.05] was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters[PaO2, intrapulmonary shunt, and effective lung compliance]. Homodilution with colloid significantly reduced hemoglobin [mean 1.2 versus 0.8 gm/dl], and serum protein and albumin level[total protein;4.8$\pm$ 0.5 versus 5.2 $\pm$0.5 gm/dl, p < 0.05: albumin: 3.2 $\pm$0.4 versus 3.6 $\pm$0.6 gm/dl, p < 0.05] by 6:00 AM on 1 day postoperatively, however there were no significant differences on 7 day postoperatively. The mean serum colloid osmotic pressure and osmolarity was similar in both group.There were no abnormal findings of liver function and kidney function in all the patients. There were no significant between-group differences in bleeding time, platelets, prothrombin time, activated partial thromboplastin time and amount of chest tube output measured on 1st and 7th postoperative day. These findings demonstrated that 10% pentastarch is more effective and safe for plasma volume expension than 5 % albumin solution with no adverse effects on coagulation. Also 10 % pentastarch is less expensive than 5 % albumin and it would appeare to be a reasonable first choice for plasma volume expansion.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.581-584
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• 1996

Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothordx, pleural effusion, or atelectasis but occasionally life threatening. Generally, reexpansion pulmonary edema is believed to o cur only when a chronically collapsed lung is rapidly reexpanded by evacuation or large amounts of air or fluid. This complication is heralded by tachypnea, unilateral rales, and profuse expectoration of frothy secretion within several hours of reexpansion. Increased dur- ation of pneumothorax and the use o( suction are important factors in the generation of reexpansion pulmonary edema. We had experienced 3 cases of reexpansion pulmonary edema. In the two cases the pneumothorax had been present for several days, and, after insertion of a chest tube, pulmonary edema developed unilaterally but improved with supplemental oxygen. In the third case, massive pleural effusion was present. and, after insertion of a chest tube, pulmonary edema developed unilaterally, followed by cardiac arrest. He died of pulmonary edema inspire of resuscitation.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.79-85
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• 1996

A clinical evaluation was performed on 305 cases of chest trauma experienced at the department of the Thoracic and Cardiovascular Surgery, Dae Jeon Eul Ji Hospital, during the period from March 1991 to November 1994. Age distribution was from 4 to 85 years, the mosts common age groups were 4-th, 5th and 6th decades. The ratio of male to female was 229:76(3:1), the ratio showed male predominance, the most common cause of trauma was traffic accidents in nonpenetrating trauma and stab wounds in penetrating trauma. Hemothorax, pneumothorax, and hemopneumothorax were observed in 159 cases (52.1 %) of total cases, Rib fracture was observed in 236 cases (77.4%) of total cases, location distribution was right : left : Both (102 : 142 : 45), with left predominant, rib fracture commonly involved from the 3th to 8th rib. Lag period from accident to admission was 155 cases (50.8%) under 6hr The principles of therapy for early complications of chest trauma were rapid r expansion of the lungs by thoracentesis 5 cases(1.6%) and closed thoracostomy 1-42 cases(46.6%), but open thoracotomy had to be done on 17 cases (5.6%) because of massive bleeding 13 cases or ruptured diaphragm, foreign body. Conservative nonoperative treatment was 140 cases (45.9%). Overall mortality rate was Bcases (2.6%) and common causes of the death were respiratory insufficiency and shock.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.562-574
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• 2021

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

• Transactions of the Korean Society of Automotive Engineers
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• v.12 no.2
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• pp.131-138
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• 2004

In the proto design stage of a new car, the performances of an occupant protection system can be evaluated by CAE even though the real test should be carried out. The number of the real test is reduced by the exact predictions followed by the appropriate design recommendation. However, the existing researches using CAE in predicting the performances do not consider the uncertainties of parameters. That often leads to inconsistency between test and CAE. In this research, the robust design of a protection system such as airbag and load limiter is suggested considering the frontal crash. The parameter design scheme of the Taguchi method is introduced to obtain the robust design of arbitrary airbag and load limiter. It is performed based on the frontal crash test condition of US-NCAP with an arbitrary passenger car. The variances of the performances such as HIC, chest acceleration and probability of combined injury are calculated by the outer array and the Taylor series expansion. Through the analysis of the Taguchi method, the robust optimum is determined.

• Journal of the Korean Society of Clothing and Textiles
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• v.21 no.6
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• pp.1031-1040
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• 1997

This study was done to analyze the body surface developments of armhole area. The major conclusions of this study are: 1. The body surface developments showed the characteristics of expansion and contraction of body at armhole area. By arm movements, front armhole lines on the body surface developments of upper arm were slow going, but back armhole lines were full and round. As a whole, armhole line of the back torso was swollen outside especially at backarmpit point area, it seemed like a line of raglan sleeve. 2. Regression Analysis was carried out to adapt armhole line on the upper arm and upper body to bodice and sleeve pattern, following the axillary circumference line and chest breadth line changed to the basic pattern form. As the result, armhole lines of 90$^{\circ}$ and 135-180$^{\circ}$ movements deviated from those of standard posture. U-type, clear armhole curve of standard posture turned to V-type, slanting line by arm movements.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.82-88
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• 1984

Total 310 cases of spontaneous pneumothorax in 281 patients were analyzed to review the results of surgical treatment for this condition. Clinical data on the age & sex distribution, recurrence, etiologic conditions and on the other aspects of spontaneous neumothorax were summarized. The results of surgical management of spontaneous pneumothorax are followings; 205 out of 310 cases[66.1%] were cured by closed thoracostomies. 82 cases[26.5%] were cured by thoracotomy. The indications of thoracotomy were 1] persistent air leakage, 2] history of recurrences, 3] blebs or bullae on thoracoscopy, 4] associated parenchymal lesion, 5] pneumothorax caused by paragonimiasis. Other reasons of thoracotomy were bilateral pneumothorax and inadequate expansion due to chronicity. Excision of blebs or wedge resection was performed in most cases with good result. Lobectomy [9 case] or pneumonectomy [3 cases] was carried out depending on the pathological involvement of the lung. There was no operative death and only one case showed recurrent pneumothorax during follow-up after thoracotomy.