• Journal of Chest Surgery
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• v.23 no.2
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• pp.236-244
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• 1990

To improve the prognosis of mitral valve replacement surgery, analysis and evaluation of pre and intra operative risk factors will be very much valuable. Author studied 205 cases of mitral valve replacement from Feb 1982 to June 1989 for the risk factors of hospital death. 90 patients were male and 115 were female, and age was from 16 to 59 years, Mitral stenosis dominant lesions were 91 cases and regurgitation 114. Suspected risk factors were NYHA functional class, cardiothoracic ratio, implanted valve type and size, operation time, age and sex, thrombus in left atrium, atrial fibrillation, aortic cross clamping time, left ventricular end diastolic and systolic dimension, nephropathy, hepatopathy and respiratory insufficiency. Statistic analysis was performed by X2 test between survivors and death group. Statistical significances as pre and intraoperative risk factors of hospital death after mitral valve replacement were confirmed in those presence of AF on the EKG, NYHA functional class[>IV], cardiothoracic ratio[>70%], and implanted valve size[>33mm]

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3045-3050
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• 2013

Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.10-16
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• 2013

Purpose: To know if magnetic resonance image (MRI) re-examination is needed before surgery, we compared the pre-operative MRI recorded at different time points and the corresponding arthroscopic findings. Materials and Methods: Depending on the timing of evaluation, the MRI was classified into three groups: group A, MRI was taken 1 month before the surgery (44 cases, average 16 days); group B, 1-6 months before the surgery (41 cases, average 91 days); and group C, 6-12 months before the surgery (25 cases, average 230 days). The anterior to posterior tear size (length) and medial retraction size (width) of rotator cuff tear were measured for each group and they were compared with the actual arthroscopic findings. Results: Results of this study showed that arthroscopic rotator cuff tear length and width were larger than those of MRI. The difference of the rotator cuff tear size was 3.6(${\pm}1.2$) mm of length and 0.6(${\pm}0.4$) mm of width in group A, 4.2(${\pm}1.7$) mm and 2.4(${\pm}1.1$) mm in group B, and 4.5(${\pm}2.1$) mm and 3.0(${\pm}1.5$) mm in group C. There was a tendency of the larger size difference for longer pre-operative period, but it was not statistically significant. Conclusion: The rotator cuff tear size did not show remarkable differences between pre-operative MRI taken within 1 year before surgery and the actual arthroscopy. It is concluded that additional MRI evaluation is not required within 1 year.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.81-85
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• 2009

As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.366-369
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• 1997

In this study, we measured upper right, lower right, upper left region to find the optimal region which represent liver function. We found that the upper right region is optimal because of high accuracy and low standard deviation. For normal subjects all the calculated HEFs were greater than 100% and all those of abnormal ones were less than 80%. Thus HEF can be assumed to discriminate abnormal livers from normal ones. It was found that the patients with surgical operation would survive if both the pre-and the post-operative HEFs are greater than 50%. Therefore HEF method can be a good estimator for surgeon to determine the surgical operation and to evaluate remaining hepatic function after surgery as well as it is reliable and simple.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.364-374
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• 1980

Twenty-two patients were selected for evaluation of pre-and postoperative pulmonary function. These patients were performed open cardiac surgery with the extracorporeal circulation from March 1979 to July 1980 at the Department of Thoracic and Cardiovascular Surgery, Kyungbook National University Hospital. Patients were classified with ventricular septal defect 5 cases, atrial septal defect 5 cases, tetralogy of Fallot 5 cases, mitral stenosis 4 cases, rupture of aneurysm of sinus Valsalva 1 case, left atrial myxoma I case, and aortic insufficiency 1 case. The pulmonary function tests were performed and listed: [1] respiratory rate, tidal volume [TV], and minute volume[MV], [2] forced vital capacity [FVC] and forced expiratory volume[FEV 0.5 & FEV 1.0], [3] forced expiratory flow [FEF 200-1200 ml & FEF 25-75%]. [4] Maximal voluntary ventilation [MVV], [5] residual volume [RV] and functional residual capacity[FRC], measured by a helium dilution technique. Respiratory rate increased during the early postoperative days and tidal volume decreased significantly. These values returned to the preoperative levels after postoperative 5-6 days. Minute volume decreased slightly, but essentially unchanged. Preoperative mean values of the forced vital capacity, functional residual capacity and total lung capacity decreased [63.2%, 87.2% & 77.3% predicted, respectively], and early postoperatively these values decreased further [19.6%, 76.0% & 38.0% predicted], but later progressively increased to the preoperative levels. In residual volume, there was no decline in the preoperative mean values [100.9% predicted] and postoperatively the value rather increased [106.3-161.7% predicted]. Forced expiratory volume [FEV 0.5 & FEV 1.0] and forced expiratory flow [FEF 200-1200 ml & FEF 25-75%] also revealed significant declines in the early postoperative period. There was no significant difference in values of the spirometric pulmonary function tests, such as FEF 1.O and FEF 25-75% between successful weaning group [17 cases] extubated within 24 hrs post-operatively and unsuccessful weaning group [5 cases] extubated beyond 24 hrs. Static compliance and airway resistance measured for the two cases during assisted ventilation, however, any information was not obtained. Long term follow-up pulmonary function studies were carried out for 8 cases in 9 months post-operatively. All of the results returned to the pre-operative or to normal predicted levels except FVC, FEV 1.0, and FEF 25-75% those showed minimal declines compared to the pre-operative figures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.2
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• pp.164-170
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• 2005

The purpose of this study was to compare a sample of patients who had condylar fractures treated with open reduction using different plating techniques, to evaluate which plating technique is useful for stable fixation for fractures of the mandibular condyle and to evaluate effectiveness of resorbable miniplate. There were 60 patients (41 males, 19 females) whose condylar fractures were treated with open reduction. Rigid fixation was performed with a single miniplate, double miniplate ot one miniplate & one microplate and single resorbable plate. All patients remained intermaxillary fixation for 1 week postoperatively. Active physiotherapy was started after 2 weeks postoperatively. Radiographic evaluation (plate fracture, plate bending, screw loosening, displacement of condyle etc.) was performed at pre-operative, immediate, 2 weeks, 1 month, 3 months, 6 months after surgery. Clinical evaluation included degree of mouth opening, occlusion, mandibular lateral excursion, infection and facial nerve paralysis. In radiographic evaluation, displacement of fractured condylar segment associated with plate bending or screw loosening were showed 6 cases and 3 cases for single miniplate system and resorbable miniplate system. There was no patients who have this problem on double miniplate system. The results revealed that the application of two miniplates were more recommendable than single miniplates. When we select resorbable miniplate system, we should consider the type of fractures, post-operative treatment protocol and surgical technique.

• Restorative Dentistry and Endodontics
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• v.38 no.4
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• pp.187-193
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• 2013

Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.

• Journal of Biomedical Engineering Research
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• v.29 no.6
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• pp.431-435
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• 2008

Quantitative information of a three dimensional(3D) kinematics of joint is very useful in knee joint surgery, understanding how knee kinematics related to joint injury, impairment, surgical treatment, and rehabilitation. In this paper, an automated 2D/3D image matching technique was developed to estimate the 3D in vivo knee kinematics using dual X-ray images. First, a 3D geometric model of the knee was reconstructed from CT scan data. The 3D in vivo position and orientation of femoral and tibial components of the knee joint could be estimated by minimizing the pixel by pixel difference between the projection images from the developed 3D model and the given X-ray images. The accuracy of the developed technique was validated by an experiment with a cubic phantom. The present 2D/3D image matching technique for the estimation of in vivo joint kinematics could be useful for pre-operative planning as well as post-operative evaluation of knee surgery.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.69-74
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• 1978

Coarctation of the aorta is rare condition among the congenital cardiovascular defects in Korea. We experienced one case of coarctation of the aorta [postductal type], which was successfully corrected with Dacron graft. This 20 year old man was admitted to our hospital for evaluation of hypertension in the upper extremities and frequent occipital headache of 2 month duration. On physical examination, grade II systolic murmur was heard over the apex and mid back, but thrill was not palpable. Blood pressures were measured at both extremities, its values were 190/70mmHg. in the arms and 120/60mmHg in the legs. Routine chest roentgenogram showed the dilated left subclavian artery high on the left mediastinal border and associated with left ventricular prominence, but notchings of lower border of rib was not seen. Electrocardiogram also showed left ventricular hypertrophy. Final Pre-operative diagnosis was made by the aortic catheterization and aortography, which showed the typical configuration of postductal type of coarctation with poststenotic dilatation of aorta. Under the moderate hypothermia by surface cooling, coarcation was resected 3.5cm in length and then Dacron graft was inserted. After prosthetic correction, blood pressures were recorded 120/60mmHg in arms and 160/120mmHg in legs. The post-operative course was uneventful.