• Journal of Chest Surgery
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• v.35 no.11
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• pp.779-784
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• 2002

Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F＝12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

• Proceedings of the Korean Aquaculture Society Conference
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• 2003.10a
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• pp.54-55
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• 2003

해수관상용으로 그 인기도가 높은 상어류는 모두가 자연에서 채집된 후 관람용 대형수조 또는 개인용 소형수조 내에서 순치 후 관상용으로 사육되고 있다. 그러나, 자연에서 채집된 대부분의 개체는 인위적인 수조 시설 내에서의 생활에 적응하는데 실패하여 결국 거의 대부분의 개체가 짧은 기간 내에 사망하게 된다. 따라서 이 연구는 인공 종묘 생산 시설에서 해수 관상용 상어류의 종묘 확보를 목적으로 실시하였다. 우리나라 제주 연안에서 채집이 비교적 용이한 까치상어 Triakis scyllium와 별상어 Cynias manazo 2종의 상어 친어를 확보하여 인공 사육 시설에서 사육하면서 수조 내에서의 자연 교미와 자연 산란에 성공하였다. 친어와 치상어의 사육관리는 자연해수를 사용하여 15~40ton 크기의 콘크리트 수조에서 사육하면서 전갱이와 같은 생사료 또는 전갱이와 어분을 주성분으로 하는 습사료를 만들어 1일 1회 급이하였다. 까치상어의 인공 종묘는 수 차례의 사산을 거듭한 끝에 2003년 5월 18일과 6월 8일 두 차례에 걸쳐서 매우 활력이 좋은 상태의 치어가 출산하였다. 별상어도 수 차례의 사산을 거듭한 끝에 2003년 5월 25일 건강한 상태의 치어를 출산시키는데 성공하였다. 지금까지 산출된 까치상어의 출산시 평균 전장은 25.70$\pm$0.88cm 평균 체중은 58.32$\pm$4.86g이었으며, 별상어의 출산시 치어의 평균 전장은 27.26$\pm$0.57cm였고 평균 체중은 55.32$\pm$1.69g로 두 종 상어의 평균 전장과 평균 체중은 유사한 경향을 보였다. 그러나, 산출 후 사육 관리 과정에서 관찰된 까치상어와 별상어의 월간 성장 중 전장을 비교한 결과, 까치상어는 1개월 전 대비 15.06%의 성장을 보였으나, 별상어는 3.15%의 성장을 보여 까치상어 보다는 별상어의 길이 성장이 느린 것을 알 수 있었다. 까치상어와 별상어의 월간 성장 중 체중을 비교한 결과에서도 까치상어는 1개월 전 대비 34.11%의 성장을 보였으나, 별상어는 2.25%의 성장을 보여 까치상어 보다는 별상어의 체중 성장이 매우 느린 것을 알 수 있었다. 출산 관리중인 까치상어와 별상어 치어의 성비를 조사한 결과, 까치상어는 ♀:♂=1:1.28, 별상어는 ♀:♂=1:2.50으로 별상어의 암 수 성비가 매우 불균형한 것을 알 수 있었다. 그리고 까치상어와 별상어의 암ㆍ수간 성장 차이를 조사한 결과, 까치상어와 별상어의 암ㆍ수간 성장 (전장, 체장 및 체중)에는 큰 차이가 없었다. 현재, 인공 사육 시설에서 관리중인 까치상어는 64마리이며 별상어는 7마리이다. 결국 소형의 수족관내에서 해수 관상어로서 사육하기 위한 조건으로서 너무 급격한 성장을 하는 어종인 경우에는 관상 기간이 짧아져 조기 폐기하여야 하는 단점을 감안하면 까치상어 보다는 별상어의 관상가치가 높을 것으로 판단되며, 반대로 대형 관람용 수족관의 경우에서는 별상어 보다 성장이 빠르고 운동력이 활발한 까치상어를 전시관람용으로 이용할 경우 전시효과가 높을 것으로 판단된다.

• The Hankook-Saengyark Bo
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• no.246
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• pp.5-5
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• 2001

약초 당근뿌리혹선충 방제(의성약초시험장 체계화) - 인삼 생력재배 시범사업 '관심' - 강원 우리꽃 새소득원 육성 - 복부자 수요급증 재배농 신바람

• Journal of Chest Surgery
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• v.33 no.11
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• pp.869-875
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• 2000

배경: 뇌혈관계 합병증은 관상동백우회술 후 발생하는 사망률 중 10% 이상을 차지하는 치명적인 질환이다. 최근들어 고령 환자, 고혈압, 당뇨병 등이 병발하고 고 위험군에 대한 수술이 증가하면서 뇌혈관계 합병증은 오히려 증가하고 있다. 본 연구는 관상동맥우회술을 받은 환자의 의무기록을 조사하여 관상동맥우회술 후 발생되는 뇌혈관계 질환의 위험 인자를 밝히고자 한다. 대상 및 방법: 1991년 3월부터 1999년 7월 사이에 관상동맥우회술을 받은 185명을 조사하여, 뇌혈관계 합병증의 위험 인자들을 통계적으로 검증하였다. 결과: 뇌혈관계 합병증의 유병율은 7.57%(14명)였으며 이중 5예는 사망하였다. 동 기간 중 전체 사망은 11예이므로 사망자의 45.5%가 뇌혈관계 합병증으로 사망한 것이다. 통계적의의가 있는 뇌혈관계 합병증 위험 인자로는 수술 후 부정맥(p=0.0064), 기왕의 뇌혈관계 병력(p=0.0090), 체외순환시간(p=0.0181), 대동맥의 동맥경화(p=0.03575) 및 당뇨병(p=0.0452) 등이었다. 경동맥협착이 동반되어 경동맥 혈관내막 절제술(carotid endarterectomy)을 동시에 시술한 경우는 2예였으나, 뇌혈관계 합병증은 발생하지 않았다. 75세 이상의 고령환자는 3명이었으며 모두 뇌혈관계 합병증은 발생하지 않았다. 결론: 관상동맥우회술 후 발생하는 뇌혈관계 질환과 통계적으로 유의한 위험요인은 수술 후 부정맥, 뇌혈관이상의 기왕력, 체외순환시간, 대동맥궁의 동맥경화, 당뇨 등이었다.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.343-350
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• 2023

Based on Lung CT Screening Reporting and Data System (Lung-RADS), which has been used to standardize reading for lung cancer screening since November 2016, the types and frequency of "S" modifier findings other than lung cancer were analyzed. As a result of this study, 360 cases (35.19%) of "S" modifier were found in 1,023 subjects, and the most frequent diseases were coronary calcification and emphysema, 145 (14.17%) of coronary calcification and 138 (13.49%) of emphysema, indicating that the discovery rate was very high compared to other findings. In addition, it was found to be highly associated with the duration of smoking, and in the case of coronary calcification, 9 cases (5.73%) were found in the non-smokers group A, 23 cases (11.44%) within 10 years of smoking, 39 cases (13.68%) in the C group within 20 years of smoking, and 31% of the E group over 30 years of smoking. In addition to coronary calcification and emphysema, abnormal findings of pneumonia, lung epilepsy, and mediastinal disease were also found to be p<0.05 as a result of the analysis of the association with the smoking period, indicating that the smoking period was affected.

• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.604-610
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• 2006

Background: Recent improvements in interventional procedure and medical therapy for congestive heart failure result in an increase of number of patients with ischemic cardiomyopathy considered for coronary artery bypass grafting. We retrospectively review the results of CABG in these patients with decreased LV function to know the early and mid-term follow-up results. Material and Method: Between January 2001 and June 2005, 1,143 patients underwent coronary artery bypass grafting and 144 of these patients had preoperative left ventricular function of equal to or less than 35% ${(LVEF{\leq}\;35%)}$. There were off-pump coronary artery bypass grafting (OPCAB) in 66 cases (45.8%), on-pump beating heart coronary artery bypass grafting in 34 cases (23.6%) and conventional coronary artery bypass grafting in 44 cases (30.6%). The combined operations including mitral annuloplasty were 48 cases in thirty five patients (24.3%). Result: The mean number of dstal anastomosis were $3.5{\pm}1.3$. The median postoperative duration of stay in intensive care unit and hospital was 2 days and 8 days, respectively. There were 6 early death (4.2%) and causes of deaths were ventricular tachycardia in 5 patients, small bowel infarction in one patient. Mean follow-up time was $21{\pm}14$ months $(4{\sim}54\;months)$. The 1-year was $95{\pm}2%$ and 3-year survival rate was $83{\pm}7%$, the 1-year and 3-year cardiac event-free survival were ${88{\pm}3%\;and\;69{\pm}7%}$, respectively. Conclusion: Based on satisfactory early and mid-term results in our study, CABG should be carried out as actively as possible in patients with ischemic cardiomyopathy. Postoperative aggressive management for ventricular arrhythmia would be helpful for better results.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.680-684
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• 2005

Background: With the increasing age of the population, coronary artery bypass grafting in the elderly patients is becoming common. Off-pump coronary artery bypass grafting (OPCAB) has been proven to be less morbidity and to facilitate early recovery. The elderly patients may have benefits by avoiding the adverse effects of the cardiopulmonary bypass. The purpose of this study is to evaluate our results of OPCAB in elderly patients. Material and Method: A retrospective chart review was carried out for 12 patients aged over 80 years who underwent isolated OPCAB from January 2001 and March 2004. Data were collected risk factors for disease, extent of coronary disease, and in-hospital outcomes. Postoperative graft patiency was evaluated in 9 patients by multi-slice computed tomography. Result: Eleven patients had triple vessel disease or left main disease. Four patients were suffered from preoperative CVA, and 4 patients had chronic obstructive pulmonary disease. Two patients had myocardial infarction (MI), among them 1 patient was suffered from pulmonary edema after preoperative MI. There was no perioperative death, perioperative MI, and no ventricular arrhythmia. Also there was no perioperative stroke and renal failure. But there was one deep sternal infection who recovered by treating of muscle flap. Atrial fibrillation was newly developed in 1 patient, but was well controlled by medication. Mean intubation time was $15.9\pm4.4(8\~20hrs)$ hrs and mean ICU stay was $2.9\pm0.8(2\~4 days)$ days. Mean hospital day was $21.6\pm14.3(13\~56 days)$ days. Postoperative mean CK-MS was $11.3\pm14.1\;ng/mL$. Early postoperative graft patency rate was $100\%(24/24)$. Follow-up was completed in all patients. In this time, there was no patients with angina or death. Conclusion: The results of this study suggest that OPCAB reduces morbidity and favors hospital outcomes. Therefore, OPCAB is safe, reasonable and might be preferable operative strategy in elderly patients.

• Clinical and Experimental Pediatrics
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• v.48 no.2
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• pp.165-173
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• 2005

Purpose : We performed the study to evaluate the value of the follow-up echocardiogram performed 6 months to 1 year after the onset of Kawasaki disease(KD), as recommended by American Heart Association(AHA) guidelines, when echocardiograms in the convalescent period were normal. Methods : Patients were selected from 147 cases diagnosed with KD at Pusan Paik hospital from January 2000 to October 2003. A total of 45 KD patients belonged to AHA risk level I and II were performed follow-up echocardiography. The patient's medical records and echocardiogram were reviewed. Additionally, we sought the opinion of pediatric cardiologists on the subject by means of a multiple-choice survey. Results : 37 children were belonged to AHA risk level I and the remaining 8 patients were belonged to risk level II. Of these 45 children, none were noted to have abnormalities on later follow-up echocardiogram. In the results of questionnaire, 37 percent of the participants advocate no follow-up after convalescent period for risk level I, and 33.3 percent favor periodic follow-up with echocardiography for risk level II up to one year. But there were no consensus about the diagnostic criteria of coronary abnormalities and how to follow-up these patients. Conclusion : All children with KD should have an echocardiogram at present and a follow-up study 6 to 8 weeks after the onset of fever. However, additional echocardiographies are not justified if the 6- to 8-week follow-up echocardiogram is normal. We would recommend that the more reasonable diagnostic criteria for coronary abnormalities and the Korean guidelines for long-term cardiovascular management and follow-up of KD need to be established.

• Journal of radiological science and technology
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• v.37 no.2
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• pp.109-116
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• 2014

Many studies have suggested that in the era of Drug-Eluting Stents(DES) are one of the causes of In-Stent Restenosis(ISR) of Stent Fracture(SF). The present study sought to evaluate clinical characteristics of patients with stent fracture after successful DES implantation. The 4,701 patients were selected for analysis who underwent a follow-up coronary angiography irrespective of ischemic symptoms. The overall incidence of SF was 32 patients(male:female=19:13, Av. age $62.44{\pm}9.8$year, 0.68%). Fractures of Sirolimus-Eluting Stents(SES), Paclitaxel-Eluting Stents(PES), Biolimus A9-Eluting Stents(BES), Everolimus-Eluting Etents(EES), Endothelial Progenitor Cell Capture Stent(EPC) and Zotarolimus-Eluting Stents(ZES) are accounted for 19(59.4%), 9(28.1%), 2(6.3%), 1(3.1%), 1(3.1%) and 0(0%) respectively. SF developed in the left Anterior Dscending(LAD) artery in 16 patients(50%) and in complex(type B2, C) lesions in 25 patients(69.4%). Ten patients were treated with heterogenous DES, the rest being treated with either homogenous DES(3 patients), plain old balloon angioplasty(3 patients), or conservative medical treatment(17 patients). None of the patients with SF suffered from cardiac death during a follow-up period of $32.9{\pm}12.4$ months. The overall rate of DES fracture over up to 3.7 years of follow-up was 0.68% with higher incidence in SES than in PES. SF frequently occurred in the LAD artery and in complex lesions. Of the patients with SF, coronary intervention was performed only when the binary restenosis lesion was significant. During the follow-up, patients with SF have continued on combination antiplatelet therapy. There is a very low rate of major adverse cardiac events(post-detection of SF), especially cardiac death associated with SF.

• Clinical and Experimental Pediatrics
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• v.49 no.7
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• pp.790-795
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• 2006

Purpose : This study was performed to compare the therapeutic effects according to duration of medium-dose aspirin(50-60 mg/kg/day) therapy at the acute stage of Kawasaki disease(KD). Methods : Total 87 patients with KD were enrolled in this study. We performed retrospective analysis of clinical characteristics and echocardiographic findings based on medical records. Patient were randomly divided into 2 groups according to the duration of aspirin therapy at the acute stage of KD. Long-term group(LG, n=55) was administered medium-dose aspirin for 2 weeks after diagnosis of KD, and short-term group(SG, n=32) for 48 hours after intravenous immunoglobulin(IVIG) administration. The parameters of therapeutic effects were duration of fever after IVIG administration, incidence of unresponsive patients to single administration of IVIG, and development of transient dilatation or aneurysm of coronary arteries. Results : There was no significant difference in the duration of fever after IVIG between the both group(LG $1.7{\pm}1.1$ days, SG $1.8{\pm}1.1$ days; P=0.588). The incidences of unresponsive patient to the single administration of IVIG were 5.5 percent, 6.3 percent in the each group. Transient dilatation of coronary arteries occurred at 18.2 percent(10/55) in the LG, and 15.6 percent(5/32) in the SG(P=0.761). Prevalence of coronary aneurysm after subacute stage were 7.3 percent(4/55) in the LG, and 9.4 percent(3/32) in the SG(P=0.728). Conclusion : There was no significant difference in the therapeutic effects between long-term(2 weeks) and short-term(48 hours) administration of medium-dose aspirin at the acute stage of KD.