• Journal of Chest Surgery
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• 제25권12호
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• pp.1550-1555
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• 1992

From June 1989 to July 1992, we used centrifugal Biomedicus pump[CBP] in 20 patients In 9 cases, CBP was used as ventricular assistance after heart surgery for those who could not be weaned off bypass even with intra-aortic balloon counter-pulsation and with maximal inotropic support In 8 patients, CBP was used as partial left heart bypass during repair of aortic aneurysms or congenital aortic anomalies. And in 3 patients, CBP was used as vena caval bypass during resection of renal cell carcinoma with tumor extension into the inferior vena cava. In 2 of 9 patients with ventricular assistance, they were weaned off the device successfully after 16 hours and 7 days respectively. But the patients died of intracranial hemorrhage and sepsis, 7 and 29 days after weaning from cardiac support, respectively. In all the patients who underwent aortic of vena caval surgery using CBP as shunt, there were no complications such as postoperative bleeding necessitating reoperation, renal failure or neurologic sequelae. In conclusion, the centrifugal type of ventricular assistance may be potentially life saving treatment modality in patients with severe postoperative low cardiac output syndrome. The CBP can be safely employed for resection of renal cell carcinoma with vena caval tumor extension and for repair of aortic aneurysms.

• 대한한방부인과학회지
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• 제19권1호
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• pp.261-271
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• 2006

Purpose : Dysmenorrhea which repeat every menstrual phase give complaints like pain, vomiting, nasal bleeding and etc. But in many textbooks pathogenesis and treatment process of dysmenorrhea obscure. So the purpose of this study is to identify the conception, pathogenesis and treatment process of dysmenorrhea. Methods : After catching the limitations of preexistence theory about dysmenorrhea, I show a meaningful argument of dysmenorrhea. Results : The conception, pathogenesis and treatment process of dysmenorrhea are like this. Dysmenorrhea which occurs for menstrual phase can make deficiency of blood. There are intimate relations between uterine function and the five Zang-organs, especially heart, spleen and liver, so menstruation induces the weakness of those organs. And the insufficiency of kidney and conception-thorough vessel which have control over the uterine function can make dysmenorrhea. Conclusion : The deficiency of kidney which is responsible for holding Qi breaks down the balance of Zang-organs Yin-Yang, then dysmenorrhea appears through Zang-organs weakness of heart, spleen and liver. For the treatment of dysmenorrhea, we should consider preferentially the deficiency of kidney, afterward Bianzheng Lunzhi of the Zang-fu organs.

• Natural Product Sciences
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• 제27권2호
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• pp.61-67
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• 2021

Since ancient times, various herbal medicines have been used in folk medicine to treat a variety of diseases. While the majority of drugs belong to the Kingdom of Plantae, some drugs from the Kingdom of Animalia are listed in various Materia medica of alternative medicines. Animal-derived drugs are mentioned in the Unani system of Medicine (USM) and have been used successfully to treat a variety of diseases. Marjān (Corallium rubrum) is a vital marine drug of animal origin that has been used in USM since ancient times and continues to be used today. It possesses a variety of beneficial pharmacological properties, including tonic effects on the heart, brain, stomach, and eyes, pregnancy protection, expectorant, and hemostyptic properties. It is used to treat hemoptysis, palpitation, bleeding piles, hemiplegia, heart failure, and general weakness. It is also an ingredient in a variety of Unani formulations with pharmacological significance. Unani physicians expanded the uses of Marjan and successfully used it to treat a variety of new diseases. There is a dearth of scientific research on its pharmacological and medicinal properties. The urgent need is to validate the Unani claims about its beneficial cardiac and nervine actions, as well as other significant actions mentioned in the Unani literature.

• Journal of Chest Surgery
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• 제42권2호
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• pp.184-192
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• 2009

배경: 수혈의 부작용은 널리 알려져 있으나, 대부분의 개심술에서 수혈이 시행되고 있다. 동종 수혈 없이 심장수술이 가능한 지에 대하여 알아보고자 본 연구를 시행하였다. 대상 및 방법: 2007년 1월부터 8월까지 다양한 혈액보존법을 적용하여 연속적으로 개심술을 시행한 환자 44명을 대상으로 심페기군(Group I, 17명)과 무심폐기군(Group II, 27명) 두 군으로 나누어 후향적 연구를 시행하였다. 혈액보존법은 수술 중 자가 혈액 채취(intraoperative autologous donation), 자가수혈기(cell saver), 역행적 자가 혈액 충전법(retrograde autologous priming), 기존 초여과법(conventional ultrafiltration), 변형 초여과법(modified ultrafiltration) 등을 사용하였고 술 후 항빈혈약을 복용시켰다. 무혈 수술 가능여부, 동종 수혈 원인, 적혈구 용적률의 변화, 술 후 출혈량 등 수술 결과를 분석하여 비교하였다. 두 군간 비교가 적당치 않은 항목은 혈액보존법 적용 전 2006년 수술한 환자를 대조군(49명) I, II로 하여 각각 비교하였다. 결과: 대상환자 44명 중 40명(90.9%)에서 무혈수술이 가능하였으며 각 군의 무혈 수술 성공률은 심폐기군 88.2% (15/17), 무심폐기군 92.6% (25/27)로 두 군간 차이는 없었다(p=NS). 수혈 원인은 술 후 출혈 2명, 술 중 출혈 1명, 원칙 적용 실수 1명이었다. 수술 결과 및 술 후 총 흉관 배액량(심폐기군 $417{\pm}359mL$, 무심폐기군 $451{\pm}237mL$)은 두 군간 차이가 없었으나(p=NS), 각각의 대조군 I, II에 비해 통계적으로 유의하게 배액량이 적었다(p<0.05). 심폐기군에서 최저 적혈구 용적률은 심정지액 주입된 직후로 $16.4{\pm}2%$였고 두 군 모두 술 후 2개월째 수술 전 수준으로 회복되었다. 결론: 본 연구에서는 수술 중 자가 혈액 채취, 수술 중 자가수혈기, 역행적 자가 혈액 충전법, 기존 초여과법, 변형 초여과법 등을 사용하여 90.9%의 환자에서 무혈 수술이 가능하였다. 다양한 혈액보존법의 복합 적용이 가장 중요하며, 수술 시의 세심한 지혈 과정 그리고 수혈 기준의 완화 등을 통해 무혈 수술이 가능하다.

• Journal of Chest Surgery
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• 제30권9호
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• pp.876-884
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• 1997

서울대학교병원 흉부외과에서는 1994년 3월부터 1996년 5월까지 14명의 환자에 있어서 심장이식술을 시행 하였다. 남자가 9명 여자가 5명이었으며 평균나이는 40.8 $\pm$ 12.4세 이었다. 수술전 모든 환자들은 UiID Fc III 또는 IV이었으며 술전 진단은 확장성 심근병증이 11명, 제한성 심근병증이 3명이었다. 장기 공여자의 평균연령은 24.9 $\pm$ 10.2세 이었으며 뇌사의 원인으로는 교통사고에 의한 뇌손상이 8명으로 가장 많았으며 거미막하 출혈이 2명, 이 물질에 의한 기도폐쇄, 추락사고, 뇌종양, 익사사고 등이 각각 1명이 었다. 수혜자와 공여자의 혈액형은 11명에 있어서는 일치되었고 2명에 있어서는 적합하였으나 1명의 환자에 있 어서는 부적합하였다. 11명의 환자에 있어서는 양대정맥을 직접 문합하는 방법을 사용하였으며 3명의 환자에 있어서는 우심방을 연결하는 방법을 사용하였으며 평균 이식심장 허혈시간은 157.8 $\pm$ 43.8분(94-220분) 이었다. 2명이 사망하 여 병원 사망률은 14.3%이었다. 사망원인은 우심실부전, 사이클로스포린 유발성 용혈성요독증후군, 거부반응 으로 인한 다발성 장기부전과 대동맥 문합부위 가성동맥류의 파열로 의심되는 酉\ulcorner銖汰潔駭\ulcorner 평균추적기간은 16.2 $\pm$ 9.0개월(3-28개월) 이었으며 만기사망은 1례 있었다. (8.3%) 마지막 추적당시 급성 거부반응으로 치료를 받고 있는 1명을 제외한 모든 환자들은 UnD Fc I이었다. 병원사망을 포함한 1개월 및 6개월, 2년 생존율은 각각 n.9 $\pm$ 6.9%, 85.7 $\pm$ 9.4% , 77.1 $\pm$ 11.7% 이었다. 결론적으로 심장이식술은 말기 심부전환자의 이상적인 치료법이며 앞으로 장기적인 추적검사가 필요하리라 생각된다.

• 대한영상의학회지
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• 제83권3호
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• pp.705-711
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• 2022

46세 남자 환자가 알코올성 간경화와 동반된 지속되는 복수로 인해 경경정맥 간내 문맥 정맥 단락술을 시행 받았다. 시술 후 9일째 흑색변 및 헤모글로빈 수치의 감소로 혈관조영 컴퓨터 전산화단층촬영을 시행하였으며 혈액담즙증 및 우간동맥과 우간내담관 사이의 동맥-담관루가 의심되었다. 혈관조영술에서 분절간동맥의 작은 분지와 우간내담관의 동맥-담관루가 확인되었다. 분절8 간동맥에 대해 코일로, 분절5 간동맥에 대해 글루-리피오돌 혼합물로, 우전 간동맥에 대해 젤폼으로 색전술을 시행하였고, 시술 후 혈관조영술에서 동맥-담관루는 소실되었다. 그러나 색전술 시행 2일 후 환자는 진행하는 파종성 혈관 내 응고로 인해 사망하였다. 경경정맥 간내 문맥 정맥 단락술 이후 위장관 출혈이 있을 경우 혈액담즙증의 가능성을 반드시 고려하여 가능한 빠른 시기에 적절한 조치가 필요할 것이다.

• Journal of Chest Surgery
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• 제32권11호
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• pp.1017-1022
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• 1999

Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

• Journal of Chest Surgery
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• 제53권6호
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• pp.361-367
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• 2020

Background: Malignant primary cardiac tumors are extremely rare, but have a poor prognosis. This study evaluated the surgical outcomes of patients with this disease. Methods: Forty patients who underwent surgery for malignant primary cardiac tumors between January 1998 and December 2018 were enrolled. Participants were divided into 3 groups based on resection margins (R0, 14 patients; R1, 11 patients; and R2, 11 patients) and their surgical outcomes were compared. Heart transplantation was performed in 4 patients with unresectable tumors. Results: Early mortality was reported in 2 cases (5%) due to postoperative bleeding and cerebral hemorrhage secondary to brain metastasis. The 1- and 2-year survival rates were 67.5% and 42.5%, respectively. The median survival time of the patients was 20.3 months (range, 9.2-37.6 months). The median survival time was 48.7, 20.3, and 4.8 months in patients with R0, R1, and R2 resections, respectively (p=0.023). Tumor recurrence occurred in 21 patients (61.7%), including 4 cases of local recurrence and 17 cases of distant metastasis. In patients who underwent heart transplantation, the median survival time was 29.5 months, with 3 cases of distant metastasis. Conclusion: Although surgery for malignant primary cardiac tumors has a poor prognosis, complete resection of the tumor may improve surgical outcomes.

• Journal of Chest Surgery
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• 제49권4호
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• pp.242-249
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• 2016

Background: We evaluated early and long-term results after heart transplantation (HTPL). Methods: One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results: Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion: Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients.

• Journal of Chest Surgery
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• 제41권4호
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• pp.516-519
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• 2008

개심술 이후 발생한 대동맥 피부 누공의 합병증은 드물지만 한 번 발생하면 매우 치명적이므로 빠른 진단과 수술적 치료가 요구된다. 국립의료원에서는 대동맥 판막과 승모판막 치환술 이후 4년 8개월 동안 흉골감염이 반복되다가 갑작스런 출혈로 응급실에 내원해서 대동맥 혈관 촬영술을 통해 대동맥 피부 누공을 진단하여 응급 체외순환하에 일차 봉합만으로 더 이상의 재발없이 2년간 외래 추적 관찰 중이다.