• Journal of Chest Surgery
• /
• 제36권3호
• /
• pp.142-149
• /
• 2003

다혈관 질환에서 양쪽 내흉동맥을 사용하여 시행한 관상동맥 우회술의 가능성(feasibility)을 알고자 단기 임상 성적과 수술 직후 시행한 관상동맥 조영술을 분석하였다. 대상 및 방법: 2001년 1월부터 2002년 7월까지 우회술을 받은 환자는 총 405명으로, 그 중 양쪽 내흉동맥만을 사용한 159명(39.3%)을 대상으로 후향적으로 조사하였다. 평균연령은 $61.2{\pm}8.5$ (범위: 30~80)세로 남자가 123명이었다. 술 전 위험인자로 당뇨를 가진 환자는 54명(34.0%), 4주 이내 심근경색이 있었던 환자는 29명(18.2%), 응급수술을 받은 환자는 6명(3.8%)이었다. 심폐기를 사용하지 않은 관상동맥 우회술(Off-pump coronary artery bypass grafting)을 받은 환자는 128명(80.5%)이었다 동반된 수술은 승모판 성형술이 5명, 대동맥판막 치환술이 3명, Dor 수술이 1명 등이었다. 결과: 평균 원위부 문합수는 $3.1{\pm}0.9$개(범위, 2~6)였으며, 수술 후 평균 재원기간은 $8.4{\pm}4.5$일로, 수술사망은 1예(0.6%)에서 있었다. 조기사망 1예를 제외한 환자에서 저심박출량증후군(low cardiac output)을 경험한 예는 없었다. 다른 합병증으로는 출혈로 인한 재수술 3예, 수술 전후로 심근경색 1예, 일시적 심정지 2예, 섬망 7예, 일시적 뇌허혈증 1예에서 있었고, 심부 창상감염은 1예에서 있었다. 최근 수술 직후 혈관조형검사를 받은 삼중혈관 환자는 19명으로, 총 문합수는 78개(평균 $4.1{\pm}0.8$/환자)로 모든 문합부위의 개존을 확인할 수 있었으나 자연 관상동맥의 협착이 심하지 않은 부위에서 경합혈류를 보이는 것을 확인하였다. 결론: 양쪽 내흉동맥만으로도 삼중혈관 질환에서도 비교적 안전하게 우회술을 할 수 있으며, 또한 적은 수이기는 하지만 비교적 좋은 단기 개존율을 확인할 수 있었다. 하지만 경합혈류를 보인 곳의 장기 개존율 및 기능적 검사는 추후 필요할 것을 생각한다.

• 대한약리학회지
• /
• 제11권1호
• /
• pp.33-38
• /
• 1975

말정혈관확장제(末精血管擴張劑)인 Ethaverine의 임상효과(임상(臨床效果)는 말초동맥질환(末梢動脈疾患)을 갖인 29명(名)의 당뇨질환자(糖尿疾患者)를 대상으로 이중맹검(二重盲檢) 비교차(非交叉) 방법(方法)에 의(依)하여 연구검토(硏究檢討)하였다. 임상적(臨床的)인 개선(改善)은 간헐성파행증(間歇性跛行症)의 발생빈도(發生頻度)를 포함하는 환노(患老)들의 병역(病歷)으로부터 평가(評價)하였다. Ethaverine을 사주(四週) 치료후(治療後)는 임상증상(臨床症狀)을 개선(改善)하는데 있어 위약(僞藥)에 비(比)하여 효과가 없었다. 어째든 간에 Ethaverine은 위약(僞藥)보다는 혈관확장제(血管擴張劑)로서 효력이 있었다. Ethaverine에 의(依)하여 유발(誘發)되는 혈관확장제(血管擴張劑)의 성질(性質)은 alcohol의 그것과 유사하였다. 말초혈관확장제(末梢血管擴張劑)를 연구(硏究)하는 새로운 임상적(臨床的) 방법(方法)을 제시(提示)하였다. 하지(下肢)의 말초혈관(末梢血管) 동맥질환(動脈疾患)의 임상증상(臨床症狀)은 촉맥강도(觸脈强度)의 감소냉감(減少冷感) 및 피부(皮膚)의 변색(變色)등을 들 수 있다. 간헐성파행증(間歇性跛行症)도 수반하는 수가 있다. 혈관조직(血管組織)에 있어서의 병변(病變)이 이같은 증상(症狀)에 선행(先行)하여 일어나며 위중(危重)한 혈관부전(血管不全)의 입증(立證)은 혈관확장제료법(血管擴張劑療法) 또는 외과적(外科的) 처치(處置)를 택하는데 있어서의 결정적(決定的)인 요인(要因)이 된다. 만성 말초동맥질환(末梢動脈疾患)이 있는 술후환자(術後患者)들도 차후혈관확장제(次後血管擴張劑)의 치료(治療)를 받아야한다. 임상보고((臨床報告)에 의(依)하면 말초혈관확장제(末梢血管擴張劑)는 폐새성(閉塞性) 혈관질환(血管疾患)에 대(對)해서 보다는 혈관경련성(血管痙攣性) 말초혈관장해(末梢血管障害)에 대해서 보다 유효하며 비교적 큰 혈관상(血管床)보다는 작은 모세혈관상(毛細血管床) 일때의 혈관(血管)이 가장 잘 감응(感應)한다고 한다. 최근(最近)에 이르러 말초혈관확장제(末梢血管擴張劑)의 임상(臨床)효과는 수많은 임상연구가(臨床硏究家)들 및 임상의(臨床醫)들의 연구대상(硏究對象)이 되고있다. 본연구(本硏究)에서 연구자(硏究者)들은 혈관경련성말초동맥질환(血管痙攣性末梢動脈疾患)을 갖인 환자(患者)들에 대(對)한 말초혈관확장제(末梢血管擴張劑)로써의 Ethaverine HCl의 임상(臨床)효과를 재평가(再評價)하였다. Ethaverine은 각종임상시험결과(各種臨床試驗結果)에 의(依)하면 항경련제(抗痙攣劑)로서는 papaverine 보다도 2배(倍) 내지 4배(倍)정도 그 약효가 강력(强力)하다고 한다.

• Journal of Chest Surgery
• /
• 제32권11호
• /
• pp.1009-1016
• /
• 1999

Background: Minimally invasive direct coronary artery bypass surgery(MIDCAB) has been increasing in interest along with the new techniques in myocardial immobilization for easier and safer procedures. Until the opening of the era of new techniques, adequate accuracy and good patency of grafts were debatable. Our experiences of MIDCAB were studied according to the stages of technical developments. Material and Methods: Since March 1996, 55 patients have undergone MIDCAB procedures. The patients of off-pump CABG(no cardiopulmonary bypass under full sternotomy) were excluded from the study. In the early experience(Stage I), a left anterior small thoracotomy through the left parasternal incision was performed(n=6); then an approach through the lower partial sternotomy was used(Stage II, n=33); and recently, a chest wall elevator for harvesting the internal thoracic artery and the foot plate for myocardial immobilization have been used(USSC, Norwalk, CT)(Stage III, n=16). Result: The surgical procedures of four patients in the Stage II group have been converted to conventional bypass because of the deeply seated left anterior descending coronary artery in two patients, fracture of the calcific lesion in the right coronary artery in one patient, and a cardiogenic shock during hypothermia in the other patient with ventricular dysfunction. Two patients in stage II experienced symptomatic recurrences after surgery and restenosis was verified on angiocardiography. They were managed by interventional procedures. All the other patients were doing well without symptoms, except one patients in Stage II who underwent PTCA procedure for a lesion in the circumflex artery during the follow up period. Conclusion: The new and specialized devices are essential to the development of MIDCAB surgery. MIDCAB and the hybrid procedures in multi-vessel disease are on the way to further development. So far, our experience is limited only to a single device among the many new devices for the purpose.

• 대한한의학회지
• /
• 제29권2호
• /
• pp.1-6
• /
• 2008

Objectives: This study aimed to investigate the seasonal variation in stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions. Methods: 226 patients with acute stroke within 14 days onset were included, who were admitted to Kyunghee Oriental Medical Center from November 2005 to October 2006. The year was subdivided into four parts: spring (March-May); summer (June-August); fall (September-November); and winter (December-February). Stroke types, ischemic stroke subtypes, stroke risk factors and Sasang constitutions in the four groups were examined. Results: Ischemic stroke was most frequent in summer, whereas hemorrhagic stroke was most frequent in winter. There was no significant difference in seasonal variation of stroke. The frequency of ischemic heart disease among stroke risk factors was significantly high in spring (p=0.031). The frequency of hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia did not differ among seasons. There was no significant difference in Sasang constitution among seasons. Frequency of small vessel occlusion was highest in summer. Large artery atherosclerosis was frequent in spring and summer,but seasonal variation of ischemic stroke subtypes did not show statistical difference. Conclusion: Acute stroke demonstrates seasonal characteristics according to stroke types, ischemic stroke subtypes, risk factors for stroke, and Sasang constitutions. These results have important clinical implications in stroke prevention.

• 대한한방내과학회지
• /
• 제28권1호
• /
• pp.92-96
• /
• 2007

Objectives : This study investigated the clinical effect of a drinking habit in acute stroke patients. Methods : 409 acute stroke patients were included from October 2005 to October 2006. Patients were hospitalized within 14 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, or Department of Cardiovascular and Neurologic Diseases (Stroke Center), Kyung Hee University Oriental Hospital. We investigated general characteristics, drinking habit, and stroke subtype by TOAST classification. Results : Among drinking subjects, hemorrhagic stroke was more frequent than ischemic stroke (odds ratio 3.04), and less in small vessel occlusion than others (odds ratio 1.84). Ischemic stroke was associated with a longer (30 yrs) drinking habit than hemorrhagic stroke. Conclusions : To acquire more concrete conclusions on this theme, we need further and larger scale research.

• 대한한방소아과학회지
• /
• 제17권2호
• /
• pp.75-83
• /
• 2003

Background : Henoch-Schonlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria, and arthalgia. The exact etiology remain unknown despite a long and intensive research, but the findings showes immune mechanism is involved in the pathogenesis of this disease. The main clinical manifestations are skin rash, abdominal symptoms, joint symptoms, and renal involvement. And the existence of renal involvement influences on the course and prognosis of the Henoch-Schonlein purpura Objective : To demonstrate the therapeutic effect of herbal medicine(Kamiguibiondamtang) on parents with Henoch-Schonlein purpura Method : We treated two cases of Henoch-Schonlein purpura in a nine-year old male and a twenty-year old female, who showed multiple petechiae and ecchymoses on both extrimities with Kamiguibiondamtang. Result : A nine-year old male recovered completely and a twenty-year old female improved. Conclusion : We repert that we had good effects of herbal medicine treatment on two cases of Henoch-Schonlein purpura.

• 한국가금학회지
• /
• 제42권3호
• /
• pp.239-245
• /
• 2015

Transgenic animals have been widely used for developmental biology studies, as disease models, and even in industry such as transgenic bioreactor animals. For transgenic birds, quail has the great advantages of small body size, short generation time, and frequent egg production. To date, retroviral or lentiviral transduction has been used to generate transgenic quail for various purposes. However, the efficiency of transgenic offspring production with these methods is relatively low and viral vector usage has safety issues. Unfortunately, non-viral transgenesis has not been established in quail due to a deficiency of stem cell and germ cell culture systems. In this study, we established a direct in ovo lipofection method that could be used to create transgenic quail without germline-competent cells or viruses. To optimize the injection stage during embryo development, the liposome complex (containing piggyBacCMV-GFP and transposase plasmids) was introduced into an embryonic blood vessel at 50 hr, 55 hr or 60 hr. GFP expression was detected in various tissues (heart, kidney, liver and stomach) on day 12 of incubation under a fluorescence microscope. Additionally, GFP-positive cells were detected in the recipient embryonic gonads. In conclusion, the direct in ovo lipofection method with the piggyBac transposon could be an efficient and useful tool for generating transgenic quail.

• Journal of Chest Surgery
• /
• 제47권3호
• /
• pp.220-224
• /
• 2014

Background: For the surgical management of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), there have been various techniques that reduce the tension and kinking of the coronary artery during reimplantation to the aorta. The aim of this study is to describe the results of our modified technique of coronary reimplantation for the treatment of ALCAPA. Methods: Between October 2003 and February 2011, seven patients underwent coronary reimplantation with the modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta). The median follow-up duration was 52 months (range, 4 to 72 months). Clinical outcomes and serial echocardiographic data were reviewed. Results: There was no mortality. One patient had a small amount of cerebral hemorrhage postoperatively and improved without any sequelae. Another patient had left diaphragm palsy and underwent diaphragm plication. Follow-up echocardiogram showed that all patients had normal ventricular function without chamber enlargement. Conclusion: Our modified technique (tubing formation with the sinus wall of the pulmonary artery and trapdoor formation at the site of implantation in the aorta) demonstrated successful clinical outcomes. We conclude that this surgical technique can be a potential alternative for the treatment of ALCAPA.

• Childhood Kidney Diseases
• /
• 제10권1호
• /
• pp.40-44
• /
• 2006

[ $Henoch-Sch{\"{o}}nlein$ ] 자반증은 소혈관의 혈관염으로 오는 전신적 혈관 장애로 자반, 위장 증세, 관절 증세, 신 증세를 주 증세로 하는 질환이다. HSP의 흔한 피부증상은 주로 궁둥이와 하지의 자반 증상이며 성인에서는 출혈성 수포를 동반하는 경우가 흔하나 소아에서는 드문 것으로 알려져 있다. 저자들은 관절통과 복통을 호소하는 환아에서 출혈성 수포가 동반되어 있어 피부조직 검사를 하였고 진피의 leukocytoclastic vasculitis와 면역 형광법상 소혈관의 IgA와 fibrinogen의 침착을 관찰하였다. HSP로 진단하여 스테로이드 치료를 하였고 수일 내로 관절통과 복통이 호전되어 문헌고찰과 함께 보고하는 바이다.

• 대한중풍순환신경학회지
• /
• 제7권1호
• /
• pp.54-58
• /
• 2006

Objectives : This study was aimed to investigated the relationship between warning signs and stroke subtype in acute stroke patients. Methods : From Oct. in 2005 to Oct. in 2006, 409 acute stroke patients were included. Patients were hospitalized within 14 days after the onset of stroke in DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, Department Cardiovascular and Neurologic Diseases(Stroke center) Kyung Hee University Oriental hospital. We investigated general characteristics, stroke subtype, and warning signs(facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke. (odds ratio 3.60) Small vessel occlusion had more neck stiffness than others. (odds ratio 2.03) Conclusion : To acquire more concrete conclusions on warning signs, we need further and large scale of prospective researches.