Ebstein 기형에 대한 개심술 -12례 보고-

안혁,박이태,노준량,서경필,이영균,Ahn, Hyuk,Park, Yee-Tae,Rho, Joon-Ryang,Suh, Kyung-Phill,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.2

Ebstein's anomaly is a rare congenital cardiac malformation oand the ideal surgical correction seems controversial at present, and some problems are left unsolved in the surgical correction of this anomaly. Between June 1978 and June 1982, 12 patients with Ebsteins' anomaly underwent corrective open heart surgery at Seoul National University Hospital. Except for one patient, who had no ASD, all had a huge right atrium, secundum type ASD, and definite atrialized right ventricle. Typically, displaced tricuspid valve leaflets were found in all cases, but the degree of displacement and deformity were variable. In the point of NYHA functional classification, five were in class II, six were in class III, and one was in class IV. Ten patients were operated on by tricuspid valve replacement and pication. Two patients were operated on only by plication and annuloplasty techniques, and in all cases, ASD was closed. Postoperatively, four patients suffered from complete A-V block, and two of them died immediately. The remaining two patients took pacemaker generator implantation with good results. The other eight patients were in good condition. Tricuspid valve replacement using tissue valve and plication of the atrialized rght ventricle seems to be a good method of surgical correction for Ebstein's anomaly.

가토 압력과부하 심근비후에서의 Nuclear DNA 의 변화

김도헌(Do Heon Kim),이예봉(Ye Bong Lee),한동선(Dong Sun Han),이학중(Hak Choong Lee),박이태(Yee Tae Park),김성숙(Sung Sook Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.3

N/A Background: During the development of cardiac hypertrophy, cytoplasmic contents of cardiac myocytes usually increase and nuclei of myocytes change as well. We used flow cytometry to study the changes of nuclear DNA in cardiac hypertrophy which was experimentally produced by aortic banding in New Zealand White Rabbits. This study was aimed to see how early these nuclear changes can occur and whether these changes correlate to the degree of cardiac hypertrophy. Methods: Each two rabbits were sacrificed at 0-,4-,8-,12- hours, and 1-,2-,4-,5-, and 9- days after experimental aortic constriction and their hearts were studied with flow cytometric analysis. Nuclear DNA was analyzed with FACScan (Becton-Dickinson Co.) after tissue preparatian using modified Hedley and Vindelov method, and staining with Krishan staining buffer. Results: The heart weight to body weight ratio (g/kg) increased progressively as a results of time lapsing after aortic banding. In control hearts (Group I ), flow cytometric analysie showed normal Diploidy pattern in all tissues. In hypertrophied hearts, Proliferative Indicies (S+GM Phase) were increased progressively in Group II (4, 8, 12 hours after aortic banding) and Group III (24 hours to 9 days after aortic banding). An Aneuploidy pattern was noticed in a severely hypertrophied heart produced 9 days aortic banding. Conclusions: Changes of nuclear DNA developed even in the early times in the experimental model of pressureoverload cardiac hypertrophy of rabbit after aortic banding and it was roughly correlated with the degree of heart hypertrophy. Abnormal DNA ploidy pattern can be observed in the severely hypertrophied heart.

단심실증의 수술치험 2례

박이태,유영선,이광숙 啓明大學校 醫科大學 1984 계명의대학술지 Vol.3 No.1

A modified Fontan procedure was performe on two patients with univentricular heart. The first patient had UVH of right ventricular type with trabecular pouch and had various associated anomalies, such as common atrium, common atrioventricular valve and combined pulmonary stenosis. The second patient had UVH of left ventricular type with ourlet chamber and the associated anomalies were atrial septal defect, tricuspid stenosis and combined pulmonary stenosis. Postoperative hemodynamic insufficiency, fluid retention and renal insufficiency were occured in the first patient, but relieved with the aid of inotropics and vasodilators. We thought that the good postoperative course and surgical result were gained from the widely patent atriopulmonary anastomosis.

인공심폐기분리시 우심실과 좌심실충만압의 상호작용에 관한 연구

박이태,유영선 啓明大學校 醫科大學 1987 계명의대학술지 Vol.6 No.1

The period of terminating cardiopulmonary bypass is one of the high-risk periods because it possesses a great deal of hemodynamic changes, This transition must be carefully controlled because a poorly performed transition can injure the patient. We inserted balloon-tipped thermo-dilution catheter in 12 patients who underwent valve replacement for evaluation of the hemodynamic changes and defining the reliable hemodynamic criteria of cardiopulmonary bypass weaning with the aid of cardiac output computer. In 7 patients, cardiopulmonary bypass weaning was uneventful at first attempt. The mean cardiac index was 2.73±0.32/min/m²and the mean CVP/PCWP ratio was 0.59±0.15. In 5 patients, at the first attempt of cardiopulmonary bypass weaning, the mean cardiac index was 1.74±0.20/min/m²and the amen CVP/PCWP ratio was 1.33±0.36. So cardiopulmonary bypass was resumed and the abnormal hemodynamic finding were corrected, then the cardiac index was resumed and the abnormal hemodynamic findings were corrected, then the cardiac index was 2.62±0.36/min/M²CVP/PCWP ratio was 0.83±0.05. These data suggest that the relationship between right and left ventricular filling pressures, the CVP/PCWP ratio, may be a more valuable guide during cardiopulmonary bypass weaning than the individual right and left ventricular filling pressures.

가토 허혈-재관류 심근에서의 Apoptosis에 대한 Superoxide Dismutase의 효과

김영권,박이태,김성숙 대한순환기학회 1997 Korean Circulation Journal Vol.27 No.9

심근세포 및 내피세포의 분화에 미치는 Dimethyl Sulfoxide의 영향

이동협,박이태,한승세,이융창 영남대학교 의과대학 1988 Yeungnam University Journal of Medicine Vol.5 No.2

효소와 기계적인 힘을 이용하여 얻어진 심장세포를 심근세포와 내피세포를 분리하여 48시간 배양한후 양군으로 나눠서 관찰하였다. 실험군은 배양중에 10% DMSO에 1시간 처리하였고 DMSO를 처리하지 않고 계속 배양한 것을 대조군으로 하였다. DMSO효과를 관찰하기 위하여 도립현미경하에서 세포의 형태, 수축능력, 증식 능력등을 관찰하였고, 심근세포에서는 succinate dehydrogenase 반응으로 사립체의 증감을 대조군과 비교하였고, 심장내피세포에서는 thiamine pyrophosphatase의 반응으로 Golgi의 양을 대조군으로 비교하였다. 실험결과를 요약하면 다음과 같다. 1. DMSO에 의하여 심근세포는 분화된 형태로 모양이 길어졌고 사립체의 증가에 의해 succinate dehydrogenase의 반응이 대조군보다 강하게 나타났다. 2. DMSO에 의해 심근세포는 근세섬유의 파괴와 혼란이 초래되었고 이로 인하여 수축능력이 감소되었다. 3. 심장내피세포는 DMSO에 의해 세포증식이 감소되고 고유기능이 강조되어 Gologi의 표지효소인 thiamine pyrophosphatase의 반응이 대조군보다 강하였다. 4. 심장내피세포는 DMSO의 세포접착력 소실과 운동성 소실작용에 의해 배양중 많은 세포의 손실이 초래되었다. To elucidate the effects of dimenthyl sulfoxide on myocardial and endothelial cells in culture, the cells were exposed to 10% dimenthyl sulfoxide in culture medium for 1 hour at 48 hours after cell isolation. The general morphology and the cytochemical reaction of marker enzymes for mitochondria and Golgi complexes were investigated. The results were summarized as follows : 1. DMSO induced elongation and narrowing of the cells and increase of mitochondrial reaction in myocardial cells. 2. DMSO induced destruction and disruption of myofibrils in myocardial cells resulting in increase of contractile activities. 3. In the endothelial cells, DMSO suppressed proliferative activities but thiamine pyrophosphatase reactions were enhanced indicating increase of Golgi complex activity. 4. DMSO seemed to hamper with the adhesiveness and motility of the endothelial cells causing the decrease of the number of cells in vitro.

원발성 종격동 정상피종 1 예

김윤년,강영우,전영준,송홍석,조진환,조준찬,박이태 대한내과학회 1986 대한내과학회지 Vol.30 No.2

Primary mediastinal seminoma is a rare germ cell tumor histologically identical to testicular seminoma. We experienced one case of Primary mediastinal seminoma recently. He was 51-year old, and complained of progressively severe anterior chest pain and dyspnea for 3 weeks before the time of diagnosis. Echo-cardiogram showed massive pericardial effusion in anterior portion of the right ventricle and posterior portion of the left ventricle with thickened pericardium, During admission, cardiac tamponade was developed, and pericardiectomy was performed. But we couldn`t excised totally because of severe adhesion of anterior mediastinal structures. Pathological findings were pure seminoma developed in thymus with fibrosis and organized hemorrhage in pericardium and pericardial peel. In our case seminoma is associated with possibly tuberculous constrictive effusive pericarditis. We treated with combination chemotherapy followed by irradiation with favorable results.

흉선지방종 1예

윤봉영,안재희,이관호,정재천,이현우,박이태,한승세,황미수,남혜주,이태숙 대한내과학회 1990 대한내과학회지 Vol.38 No.3

Thymolipoma is a rare benign tumor composed of thymic tissue and mature adipose elements and constitutes 2~9% of all thymic tumors. Most cases of thymolipoma is asymptomatic and are detected on routine chest X-rays. It is often misread as cardiac disease. The diagnosis is very difficult without operation. With the introduction of CT for the diagnosis of mediastinal disease recently, pathologic diagnosis could be expected preoperatively. A case of thymolipoma was treated at Yeung-Nam University Hospital. Its pathologic diagnosis was expected preoperatively with chest X-ray and chest CT, and confirmed postoperatively.

상행 대동맥 동맥류를 동반한 Marfan씨증후군 환자에서 생긴 대동맥 박리(Aortic Dissection) 1례

윤봉영,양창헌,김영조,심봉섭,이현우,류한영,정태은,박이태,한승세 영남대학교 의과대학 1989 Yeungnam University Journal of Medicine Vol.6 No.1

본원에서는 Marfan씨증후군과 대동맥류, 대동맥판 역류로 진단받은 환자가 1년후 흉통을 주소로 내원하여 대동맥 박리로 이행한 것으로 밝혀져 응급수술을 성공적으로 치룬 1례를 경험하였기에 보고하는 바이다. The Marfans syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aortic aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.

폐로 전이된 융기성 피부섬유육종 1예

김성숙,김정란,이영현,한동선,김도헌,이현경,오연희,이원재,박이태,이경섭 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Dermatofibrosarcoma protuberans is a locally aggressive skin tumor and the incidence is very low in general population. This tumor has a remarkable tendency to recur, however metastasis is rare. We report a dermatofibrosarcoma protuberans with pulmonary metastasis in a 33-year-old man. Aspiration cytology findings of metastatic lesion are described. The pulmonary metastasis developed 8 year after the first resection of primary skin tumor.