• Title/Summary/Keyword: rapid closure

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One Hundred Cases of Open Heart Surgery in 1977 (1977년도 년간 개심술 100례 보고)

  • 이영균
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.213-226
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    • 1978
  • One hundred cases of open heart surgery were done at this Department in 1977. There were 65 congenital anomaly and 35 acquired diseases. Out of 65 cases of congenital malformation 35 acyanotic and 30 cyanotic cases were found. Fifteen cases of ventricular septal defect and 29 tetralogy of Fallot were noted eight patients expired out of 65 congenital anomaly [12.3%] , 4 out of 35 acyanotic [11. 4%] and 4 among 30 cyanotic anomaly[13.3%]. Among 35 cases of acquired heart disease 3 atrial myxoma [2 left and one right] and 32 valvular lesions were noted. In two cases open mitral commissurotomy, and in 30 valve replacement were done. Twenty-two single valve and 8 double valve replacement were done. Seven patients expired out of 30 patients [23.3%]. Among 22 single valve replacement cases 2 and among 8 double valve 5 died. ~ In eighteen mitral valve replacement cases 2 deaths occurred. One mitral insufficiency patient who expired suffered from severe pulmonary` hypertension [PA=120/67mmHg], tricuspid insufficiency and a large ventricular septal defect. The patient underwent mitral valve replacement, tricuspid annuloplasty and patch closure of ventricular septal defect. Over all mortality rate for 100 open heart surgery cases was 15%. Since 1977 open heart surgery cases were done routinely in this institution and cases are increasing rapidly. With present rapid improvement of economical status and introduction of medical insurance system, open heart surgery will be firmly established in Korea in the very near future.

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Clinical Study of Prosthetic Heart Valve Replacement with CarboMedics. (CarboMEdics 기계판막을 이용한 심장판막 치환술의 임상 연구)

  • 장원기;구자홍;조중구;김공수
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.45-50
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    • 2000
  • Background: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75$\pm$9.74 years) Result: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06$\pm$10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombo-mbolism free rate at 36 months were 96.9% and 98.4% respectively. Consclusions: The CarboMedics valve stands for low valve related complicatons.

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RECONSTRUCTION OF INTRAORAL DEFECT WITH CERVICAL ISLAND FLAP (경부도상피판을 이용한 구강내 결손부의 재건 - 13증례분석)

  • Kim, Jong-Ryoul;Kang, Young-Ki;Seo, Jong-Cheon;Sung, Iel-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.212-216
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    • 2001
  • The cervical flap, comprising skin, fascia, and platysma muscle, has significant application in the head and neck region after radical ablative surgery for cancer of the oral cavity. The flap may be used for reconstruction of the cheek, floor of the mouth, and lateral side of the tongue. This flap minimizes donor morbidity by use of cervical operation wound and flap size available is adequate for most oral defects and the procedure is relatively simple and time-saving. However the flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We have used the cervical flap for its rapid, simple, and effective closure of oral defects after cancer ablation and found it is very useful for the reconstruction of relatively small oral defects.

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Internal Flow Analysis for a 10 inch Ball Valve using Flow Similarity (유동상사를 이용한 10인치 볼밸브 내부유동 분석)

  • LEE, SANG-MOON;JANG, CHOON-MAN
    • Transactions of the Korean hydrogen and new energy society
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    • v.26 no.4
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    • pp.386-392
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    • 2015
  • Flow characteristics inside a 10 inch ball valve have been analyzed using three-dimensional numerical analysis and experiments. Continuity and three-dimensional Reynolds-averaged Navier-Stokes equations have been used as governing equations for the numerical analysis. The numerical model has been constructed through the grid dependency test and validation with the results of experiments to ensure reliability and numerical effectiveness. The shear stress transport (SST) model has been used as the turbulence closure. The experimental test-rig has been constructed to measure pressure, temperature and flow rate along the pipeline. Some valve opening angles have been tested to evaluate the flow characteristics inside the ball valve and pipeline. The results show that the rapid pressure variations is observed while the valve opening angle decreases, which caused by flow separation at the downstream of the ball valve.

Metabolic Analysis of Poly(3-Hydroxybutyrate) Production by Recombinant Escherichia coli

  • WONG, HENG HO;RICHARD J. VAN WEGEN;JONG-IL CHOI;SANG YUP LEE
    • Journal of Microbiology and Biotechnology
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    • v.9 no.5
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    • pp.593-603
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    • 1999
  • Poly(3-hydroxybutyrate) (PHB) production by fermentation was examined under both restricted- and ample-oxygen supply conditions in a single fed-batch fermentation. Recombinant Escherichia coli transformed with the PHB production plasmid pSYLl07 was grown to reach high cell density (227 g/l dry cell weight) with a high PHB content (78% of dry cell weight), using a glucose-based minimal medium. A simple flux model containing 12 fluxes was developed and applied to the fermentation data. A superior closure (95%) of the carbon mass balance was achieved. When the data were put into use, the results demonstrated a surprisingly large excretion of formate and lactate. Even though periods of severe oxygen limitation coincided with rapid acetate and lactate excretion, PHB productivity and carbon utilization efficiency were not significantly impaired. These results are very positive in reducing oxygen demand in an industrial PHA fermentation without sacrificing its PHA productivity, thereby reducing overall production costs.

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CERVICAL ISLAND FLAP FOR INTRAORAL REPAIR (경부도상 피판을 이용한 구강내 결손부의 재건)

  • Kim, Jong-Ryoul;Seo, Jong-Cheon;Shin, Sang-Hoon;Lee, Seong-Geun;Yang, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.3
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    • pp.209-213
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    • 1995
  • Various cutaneous as well as myocutaneous flaps have been designed for the reconstruction of tissue defects caused by the excision of oral cancer. Among these flaps, cervical island skin flap have been introduced by Farr et al and more have developed by Tashiro et al. This flap has many advantages. The flap minimizes donor size by use of cervical operation wound, flap size available is adequate for most oral defects and the procedure is relatively simple and time saving. However, this flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We used this flap for it's rapid, simple, and effective, primary closure of oral defects after cancer ablation and we have found this flap very useful for the reconstruction of relatively small oral defects.

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Bleeding & Infection Control by the Circumferential Suture & Drainage on Active Bleeding Extraction Socket under Sedation And Local Anesthesia in a Multiple Medically Compromised Patient with Anticoagulation Drug (항응고제 투여중인 다발성 전신질환자에서 과도한 발치창 출혈부의 진정요법과 국소마취 시행하에 창상주위 봉합과 배농술 통한 출혈과 감염조절)

  • Yoo, Jae-Ha;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.2
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    • pp.177-182
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    • 2011
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

Loss of βPix Causes Defects in Early Embryonic Development, and Cell Spreading and Platelet-Derived Growth Factor-Induced Chemotaxis in Mouse Embryonic Fibroblasts

  • Kang, TaeIn;Lee, Seung Joon;Kwon, Younghee;Park, Dongeun
    • Molecules and Cells
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    • v.42 no.8
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    • pp.589-596
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    • 2019
  • ${\beta}Pix$ is a guanine nucleotide exchange factor for the Rho family small GTPases, Rac1 and Cdc42. It is known to regulate focal adhesion dynamics and cell migration. However, the in vivo role of ${\beta}Pix$ is currently not well understood. Here, we report the production and characterization of ${\beta}Pix$-KO mice. Loss of ${\beta}Pix$ results in embryonic lethality accompanied by abnormal developmental features, such as incomplete neural tube closure, impaired axial rotation, and failure of allantois-chorion fusion. We also generated ${\beta}Pix$-KO mouse embryonic fibroblasts (MEFs) to examine ${\beta}Pix$ function in mouse fibroblasts. ${\beta}Pix$-KO MEFs exhibit decreased Rac1 activity, and defects in cell spreading and platelet-derived growth factor (PDGF)-induced ruffle formation and chemotaxis. The average size of focal adhesions is increased in ${\beta}Pix$-KO MEFs. Interestingly, ${\beta}Pix$-KO MEFs showed increased motility in random migration and rapid wound healing with elevated levels of MLC2 phosphorylation. Taken together, our data demonstrate that ${\beta}Pix$ plays essential roles in early embryonic development, cell spreading, and cell migration in fibroblasts.

A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients

  • Kim, Ji Min;Tak, Min Sung;Kang, Jin Seok;Moon, Chul
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.287-292
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    • 2021
  • Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis. Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications. Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure. Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.

Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea (수학적 모델을 이용한 신종인플루엔자 환자 예측 및 대응 전략 평가)

  • Suh, Min-A;Lee, Jee-Hyun;Chi, Hye-Jin;Kim, Young-Keun;Kang, Dae-Yong;Hur, Nam-Wook;Ha, Kyung-Hwa;Lee, Dong-Han;Kim, Chang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.109-116
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    • 2010
  • Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.