地方自治

白完基(Baek Wan-Ki) 한국정치학회 1986 한국정치학회보 Vol.20 No.1

대동맥류 수술시의 초저체온법및 완전 순환차단에 관한 임상고찰

백완기,안혁,Baek, Wan-Ki,Ahn, Hyuk 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.5

From January 1988 to December 1990, 18 adult patients with aortic disease underwent surgical repair using hypothermia and total circulatory arrest. The age at operation ranged from 17 years to 64 years[mean 45.2$\pm$10.7 years]. We disease entities included aortic dissection in 12, aortoannuloectasia in 3 and thoracic aortic aneurysm in 3 cases. Partial cardiopulmonary bypass via femoral vessels along with surface cooling was used upon the induction of deep hypothermia[18~20oC]. Modified Bentall operation was performed in 7 cases, ascending aorta replacement in 6, graft interposition in descending thoracic aorta in 3 and others in 2 cases. The circulatory arrest was maintained for periods of 2 minutes to 86 mimutes[mean 34.7$\pm$5.0 minutes]. Overall hospital mortality was 27.8%[5/18]: brain damage was responsible for the death of 2 patients. 4 patients out of 13 survivors experienced postoperative neurologic dysfunction, which was proved to be self-limited except one case showing left hemiparesis. 12 patients were followed up postoperatively with the mean follow-up period 22.7$\pm$10.1 months. There was no death. No new neurologic problems were observed during follow-up period. All but one patient showing recurrent dissection and aortic regurgitation are in exellent clinical condition. These clinical data suggests that the principle of deep hypothermia and total circulatory arrest can be applied rather safely in adult patients, especially in the treatment of patients with aortic disease, it can be a valuable adjunct with better clinical results.

완전순환정지술의 심장질환 이외의 임상적 적용

원용순,백완기,안혁,Won, Yong-Sun,Baek, Wan-Ki,Ahn, Hyuk 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.10

Hypothermia and circulatory arrest is efficatious adjunct in the surgical treatment of conventionally difficult or otherwise inoperable lesion. This technique was utilized in 5 patients, 3 with membraneous obstruction of inferior vena cava[MOVC] and 1 with giant middle cerebral artery aneurysm and 1 with renal cell carcinoma invading inferior vena cava. All membraneous obstruction of inferior vena cava patients had excellent results but the others died of operative complications. The rationale for the use of complete cardiac arrest with hypothermia is reviewed and the use of these technique in selected patients is warrented.

동맥관개존증과 그 치료 방법이 미숙아망막병증에 미치는 영향

윤명헌,백완기,문연성,Myung Hun Yoon,MD,Wan Ki Baek,MD,PhD,Yeon Sung Moon,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.5

Purpose: This study investigated the influence of patent ductus arteriosus (PDA) and its treatment on incidence and progression of retinopathy of prematurity (ROP). Methods: The authors retrospectively reviewed the medical records of 408 infants who underwent screening examinations for ROP at the Neonatal Intensive Care Unit of our hospital. Results: The total incidence of ROP was 23.5% (96 out of 408) and the patients that needed treatment were 7.4% (30 out of 408). The mean birth weight and gestational age was 1406.1 grams and 30.67 weeks in patients without ROP, and 979.8 grams and 27.46 weeks in patients with ROP, respectively. In both total and very low birth weight (VLBW) patients, the incidence of ROP was higher in the PDA group than the non-PDA group, but the PDA group was an independent risk factor only in the VLBW group (p = 0.033). The incidence of threshold disease was not significantly different between the PDA and control groups (p = 0.757). There was no significant difference of incidence of ROP and threshold disease among the 3 treatment groups for PDA. Conclusions: In VLBW patients, the presence of PDA increased the risk of ROP and its progression, thus more attention is needed for PDA patients. However, there was no significant difference in ROP incidence and progression according to different PDA treatment methods.

관상동맥우회술 환자에서의 심근관류점수제에 대한 연구: 완전혈관재생술의 평가

채헌,백완기,안혁,김용진,노준량,김종환,서경필,Chae, Hurn,Baek,Wan-Ki,Ahn, Hyuk,Kim, Yong-Jin,Rho, Joon-Ryang,Kim, Chong-Whan,Suh, Kyung-Phill 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.9

The ideal goal of the coronary artery bypass surgery is complete revascularization. To estimate the numerical degree of completeness of revascularization, the following formula was used in 50 patients having aorta-coronary bypass grafting for the treatment of unstable angina. myocardial perfusion score of revascularized area Degree of Completeness = ----------------------------------------------------------------------------- x100[%] preoperative myocardial perfusion score Randomized patients who underwent revascularization procedures in 19Hb were compared with the patients who received similar elective operation each year from 1988 through 1991. To obtain these data, the patients aged 38 ~ 75[mean 54$\pm$9.1years], composed of 31 males and 19 females were randomly sampled. The number of grafts per patient increased from 2.30 in 1986, to 3.07 in 1988 - 89, to 3.21 in 1990, and to 3.50 in 1991. [0.05 The degree of completeness improved from 75.4% to 81.4%, 91.6% and 88.6% respectively. It improved significantly in the last two years, [P<0.05, Mann-Whitney U test] At a follow-up of three months, 90 percent[45/50] of patients remained angina, free, 6 percent[3/50] had residual angina, and 4 percent[2/50] died. The last two patients degree of completeness corresponded to 43% and 30% respectively As a conclusion, the degree of completeness seems to improve year by year, and to have close relationship with the clinical results.

심장내 점액종의 외과적 치료;15년 임상경험

송현,백완기,안혁,채헌,김종환,Song, Hyun,Baek, Wan-Ki,Ahn, Hyuk,Chae, Hurn,Kim, Chong-Whan 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.2

From April 1977 to March 1991, 44 patients have undergone excision of intracardiac myx-omas, 36 cases were located in the left atrium[81.6%], 3 cases in the right atrium[6.6%], 2 cases in the right ventricle[4.5%], 3 cases in the left ventricle[6.6%], There were 32 female and 12 male. The mean age of patients was 39.6$\pm$12.3 years[ranged 11 to 67 years]. The major preoperative symptoms included exertional dyspnea in 35[79.6%], palpitation in 23[52.3%], syncopal episodes in 9[20.4%], and signs of systemic illness; low-grade fever, weight loss, arthralgia, headache and so on. The diagnosis was made by echocardiography alone in 7[15.9%], and by combination of angiography and echocardiography in 37[84.1%]. The weight of the tumor ranged from 15 to 115gm[mean weight, 47.6$\pm$27.6gm], and the volum of the tumor was 129.1cm3[$\pm$149.0]. Follow-up time ranged from 0.6 to 9 years[mean follow-up, 65$\pm$3.22 years]. There were no early and late deaths during the follow-up period. Tumor recurred in one patient with left atrial myxoma 8 years later, who underwent successful reoperation. Postoperative complications occurred in 12 patients: episodes of sup-raventricular arrhythmia in 7, convulsion in 2, wound problem in 2, tricuspid valve regurgitation in 1, massive bleeding in 1, and intubation granuloma in one. In conclusion, surgical excision of the myxoma can be considered curative with excellent long-term result.

소아심장판막치환술

김혁,유재현,서필원,이원용,백완기,박국양,이영탁,박영관,홍승록,이영균,Kim, Hyuk,Yu, Jae-Hyeon,Seo, Pil-Won,Lee, Won-Yong,Baek, Wan-Ki,Park, Kook-Yang,Lee, Young-Tak,Park, Young-Kwan,Hong, Sung-Nok,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.4

Between 1985 and 1993, 29 children from 1 to 15 years of age have undergone cardiac valve replacements at Buchon Sejong Hospital. The patients were composed of 20 males and 9 females and 17 patient had congenital heart disease and 12 patients had acquired heart disease. Two of these patients have had second valve replacements due to paravalvular leakage and valve thrombosis. Single valve replacements were 29 and double valve replacements were 2. All the patients had received prosthetic valves except one. Among the 25 patients who had definite post-operative records, the overall mortality was 12%[4% was early mortality and 8% was late mortality].25 patients were followed up with coumadin anticoagulation for total 633 patient-months[minimum 2 months to maximum 93 months, mean 25.3 months] and actuarial survival rate was 88.5 $\pm$ 6.3% at 7 years and event free rate was 70.3 $\pm$ 11.7% at 7 years. These results suggest that pediatric valve replacements can now be performed at a low operative risk although various problems are still remained and the choice of valve is prosthetic valve mainly due to its durability at the present time.

만성 흡인을 유발하는 위 식도 역류 모델

윤용한,김루시아,조정수,김정택,백완기,김광호,Yoon, Yong-Han,Kim, Lucia,Cho, Jung-Soo,Kim, Joung-Taek,Baek, Wan-Ki,Kim, Kwang-Ho 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.2

Background : Anti-reflux procedures treat gastroesophageal reflux (GER) disease. It is known that gastroesophageal reflux is likelyrelated to the increased incidence of chronic rejection in lung transplantation recipients. Because experimental animal studies areto verify this, we have tried to make an animal model of GER in a rat. Material and Methods : Using the SD rats weighing 250-300 g, we surgically induced gastroesophageal reflux and measured the gastrostomy time under anesthesia. Of three groups, Group I was the control, Group II had lower esophageal and anterior myotomy, and Group III had lower esophageal and anterior myotomy plusdiaphragmatic crural myotomy.The animals were scarified, and lung biopsies and histological examinations were performed 1 week, 2 weeks, 4 weeks, 8 weeks and 3 months after gastroesophageal reflux surgery. Results : Baseline animals (n=5) had no GER after charcoal instillation through a gastrostomy tube in Group I. Charcoal-laden macrophages were observed in GroupsII and III. To determine evidence of GER evidence, charcoal was instillated through the gastrostomy tube in group III. In contrast, Group II demonstrated severe neurophil infiltration in the bronchioles and alveolar walls after procedure. After 12 weeks, we observed the disappearance of neurophil, lymphocyte and histiocyte infiltration, and also occasional focal bronchopneumonia and bronchitis. Group III demonstrated neurophil and basophil infiltration in the bronchioles and alveolar walls which was more severe than that in Group II. Interstitial fibrotic changes were observed in Group III.Conclusion : The purpose of our gastroesophageal reflux model was to find evidence of aspiration. There was more evidence of aspiration in Group II than in either of theother two groups.

증례보고 : 소아 환자에서 Sevoflurane 마취 후 발생한 급성 간 손상

송장호 ( Jang Ho Song ),임현경 ( Hyun Kyoung Lim ),이춘수 ( Choon Soo Lee ),백완기 ( Wan Ki Baek ),윤정원 ( Jung Won Yoon ),신혜란 ( Helen Ki Shinn ) 대한마취과학회 2007 Korean Journal of Anesthesiology Vol.53 No.6

Postoperative hepatotoxicity may develop from many causes. One of them is direct injury to the liver cell due to anesthetic agents. Each agent has different hepatotoxic risk. Sevoflurane is known to have a very low potential for hepatotoxicity. We report a case of severe hepatic dysfunction after anesthesia with sevoflurane in a pediatric patient who underwent cardiopulmonary bypass surgery. (Korean J Anesthesiol 2007; 53: 781∼4)

Giant Coronary Artery Aneurysm with a Fistula into the Left Ventricle : A Case Report 1례 보고

Baek, Wan Ki,Ahn, Hyuk Seoul National University 1990 The seoul journal of medicine Vol.31 No.2