• Journal of Chest Surgery
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• v.37 no.6
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• pp.492-498
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• 2004

Background: In this study, we investigated the risk factors for the development or progression of aortic regurgitation(AR) in patients with type I ventricular septal defect (VSD) to determine the optimal surgical timing and strategy. Material and Method: Three-hundred and ten patients with type I VSD with or without AR were included. The mean of age was 73.7$\pm$114.7 (1-737) months. One hundred and eighty six patients (60%) had no AR, 83 (27%) had mild AR, 25 (8%) had moderate AR and 16 (5%) had severe AR. Aortic valve was repaired in 5 patients and replaced in 11 patients with closure of VSD in the first operation. Four patients required redo aortic valve repair and 11 patients required redo aortic valve replacement. Age at operation, association with aortic valve prolapse, Qp/Qs, systolic pulmonary arterial pressure, VSD size and systolic pulmonary artery to aortic pressure ratio(s[PAP/AP］) were included as risk factors analysis for the development of AR. The long-term result of aortic valve repair and aortic valve replacement were compared. Result: Older age at operation, association with aortic valve prolapse, high Qp/Qs, and s[PAP/AP] were identified as risk factors for the development of AR (p<0.05, Table 2). The older the patient at the time of operation, the higher the severity of preoperative AR and the incidence of postoperative AR (p<0.05, Table 1, Fig. 1). For the older patients at operation, aortic valve repair had higher occurrence of AR compared to those who had aortic valve replacement (p<0.05, Fig. 2). Conclusion: From the result of this study, we can concluded that early primary repair is recommended to decrease the progression of AR. Aortic valve repair is not always a satisfactory option to correct the aortic valve pathology, which may suggest that aortic valve replacement should be considered when indicated.

• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.668-674
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• 2000

Objective : The classic and accepted surgical method of compound comminuted depressed skull fractures (FCCD) involves total resection of all the contaminated bone and fragments at the fracture site. A second operation for cranioplasty is then performed at a later date. However, we have believed that primary repair of these bony defects can be achieved by the replacement of bone fragments at the time of the initial debridement, and this can be accomplished without danger to patient. The authors retrospectively reviewed the surgical results to assess the advantages and disadvantages, and also propose the selection criteria of replacement of fractured bone fragments as a primary procedure in FCCD. Materials and Methods : The authors analyzed the data extracted from medical records, and radiological findings in 22 of 71 patients with FCCD, who underwent immediate replacement of fractured bone fragments between April 1993 and October 1998. The mean follow-up period was 13.7 months. The selection criteria for the operation included the patients with mild to moderate severity, regardless of the degree of contamination or dural violation, which presented in hospital within 24 hours of injury. Results : The ages of the patients varied from 4 to 63 years, and there were 20 males and 2 females. Seventeen of 22 patients were fully conscious on admission and the others also had relatively good Glasgow coma scales. Sixteen fractures were located in the frontal area, 9 with involvement of the frontal sinuses, and 6 in the parietal and temporoparietal areas. Of the 22 patients, 8(36.3%) had dural lacerations with 3 of these requiring patching with pericranium, and 12(54.5%) had intracranial hematoma requiring wide craniotomy. The degree of wound contamination was also variable. Fifteen patients had relatively clean wounds, while seven(31.8%) had seriously contaminated wounds with soil, sand, hair, and wood. Only one patient(4.5%) developed infection, and the bone fragments were removed. All wounds healed primarily without pulsatile defect, the skull has remained solid, and no complications have occurred, except the infected case. Conclusion : It is proposed that bone fragments removal for FCCD, regardless of the degree of contamination or dural violation, is not necessary and that primary bone fragments replacement avoids a second operation for cranioplasty.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.113-117
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• 2002

With an increasing awareness of the limitations of both mechanical prostheses and bioprostheses, aortic valvuloplasty has gained attention as an alternative procedure for aortic valve disease. Material and Method: Eight consecutive patients underwent aortic valvuloplasty caused by leaflet prolapse between June 1799 to June 2000. Mean age of the patients was 18.4$\pm$12.6 year. Four paitents(50%) were male. Six patients had tricuspid valves and ventricular septal defect and two patients had bicuspid valves. The extent of aortic insufficiency was 3.5$\pm$0.5 by preoperative Doppler echocardiography. The technique involved triangular resection of the free edge of the prolapsed leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. Result: There was no in-hospital mortality or morbidity. Mean follow-up was complete at 11.973.6months. There was no late mortality or morbidity. The amount of the severity of aortic insufficiency, as assessed by echocardiography preoperatively, postoperatively and at late follow-up was 3.5$\pm$0.5, 0.6$\pm$0.5 and 0.8$\pm$0.6, respectively(p value : 0.01). There was one patient with grade 2/4 aortic insufficiency and in the other patients, grade 1/2 or trivial aortic insufficiency were detected with late echocardiograms. Conclusion: Triangular resection in the patients with aortic leaflet prolapse offers a good early clinical result, but long-term follow-up is necessary.

• Journal of Chest Surgery
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• v.3 no.2
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• pp.73-90
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• 1970

Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

• Journal of the Society of Cosmetic Scientists of Korea
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• v.45 no.1
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• pp.95-103
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• 2019

Lips have a defect in maintenance of moisture due to their thin layer. As aging progresses, lips lose volume and redness, and become wrinkled. Fat grafting and filler surgery have been used to achieve attractive lips, but little research has been reported to develop better materials to replace the present methods. Recently, a study suggests that the increase of adipocyte number can be enhancing the expansion endogenous fat. In previous study, we identified that the efficacy of Magnolia officinalis bark extract (MOBE) was effective on the induction of adipogenic differentiation. In this study, we confirmed that MOBE enhanced the differentiation of human adipose-derived stem cells on the fat mimic 3D structure built by 3D bioprinting method From further experiments in human, we established a method to quantify the severity of lip wrinkle by measurement of standard deviation of gray value using Image J software. Finally, we found that topical treatment with 1% MOBE formulated lip balm significantly improved the lip wrinkle after using for 12 weeks. In conclusion, these findings suggest that MOBE has great potential, as a cosmetic ingredient, to reduce the lip wrinkle through the effect of promoting adipogenic differentiation.

• Journal of Korea Trade
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• v.26 no.1
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• pp.81-98
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• 2022

Purpose - This study aims to compare the requirements under the United Nations Convention on Contract for the International Sales of Goods (CISG) and the Korean Civil Act (KCA) regarding the buyer's right to require the delivery of substitute goods. The buyer's right to demand substitute delivery not only protect them from the seller's breach of contract but also preserves the contractual bond between the parties by providing an opportunity for sellers to protect their goodwill and circumvent the extreme remedy of avoidance. However, as substitute delivery entails additional efforts and costs for return and re-shipment, this right should not be allowed in every case of defect. Additionally, unlike the CISG, the KCA contains no specific provision related to the requirements for claiming substitute delivery. Therefore, it would be meaningful to examine and compare what requirements should be fulfilled before the buyer exercises the right in relation to non-conforming goods under the CISG and the KCA. Design/methodology - We conducted a comparative study of the requirements under the CISG and the KCA regarding the buyer's right to require delivery of substitute goods given a seller's delivery of non-conforming goods. Additionally, we referred to the opinions from the CISG Advisory Council, the draft of the KCA amendment, and related precedents, mainly focusing on the existence and severity of defects, reasonableness, and timely notice and requests as the major requirements for substitute delivery. Findings - The results of this study can be summarized as follows: First, the CISG provides more detailed requirements about the right to require delivery of substitute goods; by contrast, the KCA does not stipulate any such requirement. Thus, specific requirements for substitute delivery should be included when amending the KCA. Second, the CISG attempts to minimize overlapping and conflict with other remedies by specifying detailed requirements for the delivery of substitutes. Third, both the CISG and KCA require reasonableness for substitute delivery. Originality/value - Although there are no explicit legal requirements for substitute delivery under the KCA, there has been relatively little discussion of this issue to date. Therefore, the findings of our study can guide future revisions of the KCA to fill this loophole. Moreover, the recently released CISG Advisory Council opinion that clarifies the continuing confusion and debate, can help distinguish which remedy is suitable for a particular case. It may provide practical advice for businesspeople in international trade as well as legal implications for the future development of the KCA.

• Journal of Periodontal and Implant Science
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• v.53 no.4
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• pp.306-317
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• 2023

Purpose: Biphasic calcium phosphate (BCP), a widely used biomaterial for bone regeneration, contains synthetic hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), the ratio of which can be adjusted to modulate the rate of degradation. The aim of this study was to evaluate the clinical and radiographic benefits of reconstructing peri-implant bone defects with a newly developed BCP consisting of 60% β-TCP and 40% HA compared to demineralized bovine bone mineral (DBBM). Methods: This prospective, multicenter, parallel, single-blind randomized controlled trial was conducted at the periodontology departments of 3 different dental hospitals. Changes in clinical (defect width and height) and radiographic (augmented horizontal bone thickness) parameters were measured between implant surgery with guided bone regeneration (GBR) and re-entry surgery. Postoperative discomfort (severity and duration of pain and swelling) and early soft-tissue wound healing (dehiscence and inflammation) were also assessed. Data were compared between the BCP (test) and DBBM (control) groups using the independent t-test and the χ² test. Results: Of the 53 cases included, 27 were in the test group and 26 were in the control group. After a healing period of 18 weeks, the full and mean resolution of buccal dehiscence defects were 59.3% (n=16) and 71.3% in the test group and 42.3% (n=11) and 57.9% in the control group, respectively. There were no significant differences between the groups in terms of the change in mean horizontal bone augmentation (test group: -0.50±0.66 mm vs. control groups: -0.66±0.83 mm, P=0.133), postoperative discomfort, or early wound healing. No adverse or fatal complications occurred in either group. Conclusions: The GBR procedure with the newly developed BCP showed favorable clinical, radiographic, postoperative discomfort-related, and early wound healing outcomes for peri-implant dehiscence defects that were similar to those for DBBM.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.40-48
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• 2009

Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.29-35
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• 2014

Introduction: Persistent vesicoureteral reflux (VUR), a major cause of urinary tract infection (UTI) in children, can result in serious renal complications, such as reflux nephropathy and chronic renal failure. We evaluated the clinical characteristics and prognostic factors of VUR. Methods: From December 1993 to May 2011, we examined 117 children with vesicoureteral reflux who were admitted to the Department of Pediatrics and Urology, Chungbuk National University hospital for a UTI. The patients were managed medically or surgically. Results: Male patients had a slightly higher prevalence of VUR than female patients (55%). The degrees of the 161 refluxing ureters, as classified by the International Reflux Study Committee, were as follows: grade I, 15 ureters; grade II, 32 ureters; grade III, 54 ureters; grade IV, 26 ureters; grade V, 34 ureters. One hundred and sixty-one renal units (115 cases) underwent a 99m TC-DMSA renal scan, and 62% showed abnormal findings. The incidence of renal cortical defects showed a direct correlation with the severity of VUR. Ninety-four refluxing ureters were followed up medically, and 66 ureters (67%) either disappeared or improved. However, 9 refluxing ureters persisted. The spontaneous resolution rate of VUR seemed to be higher in younger patients with lower grades of reflux, and without renal cortical defects. Sixty-seven refluxing ureters (41%) were treated surgically, 62 refluxing ureters (92%) disappeared, and 5 refluxing ureters (8%) persisted. Conclusion: The incidence of renal cortical defects in patients with UTIs was 62% (in a 99m TC-DMSA renal scan), and showed a direct correlation with the severity of VUR. The spontaneous resolution rate seemed to be lower in the patients with higher grades of VUR, older age (over 4 years old) and diffuse renal cortical defects.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.380-391
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• 2010

Purpose : Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients. Methods : On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients. Results : During the winter season, RSV caused 20-0% of LRI admissions in children. In patients with completely repaired simple left to right (L-R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L-R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course. Conclusion : To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.