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A Clinical Study of Congenital Intrahepatic Portosystemic Shunt Diagnosed in Neonatal Period (신생아기에 진단된 선천성 간내 문맥 전신성 단락의 임상적 고찰과 치료)

  • Kim, Ji-Young;Kim, Kyung-A;Lee, Yeon-Kyung;Ko, Sun-Young;Shin, Son-Moon;Han, Byung-Hee
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.117-123
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    • 2011
  • Purpose: Congenital intrahepatic portosystemic shunts are rare disease and clinically asymptomatic shunts may be detected by chance on ultrasonogram before and after birth. We studied clinical course, treatment and prognosis of congenital intrahepatic portosystemic shunt at prenatal or neonatal period. Methods: Medical records of 8 patients which were diagnosed in intrahepatic portosystemic shunt in Cheil General Hospital from 2006 through 2010 were reviewed retrospectively. Results: Eight patients with congenital intrahepatic portosystemic shunts were identified. Six patients were diagnosed at prenatal radiological screening, including three cases of intrauterine growth restriction and two cases of preterm baby. One case with increased serum ammonia underwent coil embolization. In four cases including one case that presented elevated direct bilirubin, shunts were closed spontaneously within 11th month after birth. Two patients were diagnosed on abdominal sonogram after birth because of elevated direct hyperbilirubinemia, all of whom presented intrauterine growth restriction. Closure of shunts was confirmed during 4th month to 6th month. Conclusion: Congenital intrahepatic portosystemic shunts are clinically asymptomatic mostly and spontaneous closure is expected within 2 years age. But occasionally they have severe complication, so clinical and radiological observation is needed. Specially in cases of intrauterine growth retardation without evident cause, the possible diagnosis of congenital intrahepatic portosystemic shunts should be considered and prenatal and postnatal examination should be performed. When prenatal diagnosis is made, fetal wellbeing should be monitored periodically until spontaneous closure of shunts.

Percutaneous Mini-open Reduction for Mason II or III Radial Head and Neck Fracture (요골 두 및 경부 골절의 경피적 도수 정복술)

  • Lee, Jeong-Gil;Koh, Il-Hyun;Kim, Hyung-Sik;Choi, Yun-Rak;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.230-236
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    • 2010
  • Purpose: We wanted to evaluate the result of percutaneous, mini-open reduction for the treatment of Mason II or III radial head and neck fractures. Materials and Methods: 13 patients (8 male, 5 female) with Mason II or III radial head and neck fractures were treated by 1 cm percutaneous mini-open reduction under fluoroscopy. The average age of our subjects was 29 years. Follow up duration was 18 months. Results: Union was noted in all cases. Mean radial neck angulation was decreased from 33.2 degrees to 7.8 degrees. The mean change in angulation between the immediate post-operative and last follow-up was 0.7 degrees. The mean range of motion at the elbow joint was at last follow up, 133.1 degrees in flexion, 7.3 degrees in extension, 80 degrees in pronation and 84.3 degrees in supination. Postoperatively, mean Mayo Elbow Performance Index, American Shoulder and Elbow Surgeons elbow score, and Disabilities of the Arm, Shoulder and Hand score were 96.2, 97 and 1.2. Temporary posterior interosseous nerve palsy (1 case) and minimal cubitus valgus deformity (1 case) were noted. Conclusion: Selected Mason II or III radial head and neck fractures can be treated satisfactorily with percutaneous mini-open reduction.

Clinical Outcomes and Prognosis of Patients with Stent Fracture after Successful Drug-Eluting Stent Implantation (관상동맥 약물 방출 스텐트 삽입 후 스텐트 골절에 대한 임상결과 및 예후)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.109-116
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    • 2014
  • Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irrespective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age $62.44{\pm}9.8$year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%), 2(6.3%), 1(3.1%), 1(3.1%) and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death during a follow-up period of $32.9{\pm}12.4$ months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Treatment and Prognosis of Chondroblastoma (연골모세포종의 치료 결과)

  • Lee, Young-Kyun;Han, Il-kyu;Oh, Joo-Han;Lee, Sang-Hoon;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.81-87
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    • 2007
  • Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

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Changes in the Titer of Tooth Root Antibodies Accompanying Root Resorption Associated with Orthodontic Tooth Movement (치아이동시 치근 흡수에 따른 치근항체의 역가 변화)

  • Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.24 no.2
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    • pp.303-317
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    • 1994
  • This study was designed to measure the changes in the titer of tooth root antibodies accompanying root resorption associated with orthodontic tooth movement in dogs to explore a role of the specific immune response in root resorption during orthodontic tooth movement. Five adult mongrel dogs, 2 years of age, were used in the study. Six lower incisors were extracted as sources of homologous antigen in the dogs. Tooth root antigen preparations were made from a 6M Guanidine-HCl-10% EDTA(pH5.0) extract of these root dentins. Root resorption was elicited by intrusion of six maxillary incisors with 200-250gm intrusive force. In 9th week, resorbing six maxillary anterior teeth were extracted. Serum samples were taken from each dog prior to intrusion and weekly for 11 consecutive weeks. Serum autoantibody titers were determined with an enzyme-linked immunosorbent assay. As controls for antibody specificity, sera which were previously incubated with tooth root antigen as well as sera to an unrelated bacterial antigen (Porphyromonas gingivalis 33277) for 3 hours at 25 were measured in all runs. Root resorption was monitored monthly using occlusal radiographs. And then root resorption patterns were observed with a zoom stereo microscope (Model SZH-121, Olympus optical Co. Ltd.). Incisors did not show clear radiographic evidence of significant and progressive root resorption, but periodontal ligament space had widened. But root resorption was observed on the apical regions of the maxillary incisors with a zoom stereo microscope. Teeth showed the shallow depression generally accompanying deep resorption. These demonstrate a slight tendency for an immediate decrease followed by rebound to levels above the pre-treatment baseline. A peak titer of autoantibody to dentin antigen occurred on day 28, then steadily decreased during the 9th week period as the roots resorbed and then rapidly spiked in animals when the resorbing teeth were extracted. When sera is incubated with tooth root antigen, serum activity in the ELISA was almost absent. This is because serum activity in the ELISA could be removed by absorption of the serum with dog dentin antigen. Serum ELISA activity to the unrelated bacterial antigen remained essentially unchanged in all animals throughout the experimental period. When the time course of changes in autoantibody to homologous tooth root antigen prepatration and unrelated bacterial antigen was compared, no significant differences were found(${\alpha}=0.05$). In general, the overall pattern of changes in autoantibody was similar to the two antigens. These findings suggest the possibility that these immunologic changes precede a significant development of root resorption lesions rather than merely reflecting their presence. Therefore, this suggests that the changes of antibody levels may have some predictive value for root resorption.

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Propagation Efficiencies at Different LED Light Qualities for Leaf Cutting of Six Echeveria Cultivars in a Plant Factory System (에케베리아 6품종의 엽삽 시 식물공장시스템 내 LED 파장에 따른 번식 효율)

  • Kim, Seongmin;Kim, Jiseon;Oh, Wook
    • Journal of Bio-Environment Control
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    • v.27 no.4
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    • pp.363-370
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    • 2018
  • The succulent plants of Echeveria genus are in increasing demand worldwide, but it is difficult to supply good quality young plants throughout the year because propagation efficiencies are depend on cultivar and environmental factors. This study was carried out to investigate the propagation efficiencies of leaf cutting in Echeveria cultivars at different LED light qualities in a closed-type plant factory system. Leaf cuttings cut from stock plants of six difficult-to-propagated cultivars 'Afterglow (AG)', 'Berkeley Light (BL)', 'Mason (MS)', 'Subsessilis Light (SL)', 'Cream Tea (CT)', and 'Ben Badis (BB)' were put into cutting media in the plant factory system maintained at a temperature of $24{\pm}2^{\circ}C$ and relative humidity of $60{\pm}10%$, and watered with over-head irrigation twice a week. Cuttings were irradiated with sole or mixed red (R, 660 nm), blue (B, 450 nm), green (G, 530 nm), and far-red (FR, 730 nm) LEDs as follows: R10, R8+B2, R5+B5, R7+B2+FR1, and R7+B2+G1. PPFD just above the cuttings was $200{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ and photoperiod was 16/8 (light/dark) hours. As a result, propagation efficiencies were dependent on cultivar. Rooting and shooting were relatively easy in 'SL' but shoot formation in 'AG' was very difficult. Light qualities from LEDs also affected plant regeneration. Light conditions with a higher ratio of B, R5+B5, R7+B2+FR1, and R7+B2+G1, promoted shoot formation and growth but inhibited rooting and root growth. R10 and R8+B2 with a higher ratio of R promoted rooting and root growth and inhibited shoot formation and growth of cuttings. In addition, the treatment with FR increased leaf size and biomass of the all plants. Therefore, further studies are needed to investigate the optimum compositions of LED light quality for the improvement of leaf cutting efficiency in difficultto-propagated Echeveria cultivars.

EFFECT OF ACID-TREATMENT ON DENTIN BONDING (산 처리가 상아질 접착에 미치는 영향)

  • Kim, Young-Kyong;Kim, Sung-Kyo;Park, Jin-Hoon
    • Restorative Dentistry and Endodontics
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    • v.18 no.1
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    • pp.73-83
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    • 1993
  • The purpose of this study was to evaluate the effect of various acid treatments on dentin bonding. Freshly extracted human teeth were uprightly embedded in self curing acrylic resin, and their occlusal surfaces were grinded to expose flat dentin surfaces. The specimens were divided into 4 groups. Specimens of one group were not treated so as to be a control and those of the other three groups were threated with 10% polyacrylic acid, 10% phosphoric acid, and 10-3 solution(10% citric acid/3% ferric chloride) respectively. Primer, bonding resin and composite resin were applied over the treated dentin surfaces sequentially. All specimens were stored in $37^{\circ}C$ distilled water for 24 hours, then the tensile bond strength was measured and the treated dentin surfaces and fracured dentin surfaces were examined under a scanning electron microscope. The results were as follows: Bond strengths of acid-treated groups were higher than those of the untreated group. In the acid-treated groups, bond strength was found to be the highest in the 10-3 solution group followed by the 10% phosphoric acid group and the 10% polyacrylic acid group(P<0.01). On SEM examination of dentin surfaces, the untreated dentin surface showed a remaining smear layer and closed dentinal tubules. Dentin surfaces treated with 10 % polyacrylic acid showed a clean dentin surface without the smear layer, but showed remaining smear plugs in dentinal tubules. A dentin surface treated with 10% phosphoric acid or 10-3 solution showed open dentinal tubules without the smear layer or smear plugs. On SEM observation of the fractured dentin-resin interface, the untreated group showed that failure occurred in the smear layer. The group treated with 10% polyacrylic acid showed no resin tag remained in the dentinal tubules, but resin tags in the dentinal tubules were observed in the group treated with the 10% phosphoric acid or the 10-3 solution. On the failure mode examination, the higher the bond strength of the group, the higher the frequency of cohesive failure. The coefficient between bond strength and cohesive failure rate was 0.71.

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Effect of Low Light Intensity after Fruit Set on the Growth and Quality of Cucumber(Cucumis sativus cv. Hyakunari-3). (착과기 이후의 약공 조건이 백침게 오이의 생육반응 및 품질에 미치는 영향)

  • Seong, Ki-Cheol;Moon, Gi-Hye;Lee, Sang-Gyu;Kang, Yong-Gu;Kim, Kwang-Yong;Seo, Hyo-Duck
    • Journal of Bio-Environment Control
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    • v.13 no.1
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    • pp.44-50
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    • 2004
  • This experiment was conducted to investigate the effects of different levels of light intensity (100, 200, 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, and natural light) on the growth and the fruit quality of cucumber(Cucumis sativus cv. Hyakunari-3). The results of this experiment indicated that plant height and length of lateral shoots were decreased under low light condition, but it was not significantly different among treatments. Leaf area and root weight were lowest under low light intensity(100 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$), but no significant differences were noted between 200 and 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$. Photosynthesis rate was decreased with reduced light intensity and total chlorophyll contents, root activity and xylem sap were also decreased under low light intensity, but there was no significant difference between 200 and 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$. From the SEM observation the erosion of the guard cells and closed stomata in low light treatment were shown and the size of stoma were small also the stomatal aperture were decreased with reducing the light intensity. Chlorosis in leaves and aborted-liked fruits were appeared under low light condition and Ca and Mg uptake in leaves were decreased by shading in proportion to the decrease of light intensity. Fruit yields were decreased by 65% under 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, and by 80${\sim}$90% under 200 and 100 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, compared to those under the natural light. This low intensity of light caused the sharp decrease in the early harvested yields within two weeks and the fruit yields of lateral shoots were greatly decreased.

Selection and Treatment Effect of Plant Growth Retardants on Potted Spathiphyllum Grown in a Recirculating Subirrigation System (순환식 저면관수 시스템을 이용한 스파티필럼의 생장조절제 선발과 처리효과)

  • Won, Eun Jeong;Park, Yoo Gyeong;Jeong, Byoung Ryong
    • FLOWER RESEARCH JOURNAL
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    • v.19 no.2
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    • pp.81-88
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    • 2011
  • Effect of concentrations of different plant growth retardants (PGRs) supplied to a recirculated nutrient solution in an ebb and flow system on the growth and development of potted Spathiphyllum 'Top-Pin' and 'Mini' was examined. Plants were planted in 10 cm diameter plastic pots filled with a mixture of peat moss and perlite (1 : 1, v/v) on 30 June 2005 and grown until 23 Sep. 2005. In a closed ebb and flow system, 50, 200, 350, $500mg{\cdot}L^{-1}$ daminozide (B-9), 10, 40, 70, $100mg{\cdot}L^{-1}$ paclobutrazol (Boundy), 5, 15, 25, $35mg{\cdot}L^{-1}$ ethephon (Florel), and 1, 4, 7, $10mg{\cdot}L^{-1}$ uniconazole (Sumagic) were supplemented to a nutrient solution at the initiation of experiment. On every irrigation, the nutrient solution containing PGRs was supplied at a 2 cm depth and kept for 15-20 minutes. The surplus nutrient solution was drained back into the tank for next irrigations. Paclobutrazol gave the most pronounced effect in inhibition of stretchiness. The greatest reduction of leaf length, fresh and dry weights of shoot, and elevated chlorophyll content were recorded in Spathiphyllum, with increasing paclobutrazol concentration. Daminozide concentration greater than $200mg{\cdot}L^{-1}$ resulted in minor stunting. The lowest concentration ($1mg{\cdot}L^{-1}$) of uniconazole showed greater leaf length, leaf width, and leaf petiole length than the control ($0mg{\cdot}L^{-1}$). Uniconazole concentration greater than $1mg{\cdot}L^{-1}$ resulted in similar plant growth as the plant in the control ($0mg{\cdot}L^{-1}$). High concentration ($35mg{\cdot}L^{-1}$) of ethephon resulted in the shortest leaf length, and the greatest chlorophyll content. Inhibition of stretchiness was observed even in the lowest concentration treatments. Among the PGRs, paclobutrazol was most effective in suppressing plant stretchiness. In both cultivars, ethephon and paclobutrazol, but not daminozide and uniconazole, significantly inhibited stretchiness. The results suggested that plant growth retardants (ethephon or paclobutrazol) selected in this study may be used as the most effective agents for inhibition of stretchiness in Spathiphyllum.