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- 저자 : 金雄成 (검색결과 4 건)
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급박하지허혈증에서 서혜부 하방 동맥재걸술과 일차적 사지절단술간의 수술 위험도 비교
김웅성,이태석,김도균,박호철 대한혈관외과학회 2000 Vascular Specialist International Vol.16 No.1
Purpose: Many physicians persist in the belief that attempted revascularization is inappropriate for many patients with limbs threatened by ischemia. They continue to recommend primary amputation. Unfortunately, amputation for lower-extremity ischemia is frequently followed by infirmity, institutionalization, and death for the patient. We have reviewed our experiences on primary emputation versus infrainguinal revascularization. Methods: Between Jan. 1992 and Dec. 1997, 56 infrainguinal reconstructions and 28 primary amputations were performed in 84 patients with critical ischemia of lower extremity. Results: The male to female ratio was 11 to 1, and the most prevalent age group was the 6th decade. The etiologies were atherosclerosis obliterans in 82.1% and Buergers disease in 10.7%. The associated diseases were hypertension (38.1%), diabetes (27.4%) and cerebrovasculat accidents (21.4%). The locations were iliac in 8.3%, femoral in 73.8%, popliteal in 7.1%, tibial in 9.5%, and peroneal in 2.4%. Clinical categories were divided into acute limb ischemia in 27.4% (grade II in 13.1% and III in 14.3%), and chronic limb ischemia in 72.6% (grade I in 13.1%, II in 32.1%, and III in 27.4%). Preoperative risk was evaluated with Goldmans index, ASA scale, and Eagles criteria. According to Eagles criteria, 24 patients (28.6%) showed a low risk, 49 patients (58.3%) had a moderate risk, and 11 patients (13.1%) had a high risk. Of the 84 patients, the following surgical techniques were used, femoro-popliteal bypass in 36 (64.3%), femoro-femoral in 13(23.2%), femoto-tibial in 10 (17.9%), popliteo-tibial in 6 (10.7%), femoro-peroneal in 1 (1.2%), axillo-femoral in 1 (1.2%), below-knee amputation in 15 (33.6%), above-knee amputation in 12 (42.9%), and hip disarticulation in 1 (3.6%). The mean follow up period was 13.7 months. The mortality for revascularization was 3.6%, which was significantly different from the mortality of primary amputation (14.3%). The 1-month and 1-year and 2-year secondary graft patency rates were 90.8%, 85.3%, and 83.3%, respectively. Conclusion: Patients who underwent revascularization had a lower perioperative mortality rate (p$lt;0.05), a lower complica- tion rate (p$lt;0.05), and an increased long-term survival rate (p$lt;0.05) than the group of patients who underwent primary amputation. In summary, the results of this present study suggest that all patients with limb threatened by ischemia should be treated with mvascularization by an experienced vascular surgeon rather than with primary amputation.
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金雄成,田載植 충남대학교 1985 忠南科學硏究誌 Vol.12 No.1
Mean energy required to produce an ion pair, W-value, is one of the fundermental quantities in radiation physics and dosimetry. As a preliminary stage of W-value study a series of experimental measurement of Alpha particle ranges in several different gases was carried out. The gases used are air, N_2, CO_2 and CH_4 that are known as tisse equivalent, and the sources of alpha-particle used are ^241Am(E_α:5.48 MeV) and ^230Th(E_α:4.68 MeV), respectively. For the measurement of the range of alpha-particle in the gases, a chamber was specially designed and constructed in order to control the pressure of the gases from 200torr to 1500torr as well as the source-to-detector distance from 2 to 40 ㎝. The detector embedded in the chamber was a Si surface barrier detector, and the output signals were fed into a multichannel pulse height analyzer. The results obtained were assessed in comparison with theoretical calculation of the ranges in various condition and, very good agreements were drawn, except for the case of CH_4 gas which showed a slight descrepancy between experimental and theoretical values of the ranges. Throughout whole part of the study, a possibility of experimental measurement of dissipation energy of a charged particle in a gas at given pressure is shown on practical basis.
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