• Journal of Chest Surgery
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• 제26권4호
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• pp.276-281
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• 1993

During the 3 years through December 1992, 118 cases of coronary bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. They consisted of 80 males and 38 females with the mean age of 59. History of myocardial infarction was noted in 23 cases[20%], congestive heart failure in 11[10%], left ventricular aneurysm in 6, postinfarct VSD in 2, and mitral regurgitation in 1. The angina was stable in 13 cases, and unstable in 104 cases[89%]. Left main stem disease were 41 cases[35%], triple vessel 36[31%], double vessel 30[26%] and single vessel involvement[LAD] in 10. We performed 335 distal bypasses out of 117 cases, with single bypass in 9, double 29, triple 52, quadruple 23, and quintuple 4. Myocardial protections were cardioplegia in 29 and intermittent aortic occlusion 79 and continuous aortic perfusion 7. The ischemic time per graft was 13 minutes[intermittent aortic occlusion group] and 20 minutes [cardioplegia group] respectively, and the mean number of graft per patient is 2.85. Early mortality was 6.8% [8/117]. If we exclude the patients with LV aneurysm, the surgical mortality could be downed to 4.5% [5/111]. The causes of deaths were cardiogenic shock[6], aortic dissection[1], and neurologic complication[1]. We conclude that noncardioplegic myocardial protection may be equally beneficial or sometimes advantageous to cardioplegic technique in aortocoronary bypass graft surgery.

• Journal of Chest Surgery
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• 제26권1호
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• pp.4-11
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• 1993

The Korean Thoracic and Cardiovascular Surgical Society was founded in 1968. After the first Board Certified Examination in 1972, the Society consists of 592 members including 392 specialists [certified board members] now in 1992. Many of the great advances in cardiothoracic surgery were made by pioneering efforts of these members. The annual increment rate of certified board members in KTCSS [KTCSS Boardmen] was 11.9% which was slight greater than that of doctors [6.6%] and overall specialists [9.9%] in Korea. Their working territories were mainly urban areas [91.9%]. Some states showed regional discrepancy in supply/demand of KTCSS Boardmen. 56.1% of all [73.5% of active members] was working at a larger institute than general hospital. There were 99 institutes [41university hospitals and 58 general hospitals] and 76 private clinics where KTCSS Boardmen were employed, and more than three quarters of those institutes have less than 3 in number of KTCSS Boardmen. The rate of practicing private clinics was declined from over than 50% of the beginning to less than 30% now. We propose this survey for a basic data for specialist supply/demand and resident training program.

• Journal of Chest Surgery
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• 제41권1호
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• pp.25-33
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• 2008

배경: 말기 장기부전 환자가 증가하고 있지만 장기 공여자의 수는 부족하여 이종장기 이식의 필요성이 대두되고 있다. 하지만 아직까지 이종장기 이식 시 발생하는 면역학적 거부 반응은 해결되지 못하고 있다. 이에 본 연구에서는 이종장기 이식에서의 거부반응 극복을 위한 노력의 일환으로 돼지 심장의 생체 외 인간 혈액 관류 모델을 만들어 장기에 대한 인간 혈액의 거부반응과 관련되어 발현되는 유전자에 대한 기능을 규명하고 거부반응 극복을 위한 활용방안을 연구하고자 하였다. 대상 및 방법: 돼지의 심장을 이용한 생체 외 인간혈액 관류 모델을 구축하여 인간 혈액을 관류시킨 뒤 시간의 경과에 따른 유전자 발현양상의 변화를 관찰하여 시간 변화에 다르게 발현되는 30여 개의 유전자 중하나인 GADD45 ${\beta}$를 찾았다. GADD45 ${\beta}$의 역할을 규명하고자 쥐의 심근 세포주 H9C2에 GADD45 ${\beta}$를 삽입시켜 과발현 시켰고 다양한 염증 및 거부반응 환경에서 이 유전자의 발현양상과 기능을 알아보고자 역전사 중합 효소 연쇄반응(RT-PCR)을 통해 GADD45 ${\beta}$의 발현 정도와 심근 세포주의 자멸사 정도를 평가하였다. 결과: 세포 손상을 주지 않은 상태에서는 GADD45 ${\beta}$를 삽입한 군에서 GADD45 ${\beta}$를 삽입하지 않은 군보다 GADD45 ${\beta}$의 발현이 증가하였으며 GADD45 ${\beta}$를 삽입하지 않은 군에서 세포 손상을 준 후 측정한 GADD45 ${\beta}$발현은 시간에 따라서 변화하는 양상을 보여 1시간까지는 증가하다가 그 이후에는 감소하였다. 세포에 인간 혈청으로 세포 손상을 주고 세포의 자멸사를 평가한 결과 GADD45 ${\beta}$를 삽입한 군에서 GADD45 ${\beta}$를 삽입하지 않은 군에 비해서 자멸사 정도가 적었다. 결론: GADD45 ${\beta}$를 삽입시킨 세포주는 인간의 혈청에 의한 세포 손상이 GADD45 ${\beta}$를 삽입시키지 않은 세포주 보다 자멸사의 정도가 적어 GADD45 ${\beta}$는 세포 손상에 의한 세포의 자멸사를 줄여 세포를 보호하는 역할을 하였다.

• Journal of Chest Surgery
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• 제28권11호
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• pp.983-988
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• 1995

From January 1983 to December 1994, 48 cyanotic patients were underwent a subclavian artery-pulmonary artery shunt using polytetrafluoroethylene[PTFE for the purpose of improvement of reduced pulmonary blood flow. The diameters of the PTFE used were 4mm[4 cases , 5mm[36 cases , and 6mm[8 cases sizes. The effectiveness of modified Blalock-Taussig shunts was evaluated clinically and angiographically. There were 5 early deaths and 2 late deaths. There were 3 early shunt failures and 5 late shunt failures. The overall graft patency rate was 83.3%. Postoperative hemoglobin was reduced significantly[p = 0.0011 in comparison of the preoperative and postoperative hemoglobin, SaO2, PaO2, and cardiothoracic ratio.

• Parasites, Hosts and Diseases
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• 제47권4호
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• pp.405-407
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• 2009

On July 2009, 5 fly larvae were discovered inside the nose of a 76-year-old female. She was living in Cheonansi, and in a state of coma due to rupture of an aortic aneurysm. Surgery was performed on the day of admission, and the larvae were found 4 days later. By observing their posterior spiracle, the larvae were identified as Lucilia sericata. Considering the rapid development of this species, the infection was likely acquired during hospitalization. Further investigation on the hospital environment should be needed to know the origin of the infection.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.170-176
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• 2021

Purpose: Traumatic sternal fractures are rare but quite disabling injuries. Timely fixation of sternal fractures reduces pain and prevents respiratory complications. However, the fixation technique should be simple, effective, and readily available in local circumstances. Methods: From January 2014 to March 2020, seven patients with sternal fracture/dislocation underwent steel wire fixation with the new "Timala" technique. In this technique, adjacent ribs are anchored with two steel wires to form an "X" in front of the fractured segment of the sternum. Patients were followed up clinically and radiologically. Results: Six of the patients were men and one was a female. Five of them had injuries due to falls and two were injured in road traffic accidents. Their age ranged from 18 years to 76 years, with a median age of 41 years. All seven patients experienced immediate recovery from pain and showed evidence of fracture healing on postoperative chest X-rays and clinical examinations. Conclusions: Anchoring ribs to fix the sternum with steel wire is a safe, effective, easily available, and reproducible method to fix sternal fractures or dislocations.

• Tuberculosis and Respiratory Diseases
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• 제82권3호
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• pp.266-267
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• 2019

• Journal of Chest Surgery
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• 제42권5호
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• pp.561-565
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• 2009

배경: 최근 국내외 연구환경의 변화로 논문저술의 양상이 변하고 있으나 한국 흉부외과의사들의 저술활동에 대해서는 분석된 바가 없다. 대상 및 방법: 1995년부터 2008년까지 14년간 대한흉부외과학회 소속 의사들이 국내외 주요 학술잡지에 발표한 윈저논문을 대상으로 하였다. SCI (Science Citation Index)급 해외 흉부외과 학술잡지 3개와 대한흉부외과학회지 및 Pubmed의 인터넷 홈페이지를 통해 자료를 수집하였고 이를 연도별, 분야별로 분석하였다. 결과: 해외잡지에 게재된 논문의 총수는 14,629편이었으며 이중 한국흉부외과의사에 의해 작성된 것은 157편으로 1.07%를 차지하였다. 2002년까지 총 7,674편중 28편(0.36%)이었던 것이 2003년부터 급격히 증가하여 총 6,955편중 129편(1.83%)이 게재되었다. 반면 대한흉부외과학회지에 게재된 논문의 수는 1999년까지 연평균 126.8편이던 것이 2000년 이후로는 연평균 80.0편으로 감소하였다. 또한 원저의 비율은 1999년까지는 58.8%이었던 것이 2000년 이후에는 48.3로 감소하였다. 결론: 2000년대에 들어서면서 국내잡지보다는 해외잡지에 논문을 투고하는 경향이 증가하였으나 상대적으로 국내잡지의 게재논문 수 및 원저의 비율이 줄어들고 있어 대책마련이 시급하다.

• Journal of Chest Surgery
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• 제49권3호
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• pp.177-184
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• 2016

Background: Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Several therapeutic and preventive strategies have been introduced for postoperative AF, but the treatment and prophylaxis of AF remain controversial. We aimed to compare the efficacy of intravenous amiodarone and oral propafenone in the treatment of AF after coronary artery bypass grafting (CABG). Methods: This was a randomized controlled trial performed in two hospitals in Shiraz, Iran from 2009 to 2012. We included all patients who underwent elective CABG and developed AF postoperatively. The patients were randomly assigned to receive propafenone or amiodarone. The duration of AF, the success rate of the treatment, the need for cardioversion, the frequency of repeated AF, and the need for repeating the treatment were compared. Results: The duration of the first (p=0.361), second (p=0.832), and third (p=0.298) episodes of AF, the need for cardioversion (p=0.998), and the need to repeat the first and second doses of drugs (p=0.557, 0.699) were comparable between the study groups. Repeated AF was observed in 17 patients (30.9%) in the propafenone group and 23 patients (34.3%) in the amiodarone group (p=0.704). Conclusion: Oral propafenone and intravenous amiodarone are equally effective in the treatment and conversion of recent-onset AF after CABG.

• Journal of Chest Surgery
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• 제19권1호
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• pp.43-49
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• 1986

At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.