• Title/Summary/Keyword: ST30

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The Usefulness of Intraoperative Myelography during Spinal Surgery (수술중 시행한 척수 조영술의 유용성)

  • Yoon, Sung-Hoon;Yi, Jin-Seok;Jang, Ha-Sung;Lee, Hung-Jin;Yang, Ji-Ho;Lee, Il-Woo;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.322-327
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    • 2001
  • Objectives : There are many kinds of method to evaluate neural decompression during operation. They are direct visual and manual inspection, intraoperative ultrasound, endoscope, intraoperative computed tomography and intraoperative myelography. We used intraoperative myelography to evaluate the proper decompression of neural elements during the decompressive surgery. Methods : We injected 10-20cc of nonionic water-soluble contrast materials through direct puncture site of exposed dura during operation or lower lumbar level or lumbar drain inserted preoperatively. 12 patients were included in this study. They were 7 patients of centrally herniated lumbar disc disease, 1 patient of multiple lumbar spinal stenosis, 2 patients of thoracic extradural tumor and 2 cervical fracture & dislocations. Results : 5 of 12 patients showed remained neural compression through intraoperative myelography, so they were operated further through other approach. Myelographic dye is heavier than CSF, so the dependent side of subarachnoid space was visualized only. In one case, CSF leakage through hemovac was detected, but it was treated only bed rest for 5 days after hemovac removal. Conclusion :Intraoperative myelography is an effective method to evaluate neural decompression during spinal surgery. This technique is easy and familiar to us, neurosurgeons.

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Seizures in Patients with Brain Tumors

  • Yang, Seung-Ho;Lee, Kwan-Sung;Lee, Tae-Kyu;Jeun, Sin-Soo;Park, Chun-Kun;Hong, Yong-Kil
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.387-390
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    • 2007
  • Objective : To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. Methods : One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma [n=56], meningioma [n=31], metastatic brain tumor [n=7], primary central nervous system lymphoma [n=4], and central neurocytoma [n=2]. Anti-epileptic drugs [AEDs] were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. Results : Thirty patients [30%] presented at least a single episode of seizure at the time of admission. Five of these patients [16.7%] developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients [8.6%] without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. Conclusion : Compared with patients without seizure, patients with seizure at the time of admission showed younger age [p=0.003], a higher portion of low-grade glioma [p=0.001], tumor location in the frontal and temporal lobes [p=0.003] and cortical involvement [p=0.017]. Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.

Acellular dermal matrix (Insuregraf) in the prevention of Frey's syndrome and surgical site depression after parotidectomy

  • Choi, Jangyoun;Park, Song I;Rha, Eun Young;Seo, Bommie Florence;Kwon, Ho;Jung, Sung-No
    • Archives of Craniofacial Surgery
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    • v.20 no.3
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    • pp.176-180
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    • 2019
  • Background: Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. Methods: From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. Results: The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. Conclusion: Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.

Delayed Sternal Closure Using a Vacuum-Assisted Closure System in Adult Cardiac Surgery

  • Hyun Ah Lim;Jinwon Shin;Min Seop Jo;Yong Jin Chang;Deog Gon Cho;Hyung Tae Sim
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.206-212
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    • 2023
  • Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

DNR (Do-Not-Resuscitate) Order for Terminal Cancer Patients at Hospice Ward (호스피스 병동에서 시행되는 말기 암 환자의 DNR (Do-Not-Resuscitate) 동의)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Jin-Min;Cho, Hong-Joo;Ok, Jong-Sun;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.232-237
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    • 2004
  • Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

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Spatial and Temporal Variation of Macroinvertebrates according to Physical Factors in Gongji Stream Area (공지천 수계에서 물리적인 요인에 따른 저서성 대형무척추동물 군집의 시.공간적인 변동)

  • Lee, Jaeyong;Lee, Kwang-Yeol;Han, Sang-Jin;Lee, Seok-Jong;Jung, Yukyong;Cheon, Jaelyoung;Choi, Jaeseok;Kim, Joon Chul
    • Korean Journal of Environment and Ecology
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    • v.28 no.1
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    • pp.24-32
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    • 2014
  • Our study is purposed to understand effect on spatio-temporal variability of macroinvertebrate community 11 sampling times at 4 sites between two streams (Shinchon stream and Gongji stream in Chuncheun City) from May 2011 to October 2013. In this study, the possible physical factors on spatio-temporal variability of macroinvertebrate community were discussed. After stream improvement project, the effects of anthropogenic disturbance in study sites appeared as increased water temperature more than $30^{\circ}C$ and the difference of water temperature between Shinchon stream and Gongji stream was by maximum $9^{\circ}C$ on 2012. The monsoon rainfall decreased number of species, individuals and biodiversity index of macroinvertebrate community, particularly, in Shincheon stream compare to Gongji stream. Dominant species of macroinvertebrate taxa was caddisfly in Shincheon stream and Diptera in Gongji stream but on August 2013, it was dominated by Diptera, Chironomidae spp. in all study sites. The spatio-temporal variability of macroinvertebrate community in the streams may be useful as bio-indicator influencing anthropogenic factors such as soil erosion (landslide or cultivation) or monsoon rainfall.

Explosion Hazard Assessment of Pharmaceutical Raw Materials Powders (원료의약품 분진의 폭발 위험성 평가)

  • Lee, Joo Yeob;Lee, Keun Won;Park, Sang Yong;Han, In Soo
    • Korean Chemical Engineering Research
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    • v.55 no.5
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    • pp.600-608
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    • 2017
  • Hazard risk of explosion on pharmaceutical raw materials dust in pharmaceutical industry often exists when it is handled or processed in the industrial sites, and explosion accident is caused by this. In this study, the dust explosion characteristics of the three pharmaceutical raw materials samples were measured. The main explosion characteristics are as follows: $P_{max}$, MIE and MIT of loxoprofen acid having $5.31^{\circ}C$ of median diameter are obtained 8.4 bar, 1 mJ < MIE < 3 mJ and $550^{\circ}C$. $P_{max}$, MIE and MIT of camphorsulfonate having $95.63^{\circ}C$ of median diameter are obtained 7.9 bar, 30 mJ < MIE < 100 mJ and $510^{\circ}C$. $P_{max}$, MIE and MIT of rifampicine having $26.48^{\circ}C$ of median diameter are obtained 7.9 bar and 1 mJ < MIE < 3 mJ and $470^{\circ}C$. The deflagration index ($K_{st}$) and the explosion index (EI) were obtained by using these data. The explosion hazard assessment of pharmaceutical raw materials dust was compared and examined. As a result, the explosion hazard assessment according to deflagration index and explosion index were the explosion class with St 2 and the explosion hazard rating of severe for loxoprofen acid & rifampicine and St 1 and strong for clopidogrel camphorsulfonate, respectively.

Effect of Stimulus Waveform of Biphasic Current Pulse on Retinal Ganglion Cell Responses in Retinal Degeneration (rd1) mice

  • Ahn, Kun No;Ahn, Jeong Yeol;Kim, Jae-Hyung;Cho, Kyoungrok;Koo, Kyo-In;Senok, Solomon S.;Goo, Yong Sook
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.2
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    • pp.167-175
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    • 2015
  • A retinal prosthesis is being developed for the restoration of vision in patients with retinitis pigmentosa (RP) and age-related macular degeneration (AMD). Determining optimal electrical stimulation parameters for the prosthesis is one of the most important elements for the development of a viable retinal prosthesis. Here, we investigated the effects of different charge-balanced biphasic pulses with regard to their effectiveness in evoking retinal ganglion cell (RGC) responses. Retinal degeneration (rd1) mice were used (n=17). From the ex-vivo retinal preparation, retinal patches were placed ganglion cell layer down onto an $8{\times}8$ multielectrode array (MEA) and RGC responses were recorded while applying electrical stimuli. For asymmetric pulses, 1st phase of the pulse is the same with symmetric pulse but the amplitude of 2nd phase of the pulse is less than $10{\mu}A$ and charge balanced condition is satisfied by lengthening the duration of the pulse. For intensities (or duration) modulation, duration (or amplitude) of the pulse was fixed to $500{\mu}s$($30{\mu}A$), changing the intensities (or duration) from 2 to $60{\mu}A$(60 to $1000{\mu}s$). RGCs were classified as response-positive when PSTH showed multiple (3~4) peaks within 400 ms post stimulus and the number of spikes was at least 30% more than that for the immediate pre-stimulus 400 ms period. RGC responses were well modulated both with anodic and cathodic phase-1st biphasic pulses. Cathodic phase-1st pulses produced significantly better modulation of RGC activity than anodic phase-1st pulses regardless of symmetry of the pulse.

Aerodynamic Characteristics of Voice Disorders (Polyp, Cyst) before and after Laryngeal Micro Surgery: Focus on Running Speech (성대폴립, 성대낭종 환자들의 Laryngeal Micro Surgery 수술 전, 후 공기역학적 비교: Running Speech 중심으로)

  • Moon, Tae-Hoon;Shim, Mi-Ran;Hwang, Yeon-Shin;Kim, Geun-Jeon;Lee, Dong-Hyeon;Sun, and Dong-Il
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.95-100
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    • 2019
  • Background and Objectives For patients with polyps and cysts, glottal gaps resulting from their lesions have negative respiratory effects when they vocalize. Phonatory Aerodynamic System is clinically used, but is often limited in the measurement of vowels. So the researchers attempted to verify the usefulness of Phonatory Aerodynamic System by comparing differences in respiratory characteristics and patterns which can be measured by the level of connected speech. Materials and Method Among the subjects who were diagnosed through a stroboscopy, there were 33 patients with polyps and 23 patients with cysts. Then, 36 subjects who were found to have no specific findings through a stroboscopy and perceptual test were selected to the normal group. We compared respiratory characteristics and patterns. And compared vocal polyps and cysts before and after laryngeal micro surgery (LMS). Results First, difference in respiratory patterns between the normal group and the patients with polyps and cysts were examined to show that breath groups, breath group syllables, and expiratory·inspiratory volume were significantly higher in the polyp/cyst group than those in the normal group, indicating that precision was lowered during the conversation, due to reduction in speech intelligibility and interruption of communication. Second, there were significant differences in maximum phonation time, mean flow rate, and subglottal pressure among respiratory characteristics, breath groups, breath group syllables, and inspiratory volume before and after LMS, which appeared to be similar to the normal group. Conclusion The understanding of respiratory characteristics and patterns produced by patients in connected speech which is most similar to natural speech was found to be the objective and useful method for examining characteristics of the subjects.

Karyotype Analysis of Five Iris Species Native to Korea (한국 자생 붓꽃과 식물 5종의 핵형분석)

  • Park, Young-Wook;Kim, Dong-Ming;Hwang, Yoon-Jung;Lim, Ki-Byung;Kim, Hyun-Hee
    • Journal of Plant Biotechnology
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    • v.33 no.1
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    • pp.39-43
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    • 2006
  • A detailed karyotype analysis was carried out in five Korean native Iridaceae species; Iris pseudoacorus, I. pallasii. var. chinensis, I. tectrum, I. dichotoma and Belamcanda chinensis. Chromosome compositions of the five species showed that they have different karyotypic formulae; I. pseudoacorus 2n=34=10m+16smn+8st including two pairs of satellite chromosomes, I. pallasii var. chinensis 2n=40=26m+12sm+2st including two pairs of satellite chromosomes, I. tectrum 2n=30=14m+16sm including five pairs of satellite chromosomes, I. dichotoma 2n=32=22m+10sm including two pairs of satellite chromosomes, and B. chinensis 2n=32=20m+10sm+2st including one pair of satellite chromosomes. These results will supplement the previous cytogenetic reports in Iridaceae species and enhance our understanding on the genetic structure, which will be useful in clarifying the unique characteristics of each species for practical breeding programs for horticultural and pharmaceutical purposes.