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.

違法性의 槪念

陳鐘奭 진주여자전문대학 1988 論文集 Vol.10 No.-

Der Begriff der Rechtswidrigkeit chin, Jong-Suk. Rechtswidrigkeit bedeutet "Widerspruch gegen das Recht". Das Wesen der Rechtswidrigkeit ist demgemaβ darin zu erblicken, daβ ein Verhalten gegen eine in einer Rechtsnorm aufgesteltte Handlungs oder unterlassungsphicht versto¨βt. Mann nennt diese Seite die formelle Rechtswidrigkeit, well dabei allein der Widerspruch der Handlung Zum Normbefehl in Betracht gezogen wird. Die Rechtswidrigkeit erscho¨pft sich aber nicht in dem Verhaltnis von Handlungs und Norm, sondern Sie hat auch inhaltliche Bedeutung materielle Rechtswidrigkeit. Die Auffassung vom Wesem der Rechtswidrigkeit wird entscheidend von der Stellungnahme zu der Frage bestimmt, ob die Rechtssa¨tze Bewertungs oder Bestimmungsnopmen der beides sind. Die klassische Dogmatik legte ihren Verbrechensbegriffdie Unterscheidung zwischen rein objektiv verstanden em Unrecht und rejn subjektiv verstandener Schuld Zuggande Paraus ergibt sich fu¨r die heut'ge Dogmatick die sinnereiche Unterscheidung von Erfolgs und Handlungs un wert in Unrecbt

Ropivacaine 을 이용한 경막의 마취시 Clonidine 병용의 효과

김종일,조영훈,이상곤,민병우,이지향,반종석 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Effects of Clonidine Added to Ropivacaine in Epidural Anesthesia Young-Hoon Cho, M.D., Ji-Hyang Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^*, Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Daegu Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain clinic, Daegu, Korea Background: Clonidine has been regarded as an adequate supplementary anesthetic during epidural anesthesia and has been used with local anesthetics such as bupivacaine or lidocaine to support the effects of these anesthetics. The authors would examine whether clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural ane-sthesia. Methods: Thirty-two healthy patients undergoing a hip or lower limb surgery were diveded into two groups. In group 1, 0.5% ropivacaine 15 ml was administered. In group 2, 0.5% ropivacaine 15 ml combined with clonidine 150 ㎍ was administered. Onset, duration and maximal height of sensory block were assessed. Sedation score, blood pressure and heart rate were measured. Results: Duration of sensory block of group 2 was significantly longer than that of group 1. Sedation score of group 2 was significantly higher than that of group 1. Blood pressure of group 2 was sig-nificantly lower thatn that of group 1 at 50 min, 70 min and 90 min after epidural injection. No significant differences were observed in onset of sensory block and heart rate between the two groups. Conclusions: The addition of clonidine to ropivacaine during epidural anesthesia prolonged duration of sensory block and produced useful sedation. It caused relatively stable hemodynamic changes. These results suggest that clonidine is an adequate supplementary anesthetic when it is used with ropivacaine during epidural anesthesia. (Korean J Anesthesiol 2001; 41: 428~433)

화학적 요부 교감신경절 차단에서 한 분절 차단과 두 분절 차단의 비교

김종일,이규종,이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Chemical Lumbar Sympathetic Block: Comparison of One- Versus Two-needle Techniques Chul-Jun Mun, M.D., Kyu-Jong Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^* Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain Clinic, Daegu, Korea Background: It was frequently noticed in the course of performing a two-needle sympathectomy, that satisfactory spread of contrast solution could be produced by injection through only one of the needles. This led to a closer examination of the merits of single-needle technique. Methods: Forty patients were randomized into two groups. Patients in the single-needle group (n = 20) were injected at the second or third lumbar sympathetic ganglia, while patients in the two-needle group (n = 20) were injected at the second and thired lumbar sympathetic ganglia. Lumbar sympathetic blocks were performed using 3 ml of alcohol and the spread of injectate was verified with C-arm fluoroscopy. The indicators of a successful sympathetic block are increasing skin temperature, decreasing pain, and anhidrosis in the distal extremity. Results: The duration of anhidrosis was 12.2 ?? 2.6 months (mean ?? SD) in the single-needle group versus 13.6 ?? 3.6 months (mean << SD) in the two-needle group. Conclusions: As these results were not significantly different from those obtained in patients having considered to be effective for a neurolytic ;i,bar sympathectomy. (korean J Anesthesiol 2001; 41: 439~443)

유년기 안구적출술 및 방사선치료로 인하여 발생된 안와 열성장에 대한 재건 치험례

홍관석,김성문,김훈,임재석,최미숙,최성원,권종진 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

There are many reports of the surgical management for the craniofacial abnormalities arising from the irradiation of the head and face for treatment of childhood cancers. Since the mordern combined-modality theraphy for childhood cancers began in the late 1960s and the early 1970s, recent reports have described the occular, dental and maxillo-facial abnormalities after irradiation in long-term survivors of cancers of the head and face. The resultant deformities may be known to be difficult to reconstruct with surgical techniques. This paper describes the late reconstructive surgery for the unilateral orbital and malar hypoplasia after eyeball enucleation and irradiation during childhood to correct the facial asymmetry and expand the contracted orbital socket into the functional dimension for the retaining eyeball prosthesis with spherical implant. We reports the satisfactory preliminary results from the midfacial osteotomy through the supero-lateral orbital rim and malar bone and the antero-lateral repositioning with the autogenous bone grafting in 26 year-old female patient who will be planned to make the new eyeball prosthesis by the department of ophthalmology.

소음성난청 유소견자들의 사후관리 실태

최장선,송재석,원종욱,강종두,차봉석,노재훈 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

The number of workers with noise induced hearing loss which comprise 56.9% in the total number of workers with work-related diseases in Korea of 1994, are becoming in position of the most serious problem. Periodic health examination system which was introduced for health care of workers on hazardous workplace has played important role in health care and the prevention of work-related diseases. The goal of periodic health examination may be obtained when we not only discover occupational disease, but also control them effectively. To study the post-examination health status of workers with noise induced hearing loss diagnosed from 1991 to 1994 in the periodic health examination, all 154 workers in 102 manufacturing factories in Banwol and Siwha industrial complex were reviewed. 1. Among 154 workers, 87 workers(56.5%) were changed to different department, 67 workers(43.5%) remained in the same department. 2. Among 102 workplaces, only 23 workplaces(22.9%) had changed their working environment while 79 workplaces(77.1%) did not. 3. In this study, post-examination health care of the workers diagnosed as noise induced hearing loss had significant correlated with the presence of health care manager, Industrial Health and Safety Committee in workplace and size of industry. The improvement of working environment is also closely related with the presence of health care manager in workplace. 4. Among 154 respondents, 3 workers(1.9%) had received compensation while 151 workers(98.1%) did not. 5. The reasons for not requesting the compensation were that 117 workers(77.5%) were ignorant of the administrative procedure for compensation, 30 workers(19.9%) were not sure of receiving compensation, 4 workers(2.6%) were busy. Considering the result of this study, we must establish the guide of management or contents of post management for noise induced hearing loss. To prevent the noise induced hearing loss, and protect the workers with noise induced hearing loss, education about post management is much required for employer and employee.

重化學工業機械의 國産化方案에 關한 硏究 : 特히 窯業에 있어서의 燒成爐, 粉碎機, 排風機, 冷却機, 電氣集마器 自動枰量供給器 等의 製作을 目的으로

趙哲衡,朴碩喆,丁太權,宋鐵,桭達福,金基玉,朴煥奎,趙煥從,朴善鐘,金種一,李茂錫 朝鮮大學校 1977 綜合論文集 Vol.1977 No.-

This is to investigate the posibility of home manufacturing of heavy chemical industry machines, such as rotary kiln, crusher, blower, cooler, electrostatic precipitator and weighing feeder of cement plant. It is concluded that even though we can not make all of them (some of them are made now and some others are going to be made in the near future, some of them are made whole and some others are made partially), we can build or export the cement plant by importing the important machines which we can not make now and by substituting them with ours gradually.

하지 수술을 위한 경막외 마취시 Ropivacaine 과 Bupivacaine 의 비교

이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Comparison of Epidural Ropivacaine and Bupivacaine in Patients Undergoing Lower Extremity Surgery Chul-Jun Mun, M.D., Sang-Gon Lee, M.D., Jong-Suk Ban, M.D. and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea Background: Ropivacaine is an amide local anesthetic structurally related to bupivacaine. A ran-domized, double-blind study was performed to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower-extremity surgery. Methods: Forty-nine patients (ASA Ⅰ-Ⅱ) were randomized to receive 15 ml of 0.5% ropivacaine or bupivacaine. Twenty patients received 15 ml of ropivacaine and 20 patients received 15 ml of bupiva-caine at the L3,4 or L4,5 interspace. Parameters measured were the onset time, duration and spread of sensory block, the onset time, duration and degree of motor block, the quality of anesthesia and the heart rate and blood pressure profile during the block onset. Results: Demographic characteristics were similar among the groups. Seven patients were excluded from the study due to technical failure of the block, two patients were excluded due to insufficient data. The onset and duration of analgesia at T10 dermatome (mean ?? SD) was 18.9 ?? 7.0 minutes and 187.5 ?? 34.6 minutes respectively for ropivacaine, and was 15.2 ?? 8.8 minutes and 187.8 ?? 40.0 minutes respectively for bupivacaine. Maximum block height (mean ?? SD) was T6.5 ?? 2.0 for ropivacaine and T6.4 ?? 2.0 for bupivacaine. The incidence of complete motor block (Bromage scale 3) was low in the ropivacaine group, being 3/20 for ropivacaine and 12.20 for bupivacaine. Conclusions: The sensory blockade profile of ropivacaine, administered epidurally, is similar to that obtained with an equal dose of bupivacaine. However motor blockade with ropivacaine is less intense, less frequent, and of shorter duration than with bupivacaine. (Korean J Anesthesiol 2001; 41: 434~438)

원위 대퇴골의 고립성 골연골종에서 발생한 속발성 연골 육종 1례 보고

정필현,황장수,강석,김용민,오형호,채동주,김종필 동국대학교 경주대학 1996 東國論集 Vol.15 No.-

연골육종은 비교적 서서히 자라며 늦게 전이하는 악성 연골 종양으로 알려져 있다. 골 연골종에서 발생한 속발성 연골육종은 발생빈도는 드물며 타부위로의 전이가 적고 악성도가 낮은 경우가 많아 적합한 수술적 치료로서 좋은 예후를 보이는 것으로 보고되고 있다. 본 동국대학교 정형외과학 교실에서는 우측 대퇴골 원위부 골간단부에 생긴 고립성 골 연골종에서 이차적으로 발생한 연골육종을 치험한 바 문헌고찰과 함께 보고하는 바이다. A case of Secondary Chondrosarcoma Arising from Solitary Osteochondroma of the Distal Femur Department of Orthopaedic Surgery, College of Medicine, DongGuk University Phil Hyun Chung M.D., Jung Su Hwang M.D., Suk Kang M.D., Yang Mln Kim M.D., Hyung Ho Oh M.D., Dong Ju Chae M.D., Jong Pil Kim M.D. Chondrpsarcoma is a malignant cartilage-forming tumor that grows slowly and metastasis of this tumor occurs in late stage. Secondary chondrosarcomas arising from a solitary osteocartilaginous exostosis are rare and those have a better prognosis than other chondrosarcomas, and they rarely metastasize. We present our experience with a case of secondary chondrpsarcoma arising in solitary osteochondroma of distal metaphysis of right femur with clinical details.

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.