• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1503-1511
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• 2002

Purpose : Although the short- and long-term outcomes of low birth weight(LBW) neonatal intensive care unit(NICU) survivors have been extensively studied, much less information is available for normal birth weight(NBW) infants(greater than 2,500 gm) who require NICU care. Methods : We retrospectively examined the neonatal hospitalizations and one year health status of 302 NBW and 131 LBW admissions to our NICU. Information on the neonatal hospitalization was obtained from a review of medical records. Postdischarge health status was collected by using telephone surveys and medical records. Results : After initial discharge, 21.2% of the NBW infants and 23% of the LBW infants required rehospitalization during the first year of life and there was no significant difference between the two groups. The reasons for rehospitalization of the NBW infants included respiratory disorders (32.1%), G-I problems(26.2%), genitourinary problems(11.9%), surgery(10.7%), cardiac problems(7.1%), and congenital/developmental problems(1.2%). For the LBW infants, the order of frequency was the same, with the percentages slightly different. Neonatal risk factors related to the rehospitalization of the NBW infants included mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. But no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. Conclusion : Low and normal birthweight NICU survivors were rehospitalized at similar rates. The most common cause of rehospitalization was respiratory problems. Neonatal risk factors related to rehospitalization of NBW infants were mechanical ventilation, duration of mechanical ventilation, and congenital anomaly. However, no positive significant correlation of neonatal risk factors with rehospitalization of LBW infants was found. The data suggests that NBW infant survivors, as well as LBW infant NICU survivors, require close follow up.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.35-41
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• 1992

Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.42-49
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• 1995

Background: Hemoptysis always merits thorough investigation because even minimal bleeding may be an early indicator of the presence of significant bronchopulmonary disease. But in patients with hemoptysis & a normal chest roentgenogram, there are no clear guidelines for a diagnostic approach, including the indications of bronchoscopy. Methods: Eighty patients with hemoptysis and a normal chest roentgenogram were involved in this study. We evaluated the cause of hemoptysis in these patients by bronchoscopy and/or bronchogram or high-resolution CT of the lung and we analyzed the relationship of clinical features, such as age, sex, smoking and properties of hemoptysis, to the cause of hemoptysis. Results: 1) They were 34 men and 46 women, with the mean age of 46.7 and 41.8 years old, respectively. 2) Initial bronchoscopy provided a diagnosis in 8 patients - bronchogenic carcinoma in 3 patients (3.8%), metastatic cancer in 1 patient(1.3%) and endobronchial tuberculosis in 4 patients(5.0%). 3) Two clinical findings of patients over 50 years and/or with more than 30 pack-year smoking history were associated with bronchogenic carcinoma, and among these two factors, a more than 30 pack-year smoking history was the best predictor for diagnosis of bronchogenic cancer. 4) The 72 patients in whom no specific cause of hemoptysis was identified by initial bronchoscopy underwent bronchogram and/or high resolutional CT of the lung. Then, 6 patients were diagnosed as bronchiectasis and 5 patients rebleeded in the follow up period of 9 to 90 weeks. Of the remaining 66 patients, 33 were followed for 7 to 80 weeks. Among these patients, only 5 patients had recurrent episodes of hemoptysis & they were diagnosed as bronchiectasis in 1 patient, tuberculosis in 2 patients and catamenial hemoptysis in 2 patients. Conclusion: We conclude that patients with hemoptysis and a normal chest roentgenogram who are more than 50 years old or have more than 30 pack-year smoking history should undergo bronchoscopy to exclude possible bronchogenic carcinoma. In patients without these clinical features, a conservative approach with observation appears justified. If hemoptysis recurs to these patients, bronchogram or high-resolutional CT of the lung with sputum examination are necessary.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.108-111
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• 2004

Reoperation on the recurrent aortic aneurysm adjuvent to sternum remains a challenging problem in regard to the risk of the massive hemorrhage at the time of resternotomy resulting from inadvertent entry into the aneurysmal sac. The cardiopulmonary bypass technique of femoral cannulation and deep hypothermic circulatory arrest can provide a safe resternotomy. The left ventricle is likely to distend due to lack of contraction with ventricular fibrillation during core cooling. To prevent ventricular distention during core cooling, sufficient venous drainage is mandatory, We report a technique in which deep hypothermic circulatory arrest is achieved before resternotomy without left ventricular distention by active venous drainage using centrifugal pump.

• Food Industry And Nutrition
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• v.7 no.1
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• pp.40-44
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• 2002

본 연구는 한방에서 여러 가지 기능성을 주목받고 있는 호박을 주원료로 하고 8가지 한방 생약재를 부재료로 첨가해 이것이 마우스의 혈액 성상 중 적혈구수와 hemoglobin에 어떤 영향을 미치는지 알아보기 위해 진행되었다. 실험은 부재료로 첨가되는 한방생 약재 의 종류와 1회 복용량에 따라9가지 그룹으로 나누어 진행되었으며 먼저 마우스에게서 출혈을 유도한 후 호박 및 한방생 약재 추출물을 먹인 대조군과 비교해 출혈 전으로 회복되는 정도를 살펴보았다. 그 결과 적혈구의 경우9가지 실험구 모두가 대조구에 비해서 유의적으로 적혈구 수가 증가하였다 첨가된 부재료의 수를 줄인 A와 B그룹보다 8가지 한방생약재를 모두 부재료로 첨가한 C그룹에서 가장 높은 증가효과를 보여 주었다. Hemoglobin의 경우에도 9가지 실험구 모두가 대조군에 비해 유의성있는 증가효과를 보여주었다 Hemoglobin도 적혈구와 마찬가지로 A와 B그룹보다 8가지 한방생약재를 모두 첨가한 C그룹에서 회복효과가 가장 우수하였다 적혈구와 hemoglobin모두 1회 복용량보다 첨가되는 한방생약재의 종류에 따라 회복효과가 더 큰 것으로 생각된다.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.576-580
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• 1998

This study is to clarify the results of atrial septal defect(ASD) repair and mitral valve surgery through right anterolateral thoracotomy since 1989, and those of more generalized application of minimal invasive cardiac surgery since August 1997. We retrospectively analyzed the results of open heart surgery(OHS) through other than full sternotomy carried out until October 1997. There were 28 cases of OHS done through right anterolateral thoracotomy(17 cases of ASD, 4 cases of mitral valve repair, 6 cases of mitral valve replacement, and 1 redo mitral and tricuspid valve repalcement) which has demonstrated no surgical mortality or morbidity except only 1 case of reoperation for bleeding. During the period between August and October 1997, we performed near routine application of upper sternotomy or transverse sternotomy in aortic valve cases and routine application of minimal incision in cases with ASD and there was no evidence of early and late complications associated with this approach. We conclude that OHS with the use of minimal incisions is very safe, cosmetically excellent, and superior in terms of the amount of bleeding. The indication for minimal incision, therefore, should be extended afterwards.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.259-265
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• 2001

Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.256-259
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• 2001

식도 결핵은 아주 드문 질환으로 연하곤란과 흉통이 가장 흔한 증상이면 다량의 토형은 드문 것으로 되어 있다. 본원에서는 다량의 토형을 동반한 식도 결핵에 의한 식도 대동맥루를 가진 환자를 지험했다. 4세 남자 환자는 다량의 토혈로 응습실을 통해 입원했다. 내원 당시 응급으로 시행한 내시경 검사상 incisor로부터 25cm 하방에 0.7 cm의 풍부한 혈관성의 육아종성 병변을 발견하고, 응급개흉술로 식도의 종양성 병변에 대해 쐐기 절제술을 시행하였다. 식도의 종양성 병변부위는 대동맥과 심게 유착되어 있었고 식도에서 대동맥쪽으로의 식도루를 이중 결찰했다. 환자는 술후 8일째 갑작스런 흉관을 통한 다량의 출혈과 구토 후 토형이 있어 응급 재 개흉술을 시행하여 대동맥파열과 식도 문합부 파열을 확인하였으나 더 이상의 교정이 불가능하여 사망하였다. 이에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• v.34 no.1
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• pp.97-100
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• 2001

흉막의 고립성 섬유성 종양은 중피하에 존재하는 미분화 중배엽성 기원의 섬유 세포에서 기원하는 종양으로 알려졌다. 이 종양은 대부분 양성으로 보고되고 있으나 병리학적으로 높은 세포 밀도, 유사분열의 수가 많고(10개의 고배율 시야에서 4개 이상), 핵의 다양성, 출혈, 괴사등이 있으며 악성의 판단기준으로 보고된다. 환자는 62세 여자로 호흡곤란 및 기침을 주소로 본원에 입원하였으며 단순 흉부 방사선 및 전산화 단층 촬영상 우측 흉강내에 거대한 종양소견이 보였다. 이 종양은 23$\times$18$\times$12 cm, 2 kg의 크기와 무게를 가졌으며 우측폐 하엽과 중엽은 압박되어있었으나 종양 절개 후 재 팽창됨을 확인하였다. 또한 횡경막과 심하게 유착되어 박리도중 손상이 동반되어 봉합술이 필요하였다. 병리학적으로 종괴는 세포밀도가 높았고 방추형세포의 다발로 이루어져 있었으며 유사분열의 수가 많이(27 mitosis/10HPF)보였다. 면역 조직 화학 검사상 vimentin과 CD34에 양성 반응을 보였다. 이에 악성 고립성 섬유성 종양으로 확진되었다. 본 교실에서는 흉막에 발생한 악성 고립성 섬유성 종양을 치험하였기에 문헌 고찰과 함께 보고한다.

• Journal of Chest Surgery
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• v.26 no.2
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• pp.158-159
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• 1993

The hemorragic episode is the major problem of mechanical prosthesis, because of the necessity for anticoagulant therapy to prevent complication of thromboembolism. Double valve replacement was performed to 42 year old male due to aortic stenoinsufficiency and mitral stenosis. For anticoagulant therapy, the patient has been given wafarin under the control of prothrombin time 0.5-2 times of normal) in the our hospital. The patient was injuried the right pelvic area by waves in the beach 4 years after double valve replacement. Pelvic MRI scan showed huge hematoma in the right pelvic cavity. The patient was operated removal of intrapelvic hematoma.