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우위대망동맥을 이용한 관상동맥 우회술 100례의 임상적 고찰
송현,임한중,이현우,정종필,신제균,김종욱,박종빈,이재원,송명근,Song, Hyun,Lim, Han-Jung,Lee, Hyun-Woo,Jung, Jong-Pil,Shin, Je-Kyoun,Kim, Jong-Ook,Park, Jong-Bin,Lee, Jae-Won,Song, Meong-Gun 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.8
Background: In an effort t enhance long term patency of coronary bypass grafts, utilization of arterial conduits have been on an icrease. With the same objective, we have been using the right gastroepiploic artery(RGEA)in coronary artery bypass procedures since 1998. The current paper has been undertaken with the aim of assessing the apropriateness, problems, and short term results of using the RGEA as an arterial graft conduit by studying the postoperative clinical results of 100 patients than received coronary artery bypass grafting (CARG) with this artery. Material and Method: Between May of 1998 and May of 1999, an analysis of the mortality, postoperative myocardial infarction, and the need for IABP insertion as a result of low cardiac output were made between 100 consecutive patients undergoing CABG with the RGEA. Result: There was one postoperative death due to cerebral infarction. Postoperative complications/morbidity comprised myocardial infarction in 2, cerebral infarct in 3, reoperation due to bleeding in 1, mediastinitis in 1, and low cardiac output syndrome necessitating IABP in 3 patients. Complicatons related to harvesting of the arterial grafts were not experienced in any of the patients. Conclusion: The results of the current data show that utilization of the RGEA in CABG is not associated with increased mortality/morbidity and demonstrates satisfactory short term results suggesting the usefulnessof this conduit as an arterial graft.
신제균,정종필,홍은석 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4
Recently, increased traffic accident has resulted in a corresponding increase in incidences of blunt trauma. Tracheal and main bronchial injuries after blunt chest trauma can be life-threatening, and hence early diagnosis and early management of patients with such injuries are essential. A 3-year-old boy was transferred to the Department of Emergency Medicine after a motor vehicle accident in which he sustained multiple blunt injuries consisting of tracheal rupture, left main bronchial rupture, liver laceration, vitreous hemorrhage, and fracture of the iliac wing. The tracheal rupture was managed nonoperatively with intensive respiratory care, while the left main bronchial rupture was managed surgically by bronchoplasty. Postoperative course was uneventful and the patient was discharged without respiratory problems.
우성창,차동석,강건,백종화,신제균 대한마취과학회 1998 Korean Journal of Anesthesiology Vol.35 No.6
The laryngeal mask airway (LMA) is new method for maintaining the airway and has many advantages such as easy insertion without muscle relaxant, decreasing cardiovascular change, decreasing damage of pharynx and larynx and useful in difficult intubation. It has being increasingly used in the management of difficult airway problems, but has not been widely used in tracheal surgery. A 59 year old woman with tracheal stenosis due to tracheal tumor was admitted for tracheal reconstruction. The stenotic lesion was 5 cm above the carina and the length of the stenotic segment was 2 cm. Anesthetic management should be focus on maintenance of the airway and adequate ventilation with the number 3 sized LMA during the tracheal resection. The tracheal segmental resection and primary end-to-end anastomosis were performed without serious hypoxia and hypercarbia. We discuss the advantages and limitations of the LMA in tracheal surgery. (Korean J Anesthesiol 1998; 35: 1169∼1173)