• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.480-484
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• 2007

Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.613-618
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• 2005

Background : Recently, medical treatment of multi-drug resistant pulmonary tuberculosis has been unsuccessful. Through analyzing the cases with surgical treatment, we hope to provide some help in treating multi-drug resistant pulmonary tuberculosis in the future. Material and Method : A retrospective review was performed with 138cases of surgical treatment of multi-drug resistant tuberculosis during 10years from January 1994 to December 2003 at National Masan Hospital. Results : The ratio of men to women, 5.1:1 indicates that there were more incidences in men. The number of the resistant drugs was 5.3 with a mean age of 42.6 years. Cavitary lesions on the plain chest X-rays were seen in 94cases (68.1%). 128cases had positive sputum culture preoperatively. Types of operations were 24 pnemonectomies, 83 lobectomies, 10 bilobectomies, 19 lobectomies with segmentectomies or wedge resections, 1 wedge resection, and 1 carvenoplasty. There was no death after operation. There were 6cases of air leakage over a week, 6cases of postoperative bleeding, 8cases of bronchopleural fistula and empyema, 16cases of dead space, 1case of atelectasis, 1case of wound infection, 1case of cyst as postoperative complication. Postoperative complication showed higher long-term negative conversion rate of 92.8%. Conclusion : There has been many discussions about operative indications, postoperative drug regimens, length of postoperative chemotherapy. In our study, we showed higher long-term success rate of postoperative chemotherapy with pulmonary resection on multi-drug resistant pulmonary tuberculosis.

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.193-199
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• 2007

Purpose: Combined resection of an invaded organ in advanced gastric cancer (AGC) with infiltration of adjacent organs is essential to achieve R0 resection. However, when the tumor invades the head of the pancreas or duodenum, R0 resection interferes with the lower resectability and results in a higher morbidity. Wereviewed these cases retrospectively and considered the proper extent of the surgical resection. Materials and Methods: We retrospectively analyzed cases where patients underwent surgery for gastric adenocarcinoma at the Department of Surgery, Presbyterian Medical Center, between January 1998 and December 2003. Among the 45 patients who were suspected to have pancreatic head or duodenum invasion by a primary tumor or metastatic lymph nodes based on the operative findings, we included 22 patients without incurable factors. The patients were classified into three groups: 4 patients that underwent a combined resection (PD group), 12 patients that underwent a palliative subtotal gastrectomy (STG group) and 6 patients that underwent bypass surgery only (GJ group). We analyzed the clinicopathological features, operative data and results. Results: The patients of the PD group achieved R0 resection by PD with D3 Dissection in all Patients. A pancreatic fistula was observed in one patient (morbidity 25%). There was no surgery-associated mortality (mortality 0%). All patients of the PD group were in stage IV. However, the 2-year survival rate (SR) was 75% and the 5-year SR was 50%. Six patients of the STG group underwent surgery with marginal resection and the other six patients of the STG group had a positive distal resection margin. The 2-year SR was 41.7% and the 5-year SR was 16.7%. Most of the patients of group GJ were of old age (mean age: $72.7{\pm}8.6$ years) or had chronic diseases. The 2-year SR was 0%. Conclusion: Combined resection of the pancreas and duodenum in AGC with pancreatic head invasion is relatively safe with moderate morbidity and a lower mortality. One can expect long-term survival if combined resectionis performed in cases without incurable factors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.147-156
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• 2007

Purpose: Any battery impacted in the esophagus must be removed urgently because of the possibility of serious complications such as perforation, fistula, and mediastinitis. The use of endoscopic procedures was compared to find the most rapid, effective, and safe method to remove disk batteries. Methods: The cases of 24 children (9 males, mean age, 1.5 years) that had accidentally ingested disk batteries were reviewed. The patients had visited the Department of Pediatrics, Kyungpook National University Hospital from July 1997 to June 2007 for the removal of disk batteries. Endoscopic removal was attempted using a retrieval net or a magnetic extractor with a balloon (condom). The procedure times for removing the ingested battery were compared. Results: Children that ingested batteries with a larger diameter (20 mm) had a greater chance to have esophageal impaction with serious injury, such as esophageal mucosal necrosis or ulcers, as compared to the ingestion of smaller diameter batteries (10 mm) (p<0.01). Endoscopic removal of disk batteries was attempted either using a retrieval net in 10 children or by using a magnetic extractor with a balloon in 6 children. Endoscopic removal using a retrieval net was more effective (mean procedure time: 1.5 min) as compared to using a magnetic extractor with a balloon (mean procedure time: 3.3 min) (p<0.05). Conclusion: Both procedures, either using a retrieval net or a magnetic extractor with a balloon were effective in removing ingested disk batteries. Based on our experience, an endoscopic procedure using a retrieval net was a more effective method for foreign body removal.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.49-62
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• 2020

Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.4
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• pp.464-469
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• 2000

Experiments were conducted to determine the effects of soybean meal (SBM) as a source of protein and sago meal (SM) as a source of carbohydrate on in situ and in vivo digestibility of dietary components in four male goats (Kambing Katjang) and four male sheep (Malin) weighing 25-35 kg. Rumen volume, as well as rumen fluid dilution rate were also determined. The animals were housed in single pens with individual feeding and drinking troughs and each animal was fitted with a rumen fistula. They were fed two diets : chopped rice straw+200 g soybean meal (SBM), and chopped rice straw+190 g soybean meal+300 g sago meal (SBM+SM). Rice straw was offered ad libitum. The supplements were isonitrogenous (80 g crude protein/animal/d), but the proportions of dry matter (DM), organic matter (OM), crude fibre (CF), neutral detergent fibre (NDF) and acid detergent fibre (ADF) were lower in the SBM supplement (191, 165, 11, 40, 15 g/animal/d for DM, OM, CF, NDF and ADF, respectively) than in the SBM+SM supplement (445, 423, 25, 102, 38 g/animal/d for DM, OM, CF, NDF and ADF, respectively). Two animals from each species were fed either supplement in a cross-over design in two periods. Each period lasted for four weeks. In situ and in vivo digestibility studies were carried out, followed by the determination of rumen volume and rumen fluid dilution rate. The results showed that straw DM and total DM intakes of goats (average of $48.7g/kg\;W^{0.75}$, $72.7g/kg\;W^{0.75}$, respectively) were significantly (p<0.01) higher than sheep (average of $3.56g/kg\;W^{0.75}$, $61.6g/kg\;W^{0.75}$, respectively), but OM, N and GE intakes were not significantly different between the two animal species. When the effect of supplements was compared, animals fed SBM+SM supplement had significantly (p<0.001) higher DM, OM and GE intakes than animals fed SBM supplement. Potential degradabilities of rice straw DM were significantly (p<0.01) higher in goats (average of 48.8%) than in sheep (average of 46.1 %). The supplements had no significant effect on the potential degradabilities of DM, OM and NDF, but they had a significant (p<0.05) effect on the degradation rates of DM and NDF. The addition of sago meal in the diet reduced the degradation rates of DM and NDF of rice straw in the rumen. Potential degradability of DM of soybean meal was not significantly different between animal species as well as between supplements. Sago meal was highly degradable. At 24 h of incubation in the rumen, 90-95% of DM loss was observed. There was a significant interaction between animal species and supplements in the in vivo digestibility of ADF and GE. In animals fed SBM supplement, the in vivo digestibility of ADF was significantly (p<0.05) higher in goats ($50.6{\pm}4.22%$) than in sheep ($44.4{\pm}3.21%$), but digestibility of GE was significantly (p<0.05) higher in sheep ($70.2{\pm}1.93%$) than in goats ($63.0{\pm}3.07%$). The digestibility values of CP and OM were significantly (p<0.05) higher in sheep when compared to goats. Animals fed SBM+SM supplement showed significantly (p<0.05) higher DM and OM digestibility values than animals fed SBM supplement, but digestibility values of CP were significantly (p<0.05) higher in animals fed SBM supplement. Differences in in vivo digestibility values of CF and NDF were not significantly different between animal species or supplements. Water intake, rumen volume ($1/kg\;W^{0.75}$), rumen fluid dilution rate and mean retention time were similar between the two animal species. However, rumen fluid dilution rate and mean retention time was significantly (p<0.01) affected by supplements. Animals fed SBM+SM had faster rumen fluid dilution rate and consequently shorter mean retention time.

• Journal of Chest Surgery
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• v.35 no.7
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• pp.542-547
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• 2002

Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

• Journal of Gastric Cancer
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• v.7 no.2
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• pp.74-81
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• 2007

Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.

• Korean Journal of Animal Reproduction
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• v.25 no.3
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• pp.207-217
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• 2001

Diagnosis and treatment of major reproductive failures were carried out for 836 dairy cows of 12 farms in Kimje area from May 1999 to May 2000. Reproductive failures were classified into four categories: uterine diseases, ovarian diseases, combination of uterine and ovarian diseases, and anestrus with corpus luteum (CL), based on the diagnosis by both rectal palpation and ultrasonography (SA 600, Medison, 5.OMHz transducer). 1. Of 102 cows examined, 15 cows were diagnosed as pregnant. Cows with real reproductive failures were therefore 87 cows and the rate of reproductive failures far all the cows of 12 farms was 10.4% (87/836). 2. Of 57 cows with reproductive failures, the cows with uterine diseases were 33 heads (37.9%), with ovarian diseases: 30 heads (34.5%), with combination form: 16 heads (18.4%), and with anestrus with CL: 8 heads (9.2%). 3. Of 87 cows with reproductive failures, 7 cows were slaughtered and 80 cows were treated by hormone or douche. The cows expressed estrus were 74 cows (92.5%, 74/80 heads) and 56 cows were pregnant (70.0%, 56/80 heads) following treatment. 4. The reproductive failures tended to be increased as the period proceeded from 30 days (2.3%, 2/87 heads) to over 120 days (56.3%, 49/87 heads) after parturition. 5. Associated other diseases to reproductive failures were foot diseases(5 cows), joint diseases (5 heads), urovagina (6 heads), and rectovaginal fistula (2 cows) and the rate of occurrence of associated diseases was 20.7% (18/87 heads). 6. No reproductive record was used in 7 farms of 12 farms and 5 farms had no play ground or not used for the cows. These results indicated that diagnosis fur reproductive failures by rectal palpation along with ultrasonography was more accurate than the conventional rectal palpation and brought better result of treatment for major types of reproductive failures. It was also indicated that non-uses of reproductive record and play ground were also important factors in occurrence of reproductive failures.

• Journal of Animal Science and Technology
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• v.49 no.6
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• pp.801-818
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• 2007

This study was carried out to determine the effects of processing methods of barley as a proper source of grain in diets of Hanwoo on fermentation pattern in the rumen fluid and digestibility of the diets, the growth performance and carcass characteristics of Hanwoo. The degree of ruminal pH change in the cows fed diets of the Corn(corn basis) and GDRB(ground and dry-rolled barley) tended to be greater than those in the cows fed other two diets (ground barley, GB and dry-rolled barley, DRB). The diet of GDRB showed the lowest ruminal pH(5.5), indicating the rapid degradation of the diet in the rumen. Although ammonia concentration was not affected by diet, the GR and DBR diets maintained the low concentrations of ruminal ammonia compared with other two treatments. And the effects of feeding processed barley grain on body weight gain and meat quality of Hanwoo steers were as follows. Steers fed DRB diet had the highest body weight, 683.0kg at 28 months old, while those fed the GDRB showed the lowest body weight, 653.3kg. The average daily gain(ADG) was similar between the steers fed Corn and GR throughout the whole period, but the GDRB showed the lowest ADG. The steers fed the DRB showed the significant increase in ADG(0.89kg/d from 19 to 23 months old and 0.43kg/d from 24 to 28 months old) compared with those fed other diets. Feeding diets containing corn and/or barley did not influence live body weight, cold carcass weight, carcass yield, back-fat thickness and carcass grade of Hanwoo steers.