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폐암환자의 Dinitrochlorobenzene (DNCB) 접촉성 감작에 대한 고찰
조건현,이홍균,Jo, Keon-Hyon,Lee, Hong-Kyun 대한흉부심장혈관외과학회 1979 Journal of Chest Surgery (J Chest Surg) Vol.12 No.1
Clinical evaluation of contact sensitization to 2, 4-dinitro-chlorobenzene [DNCB] was performed in 2 groups: group A [30 patients with non-malignant disease] and group B [30 patients with bronchogenic carcinoma]. Initial sensitization was elicited out by applying 2, 000 ug of DNCB to skin surface of the both group A and B. Subsequently a relatively weak challenge dose, 200 ug of DNCB, was applied 14 days later, showing the satisfactory results of sensitization with minimizing non-specific irritative inflammatory skin response. Delayed cutaneous hypersensitivity reactions shown by spontaneous flare phenomena appeared at the challenge site, and they were assessed 48 hours later. The reaction were graded from +1 to +4 according to the degree of flare or vesicular reaction. The results were as follows: 1. 28 cases [93%] of group A, however, only 18 cases [67%] of group B exhibited delayed cutaneous hypersensitivity reaction to DNCB contact sensitization [P<0.02]. 2. Of group A, the delayed cutaneous hypersensitivity reactions above +2 of DNCB score were 25 cases [83%], meanwhile 11 cases [37%] in group B [P<0.001]. 3. Undifferentiated carcinomas showed highest incidence of anergy to DNCB contact sensitization in the all histologic types of group B. 4. In group B, 8 [42%] of 19 cases who react to DNCB were resectable, whereas only 2 [18 %] of 11 cases who failed to react to DNCB were resectable for curative cancer surgery. These study suggests that cellular immune reaction of group B was depressed remarkably comparing with that of group A.
진웅,윤정섭,조건현,곽문섭,김세화,Jin, Ung,Yoon, Jeong-Seob,Jo, Keon-Hyon,Kwack, Moon-Sub,Kim, Se-Wha 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.1
Doing CABG in patient with renal transplantation requires special concern to keep and preserve renal function safely during and after operation. We experienced two cases of CABG for treatment of myocardial ischemia. who underwent renal transplantation 2 and 3 years ago respectively. The first patient received single reversed saphenous vein graft at LAD and second one received double saphenous vein graft at LAD and OMI. Peri & postoperative urinary volume and renal function test were comparable with preoperative status in both cases. Although abnormal lipid metabolism due to long term use of immunosuppressive regimen act a causative role in development and progression of coronary artherosclerosis in renal transplantation patient, CABG can be done safely with some precaution including maintenance of adequate mean blood pressure and blood level of immunosupressive regimen during cardiopulmonary bypass.
기관지협착환자에서 기관지내 팽창성 급속 스텐트 삽입후 재발한 기관지협착 치험 2례
김우찬,진웅,나석주,조건현,이선희,곽문섭,김세화,Kim, Woo-Chan,Jin, Ung,Rha, Suk-Joo,Jo, Keon-Hyon,Lee, Sun-Hee,Kwack, Moon-Sub,Kim, Se-Wha 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.5
Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.
St.Jude 기계판막을 이용한 인공심장판막 치환의 외과적 고찰
진웅,나석주,조규도,김치경,조건현,왕영필,이선희,곽문섭,김세화,이홍균,Jin, Ung,Rha, Suk-Joo,Cho, Kyu-Do,Kim, Chi-Kyung,Jo, Keon-Hyon,Wang, Young-Pil,Lee, Sun-Hee,Kwak, Moon-Sub,Kim, Se-Wha,Lee, Hong-Kyun 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.4
Total 400 St.Jude Medical Bileaflet Valves were implanted in 336 pts from January 1983 to June 1993; 64 were aortic, 205 were mitral, 64 were double valve and 3 were tricuspid position. The follow up period extended from 6 months to 10 years[mean 24.3 months]. Male to female ratio was 1:1.7. There were total 27 deaths[cardiac related 20, cardiac non-related 7]. Overall mortality was 2.9%/pt-yr. There were 10 early deaths[3.0%] and 10 late cardiac related deaths [3.0%]. Prosthetic valve related complications occurred in 19 patients[5.7%] and among them, seven died; four died of thromboembolic events, two died of anticoagulants therapy related hemorrhagic complications and one died of bacterial endocarditis. NYHA class improved significantly especially in aortic valve replacement and double valve replacement. In AVR cases, the mean NYHA was 2.8 preoperatively and 1.3 postoperatively. And in DVR cases, 3.3 preoperatively and 2.2 postoperatively. The decision to employ a particular prosthesis was made according to the anticipated or known complications of the valve. The St.Jude Medical Valve retains all the hazards of other mechanical valves, most notably, thromboembolism. But the hemodynamic performance of St.Jude Medical Valve compared most favorably with other substitute valves in many reports. 0ur experience didn`t show any differences compared other authors in terms of valve related complication. So we concluded St. Jude Medical Valve can be primarily considered in the selection of artificial valve except in the patients when the usage of anticoagulant therapy is contraindicated.
흰쥐의 파라쿼트 중독모델에서 폐손상에 대한 N-acetylcysteine과 Methylprednisolone의 효과
최태환,조건현,오동렬,김세경 대한응급의학회 2001 대한응급의학회지 Vol.12 No.3
Background: This study evaluated the inhibitory effects of N-acetylcysteine(NAC) and methylprednisolone on lung injury in the paraquat-poisoned rat model. Methods: Sixty rats were divided into four groups(n=15 in each group) accordingly to the drug administered : group I, only intraperitoneally injected paraquat (20 mg/kg); group II, intraperitoneally injected paraquat and NAC(300 mg/kg); group III, intraperitoneally injected paraquat and methylprednisolone(60 mg/kg); and group IV, intraperitoneally injected paraquat, NAC(300 mg/kg), and methylprednisolone(60 mg/kg). On the 7th day after injection, the survival rate of experimental rats and the positive area of collagen fiber in the injured lung stained by Masson's trichroms were evaluated. Results: 1. There were no differences in the 7-day survival rates for the four groups. 2, The percent of collagen fiber for group II(6.3 ± 4.7%) was significantly decreased in comparison with that for group I (14.4±9.7%). 3. The percent of collagen fiber for Group III(13.2±5.9%) was not significantly different from that for group I(14.4±9.7%). 4. The percent of collagen fiber for Group IV(6.9±4.6%) was significantly decreased in comparison with that for group I, but was not different from that for group II. Conclusion: These results suggest that NAC protects against pulmonary fibrosis in paraquat-poisoned rats whereas methylprednisolone does not protect against pulmonary fibrosis.