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허업 한신대학교 신학대학원 2002 세계와 선교 Vol.- No.182

The Effect of Thoracoscopic Pleurodesis in Primary Spontaneous Pneumothorax: Apical Parietal Pleurectomy versus Pleural Abrasion

허업,김영대,조정수,이호석,이종근,이준호 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.5

Background: The standard operative treatment of primary spontaneous pneumothorax (PSP) is thoracoscopic wedge resection, but necessity of pleurodesis still remains controversial. Nevertheless, pleural procedure after wedge resection such as pleurodesis has been performed in some patients who need an extremely low recurrence rate. Materials and Methods: From January 2000 to July 2010, 207 patients who had undergone thoracoscopic wedge resection and pleurodesis were enrolled in this study. All patients were divided into two groups according to the methods of pleurodesis; apical parietal pleurectomy (group A) and pleural abrasion (group B). The recurrence after surgery had been checked by reviewing medical record through follow-up in ambulatory care clinic or calling to the patients, directly until January 2011. Results: Of the 207 patients, the recurrence rate of group A and B was 9.1% and 12.8%, respectively and there was a significant difference (p=0.01, Cox’s proportional hazard model). There was no significant difference in age, gender, smoking status, and body mass index between two groups. Conclusion: This study suggests that the risk of recurrence after surgery in PSP is significantly low in patients who underwent thoracoscopic wedge resection with parietal pleurectomy than pleural abrasion.

Traumatic Peripheral Arterial Injury with Open Repair: A 10-Year Single-Institutional Analysis

조호성,허업,이충원,송승환,김선희,정성운 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.5

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center. Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications. Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient). Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia

김종원,허업,송승환,성상민,홍정민,조아름 대한흉부외과학회 2019 Journal of Chest Surgery (J Chest Surg) Vol.52 No.6

Background: The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA). Methods: Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group. Results: There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period. Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.

Comparison between Kissing Stents and Direct Surgical Bypass for Aortoiliac Occlusive Disease

이충원,허업,배미주,Han Changsung,권훈,김권민 대한심장혈관흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.4

Background: The optimal management strategy for aortoiliac occlusive disease (AIOD) remains debatable. This study compared early and late outcomes between direct surgical bypass and kissing stents for AIOD treatment. Methods: We retrospectively reviewed data, including age, sex, risk factors, comorbidities, symptoms, TransAtlantic Inter-Society Consensus (TASC) II classification, operation time, perioperative complications, in-hospital mortality, and length of hospital stay, from a cohort of 46 patients treated for AIOD (24 with kissing stents and 22 with direct surgical bypass) at Pusan National University Hostpital from January 2007 to December 2016. The primary, assisted primary, and secondary patency rates in both groups were compared. Results: The hospital stay (direct surgical bypass vs. kissing stents: 16.36±5.19 days vs. 9.08±10.88 days, p=0.007) and operation time (direct surgical bypass vs. kissing stents: 316.09±141.78 minutes vs. 99.54±37.95 minutes, p<0.001) were significantly shorter for kissing stents. Kaplan-Meier analysis revealed that the primary, assisted primary, and secondary patency rates in the direct surgical bypass group were 95.5%, 95.5%, and 95.5%, respectively, at 1 year; 86.4%, 86.4%, and 95.5% at 3 years; and 77.3%, 77.3%, and 95.5% at 5 years. The primary, assisted primary, and secondary patency rates in the kissing stent group were 100.0%, 100.0%, and 100.0%, respectively, at 1 year; 95.8%, 95.8%, and 100.0% at 3 years; and 95.8%, 95.8%, and 100.0% at 5 years. Conclusion: Except for special cases wherein endovascular revascularization is difficult, kissing stents are more advantageous for TASC II C and D lesions.

복부대동맥류 형상 및 연령에 따른 동맥 벽 응력 특성 및 파열 위험성 평가

이충원,유지훈,허업,이치승,유동만 한국전산구조공학회 2020 한국전산구조공학회논문집 Vol.33 No.3

In this study, the wall stress and rupture risk for abdominal aortic aneurysms were calculated based on the age and geometry of the examined abdominal aortic aneurysms. The geometry of the abdominal aorta was simulated using computed tomography data from patients with abdominal aortic aneurysms. With regard to material properties, the Gasser-Ogden-Holzapfel model was applied to the analysis to simulate the anisotropic hyperelastic characteristics of the artery. In addition, each material parameter was estimated to consider the properties for age and for normal and aneurysm tissue. Moreover, the correlation between the diameter and angle of the aortic aneurysms was analyzed based on data from patients with abdominal aortic aneurysms, and series simulations were conducted. As a result, the rupture risk for the abdominal aortic aneurysms was evaluated based on the age and geometry of the aneurysm. 본 연구에서는 복부대동맥류가 발생한 환자들에서의 연령과 복부대동맥류 형상에 따른 벽 응력과 파열 위험성을 평가하였다. 복부대동맥류의 형상은 의료영상 데이터로부터 추출되어 모사되었으며, 재료 물성치 단계에서는 동맥 조직의 이방성 초탄성 성질을 모사하기 위해 Gasser-Ogden-Holzapfel 모델을 적용하였다. 또한, 모델에서 필요한 각 재료 정수들은 환자들의 연령과 정상 조직 및 동맥류 조직의 특성들을 고려하기 위하여 각기 다른 값들로 산정되었다. 게다가 복부대동맥류에서의 대동맥 직경과 목의 각도에 관한 상관관계를 분석하고, 이에 대한 시리즈 시뮬레이션 역시 수행되었다. 그 결과, 복부대동맥류 환자의 연령과 대동맥 직경, 그리고 대동맥 목의 각도에 따른 복부대동맥류의 파열 위험성이 평가되었다.

혈관내 풍선 확장에 의한 대동맥 차단소생술이 적용된 돼지 복부 장기 조직의 기계적 거동 평가

왕일재,유지훈,허업,송승환,안효영,송찬희,이치승,유동만,Wang, Il Jae,You, Ji-Hun,Huh, Up,Song, Seunghwan,Ahn, Hyo Young,Song, Chan-Hee,Lee, Chi-Seung,Ryu, Dong-Man 한국재료학회 2020 한국재료학회지 Vol.30 No.4

Abdominal organs are the most vulnerable body parts under vehicle trauma, and there is high mortality from acute injuries in accidents. There are various ways to reduce this high mortality; one method is Resuscitative Endovascular Balloon Occlusion of the Aorta, which has recently become very popular as a minimally invasive alternative in the emergent management of patients with non-compressible hemorrhages below the diaphragm. However, high safety factor for patients is applied in actual clinical practice because there is no exact standard for the operating time. Therefore, in this study, the effects of the mechanical behavior of organ tissues for the duodenum, kidney, and liver on the operating time of Resuscitative Endovascular Balloon Occlusion of the Aorta is investigated in order to obtain data needed to establish standards of operating time. In characteristic analysis of organ tissues, uniaxial tensile test and compression test are conducted according to the operating time.

섬유강화 고분자 복합판의 기계적 성질에 미치는 섬유길이와 섬유함유율의 영향

이상동,김혁,허업,최종대,이동기 조선대학교 에너지.자원신기술연구소 1997 에너지·자원신기술연구소 논문지 Vol.19 No.2

This paper describes effect of chopped strand length fiber content and moisture absorption on mechanical properties of fiber-reinforced polymeric composites. It was extrusion compounded long fiber-reinforced polypropylene containing 20, 30 and 50 percent and short fiber-reinforced ABS and PAS containing 30 percent b37 the weight of glass fiber. The test methods of ASTM D638, D3410-87 and D79OM are applied for tensile, compressive and bending tests respectively. The results show that, in the case of 0.2% moisture absorption, the residual strength decreases dramatically.

Comparison of Weight Control Attempts among Middle-Aged and Older Women with Obesity: Findings Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-3)

박종환,탁영진,송승환,허업,임백빈 숙명여자대학교 아시아여성연구원 2023 Asian Women Vol.39 No.2

We compared weight control attempts in middle-aged and older women with obesity via a cross-sectional study of 1,571 women aged ≥ 50 years based on data from the Korea National Health and Nutrition Examination Survey. Among the participants, 57.7% were overweight or obese, and the obesity rate of participants in their 70s was the highest. While 71.7% of women had attempted to lose or maintain weight, the older age groups were less likely to attempt intentional weight control than the younger age groups. The prevalence of weight control attempts was significantly different amongst the age groups, with the lowest rate observed in the 70s group after adjusting for BMI, WC, and chronic diseases. In particular, 41% of participants in the 70s group with obesity did not attempt to manage their body weight. Among the participants who tried to maintain or lose weight, the most commonly practiced weight control strategy was reducing the size of meals. Compared to the 50s group, the 70s group was less likely to attempt weight control. While body image was the most significant indicator of weight control attempts in the 50s group, educational level was the key factor associated with weight control in the 70s group. Our findings reflect an active investment by older Korean women in body weight management and provide insight into policy efforts that may help women with obesity maintain a healthy body weight.

The Laparoscopic Repair of a Morgagni Hernia in a Child

Yong Joon Ra,허업,Sang-Gwon Lee,Hyung Gon Je 대한흉부외과학회 2011 Journal of Chest Surgery (J Chest Surg) Vol.44 No.1

A 12-year-old female presented with the abnormal findings on the chest PA. The chest CT revealed a retrosternal defect of the diaphragm and a fatty opacity in the pleural cavity, resulting in a diagnosis of Morgagni hernia. It was decided to undergo a laparoscopic surgery. The retrosternal defect of the diaphragm measuring 3.5 cm in diameter was found, through which a portion of the greater omentum and the fatty tissue connected with the falciform ligament were herniated into the pleural cavity. The greater omentum was pushed back into the peritoneal cavity and the fatty tissue connected with falciform ligament was excised. The mediastinal pleura was plicated and the defect of the diaphragm was repaired primarily. Immediately after the operation, the patient developed a right pneumothorax for which a chest tube was inserted. She was discharged at the post-operative third day without any further complications.