• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.65-72
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• 2007

Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

• Journal of Korean Society of Environmental Engineers
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• v.38 no.11
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• pp.611-617
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• 2016

Remanufacturing that is the rebuilding of a product to specifications of the original manufactured product by collecting used-product, completely disassembling, cleaning and repairing or replacing with a new part and reassembling has been received attention in aspects of resource, recycling because it is a great environmental improvement. Remanufacturing is the rebuilding of a product to specifications of the original manufactured product by collecting used-product, completely disassembling, cleaning and repairing or replacing with a new part and reassembling. With a great environmental improvement and resource recycling and conservation, many studies were conducted. Up to date, remanufacturing activities are mainly applied to automobile parts and printer toner cartridge in South Korea. However, remanufacturing of rental product is not well conducted although rental products are collected in good condition and could be remanufactured in the same condition as a new product. Therefore, in this study, we conducted life cycle assessment (LCA) to an air cleaner product that is one of rental products. This study attempts to identify the processes in new products and remanufacturing life cycles that contribute the most environmental impacts. The results show that air cleaner remanufacturing could reduce about 20% of environmental impacts compared to new product. The greatest benefit related to environmental impact is with regard to ozone layer depletion potential (ODP), which is reduced by 94%. In the life cycle of air cleaner, raw material extraction stage had the most environmental impacts, especially with regard to abiotic depletion potential (ADP) and global warming potential (GWP). In the environmental impacts in each part, the ABS power had the highest environmental impacts.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.547-552
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• 2004

Recently, autologous bone marrow cell transplantation (CTx) for angiogenesis and myogenesis in ischemic myocardium has been extensively investigated to improve heart functions. This study was designed to evaluate the effects of CTx with off-pump coronary artery bypass grafting (OPCAB) in patients who were not feasible for complete revascularization. Material and Method: Four male patients underwent CTx and OPCAB simultaneously. Bone marrow was aspirated from iliac bone. Mean 1.5 ${\times}$ 10$^{9}$ mononuclear cells including mean 6.7 ${\times}$ 10$^{6}$ CD34 + cells and 3.7 ${\times}$ 10$^{6}$ AC133 + cells were obtained and concentrated with 10 cc. These cells were transplanted into non-graftable ischemic myocardium after OPCAB. The heart function of all patients were evaluated using the MIBI scan, echocardiogram and MRI preoperatively. The effects of CTx was evaluated using MIBI scan and echocardiogram at 1 month postoperatively. Result: An average of 2 grafts were bypassed to left anterior descending artery territory. Other territories were transplanted with isolated mononuclear cell. All patients had uncomplicated postoperative course. After 1 month follow up, there were improvement in symptom, ejection fraction (from 49% to 55%) on echocardiogram and myocardial perfusion on MIBI scan in all patients. Conclusion: These preliminary data showed improvement of heart function and myocardial perfusion and also showed the feasibility and safety of combined therapy with OPCAB and CTx in ischemic myocardium. However, the effectiveness of CTx alone cannot be readily assessed. Further randomized, controlled studies are required to evaluate the effectiveness of CTx alone.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.30-35
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• 2013

Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

• Journal of Korean society of Dental Hygiene
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• v.9 no.4
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• pp.753-767
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• 2009

Objectives : The study is to gain some basic material for the improvement of dental clinics' homepages through a survey investigation, in which college students of three Dental Hygienic departments participated in Kwangju and Cheollanamdo Province. Methods : In the investigation three factors were analyzed : the degree of knowledge on dental clinics' homepages, the degree of recognition on them, and whether they have paid a visit on them or not. A total of 509(96.8%) respondents are valid except 17sheets of responses. Results : 1. When asked about the degrees of knowledge on the formation of the homepages by students' years, the correct rate on Information Service was higher in a row of the second year, the first year, and the third year. And it shows statistically significant difference(p<0.05). In the part of Counseling Service, the rate of correct answers was highest in the second year, and then the first year and the third year. It also shows significant difference(p<0.05). In case of Visual Service, the second year got the highest rate of correct answers, and then the first year and the third year. Here is significant difference by the school years<0.01) 2. It was asked whether they have visited the dental clinics' homepages. The results are like this: 145 sophomores(28.5%) have visited them, and 115 juniors(22.6%) and 85 freshmen(16.7%), and it show significant difference (p<0.001). 3. It was asked how many sites they have visited. Among the freshmen, not a few students visited two sites (34, 9.9%), among sophomores 48 students visited five sites(13.9%), and among juniors the highest answers were two sites (41, 11.9%). It shows signigicant difference(p<0.01). 4. It was asked what is the purpose of the visits. At this 27 freshmen answered for having counseling(7.8%), and 80 sophomores(23.3%) and 43 juniors(12.5%) answered they visited them for the purpose of gaining some materials about their major. It shows significant difference(p<0.001). 5. It was asked with what opportunity they have visited them. They answered through searching activities like this : freshmen (68, 19.8%), sophomores (130, 37.9%), and juniors (98, 28.6%). It shows significant difference(p<0.05). 6. In regard with the recognition of the homepages, all the participants said that the management of the homepages are closely related with the images of the clinics($3.96{\pm}0.781$). But it is found that they do not think that the effective management of dental clinics' homepages is the task of dental hygienic workers as a part of dental hygienic($3.12{\pm}0.971$). 7. There is some difference concerned with the homepages among each group of students; sophomores have highest recognition on them and then juniors and freshmen, and it shows significant difference(p<0.01). In addition, those who have visited them show higher recognition than those who have never visited them(p<0.001). Conclusions : There are some differences among each group of students in regard with the formation service, the purpose of visiting them and such experiences, and the opportunities. Whereases they think that the management of the homepages are closely related with the images of the clinics, they do not think that the effective management of dental clinics' homepages is the task of dental hygienic workers as a part of dental hygienic. Therefore it is necessary to study actively for the qualitative improvement of the dental clinics' homepages, which will result in the higher recognition on the homepages by the dental hygienic students and the workers.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.662-671
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• 2001

Background: This study was aimed to assess improvement in myocardial perfusion after TMR by measuring regional myocardial blood flow(RMBF) in porcine model of chronic myocardial ischemia. Material and Method: Ameroid ring was placed around the proximal left circumflex coronary artery in fourteen pigs. After 4 weeks, the control group(7 pigs) underwent rethoracotomy only, and the TMR group(7 pigs) underwent Ho:YAG laser TMR at the circumflex territory. After another 4 weeks, the animals were sacrificed for the measurement of RMBF using colored microspheres. The ratio of RMBF between the circumflex territory and the interventricular septum was calculated and compared. Result: At 4 weeks after ameroid constriction, RMBF of the circumflex territory decreased to 46∼89% of RMBF of the interventricular septum. In five of six animals in the TMR group, RMBF of the circumflex territory at 8 weeks after ameroid constriction was higher compared with RMBF at 4 weeks after ameroid constriction. However, the improvement was statistically significant only in two animals. In three of the four animals in the control group, RMBF of the circumflex territory also increased at 8 weeks compared with RMBF at 4 weeks. The degree of increase in RMBF was not different between the control and the TMR groups. Conclusion: In porcine model of chronic myocardial ischemia, the degree of increase in RMBF of the ischemic area after Ho:YAG TMR was not different from the increase by development of native collateral circulation. Perfusion of ischemic myocardium after TMR is not thought to improve to the degree that can be demonstrated by currently available method of assessment such as radioisotope myocardial scintigraphy.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.369-375
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• 2007

Background: Patients suffering with pectus carinatum complain of cosmetic problems when they stand and this in spite of wearing cloths. The standard surgical treatment of pectus carinatum is resection of the deformed cartilages, but the wide operative scar, post-operative pain and complications related with such an operation can occur. Therefore, we have peformed compressive brace therapy as a non-operative treatment for pectus carinatum and we observed the effects and the efficiency of this treatment. Material and Method: From January, 2001 to December, 2006, 109 patients wore the compressive brace for all day. The degree of satisfaction was evaluated after $6\sim9$ months of wearing the compressive brace. The degree of satisfaction was evaluated by a score of from $1\sim4$. A score of 1 was assigned when the status was worse, 2 when it was the same, 3 when there was partial improvement and 4 when remarkable improvement was observed. The degree of satisfaction was assessed subjectively by the parent if the patient was a child younger than middle school age, and the patients older than middle school age assessed the score themselves. Result: The mean score of the overall degree of satisfaction was $3.93{\pm}0.33$. Recurrence of pectus carinatum after removal of compressive brace occurred in 6 patients (5.5%) of the total 109 patients. But 4 patients of the total 6 recurred patients stopped wearing of compressive brace against our advice. The 6 recurred patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed the compressive brace. The complications were discomfort with initially wearing the compressive brace, which occurred in all patients, skin rash due to the compressive brace for 76 patients (69.7%) and skin discolorization with excessive compression for f6 patients (5.5%). The skin rash and discolorization returned to normal within a few months after removal of the compressive brace. Conclusion: This study demonstrated that non-surgical treatment with using the compressive brace for patients with pectus carinatum was effective, and especially for children and teenagers. Non-surgical treatment with using a compressive brace would be helpful for the patients suffering with pectus carinatum and who dislike surgical operations because of their fear about general anesthesia and operation-related complications. Yet long-term follow up is necessary to accurately evaluate the effectiveness of this compressive brace and the recurrences after removal of the compressive brace.

• Journal of Chest Surgery
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• v.41 no.4
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• pp.457-462
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• 2008

Background: Emergency airway access is essential when a patient has dyspnea that's due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that's due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope. Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was $59.4{\pm}18.4$ years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures. Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients. Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.127-132
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• 2002

Video-assisted thoracic sympathicotomy is a safe and effective therapy for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathicotomy at various levels and the extent of block, we are to determine the optimal level of sympathicotomy and which method will result in minimal side effects and maximal benefits. Material and Method: From January 1998 to June 2001, the thoracoscopic sympathicotomy was performed in 150 patients suffering from essential hyperhidrosis in the Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into three groups. GroupI(n=50): patients having undergone 72,3,4 sympathicotomy, GroupII (n=50): patients having undergone 72 sympathicotomy which consist of blocking the interganglionic neural fiber on the second rib, and group 111(n=50): patients having undergone 73 sympathicotomy which consist of blocking the interganglionic neural fiber on the third rib. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory sweating, postoperative complications, and changes of plantar sweating. Results: There was no difference in age and sex among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However the rate of long-term satisfaction were 80%, 92%, and 96% in groupsI,II, and III respectively(p<0.05). More than embarrassing compensatory hyperhidrosis was present in 50%, 28%, and 18% in groups I,II ,and III respectively(p<0.05). Slight but comfortable amounts of palmar humidness was expressed in decreasing order, group III(34%), groupII(6%), and group I(4%) respectively(p<0.05). In regard to plantar sweating, decrease in sweating was expressed in each of the three groups, but was not significant between the groups.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.11-18
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• 2004

Background: We tested the effect of indomethacine and total spinal anesthesia on the improvement of placental flow during cardiopulmonary bypass on fetal lamb. Material and Method: Twenty fetuses at 120 to 150 days of gestation were subjected to bypass via trans-sternal approach with a 12 G pulmonary arterial cannula and 14 to 18 F venous cannula for 30 minutes. All ewes received general anesthesia with ketamine. In all the fetuses, no anesthetic agents were used except muscle relaxant. Ten served as a control group in which placenta was worked as an oxygenator during bypass (Control group). The remainder worked as an experimental group in which pretreatment with indomethacine and total spinal anesthesia was performed before bypass with the same extracorporeal circulation technique as control group (Experimental group). Observations were made every 10 minutes during a 30-minute bypass and 30-minute post bypass period. Result: Weights of the fetuses ranged from 2.2 to 5.2 kg. In Control group, means of arterial pressure decreased from 44.7 to 14.4 mmHg and means of Pa$CO_2$ increased from 61.9 to 129.6 mmHg at each time points during bypass. Flow rate was suboptimal (74.3 to 97.0 $m\ell$/kg/min) during bypass. All hearts fibrillated immediately after the discontinuation of bypass. On the contrary, in Experimental group, means of arterial pressure reamined higher (45.8 to 30 mmHg) during bypass (p<0.05). Means of Pa$CO_2$ were less ranging from 59.8 to 79.4 mmHg during bypass (P<0.05). Flow rates were higher (78.8 to 120.2 $m\ell$/kg/min) during bypass (p<0.05). There were slower deterioration of cardiac function after cessation of bypass. Conclusion: In this study, we demonstrated that the placental flow was increased during fetal cardiopulmonary bypass in the group pretreated with indomethacine and total spinal anesthesia. However, further studies with modifications of the bypass including a creation of more concise bypass circuit, and a use of axial pump are mandatory for the clinical application.