• Conservation Science in Museum
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• v.26
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• pp.83-182
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• 2021

This study summarized the results of the conservation treatment and investigation on the production method of the golden crown (Treasure No. 339) excavated from Tomb No. 129 (also known as Seobongchong Tomb) in Noseo-dong, Gyeongju-si, Gyeongsangbuk-do Province. The golden crown from Seobongchong Tomb was discovered during the excavations conducted by the Museum of the Government-General of Korea in 1926 during the Japanese colonial era. It is currently in the collection of the National Museum of Korea. A total of six Silla golden crowns have survived in Korea, among which the crown from Seobongchong Tomb is the only example with a dome-shaped hemispherical decoration attached with a bird ornament while otherwise showing the typical features of Silla crowns. The crown had been repaired following its excavation using metallic materials and adhesives, but due to the partial deformation and damage brought about by the repair materials, it required further conservation treatment. This article describes in detail the overall process of the conservation treatment and the restoration of the original form of the golden crown from Seobongchong Tomb, particularly the method of reinforcing the joints to secure the stability of the crown. It presents the characteristics of the crown's production as revealed in the investigation during the conservation treatment, and further analyzes the relationship of this crown from Seobongchong Tomb with other Silla crowns through a comparison of their production techniques. The investigation revealed that the crown was primarily decorated with golden sequins at the time of its production. At a later point some of the sequins in the upright ornament were replaced with comma-shaped jade beads and additional comma-shaped jade beads were added to the headband. In order to determine if such modifications to the decoration had occurred with other Silla crowns, the decoration of the six extant Silla golden crowns were investigated. The crown from Cheonmachong Tomb features traces of this same modification to the decoration and possesses other similarities with the crown from Seobongchong Tomb.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.102-112
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• 2002

This study was undertaken to analyze the outcome of composite valve graftreplacement(CVGR) for the treatment of aneurysms of the ascending aorta involving the aortic root. Material and Method: Between April 1995 and June 2001, 56 patients had replacement of the ascending aorta and aortic root with a composite graft valve and were reviewed retrospectively. Aortic regurgitation was present in 50 patients(89%), Marfan's syndrome in 18 patients(32%), and bicuspid aortic valve in 7(12.5%). The indications for operation were annuloaortic ectasia(AAE) in 30 patients(53.6%), aortic dissection in 13(23.2%), aneurysms of the ascending aorta involving aortic root in 11(19.6%), and aortitis in 2(3.6%). Cardiogenic shock due to the aortic rupture was present in 2 patients. Nine patients(16%) had previous operations on the ascending aorta or open heart surgery. The operative techniques used for CVGR were the aortic button technique in 51 patients(91%), the modified Cabrol technique in 4, and the classic Bentall technique in 1. The concomitant procedures were aortic arch replacement in 24 patients(43%), coronary artery bypass graft in 8(14.3%), mitral valve repair in 2, redo mitral valve replacement in 1, and the others in 7 The mean time of circulatory arrest, total bypass, and aortic crossclamp were 21$\pm$14 minutes, 186$\pm$68 minutes, and 132$\pm$42 minutes, respectively. Result: Early mortality was 1.8%(1/56). The postoperative complications were left ventricular dysfunction in 16 patients(28.6%), reoperation for bleeding in 7(12.5%), pericardial effusion in 2, and the others in 7. Fifty-three patients out of 55 hospital survivors were followed up for a mean of 23.2 $\pm$ 18.7 months(1-75 months). There were two late deaths(3.8%) including one death due to the traumatic cerebral hemorrhage, and CVGR-related late mortality was 1.9%. The 1- and 6-year actuarial survival was 98.1$\pm$1.9% and 93.2$\pm$5.1%, respectively. Two patients required reoperation for complication of CYGR(3.8%) and two other patients required subsequent operations for dissection of the remaining thoracoabdominal aorta. The 1- and 6-year actuarial freedom from reoperation was 97.8$\pm$2.0% and 65.3$\pm$26.7%, respectively.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.37 no.4
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• pp.1-10
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• 2019

The purpose of this study is to examine the design ＆ construction methods of the traditional landscape space of the past and the repair and maintenance of cultural heritages to maintain it today. To this end, the method of narrative description, process extraction and construction related to traditional landscaping were compared to each other based on the 『Imwongyeongjeji』 「Seomyongji」 and 'Standard Specification for Repairing Cultural Heritages'. The results are as follows; First, to analyze at the description methods of the 『Imwongyeongjeji』 「Seomyongji」 and 'Standard Specification for Repairing Cultural Heritages' and related processes in the field of traditional landscaping. 『Imwongyeongjeji』 「Seomyongji」 was an encyclopedia of the overall construction method of the living space, describing the location, effect, and advantages and disadvantages of each component and presenting quantitative figures to institutionalize the construction of traditional landscaping spaces. 'Standard Specification for Repairing Cultural Heritages' presented the entire process of repairing cultural heritages, and it is becoming a kind of guide for reference at the site. Among them, foundation construction, roof construction, landscape construction, and fence construction were drawn as items that could be applied to traditional landscaping areas. Second, the traditional landscape space construction method was divided into the processes of foundation construction, roof construction, landscaping construction, and fence construction. Foundation construction is a way of repeating the process of land-tramping. During the construction of the roof, the tile-roofed building was built on top of the rafters and roofed with tiles. And thatched roof was made to a number of rice straws bundles to cover the roof one after the other. Instead of tiles, the stone roof was made of thin and wide stones, and the wooden boards were used for the single roof and the bark roof were constructed with many layers of dried corrugations. Landscape construction mainly consists of the Paving technique through tramping rubble and the construction of terraced flower by planting stone, plants, and shrubs on the top. According to the building materials, the wall construction was derived from the earth-stacked earthen wall, stone walls using stone and clay, marble walls made of tile patterns, and the construction of a board wall using a wood board as a wall. Third, comparing the construction methods of the 『Imwongyeongjeji』 「Seomyongji」 and 'Standard Specification for Repairing Cultural Heritages', 『Imwongyeongjeji』 「Seomyongji」 focuses on standardizing the construction methods to create a new traditional space. There is a difference in the setting of the scope of the 『Imwongyeongjeji』 「Seomyongji」 and the construction because 'Standard Specification for Repairing Cultural Heritages' provides the overall construction procedure considering the diversity of the cultural heritages. In addition, the traditional landscape space used to be a residential space in the past, but today, the maintenance process of the already established facilities as designated cultural heritages has been carried out, and construction methods have been added to create viewing conditions. In terms of the succession of traditional knowledge, some similar methods were found in the repair of cultural assets today, and some cases were also confirmed in the reconstruction of traditional technologies such as application of some materials or mix, separation of added facilities and introduction of efficient construction methods.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.28-33
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• 2009

Background: Functional tricuspid regurgitation (TR) greater than or equal to a mild grade requires tricuspid valvuloplasty, and tricuspid valvuloplasty with ring annuloplasty has shown good outcomes. We report here on our early experience with the Edwards $MC^3$ annuloplasty system (Edwards LifeSciences, Irvine, CA). Material and Method: From November 2004 to July 2006, 72 patients with tricuspid annular dilatation and TR underwent tricuspid valvuloplasty with using the Edwards $MC^3$ annuloplasty ring. Sixty-eight patients were operated on via median sternotomy and four patients were operated on using robotic assisted minimal invasive thoracotomy. The patient population included 21 males and 51 females and their mean age was $53.9{\pm}12.3$. The mean grade of TR, as assessed by the preoperative echocardiography, was $2.2{\pm}1.0$. The mean NYHA functional class was $3.1{\pm}0.8$. The mean left ventricular ejection fraction was $57.0{\pm}9.9$%. Result: The TR and NYHA functional class, as assessed by postoperative echocardiography, was significantly reduced (mean=$0.4{\pm}0.6$ and $2.0{\pm}0.7$, respectively p<0.001). There was one case of hospital mortality. One patient required permanent pacemaker insertion for third degree atrioventricular block. Conclusion: Our study shows that the Edwards $MC^3$ remodeling ring is easy to implant and it effectively corrects functional TR with excellent clinical and echocardiographic outcomes. Further follow-up and a larger clinical series are required to establish the long-term stability of this repair technique.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.568-572
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• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.368-372
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• 1999

Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.350-355
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• 2002

Background: Most of pulmonary regurgitation with or without stenosis appears to be well tolerated early after the repair of pulmonary outflow tract. However, it may result in symptomatic right ventricular dilatation, dysfunction and arrhythmias over a long period of time. We studied the early outcome of pulmonary valve replacement with tissue valves for patients with the above clinical features. Material and Method: Sixteen consecutive patients who underwent pulmonary valve replacement from September 1999 to February 2002 were reviewed(9 males and 7 females). The initial diagnoses included tetralogy of Fallot(n=11), and other congenital heart anomalies with pulmonary outflow obstruction(n=5). Carpentier-Edwards PERIMOUNT Pericardial Bioprostheses and Hancock porcine valves were used. The posterior two thirds of the bioprosthetic rim was placed on the native pulmonary valve annulus and the anterior one third was covered with a bovine pericardial patch. Preoperative pulmonary regurgitation was greater than moderate degree in 13 patients. Three patients had severe pulmonary stenosis. Tricuspid regurgitation was present in 12 patients. Result: Follow-up was complete with a mean duration of 15.8 $\pm$ 8.5months. There was no operative mortality. Cardiothoracic ratio was decreased from 66.0 $\pm$ 6.5% to 57.6 $\pm$ 4.5%(n=16, p=0.001). All patients remained in NYHA class I at the most recent follow-up (n=16, p=0.016). Pulmonary regurgitation was mild or absent in all patients. Tricuspid regurgitation was less than trivial in all patients. Conclusion: In this study we demonstrated that early pulmonary valve replacement for the residual pulmonary regurgitation with or without right ventricular dysfunction was a reasonal option. This technique led to reduce the heart size, decrease pulmonary regurgitation and tricuspid regurgitation as well as to improve the patients'functional status. However, a long term outcome should be cautiously investigated.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.597-603
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• 2009

Background: Atrioventricular valve regurgitation in pediatric patients with a functional single ventricles (FSV) - has been known as one of the important risk factors for death and unfavorable long-term results after a Fontan operation. We evaluated early and mid-term results of bivalvation valvuloplasty in FSV patients. Material and Method: We retrospectively evaluated 11 patients with a functional single ventricle who underwent bivalvationvalvuloplasty between 1999 and 2007. The degree of common atrioventricular valve regurgitation (CAVVR) was determined by color Doppler echocardiography (regurgitation grade scoring, trivial; 1, mild; 2, moderate; 3, severe; 4). Mean age at valve surgery was $6.9{\pm}7.0$ months (median 4 months, 24 days$\sim$21 months)and mean body weight was $6.2{\pm}2.8\;kg$ ($3.1{\sim}11.3\;kg$). Nine patients had isomerism heart and two of them had TAPVC. The concomitant procedures were performed in all but one patient. Additional commissural closure was performed in 3 patients and commissural annuloplasty in another 3 patients. Result: There was one hospital death after. surgery. A 32-day old patient who had been preoperatively dependent on a ventilator died of air way and lung problems 4.3 months after pulmonary artery banding and bivalvation valvuloplasty. Mean follow-up duration was 40 months ($4.3{\sim}114$ months). Mean preoperative CAVVR score was $3.3{\pm}0.6$, which decreased to $1.9{\pm}0.7$ postoperatively (p<0.0001). This residual regurgitation slightly increased to $2.2{\pm}0.4$ (no statistical significance) after a mean follow-up of 1.4.3 months. Six patients (60%) required re-operations for residual regurgitation at a subsequent bidirectionalcavopulmonary shunt or Fontan operation. One patient with Ebsteinoid malformation of the right sided atrioventricular valve required valve replacement due to stenoinsufficiency. Another patient required edge-to-edge repair at the right sided AV valve (between the right mural leaflet and the bridging leaflets). The remaining 4 patients required additional suture placements between bridging leaflets with or without commissural annuloplasty. All survivor had trivial or mild CAVVR at the latest follow-up. Conclusion: Bivalvation valvuloplasty for CAVVR in FSV patients is. an effective and safe procedure. However, significant numbers of the patients have small residual regurgitation and require additional valve procedures at subsequent operations. Long-term observations to monitor progression of the CAVVR is mandatory.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.490-498
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• 2010

Background: A hybrid procedure using an open surgical extra-anatomic bypass of aortic arch vessels and thoracic endovascular aortic repair (TEVAR) is less invasive than open surgery, and provides a suitable proximal landing zone. Here we report our experience with a hybrid TEVAR procedure at a single center. Material and Method: We retrospectively reviewed consecutive patients with thoracic aortic disease who received a hybrid TEVAR procedure between August 2008 and January 2010. Patients' data were prospectively collected and mean follow-up was $10.8{\pm}5.5$ months (range 3~20). Result: Nine patients (7 males and 2 females) with a mean age of $63.8{\pm}15.8$ years (range 38~84) underwent a hybrid procedure. Five patients had an arch or a proximal descending aortic aneurysm, two had a dissecting aneurysm of the descending aorta, and two had an aneurysm of the ascending arch and descending aorta. Mean expected mortality calculated by logistic EuroSCORE was 21%. Six patients underwent debranching and rerouting from ascending aorta to arch vessels, 2 had carotid-carotid bypass grafting, and 1 underwent carotid-axillary bypass grafting. Mean operation time was $221.4{\pm}84.0$ min (range 94~364). Deployment success of endovascular stent grafting was 100% with no endoleak on completion angiography. There was no mortality, and a small embolism in the branch of the right opthalmic artery in one patient. During follow-up, one intervention was required for the endoleak. Actuarial survival at 20 months was 100%. Conclusion: Early and mid-term results are encouraging and suggest that hybrid TEVAR procedures are less invasive and safer and represent an effective technique for treating thoracic aortic disease.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.14-21
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• 2009

Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.