• Journal of Chest Surgery
• /
• v.37 no.7
• /
• pp.578-584
• /
• 2004

Sinus of Valsalva aneurysm is a rare cardiac anomaly and a long-term survival after surgical treatment has not been well established. This study was designed to evaluate the long-term surgical results after the repair of sinus Valsalva aneurysm. Material and Method: From April 1991 to November 2003, 35 patients (23 male, 12 female, mean age 35.2 years, range 11∼64) underwent operation for sinus of Valsalva aneurysm. Twenty six patients (74.3%) were in the New York Heart Association (NYHA) class III∼IV before surgery. In preoperative echocardiogram, mean EF was 63.32 $\pm$ 11.43% and nine patients (25.7%) were in AR grade III∼IV. Direct closure, patch closure of ruptured sinus Valsalva were performed in fourteen patients (46.7%), sixteen patients (53.3%) respectively. Aortic valve replacement, valvuloplasty were performed in five patients (14.3%), three patients (8.6%) respectively. Three patients (8.6%) underwent the Bentall procedure. Concomitant procedures were performed in 15 patients (42.9%), which were closure of VSD and ASD. Mean CPB time and ACC time were 116.79 $\pm$ 38.79 and 81.2 $\pm$ 28.97 minutes. Result: There was no operative mortality. One patient (2.9%) developed complete heart block that required a permanent pacemaker implantation. Three patients (8.6%) required reoperation due to a recurred rupture of the sinus Valsalva aneurysm and developed aortic insufficiency. Mean follow-up time was 58.55 $\pm$ 38.38 months. There was one late death. Actuarial 5 year freedom rate from reoperation was 87.1 $\pm$ 7%. Conclusion: Surgical treatment for sinus of Valsalva aneurysm is safe and has satisfactory long-term results.

• Journal of Chest Surgery
• /
• v.35 no.12
• /
• pp.871-875
• /
• 2002

Despite early aggressive treatment, post myocardial infarction(MI) ventricular septal defect(VSD) revealed high surgical mortality. We reviewed the 10-year experiences of surgically treated post-MI VSD in Yonsei University. Material and Method: From Jan. 1991 to May 2001, 17 patients underwent surgical repair of post-MI VSD. Ages ranged between 47 and 77 years(mean age＝63.2$\pm$9.1). There were 10 males and 7 females. VSD was located at anterior in 16 patients and at posterior in one. IABP was inserted preoperatively in 12 patients due to cardiogenic shock. Mean interval from MI to occurrence of VSD was 5.6 days. Among patients undergoing early surgical correction(n＝13), mean interval from occurrence of VSD to operation was 2.5 days. In 11 patients, concomitant CABG was performed during repair of VSD. Result: Four patients died within 30 days after the operation(30 day mortality＝23.5%). Among 12 patients with preoperative cardiogenic shock, 4 patients died within 30 days(30-day mortality＝33.3%). During mean follow up period of 52 months, one patient died of unknown cause and 10-year survival of discharged patients was 66.7%. All follow-up patients were in NYHA functional class I or II when their last OPD visit. Conclusion: In the treatment of post-MI VSD, aggressive medical treatment with early surgical correction seems to be very important in terms early and long-term survival of patients.

• Journal of Chest Surgery
• /
• v.34 no.6
• /
• pp.472-476
• /
• 2001

Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.17 no.6
• /
• pp.145-152
• /
• 2013

As a typical construction material, concrete has been used in building all kinds of structures since the late $19^{th}$ century. Although it was recognized to secure durability as long as the regulations on design and construction have been reasonably complied, the trends of life-shortening and deterioration have frequently occurred due to all kinds of the external effects that have been experienced during the procedures of using the structures. To make matters even worse, deterioration of the concrete structures according to deterioration can not be controlled any more. Finally, the reality is that repair and maintenance are necessary in the maintenance aspect of the concrete structure. In this study, CRM(Chemical Resistance of Laminating Reinforcement Method), which had been developed to reinforce the surface of concrete and specially improve chemical resistance performance, has been applied to enhance the existing repairing and maintenance method. Therefore, the result has been drawn with comparison and analysis of the specimens applied with the general repairing and maintenance method and CRM through a variety of durability test in this study. With the result of the test, durability of the specimen applied with CRM has been more improved than the existing repairing and maintenance method, which is judged as because of the laminating effect due to reinforcement of epoxy impregnated of alkali-resistance fiber and double layered fiber reinforced seat.

• Journal of Chest Surgery
• /
• v.35 no.7
• /
• pp.517-522
• /
• 2002

Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.

• Journal of Chest Surgery
• /
• v.37 no.4
• /
• pp.313-321
• /
• 2004

Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (＞30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.60.1-60.6
• /
• 2019

Background: The lingual nerve plays an important role in multiple functions, including gustatory sensation and contact sensitivity and thermosensitivity. Misdiagnosed conservative treatments for serious lingual nerve (LN) injuries can induce the patient to serious mental disability. After continuous observation and critical diagnosis of the injury, in cases involving significant disruption of lingual nerve function, microneurosurgical reconstruction of the nerve is recommended. Direct anastomosis of the torn nerve ends without tension is the recommended approach. However, in cases that present significant gaps between the injured nerve ends, nerve grafts or conduits (tubes of various materials) are employed. Recently, various reconstruction materials for peripheral nerves were commercially offered especially in the USA, but the best method and material is still unclear in the world. There currently exists no conventional protocol for managing LN neurosensory deficiency in regard to optimal methods and the timing for surgical repair. In Japan, the allograft collagen nerve for peripheral nerves reconstruction was permitted in 2017, and we tried to use this allograft nerve and got a recommendable result. Case presentation: This report is a long-term abandoned torn LN reconstructed with allograft nerve induced by the lower third molar extraction. Conclusions: In early sick period, with the exact diagnosis, the LN disturbance should be managed. In a serious condition, the reconstruction with allograft nerve is one of the recommendable methods.

• The Journal of Fisheries Business Administration
• /
• v.8 no.2
• /
• pp.1-19
• /
• 1977

The results analyzed of the actual state of medium size two-boat trawler fishery based on the cost expended in 1975 are as follows: According to the calculation of interest, the total cost of this fishery comes to ￦ 55,353,807, and in this account, the production cost comes to ￦ 49,747,383 (89.9%) and the material cost comes to ￦ 27,027,662(48.8%), the labour cost comes to ￦ 10,381,013 (18.8%) the expenses, ￦12,338,708(22.3%) and commision and interest comes to ￦ 5,606,424 (10.1%). As above the fishery comes is 90% of production cost for the expense of production. The ratio of cost element to the total cost 100 is as follow: Fuel: 23.6%, allocation: 14.3%, fishing gear: 14.1%, boat repair: 13.0%, fish box: 8.5%, ice: 14.1%, commission: 6.9%, food cost: 4.5%, interest: 3.2%, transportation fee: 2.8%, consumption: 2.6%, tax: 2.5%, depreciation: 2.4%, administrative expense: 1.6%. The unit cost of catches to each box, including the interest, cames to ￦ 2,167 and not calculating the interest it comes to ￦ 2,098. The cost production to each kg comes to ￦ 114 including interest, without interest, it comes ￦110. When the production cost comes to 90.6%, it comes to 9.4% of total revenue. The reason which this fishery brings low income is that the boats are almost old and semi-diesel engine is used. So, fuel expense and repaire expenses needs too much. Acconding to above this fishery needs to replace new boat and new engine. And new are for this fishery needs to bring under cultivation in order to bring good income with the new method for this fishery. Specially, this fishery brings low income from July to September because of its rest from labour. And so, the expenses, item, and account of money, and the trust money the cost element are not showed in August.

• Nutrition Research and Practice
• /
• v.11 no.4
• /
• pp.275-280
• /
• 2017

BACKGROUND/OBJECTIVES: Re-epithelialization has an important role in skin wound healing. Astaxanthin (ASX), a carotenoid found in crustaceans including shrimp, crab, and salmon, has been widely used for skin protection. Therefore, we investigated the effects of ASX on proliferation and migration of human skin keratinocyte cells and explored the mechanism associated with that migration. MATERIAL/METHOD: HaCaT keratinocyte cells were exposed to $0.25-1{\mu}g/mL$ of ASX. Proliferation of keratinocytes was analyzed by using MTT assays and flow cytometry. Keratinocyte migration was determined by using a scratch wound-healing assay. A mechanism for regulation of migration was explored via immunocytochemistry and western blot analysis. RESULTS: Our results suggest that ASX produces no significant toxicity in human keratinocyte cells. Cell-cycle analysis on ASX-treated keratinocytes demonstrated a significant increase in keratinocyte cell proliferation at the S phase. In addition, ASX increased keratinocyte motility across the wound space in a time-dependent manner. The mechanism by which ASX increased keratinocyte migration was associated with induction of filopodia and formation of lamellipodia, as well as with increased Cdc42 and Rac1 activation and decreased RhoA activation. CONCLUSIONS: ASX stimulates the migration of keratinocytes through Cdc42, Rac1 activation and RhoA inhibition. ASX has a positive role in the re-epithelialization of wounds. Our results may encourage further in vivo and clinical study into the development of ASX as a potential agent for wound repair.

• Industrial Engineering and Management Systems
• /
• v.11 no.2
• /
• pp.155-164
• /
• 2012

As the global market becomes more competitive, manufacturing industries face relentless pressure caused by a growing tendency of greater varieties of products, shorter manufacturing cycles and more sophisticated customer requirements. Efficient and effective supplier selection and order allocation decisions are, therefore, important decisions for a manufacturer to ensure stable material flows in a highly competitive supply chain, in particular, when customers are willing to accept products with less desirable product attributes (e.g., color, delivery date) for economic reasons. This paper attempts to solve optimally the challenging problem of supplier selection and order allocation, taking into consideration the customer flexibility for a manufacturer producing multi-products to satisfy the customers' demands in a multi period planning horizon. A new mixed integer programming model is developed to describe the behavior of the supply chain. The objective is to maximize the manufacturer's total profit subject to various operating constraints of the supply chain. Due to the complexity and non-deterministic polynomial-time (NP)-hard nature of the problem, an improved genetic approach is proposed to solve the problem optimally. This approach differs from a canonical genetic algorithm in three aspects: a new selection method to reduce the chance of premature convergence and two problem-specific repair heuristics to guarantee feasibility of the solutions. The results of applying the proposed approach to solve a set of randomly generated test problems clearly demonstrate its excellent performance. When compared with applying the canonical genetic algorithm to locate optimal solutions, the average improvement in the solution quality amounts to as high as ten percent.