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李寧均,元官喜,朴鍾善,鄭埈 中央醫學社 1963 中央醫學 Vol.5 No.3
Fifty cases of congenital cardiac malformation and fifty cases of acquired heart disease and injuries of cardio-vascular system were treated Surgically in this department. Main lesions of congenital origin were twenty-two cases of tetralogy of FalIot and 16 cases of patent ductus arteriosus. Mair lesions of acquired type were five cases of cardiac trauma, nine cases of aortic and major arterial injury, and thirteen cases of mitraI stenosis, Three cases of typical pulseless disease with eye-ground findings and four cases of Mitral insufficiency. In twelve cases general hypothermia were utilized. Oul of seventeen open heart Surgery cases with Bubble type oxygenator four Mitral insnfficiency and one Atrial septal defect cases surrvied but all six teralogy cases expired, . In two cases hypothermic hemodilution peousfusion with double helix resesvoir oxygenator were` utilized with one surviirval. In congenital cyanotic malformation group Glenn proceadures were performed in nineteen cases,. inducing fifteen cases of tralalogy of Fallot. In mitral insufficiency open mitral valvuloplasty was done with ivalon baffle attachment to the mural cusp in two cases.
완전뇌허혈후 재관류시에 국소뇌혈류, 체성감각유발전위 및 신경학적 회복에 대한 Mannitol과 Thiopental의 효과
박춘근,이상원,박영섭,최승진,허필우,정동섭,강준기,최창락 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.2
The cardiopulmonary bypass or cerebral circulation arrest is often used in the treatment of complex aneurysm or of arteriovenous malformation to decrease the risk of intraoperative aneurysm rupture. Although experimental studies have suggested that some drugs may protect the brain from ischemic injury, there are limitations in maintaining cerebral perfusion arrest without incurring neurologic deficits due to the initiation of detrimental processes including excitotoxic neuronal injury, activation of phospholipases, influx of calcium, and generation of damaging free radicals. The purpose of this study is to determine wheter mannitol or thiopental has any favorable effects on the recovery of neurologic deficits and on the regional cerebral blood flow(rCBF), somatosensory evoked potential(SEP) and electroencephalogram(EEG) in cats which underwent 15 minutes-complete global ishcemia-reperfusion. The complete global ischemia was produced in 38 cats by temporary intrathoracic occlusion of the innominate artery and the subclavian artery following ligation of bilateral mammary arteries and simultaneous induction of hypotension. The cats were allocated randomly to one of 4 treatment groups : (1) control group, 8 cats received equal volume of saline solution : (2) thiopental group, 10 cats received 45㎎/㎏ thiopental intravenously, (3) mannitol group, 10 cats received 2g/㎏ mannitol intravenously, (4) combined mannitol and thiopental group, 10 cats received equal dose of mannitol and thiopental intravenously. The drugs were administrated in a equally divided dosage before and after the ischemic episode. The results were as follos : 1) Eight animals which received saline showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia. 2) Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours the ischemia. 3) Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of 10 mannitol-treated animals and 8 of 10 combined treated animals were significantly recovered in all parameters. There were not significant differences in all parameters between the mannitol-and combined treated groups. 4) Thirty-four of 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits inspite of treatment with mannitol, thiopental or both of them. These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be far less than 15 minutes.
Choon Sung Lee,Chang Ju Hwang,Dong-Ho Lee,Yung-Tae Kim,Hee Sang Lee 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.1
Background: Lumbar spine fusion rates can vary according to the surgical technique. Although many studies on spinal fusionhave been conducted and reported, the heterogeneity of the study designs and data handling make it diffi cult to identify whichapproach yields the highest fusion rate. This paper reviews studies that compared the lumbosacral fusion rates achieved with differentsurgical techniques. Methods: Relevant randomized trials comparing the fusion rates of different surgical approaches for instrumented lumbosacralspinal fusion surgery were identifi ed through highly sensitive and targeted keyword search strategies. A methodological qualityassessment was performed according to the checklist suggested by the Cochrane Collaboration Back Review Group. Qualitativeanalysis was performed. Results: A literature search identifi ed six randomized controlled trials (RCTs) comparing the fusion rates of different surgical approaches. One trial compared anterior lumbar interbody fusion (ALIF) plus adjunctive posterior transpedicular instrumentation withcircumferential fusion and posterolateral fusion (PLF) with posterior lumbar interbody fusion (PLIF). Three studies compared PLFwith circumferential fusion. One study compared three fusion approaches: PLF, PLIF and circumferential fusion. Conclusions: One low quality RCT reported no difference in fusion rate between ALIF with posterior transpedicular instrumentationand circumferential fusion, and PLIF and circumferential fusion. There is moderate evidence suggesting no difference in fusionrate between PLF and PLIF. The evidence on the fusion rate of circumferential fusion compared to PLF from qualitative analysiswas confl icting. However, no general conclusion could be made due to the scarcity of data, heterogeneity of the trials included,and some methodological defects of the six studies reviewed.