• Journal of Chest Surgery
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• 제23권6호
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• pp.1118-1127
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• 1990

Arterial switch operation for repair of nineteen cases of transposition of the great arteries associated with ventricular septal defect and three cases with double outlet right ventricle with subpulmonary ventricular septal defect[Taussig-Bing type DORV] was performed from November 1987 to September 1990 at the Seoul National University Children`s Hospital. Sixteen of them were under six months of age, and three were under one year of age with body weight ranged from three to fourteen kilograms. Preoperative cardiac catheterization was done in eighteen patients, in which the pressure of the left ventricle was greater than 70% of the right ventricle in all but one. Patent ductus was associated in thirteen cases[68.4%] of TGA+VSD, and atrial septal defect or patent oval foramen was in sixteen cases. Four atrial septostomy, one modified Blalock- Taussig shunt, one pulmonary artery banding, one coarctoplasty using subclavian arterial flap, were perfomed before arterial switch operation. There were five hospital deaths, all in the. patients with transposition of the great arteries with ventricular septal defect[overall mortality rate 22.7%]. Lecompte Maneuver was used in all patients, and in all patient the U-shaped flap of coronary arteries were transposed to V-shaped cleavage created in the neoaorta. Arterial defect in the neopulmonary artery was covered with 0.0625% Glutaraldehyde fixed autogenous pericardium There have been no late deaths, Postoperative cardiac catheterization and angiocardiogram in four patients has revealed no stenosis in the neopulmonary artery or neoaorta with reasonable P[RV/LV], Anatomic correction for transposition and double outlet right ventricle with subpulmonary ventricular septal defect would seem to be a good operative alternative to intraatrial switch procedures, with the advantage of incorporating the left ventricle to systemic circulation.

• Journal of Chest Surgery
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• 제49권3호
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• pp.195-198
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• 2016

We report a 72-year-old male with known myelodysplastic syndrome who presented to the emergency department with a 7-day history of fever and dyspnea. Echocardiography revealed a round echogenic mass $13{\times}16mm$ in size attached to the atrial side of the tricuspid valve. Considering the high risk of infective endocarditis in the patient with a low absolute neutrophil count ($130/mm^3$), emergency surgery was performed. Intraoperatively, a single gelatinous neoplasm was resected, and subsequent reconstruction of the involved leaflet was accomplished using autologous pericardium. The tumor was pathologically confirmed as papillary fibroelastoma with no evidence of infective endocarditis. Papillary fibroelastoma is a rare cardiac neoplasm that occurs in either the mitral or aortic valves. Interestingly, a few cases of tricuspid valve papillary fibroelastoma have been reported so far. Similar echocardiographic findings between vegetation and tricuspid valve neoplasm make it difficult to distinguish these two disease entities.

• Journal of Chest Surgery
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• 제45권6호
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• pp.368-379
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• 2012

Background: Bioprostheses for cardiovascular surgery have limitations in their use following as calicification. ${\alpha}$-galactosidase epitope is known as a stimulant of immune response and then shows a progressing calcification. The objective of this study was to evaluate histologic characteristics and mechanical properties of decellularization and treated with ${\alpha}$-galactosidase. Materials and Methods: Bovine pericardial tissues were allocated into three groups: fixation only with glutaraldehyde, decellularization with sodium dodesyl sulfate and decellularization plus treatment with ${\alpha}$-galactosidase. We confirmed immunohistological characteristics and mechanical properties as fatigue test, permeability test, compliance test, tensile strength (strain) test and thermal stability test. Results: Decellularization and elimination of ${\alpha}$-gal were confirmed through immunohistologic findings. Decellularization had decreased mechanical properties compared to fixation only group in permeability (before fatigue test p=0.02, after fatigue test p=0.034), compliance (after fatigue test p=0.041), and tensile strength test (p=0.00). The group of decellularization plus treatment with ${\alpha}$-galactosidase had less desirable mechanical properties than the group of decellularization in concerns of permeability (before fatigue test p=0.043) and strain test (p=0.001). Conclusion: Favorable decellularization and elimination of ${\alpha}$-gal were obtained in this study through immunohistologic findings. However, those treatment including decellularization and elimination of ${\alpha}$-gal implied the decreased mechanical properties in specific ways. We need more study to complete appropriate bioprosthesis with decellularization and elimination of ${\alpha}$-gal including favorable mechanical properties too.

• Journal of Chest Surgery
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• 제47권5호
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• pp.483-486
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• 2014

A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

• Journal of Haehwa Medicine
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• 제14권2호
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• pp.159-169
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• 2005

Objectives and methods: We investigated 17 books to study symptoms, pathology and acupuncture & moxibustion treatment of Hu-Ro(fatigue). Results and Conclusions: 1. The symptoms of Hu-Ro are the deafness, the amblyopia, the mass of sweat, the stiff joint, etc. There are also symptoms such as the fever of palm and legs, avoiding cold temperature in the afternoon, the fever during night time, the stomach fullness and diarrhea, the powerlessness of limbs, red colored urine. 3. The representing pathological mechanisms of Hu-Ro are Yang-deficiency(陽虛), Yin-deficiency(陰虛), Energy(Qi)-deficiency(氣虛), Blood(Hyul)-deficiency(血虛). The other pathological mechanisms are deficiency of Liver, Heart, Spleen, Lung, Kidney and the basic Energy. 4. The fundamental treatment of Hu-Ro is "warming on worned ones(勞者溫之), supplying on damaged ones(損者益之), strengthening the weakened ones(虛卽補之)" as basis and also supplying blood with fostering spleen(養血建脾) and droping fever with clearing the clogged(降火淸鬱). 5. The meridians that could be used in acupuncture and moxibustion treatment application of Hu-Ro are the urinary bladder meridian, the conception vessel meridian(任脈), governor channel meridian(督脈), kidney meridian(腎經), liver meridian, heart meridian, spleen meridian, lung meridian, stomach meridian, small intestine meridian, gall bladder meridian, pericardium meridian and triple-warmer meridian in order of frequently refered. 6. The meridian points that could be used in acupuncture and moxibustion treatment application of Hu-Ro are Joksamni (足三里:25times), Sinsu(腎兪:20回), Bisu(脾兪:19回), Pyesu(肺兪:18回), Qihye(氣海:17回), Gohwang(膏肓:15回), Kwanwon(關元:14回), Sameumgyo(三陰交:13回), Eumgeuk(陰郄:12回), Daechu(大樞:12回), Sinmun(神門:11回), Simsu(心兪:11回), Nyegwan(內關:10回), Jungwan(中脘:10回) in order of frequently refered.

• Journal of Haehwa Medicine
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• 제20권1호
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• pp.1-10
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• 2011

By studying the portions and layers(分部), left and right, superior and inferior, location of yin and yang, and beginning and end of diseases of skin, which is the core point of the theory of cutaneous region(皮部論) in "Naejing(內經)", in the physiological and pathological perspective, based on opinion of historic memorial doctors, arrived to the conclusion as below. Cutaneous region means not only the distribution of three yin and three yang(三陰三陽) of the surface, but also inside and outside, shallowness and depth, and it is the system which unites meridians, networks, and vessels. It is divided into portions and layers. The origin and beginning of diseases and the rule of favorable pattern and unfavorable pattern can be known through it. The portion of skin is not only the area that meridian vessels belongs to skin, but also the area that activation of twelve meridian vessels are expressed in the surface. The layer of skin is consisted in order of skin-tertiary collateral vessel-collateral vessel-meridian vessel-bone. In "Naejing", there are two preconditions to divide three yin and three yang into yin and yang. The first is standing while looking the south, and second is the quotation "outside is side of yang(外者爲陽 內者爲陰)." According to this preconditions, yang of outside of yang brightness, lesser yang, and greater yang is the whole body, except inside of hand and foot which yin of lesser yin, pericardium, and greater yin. Superior and inferior of the portions and the layers is designated as hand and foot, theological basis of which superior and inferior work in same diagnostic method can be found in the root and the basis(標本) and the origin and the insertion(根結). In conclusion, cutaneous region not only manages layer of the skin, but also it is divided into layers and portions, so it has close relations between meridian vessels and collateral vessels. The in-depth study of cutaneous region and meridians should be progress, in order to practice of diagnosis and acupuncture and moxibustion more.

• Journal of Chest Surgery
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• 제29권3호
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.297-301
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• 2015

Malignant mesothelioma is a rare malignant neoplasm that arises from mesothelial surfaces of the pleural cavity, peritoneal cavity, tunica vaginalis, or pericardium. Typically, pleural fluid cytology or closed pleural biopsy, surgical intervention (video thoracoscopic biopsy or open thoracotomy) is conducted to obtain pleural tissue specimens. However, endobronchial lesions are rarely seen and cases diagnosed from bronchoscopic biopsy are also rarely reported. We reported the case of a 77-year-old male who was diagnosed as malignant mesothelioma on bronchoscopic biopsy from obstructing masses of the endobronchial lesion.

• Journal of the Korean Institute of Oriental Medical Informatics
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• 제18권1호
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• pp.64-77
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• 2012

Donguibogam, Korea's cultural heritage and traditional Oriental medicine book listed in the World Heritage three years ago, is indeed great in its importance and value. Korea's posterity has sought treatment methods through the medical book and their researches on that book have continued. However, it is rare to make the concrete analysis on the medicines for prescriptions recorded in the book. In this study, we reviewed "Ears" in the Section "Bodily Appearance" among the five chapters of Donguibogam, and analyzed the 55 types of prescriptions for ear diseases, the medical characteristics, tastes, prime classification of medical herbs, and acupunctural effects, and the dosage forms depending on prescriptions. For insect-entering ear diseases and 20 kinds of a single-medicine prescription also, the treatments are presented in the book, but we presented the texts only and excluded them in the analysis. We also excluded overlapping prescriptions and adding and reducing prescriptions of the 55 prescriptions, and thus classified the left 42 proscriptions by dosage form. As a result: 1. With respect to medical characteristics, the medicine with warm characteristics reached 9 types(40.9%), the highest rate, followed by the medicine with cold characteristics 8 types (36.4%). 2. Concerning medical tastes, the medicine with bitter taste included 12 types (54.5%), the medicine with sour taste 10 types (45.5%), and the medicine with sweet taste 7 types (31.8%). It was unusual that of the 22 medicines used for multipurpose, no medicine with the taste was found. 3. For the acupunctural effects, the medicine with acupuncture effects for spleen medirian reached 12 types in total (54.5%). On the contrary, the medicine with the effects for pericardium meridian reached only one (4.5%) among the total of 22 medicines. 4. In the dosage form of 42 prescriptions, powder medicine was 15 types (35.7%), and decoction medicine was 14 (33.3%). Powder, dedoction, and pill medicines accounted for 90.4% of the total medicine type. It was found that in particular, for ear diseases powder medicine was used more frequently than decoction medicine.

• Journal of Periodontal and Implant Science
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• 제46권5호
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• pp.291-302
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• 2016

Purpose: The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Methods: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Results: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. Conclusions: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.