• Journal of Chest Surgery
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• 제53권6호
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• pp.346-352
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• 2020

Background: We aimed to assess the clinical outcomes of patients who underwent surgical repair of Kommerell diverticulum (KD) with individualized surgical methods. Methods: A retrospective analysis was performed of adult patients (aged ≥17 years) who underwent surgery to treat KD between June 2008 and October 2019. Results: Nine patients (median age, 45 years; range, 19-67 years; 7 men) underwent surgical repair. The indications for surgical therapy were acute aortic dissection in 2 patients, the presence of compressive symptoms due to dilated KD in 4 patients, and aneurysm growth in 3 patients. Various surgical techniques were used: (1) resection of the diverticulum stump and revascularization of the aberrant subclavian artery (n=3), (2) one-stage total-arch replacement including the diverticulum segment (n=3), and (3) hybrid repair (n=3). Early mortality occurred in 1 case of hybrid repair. Transient paraparesis occurred in a patient who underwent total arch repair as part of complicated acute aortic dissection. During follow-up (median duration, 30 months; range, 7-130 months), no late death or associated aortic complications were documented. All survivors were free from symptoms and had no abnormal findings on follow-up computed tomography. Conclusion: With a customized surgical approach and appropriate consideration of patient-specific anatomy and associated comorbidities, KD can be repaired with favorable outcomes.

• The Korean Journal of Pain
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• 제26권4호
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• pp.336-346
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• 2013

Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.

• Clinical and Experimental Reproductive Medicine
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• 제25권3호
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• pp.269-275
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• 1998

It has been reported that the $Ca^{2+}$-ATPase and the $Ca^{2+}-Na^+$ exchanger play an important role for the regulation of intracellular $Ca^{2+}$ in somatic cells, the $Ca^{2+}$-ATPase located in the plasma membrane helps the $Ca^{2+}$ concentration in maintain low $[Ca^{2+}]_i$. Roldan & Fleming reported that the spermatozoan $Ca^{2+}$-ATPase plays an important role in the capacitation and acrosome reaction. We used to assess $Ca^{2+}$ changes by chlortetracycline (CTC) patterns in the capacitation and acrosome reaction of human and hamster spermatozoa. In the present study applying quercetin which has been known as an ATPase antagonist, the enzymatic effect of $Ca^{2+}$-ATPase on capacitation and acrosome reaction was found to be remarkable: a significant increase of the transformation from the original type to the B type and the AR type of spermatozoa. This finding suggests that $Ca^{2+}$-ATPase play an important role in the efflux and the influx of the $Ca^{2+}$ which have been known to be an essential factor for the capacitation and acrosome reaction, and that the inhibitory action of the $Ca^{2+}$-ATPase might be a prerequsit step toward the capacitation and acrosome reaction. In conclusion, this study suggest the considerable evidence as follows: the increment of the intracellular $Ca^{2+}$ concentration occurred by controlling the slope of $Ca^{2+}$ concentration through $Ca^{2+}$-ATPase activites in both the intracellular and extracellulr fluid may be important procedures for the capacitation and the acrosome reaction, and finally for fertilization of the sperm and ovum.

• Clinical and Experimental Reproductive Medicine
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• 제39권4호
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• pp.153-160
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• 2012

Objective: The aim of this study was to compare vitrification optimization of mouse embryos using electron microscopy (EM) grid, cryotop, and thin plastic strip (TPS) containers by evaluating developmental competence and apoptosis rates. Methods: Mouse embryos were obtained from superovulated mice. Mouse cleavage-stage, expanded, hatching-stage, and hatched-stage embryos were cryopreserved in EM grid, cryotop, and TPS containers by vitrification in 15% ethylene glycol, 15% dimethylsulfoxide, 10 ${\mu}g/mL$ Ficoll, and 0.65 M sucrose, and 20% serum substitute supplement (SSS) with basal medium, respectively. For the three groups in which the embryos were thawed in the EM grid, cryotop, and TPS containers, the thawing solution consisted of 0.25 M sucrose, 0.125 M sucrose, and 20% SSS with basal medium, respectively. Rates of survival, re-expansion, reaching the hatched stage, and apoptosis after thawing were compared among the three groups. Results: Developmental competence after thawing of vitrified expanded and hatching-stage blastocysts using cryotop and TPS methods were significantly higher than survival using the EM grid (p<0.05). Also, apoptosis positive nuclei rates after thawing of vitrified expanded blastocysts using cryotop and TPS were significantly lower than when using the EM grid (p<0.05). Conclusion: The TPS vitrification method has the advantages of achieving a high developmental ability and effective preservation.

• Clinical and Experimental Reproductive Medicine
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• 제40권1호
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• pp.33-37
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• 2013

Autophagy is a degradation process that acts in response to environmental stressors. Recently, autophagy has been detected in normal term, preeclamptic and intrauterine growth-restricted placentas. The object of this work was to investigate the presence of autophagy in first trimester voluntary interruption of pregnancy placental villi by the expression of autophagy-related proteins, light chain 3 (LC3), and Beclin-1. In first trimester placental villi laser scanning confocal microscopy (LSCM) analysis revealed LC3 and Beclin-1 immunoreactivity prevalently located in villous cytotrophoblasts. Using LSCM, LC3, and Beclin-1 were localized to the cytoplasm of the trophoblast layer in human full-term placentas. Beclin-1 expression and LC3 activation were confirmed by western blotting. These data emphasize that autophagy activation is different among cytotrophoblasts and syncytiotrophoblasts depending on the gestational age and thus we speculate that autophagy might play a prosurvival role throughout human pregnancy.

• 대한관절경학회지
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• 제2권1호
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• pp.25-32
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• 1998

The distinction between isolated and combined injuries is crucial both for treatment and prognosis. For most combined injuries, surgical treatment continues to be favored over nonoperative treatment. It is generally agreed that isolatel PCL injuries do well without surgery. There has been an interest by many authors to fix the graft directly to the posterior aspect of the tibia(tibial inlay). With this procedure, tibial graft fixation will be more direct and theoretically reduce the bending effects of the graft with a fixation site far away from the tibial insertion. Modified tibial inlay technique, which is the posterior approach does not require the patient to be in the prone or lateral decubitus position during the operation. Use of a double-bundle reconstructive technique is attractive and has been performed by some surgeons. At this time, this procedure is still being investigated and should not be routinely used in the clinical setting until studies have indicated an advantage over current single-bundle techniques. However theologically, double-bundle reconstructive technique is more useful in severe posterior unstable knee. Recent advances have increased our knowledge of the anatomy and mechanical characteristics of the PCL. Basic science research has further increased our awareness of the interaction of the posterolateral structures with the PCL. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the postero-lateral structures. Surgical treatment is often complex and requires a wide range of surgical techniques and skills to treat associated injuries. When the PCL is reconstructed, most surgeons choose to reconstruct the anterolateral component using a graft of sufficient size and strength. The initial postoperative rehabilitation should be addressed cautiously in an effort to avoid excessive forces on delicate repairs and reconstructions in these complex injuries. Further research is necessary to evaluate new surgical approaches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

• 대한한방소아과학회지
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• 제29권3호
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• pp.54-64
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• 2015

Objectives : This study was to investigate the anti-oxidative and anti-inflammatory effect of Lonicera japonica water extracts (LE) on Ulcerative Colitis Induced by DSS (Dextran Sulfate Sodium) in Mice. Methods : Colitis was induced by DSS in Balb/c mice. The sample group was divided into three. The mice in control group were not inflammation-induced. The pathological group was composed of untreated colitis elicited mice. The experimental group was administered Lonicera japonica water extracts (LE) after colitis elicitation. The effects on ulcerative colitis were evaluated the anti-oxidant effect, inhibition of COX-2 mRNA expression, the morphological change of colonic mucosa, decrease effect of HSP 70 and COX-2 in mucosa. Results : The SOD ability of LE was dose-dependently increased and the LPS-induced COX-2 mRNA expression of LE was dose-dependently decreased. LE showed the protective effects on DSS-induced experimental colitis. LE inhibited shortening of colon length, the hemorrhagic erosion in colonic mucosa. LE also showed the decrease effect for HSP70 and COX-2 in mucosa. Conclusions : The current results demonstrate the clinical utility of LE in traditional medicine and indicate the possible treatments for ulcerative colitis from natural products. Further investigations for exact mechanisms will be needed.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1430-1434
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• 2001

The authors present a case of brain abscess in a patient with primary mucociliary transport failure. Primary mucociliary transport failure is unfamiliar term to neurosurgeon. It encompasses three hereditary disorders, that is, primary ciliary dyskinesia, cystic fibrosis and Young's syndrome. Clinical manifestations in these disorders appear to overlap each other, e.g., male infertility and chronic sinopulmonary infections. These are characterized by ciliary dysfunction or abnormality of mucus secretion therefore recurrent infection occurs in organs containing the mucociliary transport system. Major causes of non-traumatic brain abscess are sinusitis and pulmonary infection. So the possibility of brain abscess is much higher if mucociliary transport failure exists. Especially, young patients who have brain abscess coexisting with chronic sinopulmonary infection should be considered primary mucociliary transport failure.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.61.1-61.8
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• 2019

Background: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. Methods: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. Results: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. Conclusion: Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

• Journal of Chest Surgery
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• 제28권6호
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• pp.583-590
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• 1995

The three hundred and sixty nine patients who underwent either isolated or concomitant coronary artery bypass graft surgery since May, 1977 till December, 1993 at the Yonsei University Cardiovascular center were studied with respects to the incidence of operative risk factors, surgical methodology and consequent results. The patients were classified into two periods, according to the time of the surgery in relation to the date of the opening of the Yonsei cardiovascular center. Period I[1977 to 1990 , consisting of the patients who underwent surgery prior to the opening date, harboured a total of 189 patients with the mean age of 55 years, and the second, Period II[1991 to 1993 , those who underwent after the opening, of 180 patients with the mean age of 60 years. The Period II patients were involved in more operative risk factors, compared to the ones in Period I. The anatomy of the coronary arteries of the patients of Period II were more likely to have multilesional and left main disease. The patients in Period I were older, had more prominent left ventricular dysfunction and were more likely to be exposed to the risk factors. The number of implanted grafts were greater period II[average of 2.5 grafts per patient in Period I VS 3.2 in Period II and the frequency which the used left internal mammary artery was also significantly higher in Period II[49 and 104 cases in Period I and Period II . The incidence of perioperative myocardial infarction was 20 patients[10.6% in Period I, 14 patients[7.8% in period II. And the operative mortality was 20 patients[10.6% in period I, 8 patients[4.4% in period II. In conclusion we think that the operative results have improved in Period II, compared to that of Period I, in spite of the higher risks, due to accumulation of surgical experiences, improved surgical techniques and myocardial protection, specialized teamwork, application of the intraoperative TEE and appropriate pharmacological interventions by anesthesiologist.