Hybrid Treatment for Thoracic Aortic Aneurysm Combined with Aberrant Right Subclavian Artery

An aberrant right subclavian artery (ARSA) is the most common vascular abnormality of the aortic arch and is associated with development of aneurysms in 3-8% of these anomalies. In this case report, we describe an 84-year-old man with a symptomatic ARSA treated with staged hybrid procedure combining surgical replacement of the ascending aorta and bilateral carotid-to-subclavian artery bypass with implantation of a stent graft in the aortic arch and descending aorta. Our case suggests that a less invasive hybrid therapy can be performed successfully for the treatment of ARSA with aneurysmal change in patients at high surgical risk.

The Effect of Seed-borne Mycoflora from Sorghum and Foxtail Millet Seeds on Germination and Disease Transmission

The seed-borne mycoflora of sorghum and foxtail millet collected from different growing areas in South Korea were isolated and taxonomically identified using dry inspection, standard blotter and the agar plate method. We investigated the in vitro and in vivo germination rates of disinfected and non-disinfected seeds of sorghum and foxtail millet using sterilized and unsterilized soil. The percent recovery of seed-borne mycoflora from the seed components of sorghum and foxtail millet seeds was determined and an infection experiment using the dominant species was evaluated for seedling emergence and mortality. A higher number of seed-borne fungi was observed in sorghum compared to that of foxtail millet. Eighteen fungal genera with 34 fungal species were identified from the seeds of sorghum and 13 genera with 22 species were identified from the seeds of foxtail millet. Five dominant species such as Alternaria alternata, Aspergillus flavus, Curvularia lunata, Fusarium moniliforme and Phoma sp. were recorded as seed-borne mycoflora in sorghum and 4 dominant species (Alternaria alternata, Aspergillus flavus, Curvularia lunata, Fusarium moniliforme) were observed in foxtail millet. The in vitro and in vivo germination rates were higher using disinfected seeds and sterilized soil. More seed-borne fungi were recovered from the pericarp compared to the endosperm and seed embryo. The percent recovery of seed-borne fungi ranged from 2.22% to 60.0%, and Alternaria alternata, Curvularia lunata and 4 species of Fusarium were isolated from the endosperm and embryo of sorghum and foxtail millet. Inoculation of the dominant seed-borne fungi showed considerable mortality of seedlings. All the transmitted seed-borne fungi might well be a primary source of infection of sorghum and foxtail millet crops.

Analysis on correlation between bone strength by FEA, micro-CT parameters and bone mineral density / 대한구강악안면방사선학회지

PURPOSE: Bone mineral density (BMD) and bone microarchitecture are important determinants for bone strength. Recently micro-CT have provided possibilities for measuring a variety of structural indices to characterize bone microarchitecture. The objective of this study was to compare the BMD and micro-CT parameters with Young's modulus calculated by finite element analysis (FEA) for the evaluation of bone strength. MATERIALS AND METHODS: Bone specimens were obtained from the 18 female rabbits aged 16 weeks. Of those, 36 samples (right and left femur) were selected for 3D micro-CT analysis (ANTTM, SKYSCAN, Belgium) and BMD by PIXImus 2 (GE Lunar Co. USA). Five microstructural parameters of micro-CT, such as trabecular thickness (Tb.Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI) and degree of anisotropy (DOA) were studied. Young's modulus was obtained by software program (ANSYS 9.0, ANSYS Inc, Canonsburg, PA) based on micro-CT three dimensional images. RESULTS: Young's modulus assessed by FEA correlated significantly with Tb.Th, BV/TV, BS/BV and SMI respectively. Young's modulus showed higher correlation with these microstructural parameters of micro-CT than BMD. Microstructural parameters except DOA showed significant correlations within the examined group. CONCLUSION: The microarchitectural parameters of micro-CT and BMD represented some informations in the evaluation of bone strength assessed by FEA.

Relationship of bony trabecular characteristics and age to bone mass / 대한구강악안면방사선학회지

PURPOSE: Bony strength is dependent on bone mass and bony structure. So this study was designed to investigate the relationship between the bone mass and bony trabecular characteristics. SUBJECTS AND METHODS: Study subjects were 51 females (average age 68.6 years) and 20 males (average age 66.4 years). Bone mineral density (BMD, grams/cm2) of proximal femur was measured by a dual energy X-ray absorptiometry (DEXA). Regions of interest (ROIs) were selected from the digitized radiographs of proximal femur. A customized computer program processed morphologic operations (MO) of ROIs. 44 skeletal variables of MO were calculated from ROIs on the Ward's triangle and greater trochanter of femur. WHO BMD classes were predicted by MO variables of the same ROI. Classification and Regression Tree analysis was used for calculating weighted kappa values, sensitivity and specificity of MO. RESULTS: The discriminating factors of morphologic operation were branch point, branch point [per cm sq]. Age also played important role in distinguishing osteoporotic classes. The sensitivity of MO at Ward's triangle and Greater Trochanter was 91.8%, 65.6%, respectively. The specificity of MO was 100% at Ward's triangle and Greater Trochanter. CONCLUSION: Bony trabecular characteristics obtained using radiological bone morphometric analysis seem to be related to bone mass.

Diagnostic accuracy of Insight intraoral film on dental caries / 대한구강악안면방사선학회지

PURPOSE: To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. MATERIALS AND METHODS: Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. RESULTS: The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97, 0.95, 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). CONCLUSION: Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films.

Bony ankylosis of temporomandibular joint / 대한구강악안면방사선학회지

Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

Arterry Bypas Graft with the Right Gastroepiploic Artery: Clinical and Angiographic Short-Term Results / 대한흉부외과학회지

BACKGROUND: The right gastroepiploic artery(RGEA) has been use in coronary artery bypass grafting from 1987. The RGEA is the most useful arterial conduit in coronary artery bypass grafting(CABG) followed by the internal mammary artery, MATERIALS AND METHOD: From Septermber 1998 to February 1999 the RGEA was used for coronary artery bypass grafting in 11 patients 10 males and 1 female. Postoperative angiography was performed in all of the patients before discharge RESULT: Early patent rate of the RGEA was 100%. The flow competition of the REGA graft was seen in 4 patients(36.4%) The flow pattern war RGEA dependent type in the inner diameter of the recipient coronary artery 1.5 mm the inner diameter of the RGEA 2.5 mm and the rtio of inner diameter of the RGEA and the recipient coronary artery 1(p<0.05) CONCLUSION: Early results of CABG with RGEA was satisfactory. However the RGEA graft has a tendency of flow competition in relation to the inner diameter of graft. Preoperative angiographic evaluation for RGEA and meticulous operative technique are required for a good surgical results.

Postinfarction Left Ventricular Free Wall Rupture / 대한흉부외과학회지

Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.