최근 10년간 원광의대병원에서 시행한 소아 심장혈관 수술의 임상적 고찰

윤향석,정수미,최두영,오광수,오연균,김종덕,양현웅,이삼윤,김형곤,최종범,최순호,노병석 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We reviewed 10 years experiences of the clinical aspects and early postoperative results in 544 pediatric patients(age less than 16 years old). Among them. 529 cases had the congenital heart diseases, and 15 had the acquired diseases. Open heart surgery was performed in 413 patients. 115 cases were treated with non-open heart surgery. 16 with interventional catheterization. Annual increase of the cardiac patients was not significant in recent 10 years, except slight increase in 1994. The mean age of the study patients had been evidently changed to younger year by year. Total mortality rate of the open heart surgery was 6.4%. The cyanotic congenital heart diseases were high in early postoperative mortality by 25.7%, whereas 4% in acyanotic group. The age group less than one month was most highest in surgical mortality(66.7%). There were no deaths in patients with patent ductus arteriosus(103 cases), atrial septal defect(83 cases) or pulmonary stenosis(17 cases). Among 220 patients with ventricular septal defects(VSD). 10(4.5%) were died early postoperatively. In cyanotic group, the patients with pulmonary atresia with ventricular septal defects(PAVSD), transposition of the great arteries(TGA), interrupted aortic arch(IAA), complex cardiac anomalies with isomerism seemed to be most susceptible to an early death.

심부 매복 정중 과잉치 수술 시 마취방법 선택

민수영,송제선,이제호,최형준,손흥규,김성오 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it’s need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc. 정중 과잉치(mesiodens)는 대개 상악 절치부에서 발견되며, 주로 구개측에 위치하는 경향이 있다. 정중 과잉치의 자연맹 출 가능성이 관찰되면, 주기적으로 검사하여 구강내로 충분히 맹출한 후에 단순발치를 시행한다. 주기적 검사에서 자연맹출 소견이 보이지 않거나, 형태이상 혹은 맹출방향의 이상으로 구강 내로 자연맹출 할 가능성이 없으면, 수술적 제거방법을 고려 해야 할 것이다. 특히, 인접한 중절치나 측절치의 맹출을 방해하고 있는 상황이 관찰된다면, 빠른 시일 내에 과잉치 제거를 위 한 수술적 방법을 시도하는 것이 타당하다. 한편, 외과적 수술의 시기를 늦추는 것을 고려해야 하는 경우도 있다. 정중과잉치가 인접하여 발육중인 정상 치아의 맹출을 방해하지 않는 경우이다. 이때, 삼차원 CT사진을 촬영하여보면, 과잉치 주변으로 영구절치의 치배가 근접하여 성곽처럼 둘러 싸고 있는 것을 볼 수 있다. 미성숙한 치배가 둘러 싸고 있는 상황에서, 무리하게 과잉치를 제거하려고 시도할 경우 인접 치배 를 손상시킬 가능성을 배제하기 어렵다. 이 점을 고려 한다면, 가급적 인접한 치아의 치근이 보다 발육한 후에 수술을 시도하 는 것이 바람직할 것이다. 초등학교 2학년 이상의 어린이들은 외래에서 국소마취하 제거하는 수술방법에 대개 잘 적응하며 고학년이 될수록 보다 수월해진다. 수술시기를 너무 늦추거나, 과잉치가 너무 늦게 발견된 경우 구개측 심부로 깊이 이동한 것을 볼 수 있다. 때로는 과잉치의 위치가 처음부터 심부에 매복되어 있을 수 있다. 이와 같은 경우, 전신마취방법을 생각해 볼 수 있을 것이다. 본 증례는 상악 정중부의 깊은 부위에 역위 매복된 과잉치를 외래에서 국소마취하에 치료를 시도할 때 관찰되는 문제점을 고찰하였고, 전신마취방법을 결정하기 위한 기준을 제시하였다. 심부 매복된 치아의 외과적 발거시 어린이의 행동조절이 가장 큰 문제였으며, 방사선 소견상 과잉치 치관의 위치가 절치의 치근단보다 상방에 위치할 경우 전신마취로 전환 하는 것이 바람직 할 것으로 사료된다.

대동맥-장골동맥 폐색증에 대한 경피경관 혈관성형술 및 스텐트삽입술의 누적개존율

최동현,이상목,고석환,홍성화,오수명,윤충,박호철,오주형 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

하악 제3대구치와 하악관과의 위치관계에 대한 파노라마 방사선사진과 cone beam형 전산화단층영상의 비교

최형수,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.3

Purpose : To assess the diagnostic accuracy and value in an imaging technique field through the comparison of cone beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Materials and Methods : Participants consisted of 100 patients offered the images through cone beam computed tomography and panoramic radiography. PSR-9000 Dental CT system (Asahi Roentgen Ind. Co., Ltd, Japan) was used as the unit of cone beam computed tomography. CE-II (Asahi Roentgen Ind. Co., Ltd, Japan) and Pro Max (Planmeca Oy, Finland) were used as the unit of panoramic radiography. The images obtained through panoramic radiography were classified into 3 types according to the distance between mandibular canal and root of mandibular third molar. And they were classified into 4 types according to the proximity of radiographic feature. The images obtained through cone beam computed tomography based on the classification above were classified into 4 types according to the location between the mandibular canal and the root and were analyzed. And they were classified into buccal, inferior, lingual, and between roots, according to the location between mandibular canal and root. The data were statistically analyzed and estimated by χ²-test. Results : 1. There was no statistical significance according to 3 types (type l, type ll, type lll) through CBCT. 2. The results of 4 types (type A, type B, type C, type D) through CBCT were as high prevalence of CBCT 1 in type A, CBCT 2 in type B, CBCT 3 in type C, and CBCT1 in type D and those of which showed statistical significance (P value=0.03). 3. The results according to location between mandibular canal and root through CBCT recorded each 49, 25, 17, 9 as buccal, inferior, lingual, between roots. Conclusion : When estimating the mandibular canal and the roots through the panoramic radiography, it could be difficult to drive the views of which this estimation was considerable. Thus it is required to have an accurate diagnostic approaching through CBCT that could estimate the location between mandibular canal and roots.

개심술(開心術)의 임상적 고찰 : 치험 200예 200 Cases

최형호,서홍주,임영혁,김정중,배대양,이석기,임진수 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Background and Objectives: Two hundred cases of the open heart surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 2001. Material and Methods: The number of congenital heart disease was 132 cases. 68 cases were acquired heart disease. 'The age of the congenital heart disease was from 22 days to 45 years. In the acquired heart disease, the age was from 14 to 72 years. Result: Congenital heart disease consisted of 113 congenital acyanotic heart disease, 19 congenital cyanotic heart disease. Corrective operation was done for congenital heart disease with 4. 5 % operative mortality. Of 68 cases acquired heart disease, 44 patients were valvular heart disease, 3 cardiac tumors, 9 ischemic heart diseases, 12 aortic dissections and etc. The operative mortality was 13%. Conclusion: The postoperative complications were appeared in 68 cases and the complications were wound infection, occipital alopecia, low cardiac output syndrome, arrhythmia, septicemia etc. The mortality after open heart surgery was 15 cases and the causes of death were low cardiac output syndrome, septicemia, respiratory failure and left ventricle rupture.

정보기술이 저항수준에 미치는 영향에 관한 연구

최수형 울산대학교 1999 경영학연구논문집 Vol.6 No.1

Responses from the information users on the information technology(IT) are very important to the success of IT, when new IT is introduced, resistance from the information users are likely to be happen. If appropriate management for IT is not carried out, resistance from the users of IT will be continued. It is necessary for the organizations to minimize user's resistance to the IT in order to reduce the introduction cost of IT and to enhance the degree of usage. To reduce the resistance of users the resistance factors should be analyzed first and then, they should be controlled later on. The purpose of this study is to find out the various factors which affect the employees' resistance to IT in the process of introducing IT, and identify differences in the resistance management according to the organizational level.

해안 저질토중 중금속과 유기물질의 오염에 관한 연구

최형일,정경훈,김인수,송영일 조선대학교 환경연구소 1994 環境公害硏究 Vol.11 No.-

The contents of heavy metals and total organics in bottom mud of the Mokpo marine have been investigated. This area was divided into three regions; Daebul, Mokpo, and Sanjung, and sampling sites region were selected by eight sites. Marine bottom mud mere investigated three times during this study and twenty-four samples are taken from eight sampling sites. Analytical species were Cdmium, Copper, Lead, zinc, Arsenic and total organics. The Heavy metals were analyzed by atomic absorption spectrophotometry, also total organics were analyzed by gravimetry. The major resurts of the studies were as follows: 1. The contents of the heavy metals and total organics in marine bottom mud were Cadium 0.272 mg/kg, Copper 3.384 mg/kg, Lead 9.647 mg/kg, zinc 10.031 mg/kg, Arsenic 0.636 mg/kg, Total organics 5.99 wt%. 2. The Zinc was higher than any other heavy metals in the marine bottom mud. The mean contents of heavy metals in Sanjung region was the lowest. 3. Lead and Arsenic species were influenced by the pollutants influxed from Youngsan River, and Cadium and Copper were less than it's contents of the natural soils. 4. The total organics in the marine bottom mud was exceedingly increased as the contrasted with the small particle size of the marine bottom mud, and the corelation coefficients between heavy metals and total organics were high. (0.5<r<0.8)

흰쥐 적출 대동맥에서의 알파-1 아드레날린성 수용체 탈감작 현상

최도희,한형수,박정숙,김중영 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.4

목적 : 흰쥐의 적출 대동맥 절편에서 알파-1 아드레날린성 수용체의 탈감작에 따른 수축력 변화를 확인하고 수축력 변화와 관련된 요인들과의 관계를 검정하기 위해 실시되었다. 대상 및 방법 : Sprague-Dawley rat의 대동맥을 적출하여 알파-1 아드레날린성 수용체 선택적 효현제인 phenylephrine으로 탈감작시킨 뒤 수축력과 이완력의 변화를 확인하였다. 결과 : Phenylephrine에 의한 수축력은 phenylephrine 탈감작에 의해 감소되었다. EDRF와 관련이 있는 이완제인 acetylcholine과 histamine에 의한 이완반응은 phenylephrine 처치로서 변화를 볼 수 없었으나 sodium nitroprusside에 의한 이완은 항진되었다. 탈감작현상은 LNMMA와 methylene blue처치로 인해 영향을 받지 아니하였다. KCl에 의한 수축은 phenylephrine 탈감작으로 억제되었으나 phorbol ester에 의한 수축은 phenylephrine 탈감작으로 인해 영향을 받지 아니하였다. 결론 : phenylephrine에 의해 나타나는 알파-1 수용체 탈감작에 따른 수축력 감소 현상은 이완 작용의 변화와는 관련이 없으며 수축기전의 변화, 특히 calcium에 대한 반응성의 변화에 기인함을 시사하였다. We evaluated alpha 1 adrenergic receptor desensitization and decreased contractility in isolated rat aorta. 4 hour exposure to 10^-5M of phenylephrine (phenylephrine exposure) decreased phenylephrine(10^-10 to 10^-5M)-induced contractility. Phenylephrine exposure had no effect on the relaxation by NO releasing agents, such as acetylcholine(10^-9 to 10^-5M) and histamine(10^-8 to 10^-4M), but enhanced nitroprusside(10^-10 to 10^-6M)-induced relaxation. Phenylephrine-induced desensitization was not altered by the presence of methylene blue and N-monomethyl-L-arginine. After phenylephrine exposure KCl-induced contractility was decreased but phorbol ester-induced contractility was not changed. From these results we can assume that prolonged phenylephrine exposure alter calcium-dependent contraction mechanism and involve in alpha 1 adrenergic receptor desensitization-mediated decrease in contractility.

鑄鐵材料의 Melt Treatment 및 Carbon Contents에 關한 硏究

최익수,김성주,문형태,노무근 삼척대학교 산업과학기술연구소 2001 産業科學技術硏究論文集 Vol.6 No.1

It is the purpose of this study to investigate the melt treatment and properties of cast iron by varifying the holding time after inoculation treatment and carbon contents. The main results obtained by investigating the microstructure and carbon contents are as follows : The number of graphite in cast iron decreases by increasing the holding time of melts after inoculation treatment, and the coarsening of graphite is achieved by increasing the length and thickness of graphite. As the carbon contents increase in cast iron, the shape and size of graphite in cast iron structure increase continuously.

4세대 이동 멀티미디어 시스템의 연구동향 분석

최명수,박형준,박남철,김경호,이성로 목포대학교 정보산업연구소 2000 情報産業硏究誌 Vol.8 No.-

In this paper, we first define 4th-generation multimedia systems that play an important role in 21C information society. Nest, we investigate and analyze the international trend of the related research and then predict the evolutionary model for 155Mbps wireless mobile multimedia systems.