• Journal of Chest Surgery
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• 제37권1호
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• pp.56-63
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• 2004

배경: 좌주관상동맥 개구부 협착에서의 혈관성형술은 기존의 관상동맥우회술 시행 시에 발생할 수 있는 혈류 경합과 역행성 혈류의 문제를 해결할 수 있는 방법으로 여겨지고 있다. 본 연구에서는 좌주관상동맥 혈관성형술의 수술 성적과 예후에 대한 분석을 시행하여 좌주관상동맥 혈관성형술의 수술적 효용성을 확인하고자 하였다. 대상 및 방법: 1991년 7월부터 2003년 5월까지 부천세종병원에서 좌관상동맥 개구부 협착으로 혈관성형술을 시행 받은 29명의 환자들을 대상으로 환자들의 수술 전 임상양상, 수술결과, 수술 후 관상동맥조영술과 심초음파 검사 등을 후향적으로 분석하였다. 대상 환자들의 평균나이는 53.1$\pm$12.5세였으며 남녀비는 8 : 21이었다. 여성 환자 중 12예에서는 뚜렷한 죽상 경화증의 위험인자를 확인할 수 없었다. 26예(89.7%)의 환자는 다른 원위부 관상동맥에 병변이 없는 단독 좌주관상동맥 개구부 협착 소견을 보였다. 결과: 28예의 환자에서 전방접근법을 사용하였고, 1예의 환자에서 상방접근법을 사용하였으며, 주폐동맥의 절단을 1예에서 시행하였다. 4예의 환자에서 관상동맥우회술을 동시에 시행하였다 수술 사망은 1예(3.4%)에서 발생하였으며 장기 추적관찰 결과 1예에서 외상으로 인한 만기 사망이 발생하여 5년 생존율은 91.2$\pm$6.1%였다. 수술 후 13예(44.8%)의 환자에서 17차례의 관상동맥조영술이 시행되었으며, 이 중 2예에서 첩포 원위부 협착이 발생하였고 1예에서 우관상동맥 개구부의 새로운 협착이 발생하여 3예의 경피적 중재술이 시행되었다. 1예의 환자에서 첩포 근위부 협착이 발생하여 관상동맥우회술을 시행하였다. 대상 환자들의 5년 재시술 회피율은 82.4$\pm$8.5%였다. 수술 후 1도 이하의 새로운 대동맥 폐쇄부전이 4예에서 그리고 수술 전 동반되었던 대동맥 폐쇄부전의 심화가 1예에서 관찰되었다. 결론: 본 연구에서 좌주관상동맥 혈관성형술은 좌주관상동맥 개구부의 협착에 사용될 수 있는 효과적인 수술방법임을 확인할 수 있었다. 그러나 수술 후 발생할 수 있는 혈관성형술 부위의 협착과 대동맥 폐쇄부전에 대한 면밀한 추적 관찰이 필요할 것으로 생각된다.

• Journal of Chest Surgery
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• 제13권4호
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• pp.495-502
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• 1980

A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

• 한방재활의학과학회지
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• 제27권1호
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• pp.67-75
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• 2017

The purpose of this study is to report the effectiveness of diarrhea-inducing treatment by Gamsui-mal for lumbar spinal stenosis. During hospitalization four patients with lumbar spinal stenosis were treated with diarrhea-inducing treatment by Gamsui-mal and acupuncture, herbal medicine, moxibustion, cupping treatment, Bee-venom pharmacopuncture. Before treatment, we explained in detail about diarrhea-inducing treatment by Gamsui-mal and patients agreed with treatment. The symptoms appeared in patients of diarrhea, abdominal pain, and vomiting in the treatment process. We evaluated the degree of improvement by visual analogue scale (VAS), oswestry disability index (ODI). After treatment, we found that pain was reduced and patient's symptoms were improved by visual analogue scale (VAS), oswestry disability index (ODI) score. The results show that diarrhea-inducing treatment by Gamsui-mal was rapidly improving symptoms. Further studies are needed to clarify the effect of diarrhea-inducing treatment by Gamsui-mal.

• Advances in pediatric surgery
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• 제5권1호
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• pp.64-68
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• 1999

The length, diameter and muscle thickness of the pylorus were measured by ultrasonograms in 15 infants with infantile hypertrophic pyloric stenosis(IHPS). These measurements were compared to assemble measurements of infants who came in for the routine vaccination and underwent ultrasonogram. This study also studied by ultrasound the changes in the pylorus of patients who underwent pyloromyotomy 4 weeks and 8 weeks postoperatively. According to $Carver^5$, the pyloric muscle volume(PMV) and pyloric muscle index(PMI) were calculated in each case. The pyloric muscle volume, PMI and the thickness of pyloric muscle proved to be a more reliable guide to diagnose IHPS than length and diameter of pylorus. The pyloric muscle length, diameter, thickness and pyloric muscle volume were not normalized at 4 and 8 weeks after pyloromyotomy. However, pyloric muscle index was normalized at 4 weeks postoperatively perhaps as the result of rapid weight gain after pyloromyotomy.

• 대한기계학회논문집B
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• 제29권9호
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• pp.1042-1048
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• 2005

Numerical investigation has been made on the stent design to minimize the neointimal hyperplasia. Computational fluid dynamics is applied to investigate the flow distributions in the immediate vicinity of the given idealized stent implanted in the blood vessel. Parametric study on the variations of the number of stouts, stent diameters, stent spacings and Reynolds numbers has been conducted using axi-symmetric Navier-Stokes equations. An initial difficulty in the study is to determine the optimal stent design to understand the flow physics of the flow disturbance induced by stent. The size of recirculation zone around stent is depend on the stent diameter, number of stent wire and Reynolds number but is insensitive to the stent wire spacing. It is also found that when the flow is in acceleration, the flow sees a more favorable pressure gradient, and the separation zones are smaller than the steady flow case. When the flow is in deceleration and the flow sees a more adverse pressure gradient so that the separation zones are larger.

• 한국정밀공학회지
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• 제23권3호
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• pp.195-202
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• 2006

The degenerative lumbar spinal stenosis (DLSS) is a disease inducing low back pain, leg pain, convulsion. numbness, and neurogenic claudication from compression of nerve root. Intervertebra fixation was reported to increase the degeneration of neighbor lesion after treatment. Recently, a new surgical technique of inserting a fixator between interspinous processes has been introduced. The purpose of this study is to design the interspinous process fixator with flexibility to complement the trouble of using fixator in DLSS. This study evaluated the existing fixator through the mechanical test and modified it using the finite element analysis (FEA). The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and calculated from the FEA in the biomechanical loading condition. Effects of variation in length and thickness were investigated to design an optimal fixator. Three prototypes were manufactured using FEA results. Mechanical tests under the biomechanical loading condition were performed to select the best one from these three. The selected fixator increased flexiblity by 32.9%.

• Clinical and Experimental Pediatrics
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• 제49권12호
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• pp.1363-1366
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• 2006

신생아에서 흉강내 대동맥류는 드물며, 말판 증후군, 대동맥 축착, 대동맥 판막 협착, 동맥염, 터너 증후군, 결절성 경화증 등과 연관되어 보고된 바 있다. 신생아에서 발견되는 ductus arteriosus aneurysm은 매우 드문 질환이나, 대동맥 파열이 유발 될 수 있는 기형이다. 병인으로 대동맥 쪽에 있는 동맥관의 폐쇄 지연, 선천적으로 동맥관 벽이 약한 경우, 자궁내에서 동맥관으로 혈류 증가, 자궁내에서 동맥관의 협착 등이 있으나 명확하지 않은 상태이다. Ductus arteriosus aneurysm은 흉부 방사선, 심초음파, 3차원 전산화단층촬영, 자기 공명영상 검사 등으로 진단할 수 있다. 치료는 인도메사신의 투여, 수술적 절재 등의 방법이 있으며, 자연 소실되는 경우도 있다. 저자들은 태변흡인증후군 환아에서 우연히 발견된 ductus arteriosus aneurysm이 생후 4주 뒤 자연 소실되는 1례를 경험하였기에 보고하는 바이다.

• The Korean Journal of Pain
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• 제19권1호
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• pp.63-67
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• 2006

Background: Pain due to spinal stenosis is one of the major causes of low back pain, and it sometimes does not respond to conservative treatment. We postulated that anterior epidural irrigation could be a good choice for treating lumbar spinal stenosis patients. However, the effects and theoretical basis of anterior epidural irrigation have not been investigated for spinal stenosis. So, this study was designed to identify the clinical efficacy of anterior epidural irrigation for treating lumbar spinal stenosis. Methods: 71 patients with lumbar spinal stenosis underwent anterior epidural irrigation. Anterior epidural irrigation was performed with normal saline and a mixture of local anesthetic with steroid through a catheter under fluoroscopic guidance. The findings were evaluated with using visual analogue scales for low back pain and leg symptoms. Results: Relief from low back pain and leg pain was observed for up to 12 months after anterior epidural irrigation. None of the patients showed any deterioration of their motor or sensory deficits during follow up. Conclusions: Anterior epidural irrigation is effective for the relief of back and leg pain in spinal stenosis patients.

• 한국임상수의학회지
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• 제28권1호
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• pp.133-138
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• 2011

A 4-year-old female Fox Terrier dog (weighting 8 kg) with history of severe abdominal distention and anorexia was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, grade 4/6 systolic murmur heard at the left heart base. Electrocardiography showed right ventricular enlargement (right axis deviation and deep S wave) and right atrial enlargement (P pulmonale). Diagnostic imaging studies revealed hypertrophy of right ventricle, enlargement of right atrium and tricuspid regurgitation and turbulence in the pulmonary artery in right parastenal short axis view. Based on the diagnostic findings, the dog was diagnosed as a case of valvular pulmonic stenosis.

• Journal of Chest Surgery
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• 제11권1호
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• pp.81-84
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• 1978

A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.