• Journal of Chest Surgery
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• v.43 no.4
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• pp.413-416
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• 2010

A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.75-82
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• 1983

This report is concerned to our experience of 10 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital during the period between May, 1982 and February, 1983. 1. Six cases were male and two cases were female. Age was varied from 21 years to 50 years and mean age was 34 years. 2. The cases included 2 Ventricular Septal Defects, 1 Atrial Septal Defect, I Tetralogy of Fallot and 6 acquired valvular heart diseases. 3. The surgical managements were 3 primary repairs for Ventricular Septal Defects and Atrial Septal Defect, I total correction for Tetralogy of Fallot and 6 mitral valve replacements with bovine xenograft by Ionescu-Shiley combining 3 Tricuspid annuloplasties [ De Vega method ] and 1 deauricularization of left atrial appendage for acquired valvular heart diseases. 4. The average cardiopulmonary bypass time was 37 minutes for acyanotic congenital heart diseases and 92 minutes for cyanotic heart disease and acquired valvular heart diseases. And the average aortic cross clamping time was 19 minutes for the former and 70 minutes for the latter. 5. Postoperatively, there were 1 hemolytic anemia, 1 congestive heart failure, 1 hemolytic jaundice and 1 thermal burn as complications, but there was no operative mortality. 6. All patients received valve replacement were recommended anticoagulation with Persantin and Aspirin.

• Cross-Cultural Studies
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• v.38
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• pp.115-144
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• 2015

The purpose of this study is to look into the support activities of the 17th century spanish plays which had been taken in various paths in terms of responses of the then-public who had been enthusiastic about great plays and artworks. Such a phenomenon clearly appeared in the open-air theater 'corral' where 'Teatro nacional' was performed at that time. Therefore, this study tries to investigate the functional relation between the public's responses and the prosperity of then-plays from the concrete standpoint of Lope's public-oriented plays. Although Lope's plays basically include system-protection ideology, they are thoroughly based on the public's support and popularity. In short, at that time, Lope's dramatic reform and entailing remarkable hit and success were made possible through thorough compliance with the public's preference and thereby the public's absolute support and affection. The tendency of his public-oriented plays appears in two aspects. One is the common people persecuted and punishment of a wicked man of power. The typical plays in point are Lope's Perib??ez y el comendador de Oca?a and El mejor alcalde, el rey. Through the plays, the playwright Lope not only implemented praise of absolute monarch very effectively, but soothed the wounded heart of the common people who had suffered pains due to their unfair and lowly social status. In this way, his plays might give senses of reliefs and satisfaction to most viewers who identified with the common people in the plays. The other one is the decisive raise of status of an exemplary commoner, the subject matter which had been used by Lope as one of useful means to show the public-oriented tendency of his plays. The cases in point are Los Tellos de Meneses and its succeeding work Valor, fortuna y lealtad. The two-part work of Lope is about the hard journey, ups and downs, and ascent to the nobility of Tello, an exemplary and rich farmer, and hits young son Tello. Through the two-part play, Lope demonstrated how an exemplary and good-mannered commoner rose to the nobility and thereby gave vicarious satisfaction to the then-public and received a lot of praise from them. As mentioned earlier, through his public-oriented plays, Lope not only satisfied the public's desires and achieved his realistic goal of big success. Not all Lope's plays are public-oriented. Nevertheless, the popular success of 'Teatro nacional' made by Lope and his followers is based on the public's preference and the plays' dramatic responses to their desires, and the strategic elaboration to comfort the public suffering lot of pains in daily life.

• Imaging Science in Dentistry
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• v.39 no.1
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• pp.19-25
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• 2009

Purpose: To longitudinally observe the healing process of extracted socket and the alterations of the residual ridge in healthy adult dogs using cone beam CT (CBCT). Materials and Methods: The mandibular premolars of two beagle dogs were removed and the extraction sites were covered with the gingival tissue. CBCTs (3D X-ray CT scanner, Alphard vega, Asahi Co.) were taken at baseline and at 1 week interval for 12 weeks. Radiographic density of extracted wounds was measured on normalized images with a custom-made image analysis program. The amount of alveolar crestal resorption after the teeth extraction was measured with a reformatted three-dimensional image using CBCT. Bony healing pattern of extracted wound of each group was also longitudinally observed and analyzed. Results: Dimensional changes occurred during the first 6 weeks following the extraction of dogs' mandibular premolars. The reduction of the height of residual ridge was more pronounced at the buccal than at the lingual aspect of the extraction socket. Radiographic density of extracted wounds increased by week 4, but the change in density stabilized after week 6. New bone formation was observed at the floor and the peripheral side of extracted socket from week 1. The entrance of extracted socket was sealed by a hard-tissue bridge at week 5. Conclusion: The healing process of extracted wound involved a series of events including new bone formation and residual ridge resorption.

• Journal of Chest Surgery
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• v.19 no.4
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• pp.644-662
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• 1986

Seventy cases of open heart surgery were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje College, from Oct. 1985 to Oct. 1986. And the results were summarized as follows. 1. Among the 70 cases, there were 48 cases of congenital heart anomalies and 22 cases of acquired rheumatic valvular heart diseases. Age range of the congenital patients was 7 months to 31 years with the mean age of 10 years, and the acquired patients was 18 to 62 years with the mean age of 40 years. 2. The heart-lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 5 of membrane type and 65 of bubble type. For all cases GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 48 congenital anomalies, there were 12 cases of ASD group, 29 of VSD group, 3 of ECD, 3 of TOF and one of PDA + MR, and to all of which the appropriate radical operations were applied. 4. Among the 22 acquired valvular diseases, there were 11 cases of mitral valve diseases [MS; 4, MSr; 3, MRs; 4], 3 cases of aortic valve diseases [AR:1, ARs;1, ASr;1], 4 cases of double valve diseases [MRs+TR; 3, MRs+ARs; 1] and 4 cases of triple valve diseases [MSr+ASr+TR; 3, MSr+Ar+TR; 1]. To all the diseased mitral and aortic valves, artificial valve replacement was applied except one [As], in which valve plication was applied. And to all the diseased tricuspid valve, DeVega annuloplasty was applied. 5. The number of replaced artificial valves were 29 in 25 patients [congenital; 3, acquire; 22]. In MVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 15 of tissue valves [Carpentier-Edward valve; 11, lonescu-Shiley valve; 4] were used. In AVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 2 of tissue valves [Carpentier-Edward valve; 2] were used. 6. Postoperative complications were occurred in 12 cases. Among them 11 cases were recovered with intensive cares, but one patient [VSD + Fistula of Valsalva sinus] was expired with low cardiac out put syndrome.

• Animal Bioscience
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• v.36 no.5
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• pp.704-709
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• 2023

Objective: In tropical, subtropical and arid zones, heat stress is the main cause of productivity reduction in cattle. When climate stressors occur, animals become thermal adapted through differential expression of some genes, including heat shock proteins (HSP) family. The aim of this study was to determine levels of expression of HSP60, HSP70, and HSP90 genes in Simmental cattle raised in tropical environments of Mexico. Methods: In this study, expression of HSP60, HSP70, and HSP90 genes was analyzed in 116 Simmental cattle from three farms with tropical climate located in western Mexico. Animals were sampled twice a day, in the morning and noon. Gene expression was evaluated by quantitative polymerase chain reaction using probes marked with fluorescence. The MIXED procedure of SAS with repeated measures was used for all statistical analysis. Results: HSP60 gene expression differences were found for sex (p = 0.0349). HSP70 gene differences were detected for sampling hour (p = 0.0042), farm (p<0.0001), sex (p = 0.0476), and the interaction sampling hour×farm (p = 0.0002). Gene expression differences for HSP90 were observed for farm (p<0.0001) and year (p = 0.0521). HSP70 gene showed to be a better marker of heat stress than HSP60 and HSP90 genes. Conclusion: Expression of HSP70 gene in Simmental herds of the tropical region of western México was different during early morning and noon, but the expression of the HSP60 and HSP90 genes was similar. Identification of resilient animals to heat stress will be useful in the genetic improvement of the Simmental breed.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.136-141
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• 2003

We assessed the intermediate-term result of tricuspid annuloplasty (TAP) for tricuspid valve regurgitation (TR) associated with congenital heart disease in adults. Risk factors for residual TR were also analysed. Material and Method: From August 1989 to June 2001, seventy three adult patients, 51 females and 22 males, underwent TAP for TR associated with various congenital heart disease. Their age ranged from 46 years to 73 years (mean:43). Associated heart anomalies were atrial septal defect (55), ventricular septal defect (6), partial anomalous pulmonary venous return (4) and others (8). Preoperative and post-operative TR velocities were 3.25 m/sec and 2.56 m/sec respectively, and the types of TAP were De Vega in 43, Kay in 18 and Ring annuloplasty in 12. Postoperative follow-up duration was 2,347 patient-month (mean: 32.6 months), and 134 two-dimensional echocardiographic examinations were done during this period. Residual TR greater than III/IV was considered as TAP failure. Result: TAP failure was observed in 7 patients (9.6%), and one patient among them underwent tricuspid valve replacement. Risk factors for TAP failure were diagnosis other than atrial septal defect (p=0.001), preoperative (p=0.038) and postoperative (p=0.028) high TR velocity. There was no statistical significance in terms of TAP methods. Conclusion: Careful evaluation of valve morphology and aggressive surgical intervention are mandatory for the repair of TR with preoperative or residual RV pressure overload.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.255-261
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• 1999

Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.

• Cross-Cultural Studies
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• v.50
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• pp.371-394
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• 2018

La estrella de Sevilla, is a representative masterpiece of the Golden Age of Spain, and is a tragic work of Lope de Vega, who was a representative drama writer living in the 17th century. However, regardless of its great literary value, there are insufficient researches on this drama even in Spain, due to several controversies surrounding the truth about Lope's creation. Here, this research concretely investigated the tragic characteristic of this drama, by largely dividing it into the viewpoint of Aristotle and Shakespeare. Thanks to the noble social status of the characters and proper dialogue of the hero Sancho Ortiz in trouble, there seems to be no problem in performing the cathartic function that Aristotle mentioned regarding the work in his review. However, there are a few problems in the aspect of the 'hero's free will to resist the absolute fate,' which is fundamentally the essence of the associated Aristotelian tragedy. Because, there's no Hamartia in this drama, the core mechanism that forms the absolute fate, makes the statement that accordingly, no absolute fate or irresistible force of destiny is established. Rather, the tragic characteristic of this drama can be more properly investigated from the viewpoint of Shakespeare. As noted differently from Aristotle, Shakespeare considered that the tragic characteristic came from the hero's characteristic. According to him, tragedy starts from the hero's value view and personality, instead of the external factors such as an absolute fate. Actually, Busto's death and separation between Sancho Ortiz and Estrella, two tragic affairs of La estrella de Sevilla, were caused by the crooked selfishness of King Sancho IV, who abused his authority, and Sancho Ortiz' excessively blind loyalty to the King, rather than the irresistible event. In conclusion, in light of a lethargic and hopeless situation, with no eventual choice of options before the injustice of absolute power, is must have been a significant tragedy for the audience, witnessing the play's tragic ending.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.855-858
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• 2007

A left ventricular rupture might be one of the most disastrous complications after a mitral valve replacement. An acute atrioventricular groove rupture (type I) was detected in a 54-year-old female diagnosed with a mitral stenosis combined with severe tricuspid regurgitation. She had a prior medical history of an open mitral commissurotomy in Japan at 30 years ago. The surgical findings suggested that the previous procedure was not a simple commissurotomy but a commissurotomy combined with a posteromedial annuloplasty procedure. After a successful mitral valve replacement and a measured (De Vega type) tricuspid annuloplasty, the weaning from a cardiopulmonary bypass was uneventful. However, copious intraoperative bleeding from the posterior wall was detected and the cardiopulmonary bypass was restarted. Exposure of the posterior wall of the left ventricle showed bleeding from the atrioventricular groove 3 cm lateral to the left atrial auricle. Under the impression of a Type I left ventricular rupture, epicardial repair (primary repair of the Teflon felt pledgetted suture, continuous sealing suture using auto-pericardial patch and application of fibrin-sealant) was attempted. Successful local control was made and the patient recovered uneventfully. The patient was discharged at 14 postoperative days without complications. We report this successful epicardial repair of an acute type I left ventricular rupture after mitral valve replacement.