• Title/Summary/Keyword: 인조

Search Result 508, Processing Time 0.022 seconds

Clinical Analysis of Palliative Treatments in Occlusive Vascular Disease (폐쇄성 혈관 질환을 가진 환자의 고식적 치료에 관한 임상적 고찰)

  • 김학제;조원민;류세민;황재준;송영상;최영호
    • Journal of Chest Surgery
    • /
    • v.35 no.4
    • /
    • pp.283-289
    • /
    • 2002
  • Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
    • /
    • v.33 no.11
    • /
    • pp.886-893
    • /
    • 2000
  • 배경: 흉복부 대동맥류는 질환 자체가 광범위하고 수술 중 척수를 포함한 각종 장기의 보호 및 허혈 방지라는 면에서 아직도 수술 합병증이 높은 질환이다. 본 연구에서는 그 동안의 임상경험을 바탕으로 치료성적, 합병증 발생, 사망률 등을 검토하였다. 대상 및 방법: 1990년 1월부터 1999년 12월까지 흉복부동맥류로 수술을 시행한 38명의 환자를 대상으로 의무 기록 검토을 통한 후향적 분석을 시행하였다. 결과: 남자가 22명, 여자가 16명, 평륜 연령은 46.2$\pm$12.3세였고, 크로포드 진단분류 상 1형 이 13례(34.2%), 2형이 19례(50%), 3형이 4례(11%), 4형이 2례(4.8%)였다. 만성 대동맥박리증에 관련된 경우가 29례(76.3%)로 가장 많았고, Marfan 증후군이 동반된 경우가 9례(23.7%)에서 있었다. 원위부 대동맥 관류를 35례에서 시행하였으며, 고동맥-고정맥 심폐바이패스를 31례에서, 좌심방-고동맥 바이패스를 4례에서 시행하였다. 심폐바이패스를 이용한 31례중 4례에서 초저체온하 완전순환정지를 이용하였다. 대동맥 차단 중 복강내 주요 대동맥 분지로의 선택적 관류를 시행하였다. 대동맥류의 최대직경은 평균 8.2$\pm$2.4cm이었고, 동맥류가 파열된 경우는 11례(28.9%)에서 있었다. 전례에서 인조혈관을 이용한 대동맥의 치환술을 시행하였다. 단계적으로 흉복부 대동맥을 겸자하면서 인공혈관을 문합하였고, Adamkiewicz 동맥으로 생각되는 부위의 늑간 동맥을 문합해주었는데, 8번째부터 12번째 흉추 사이의 늑간 동맥 중 역류혈류가 나타나고 상대적으로 내경이 큰 것들을 문합해 주었다. 술 후 조기사망은 3례에서 있었으며, 사인은 심폐기 이탈 실패 (2례), 저혈압 및 산증(1례) 등이었다. 조기 합병증으로는 애성 5례, 출혈 5례, 창상간염 3례, 장기간의 인공호흡기보조가 3례 등이 있었다. 치명적인 조기 합병증인 하지마비는 2례(5.3%)에서 발생하였고, 이 중 1례는 대동맥의 심한 석회화로 늑간동맥을 문합해 주지 못했던 경우였다. 35명의 환자에서 평균 추적기간은 103.1$\pm$6.1 개월, 2년 생존율은 93.8%, 5년 생존율은 86.1%, 8년 생존율은 80.7%였다. 추척기간 동안 4례의 만기사망이 관찰되었고, 사인은 2례에서는 갑작스런 의식소실이 발생하여 규명하기 어려웠으며, 대동맥-식도루 발생에 의한 경우가 1례, 경동맥류 파열에 의한 경우가 1례 등이었다. 만기 합병증으로는 복부 대동맥류(2례), 상행 대동맥 및 대동맥 근부 확장(1례), 대동맥-늑막루(1례), 창상 부위 탈장(1례), 역행성 사정(1례) 등이 있었다. 결론: 저자들은 흉복부대동맥류의 수술에 있어 심폐우 회술 혹은 좌심방-고동맥 바이패스를 통한 원위부 관류 및 저체온법, 수술 시 척수의 혈류공급과 관련된 늑간동맥의 연결 등으로 주요 신경합병증의 발생을 줄이고 좋은 성적을 거두고 있다고 판단하였으며 향후 임상 경험 축적과 함께 보다 정련된 위험인자의 분석이 필요하다고 본다.

  • PDF

Clinical Analysis of Arterial Bypass on the Atherosclerotic Occlusive Disease in Lower Extremities (폐쇄성 하지동맥 경화증에서 동맥 우회술의 임상적 고찰)

  • Park, Sung-Hyuk; Youm, Wook
    • Journal of Chest Surgery
    • /
    • v.30 no.2
    • /
    • pp.195-199
    • /
    • 1997
  • From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20% . Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.

  • PDF

Hemodynamic evaluation of the Ionescu-Shiley pericardial xenograft heart valve (Ionescue-Shiley 인조판막을 이용한 판막대치술의 혈류역학적 성적)

  • Jeong, Won-Sang;Kim, Geun-Ho
    • Journal of Chest Surgery
    • /
    • v.17 no.2
    • /
    • pp.223-230
    • /
    • 1984
  • Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.

  • PDF

Reoperation for Dysfunction of Cardiac Valve Prosthesis (인공 심장판막 기능부전 환자에서의 심장판막 재치환술)

  • 윤정섭;김치경;조규도;이성호;곽문섭;김세화
    • Journal of Chest Surgery
    • /
    • v.31 no.3
    • /
    • pp.242-246
    • /
    • 1998
  • From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

  • PDF

Mitral Valve Repair for Mitral Regurgitation (승모판막폐쇄부전에 대한 승모판막재건술)

  • 최세영;유영선;박기성;최대융;박창권;이광숙
    • Journal of Chest Surgery
    • /
    • v.31 no.3
    • /
    • pp.221-225
    • /
    • 1998
  • From February 1996 to May 1997, 18 patients underwent mitral valve repair for mitral regurgitation. There were 9 male and 9 female patients aged from 19 to 68 years(mean, 53). Thirteen patients were in New York Heart Association(NYHA) class III and IV. The cause of mitral regurgitation was degenerative in 12 patients, rheumatic in 5 patients and infective in 1 patient. Fifteen patients were in Carpentier's functional classification II, 2 patients in Carpentier's class III and 1 patient in Carpentier's class I. Surgical procedures included prosthetic ring annuloplasty(16 cases), rectangular resection of posterior leaflet(15 cases), chordal shortening(5 cases), triangular resection of anterior leaflet(2 cases), commissurotomy(2 cases), partial transposition of posterior leaflet(1 case). These procedures were combined in most patients. There was no operative death. These patients have been followed from 1 to 15 months, mean of 6.7 months. There was one late death resulted from low cardiac output following mitral valve replacement. The function of the repaired valve in other 17 patients has remained satisfactory during the observed interval. We consider that mitral valve repair is highly satisfactory in patients with mitral regurgitation.

  • PDF

A study on the Process Characteristics of the N/P Micro-fiber Fancy yarn and fabrics (N/P 분할사를 이용한 Fancy 가공사 직물의 공정특성 및 물성에 관한 연구)

  • Hong, Sang-Gi;Park, Seong-Woo;Park, Jang-Hwan;Lee, Yeong-Hyeong
    • Proceedings of the Korean Society of Dyers and Finishers Conference
    • /
    • 2012.03a
    • /
    • pp.90-90
    • /
    • 2012
  • 극세섬유는, 1970년대 말부터 일본의 합섬업체들이 천연소재인 Silk를 모방하기 위해 개발을 시작하였으며, 개발된 섬유의 굵기가 0.5d(1denier=1g/9,000m)이하인 것을 말한다. 이후 극세사에 대한 끊임없는 노력으로, 1980년대에는 천연스웨이드 풍의 인조피혁의 제조가 가능한 0.1d이하급 초극세사가 N/P(Nylon/Polyester) 복합방사된 형태로 개발되었으며, 일본, 및 한국 등에서 이들 소재로 제조된 직편물 제품이 첨단 고부가소재로서 호황을 누려왔다. 이러한 초극세사는 다양한 형태로 발전되어왔는데, 해도형(Islands-in-a-Sea Type), N/P(Nylon/PET), P/N(PET/Nylon) 등이 대표적인 형태이며, 가공공정 중에서 분할이 되면서 그 특성을 발현한다고 하여 분할사, 형태에 따라서 N/P 분할사라 하기도 한다. 최근들어 이러한 N/P 분할사는 기존의 의류용 용도뿐만 아니라, Wiping Cloth, 극세사 타울, 항진드기용 침장 등 다양한 비의류용 소재로도 확대 전개되고 있으며, 이렇게 다양화 되어가고 있는 용도에 따른 공정별 최적 가공 방법에 대한 연구가 진행 중이다. 사가공 공정에 있어서는 텍스쳐링 방법이 적용되기도 하는데, 가장 보편화된 텍스쳐링 방법으로는 DTY(Draw Texturing Yarn), ATY(Air Texturing Yarn) 등의 형태가 있으며, 이러한 텍스쳐링 방법은 물성에 민감한 N/P 분할사의 강도, 신도, 분할도에 영향을 미치게 된다. 본 연구에서는 기존의 텍스쳐링 방법이 아닌 Fancy사 형태로 사가공을 하였으며, 직물로 제직하고, 분할 가공하여 직물로써의 물성까지 분석하였다. Fancy사는 색이나 형의 변화로 디자인효과를 준 실을 말하는데, 심사, 부사, 압사로 이뤄지며 의장사, 장식사 등으로 불려지기도 한다. 주요 공정을 보면, 크릴형성용 부사를 500-600T/M으로 가연한 연사를 얻는 제1공정과, 이 가연된 부사와 심사를 합사하는 제2공정 및 합사된 크릴의 뒤틀림을 방지하기 위하여 압사로 크릴을 고정하여 주는 제3공정으로 이루어진다. 사용된 N/P 분할사는 NP30/36dty, NP50/36dty를 사용하였으며, 부사의 오버피드 및 피드되는 사에 따라 각각 8종, 7종의 Fancy사를 제조하여 섬도(Denier), 강도(Tenacity), 신도(Elongation)를 측정하였다. 또한, 이들 사들로 제직 및 분할가공을 하여 인장강도, 인장신도, 인열강도, 마모강도, 공기투과도 등의 물성과 중량, 두께를 측정하였으며, 온도, NaOH 농도, 시간 등의 분할 가공조건에 따른 직물의 인열강도 변화도 측정하였다. 이렇게 공정별 조건에 따른 물성의 변화분석을 통해 추후 N/P의 제품화 전개에 도움이 되고자 하였다.

  • PDF

Issues and Directions of National Policy on Sports Facilities (정부의 체육진흥시설 정책의 과제)

  • Ko, Wi-Sug;Cho, Min-Heang
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.1
    • /
    • pp.291-299
    • /
    • 2018
  • The purpose of this study was to review the government's policy on the enhancement of sports facilities for community residents regarding the lack of knowledge surrounding the infrastructure of sports facilities. The government has invested approximately 2.4 trillion won to establish 220 community sports centers, 385 billion won for 194 multi-purpose indoor centers, and 1.3 trillion won for rebuilding 1,870 school outdoor fields. On the other hand, there are problems with the link between the crumb rubber infill on sports fields and cancer, a lack of availability of indoor sports centers, and an increased federal budget deficit. It is the responsibility of government to plan and construct outdoor fields that are large enough to accommodate all people and allow them to play activities. In addition, the guidelines should ensure that the indoor space required for physical activities at each teaching station is large enough to accommodate all students in the class and handle two classes. The government should suggest the federal government guidelines based on a good understanding of the concept of infrastructure in sports facilities. The government also should make efforts to reduce the regulatory powers and provide the community with an autonomous right to plan and construct sports facilities.

Effects of air pollutants on the weathering of stone cultural properties in Gyeongju (경주지역 석조문화재 풍화에 미치는 대기오염물질의 영향)

  • Jung, Jong-Hyeon;Jung, Min-Ho;Choi, Won-Joon;Seo, Jung-Ho;Hwang, In-Jo;Shon, Byung-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.11 no.2
    • /
    • pp.597-603
    • /
    • 2010
  • The amount of pollutants from stationary sources of businesses classified into 1-3 type in Gyeongju was found to be 0.70 ton/yr for PM-10, 13.95 ton/yr for $SO_2$, and 37.12 ton/yr for NOx ; with respect to area sources, 1.02 ton/yr for PM-10, 13.44 ton/yr for $SO_2$, and 21.10 ton/yr for NOx ; and with respect to mobile sources 963.91 ton/yr for PM-10, 1415.02 ton/yr for $SO_2$, and 5612.70 ton/yr for NOx. This study surveyed the concentration distribution of PM-10, $SO_2$, and NO2 in the air in around Gyeongju and Pohang, and found that high concentration was mainly distributed around Pohang Steel Industrial Complex and the around of mobile sources. In Gyeongju area, $SO_2$ was predicted to increase from 0.002 ppm in 2006 to 0.005 ppm in 2015, and that of $NO_2$ was predicted to increase from 0.004 ppm to 0.010 ppm during the same period. At this point, practicing guidelines to reduce air pollutants and management plan for environmental pollutants should be devised, and also practicing and management programs to protect the stone cultural properties from environmental pollutants and other chemical, physical, and biological factors should be actively introduced.

Estimation of Greenhouse Gas Emissions (GHG) Inventory and Reduction Plans for Low Carbon Green Campus in Daegu University (저탄소 그린캠퍼스 조성을 위한 온실가스 인벤토리 구축 및 감축잠재량 분석 - 대구대학교를 중심으로)

  • Jeong, YeongJin;Li, KaiChao;Kim, TaeOh;Hwang, InJo
    • Journal of Korean Society of Environmental Engineers
    • /
    • v.36 no.7
    • /
    • pp.506-513
    • /
    • 2014
  • The objective of this study is to establish the greenhouse gases (GHG) inventories and estimate the GHG reduction plans for Daegu University from 2009 to 2011. The annual average of GHG emissions in Daegu University was estimated to be 19,413 ton $CO_2$ eq during the study period. Emissions of electricity usage in Scope 2 most contributed about 55.4% of the total GHG emissions. Also, GHG emissions of Scope 2, Scope 1, and Scope 3 contributed 60.4%, 22.6%, and 17.0%, respectively. In order to estimate reduction potential of GHG, the Long-range Energy Alternatives Planning (LEAP) model was calculated using three scenarios such as sensor installation, LED replacement, and solar facility. The GHG will be reduced by 1,656 ton $CO_2$ eq for LED scenario, by 1,041 ton $CO_2$ eq for sensor scenario, and by 737 ton $CO_2$ eq for solar scenario compared to 2020 business as usual (BAU). Therefore, the total GHG emissions in 2020 apply three scenarios can be reduced by 15% compared with 2020 BAU.