• Journal of Chest Surgery
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• v.30 no.3
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• pp.300-307
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• 1997

We have experienced 25 cases of aortic aneurysm from October 1987 to January 1996. Patients ranged in age from 26yrs to 73yrs(mean age 52. Syrs). There were 13 males and 12 females. Eighteen cases were thoracic aneurysm and seven were abdom nal aneurysm. The cause of aneurysm were dissecting in 16cases aneurysms and non-dissecting in 9 cases. Risk factors of aortic aneurysm were hypertension, hypercholesterolemia, Marfan's syndrome. In thoracic aneurysm patients, 1'S cases of dissecting aneurysm underwent aneurysmectomy and replacement of vessel interposition graft with or without coronary artery implantation on the graft. 6 cases of non-dissecting aneurysm underwent operation with same policy as dissecting aneurysm. In 7 case of abdominal aneurysm,all patients underwent aneurysmectomy and graft interposition with straight i)r Y graft. Thcre were 5 postoperative death(mortality 20%). Several cases of complications were improved with proper managements. All survivors showed improvement in clinical symptom and sign and discharged without specific complications.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.336-339
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• 1997

The surgical treatment of diseases of thoracic aorta has had much better success rate in recent years compaired to the past. Aortic aneurysms or dissections that extend along the entire thoracic aorta are usually approached in two or three stages. Recently we successfully perfofm d one-stage aortic replacement from the aortic root to the abdominal aorta in chronic DeBakey type I dissection. A 25 year-old man who had dyspnea on exertion (NYHA Fc II) and a Marfanoid feature was operated under the diagnosis of chronic type I dissection with severe aortic regurgitation. ' At operation, a huge ascending aorta with two intimal tearings was seen and the blood supply of intercostal arteries and right renal artery was done from the false lumen. Modified Bentall operation with total aortic replacement was done successfully, and the patient is being followed-up without major complications.

• Biomolecules & Therapeutics
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• v.18 no.1
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• pp.106-110
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• 2010

The pharmacokinetics and bioavailability of ambroxol, an expectoration improver and mucolytic agent, were studied to determine the feasibility of enhanced transdermal delivery of ambroxol from the ethylene-vinyl acetate (EVA) matrix system containing polyoxyethylene-2-oleyl ether as an enhancer in rats. The ambroxol-010 matrix system (15 mg/kg) was applied to abdominal skin of rats. Blood samples were collected via the femoral artery for 28 hrs and the plasma concentrations of ambroxol were determined by HPLC. Pharmacokinetic parameters were calculated using Lagran method computer program. The area under the curve (AUC) was significantly higher in the enhancer group ($1,678{\pm}1,413.3\;ng/ml{\cdot}hr$) than that in the control group $1,112{\pm}279\;ng/ml{\cdot}hr$), that is treated transdermally without enhancer, showing about 151% increased bioavailability (p<0.05). The average $C_{max}$ was increased in the enhancer group ($86.0{\pm}21.5\;ng$/ml) compared with the control group ($59.0{\pm}14.8\;ng$/ml). The absolute bioavailability was 13.9% in the transdermal control group, 21.1% in the transdermal enhancer group and 18.1% in the oral administration group compared with the IV group. The $T_{max}$, $K_a$, MRT and $t_{1/2}$ of ambroxol in transdermal enhancer group were increased significantly (p<0.01) compared to those of oral administration. As the ambroxol-EVA matrix containing polyoxyethylene-2-oleyl ether and tributyl citrate was administered to rats via the transdermal routes, the relative bioavailability increased about 1.51-fold compared to the control group, showing a relatively constant, sustained blood concentration. The results of this study show that ambroxol-EVA matrix could be developed as a transdermal delivery system providing sustained plasma concentration.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.707-713
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• 2009

Purpose: The deep inferior epigastric perforator(DIEP) free flap is well known as an ideal donor site for the breast reconstruction. The flap can provide huge amount of fat tissue for breast and buttock contour, while it is also very useful as a thin skin flap to reconstruct the upper and lower extremities. We used a DIEP free flap in various site reconstructions besides the breast and would like to reinsure the usefulness of this flap. Methods: Twenty nine consecutive patients who underwent DIEP free flap surgery from 2001 January to 2007 December were reviewed. The case constituted seven male patients and twenty two female patients. There were sixteen breast reconstructions, five face reconstructions, five lower extremity reconstructions, two upper extremity reconstructions, and one buttock contour reconstruction. All clinical data were based on the patient's medical records. Results: All DIEP free flaps survived without major complications. There was no hematoma, seroma, or partial necrosis. The donor sites were closed primarily with linear scar on lower abdomen. The thinnest part of flap was 0.7 cm in thickness. The size of the largest flap was $38{\times}13cm$. The flaps were used in various types of skin and adipose tissue, adipose tissue only, and skin only according to the requirement of recipient site. Conclusion: The DIEP free flap was enough to provide a thin and huge flap for both breast and extremity reconstructions. It was able to provide versatile designs with sufficient adipose tissue. So we use it for 3 - dimentional face and buttock contour reconstructions. The DIEP free flap is a valuable reconstructive donor for face, upper and lower extremity in addition to breast without compromising the integrity of abdominal wall.

• Journal of Chest Surgery
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• v.5 no.1
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• pp.19-24
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• 1972

The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

• Journal of Veterinary Clinics
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• v.25 no.1
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• pp.48-51
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• 2008

A ten-year-old Yorkshire Terrier developed serious abdominal distension and respiratory distress. Radiography and ultrasonography revealed a hyperechoic mass around the aorta that was contiguous with the right atrium and main pulmonary artery. It was resulted in failure of the right side of the heart including tricuspid regurgitation, hepatomegaly with dilation of the hepatic vein and severe ascites due to a large, expansile mass. Computed tomography(CT) identified a large mass originating at the cardiac hilar region and spanning from the cranial vena cava to the caudal vena cava. The tumor had invaded the cranial vena cava, caudal vena cava, heart and pleural wall. A tentative diagnosis of chemodectoma was assigned to the tumor through a fine needle aspiration. This report focuses on the typical features of imaging diagnosis of heartbase tumors by radiography, ultrasonography and CT.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.441-444
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• 2005

Abdominal tumors that can grow through vascular lumen and spread to the right heart are rare. Intravenous leiomyomatosis is a rare tumor that originates from the uterus and spreads through the vessels. Although histologically benign, tumor extension with mechanical obstruction of the inferior vena cava, right cardiac cavities, or even the pulmonary artery, may occasionally result in fatal outcome. The best treatment is complete surgical resection of the entire tumor using cardiopulmonary bypass and total circulation arrest, We report a case of intravenous leiomyomatosis of the uterus that showed intravascular growth up to the right atrium. The patient underwent successful resection of the tumor by one-stage cardiotomy with laparotomy.

• Journal of Chest Surgery
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• v.2 no.2
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• pp.155-166
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• 1969

Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

• The Korean Journal of Pain
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• v.2 no.2
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• pp.135-144
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• 1989

Celiac plexus block is recommended in patients with intractable upper abdominal cancer pain. The success rate of a celiac plexus block is variable among the authors. One of the causes of this is the anatomical variations of the celiac plexus. There has not been a study concerning anatomical observations of the celiac plexus in Korean cadavers. So, anatomical dissections were performed and observations were made of the celiac plexus and related structures in Korean cadavers. The results were as follows: 1) The subjects were 21 male bodies and 5 female bodies. The mean age at death was $69.9{\pm}15.5$ years (range 37~93). The mean height was $155.5{\pm}8.3\;cm$ (range 143~172). 2) The number of celiac ganglia ranged from 1~4. The mean numbers were $2.3{\pm}1.9$ in the right plexus and $1.9{\pm}0.8$ in the left, and the mean sizes were $18.9{\pm}7.7{\times}8.0{\pm}3.8\;mm^2$ and $18.5{\pm}8.3{\times}9.5{\pm}3.9\;mm^2$ respectively. 3) Celiac ganglia were most frequently located at the level of the upper third and middle third of L1 in both sides (65.5% in right, 64.0% in left). The vertical range of celiac ganglia ranged from 1 space, which is one third the height of one vertebral body, to 4 spaces. Mean vertical ranges were $1.5{\pm}0.6$ spaces in the right plexus and $1.6{\pm}0.7$ spaces in the left. The celiac ganglia located at the level of the upper third of L1 in the right and the lower third of L1 in the left side, had the largest vertical ranges respectively ($1.8{\pm}0.5$ spaces in right, $2.3{\pm}0.6$ spaces in left) 4) Right side celiac ganglia were located near the midline of the vertebrae compared to the left ones (mean 5.0 mm) The horizontal dimension was greater in the right ganglia ($24.2{\pm}9.2\;mm$) than in the left ganglia ($l8.8{\pm}7.0\;mm$). 5) There was no vertebral level difference between both celiac ganglia in most cases (60%). However, of the 40% of cases at different levels, in half of these (20%) the right ganglia were located higher than the left ganglia; and in the other 20%, this was reversed. 6) The origin sites of the celiac artery were most frequently in the upper third and middle third of L1 (61.6%). The celiac ganglia were usually located at the same level as the site of origin of the celiac artery (61.6% in right, 52.0% in left). 7) The vertebral level of the splanchnic nerves piercing the abdominal surface of the diaphragm was most frequently in the upper third and middle third of L1 (66.6% in right, 66.7% in left). 8) The level of the origin of diaphragmatic crura from the anterior surface of the vertebral bodies varied from the L1-L2 interspace to the L3-L4 interspace. Right crura most frequently originated at the level of the lower third of L2 to the upper third of L3 (57.6%), while left crura originated from the level of the L2-L3 interspace to the middle third of L3 (69.3%). From the above results, we realized that there were some anatomical variations of the celiac plexus and its relations to adjacent structures in Korean bodies. However, when the needle point is behind the anterior margin of the upper third of L1, it is possible to perform a successful retrocrural splanchnic nerve block.

• Journal of Nutrition and Health
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• v.40 no.2
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• pp.162-171
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• 2007

Obesity is an independent risk factor fur coronary artery disease in the postmenopausal women, which may be mediated by alteration of blood lipid metabolism. We are aimed to evaluate the effects of low energy diet, restriction of high fat foods and exercise education on weight, fat mass and blood lipid profile. Fifteen postmenopausal obese women were studied. Subjects received detailed advice about how to achieve a reduction of weight by a low-energy diet (1,200kcal), restriction of high fat food and increased exercise in every 4 wks during 8 wk. To evaluate the effectiveness for education programs, dietary fat habit and daily nutrient intakes, exercise were tested before and after intervention. Anthropometry, computerized tomography, and blood lipid profile were assessed before and after intervention. According to the nutrition education, energy intake (from 1776.1 ${\pm}$ 28.2 kcal to 1268.7 ${\pm}$ 115.2 kcal, p < 0.001) and percent of energy from fat (21.9%, p < 0.01) were significantly decreased. However, the index of nutritional quality was over 1.0. On the contrary, exercise (from 341.3 ${\pm}$ 222.1 kcal to 569.4 ${\pm}$ 309.8 kcal, p < 0.05) was increased and dietary fat habit scores (from 30.8 ${\pm}$ 5.2 to 36.1 ${\pm}$ 3.0, p < 0.01) were improved. Also, body weight (4.2%, p < 0.001), BMI (4.5%, p < 0.001), body fat mass (3.4%, p < 0.05) and waist to hip ratio (1.1%, p < 0.05) were decreased. Among abdominal fat, visceral fat (26.1%, p < 0.05) and subcutaneous fat (14.8%, p < 0.01) were decreased. But there was no difference in visceral fat to subcutaneous fat ratio. We observed HDL-cholesterol increase (11.7%, p < 0.05), triglyceride reduction(14.8%, p < 0.05) and atherogenic index improvement (from 2.7 ${\pm}$ 0.7 to 2.3 ${\pm}$ 0.7, p < 0.05) However, there was no change in LDL-cholesterol and total cholesterol. Theses results showed that low energy diet, restriction of high fat foods and exercise education could result in reduction of body weight, fat mass, visceral and subcutaneous fat, and in improvement of blood lipid profile in the postmenopausal obese women.