개흉수술 후에 재발된 월경성 기흉

이철세 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

A 21 years old female was admitted our hospital due to repeated pneumothorax. Pneumothrax episode was related to the menstruaction. We diagnosed her case as catamenial pneumothorax. Bullectomy and pleurodesis were done without hormonal therapy. But 2 years later, pneumothorax recurred on same side of the chest. Open thoracotomy was done. And careful searching for endometriotic lesion on pleura and diaphragm was performed but no evidence was obtained. Machanical and chemical pleurodesis were applied, The patient was discharged uneventfully. The patient was taking oral contraceptive medication. OPD follow-up was done without recurrence up to now.

외상성 기관지 가성류

이승진,이석열,박형주,이철세 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Rupture of the main bronchus followed by blunt chest trauma is relatively rare but, with increasing traffic accidents, the incidence has been increasing recently. Early diagnosis and management for the traumatic bronchial rupture is essential to reduce morbidity, mortality and late complication but often, it is comcealed in cases of blunt chest trauma and particularly it is associated with multiple other organ injuires. Especially, bronchial pseudoaneurysm which maintains airway patency after complete transection of the bronchus by blunt chest trauma is very unusual case. We report a case of a 15 year old male who had complete bronchial transection with bronchial pseudoaneurysm.The bronchial rupture was comfirmed by spiral chest CT and 3D reconstruction. In the operation, right main bronchus was completely transected and separated but the airway was patent to the right lung by pseudoaneurysm of the bronchus. Resection of the pseudoaneurysm and end to end anastomosis of the bronchus was performed successfully.

자연기흉에서 흉강경 검사와 HRCT를 이용한 폐기포의 Mapping 및 수술적 적응

허균,이석열,박형주,이철세 순천향의학연구소 2002 Journal of Soonchunhyang Medical Science Vol.8 No.1

Spontaneous pneumothorax develops frequently in young, slender men and can be life threatening in a severe case. Treatment modalities consist of conservative treatment, thoracentesis and closed thoracostomy. However, for the radical treatment, bullectomy through open thoracotomy is necessary. Recently video assisted thoracoscopic bullectomy has become popular as a principal surgical treatment modality. Video assisted thoracoscopic bullectomy has advantages over open thoracotomy in many aspects but the recurrence rate is higher than open thoracotomy because blebs can be missed in operation due to a limited operative view. Therefore, accurate diagnosis of bullae using appropriate diagnostic modalities is important before operation. To present, only chest radiography and computerized tomography have been used routinely in order to determine the location and degree of bullae. This study was performed to analyze and compare the efficacy of diagnostic modalities on patients who underwent preoperative thoracoscopic examination and HRCT with the final operative findings of subsequent video assisted thoracoscopic bullectomy. A total of 35 patients with more than 50% pneumothorax who received thoracoscopic examination prior to closed thoracostomy and chest HRCT upon full expansion of the lung were enrolled in this prospective study. The presence and location of bullae in each modality were compared. On the basis of these data, video assisted thoracoscopic bullectomy was performed under general anesthesia and final results were analyzed. Comparisons of the pre and post-operative findings lead to conclusion that chest HRCT was more effective than thoracoscopic examination on preoperative detection of preoperative detection of bullae.

중증 객혈환자의 구명을 위한 새로운 외과적 접근 : 흉골 정중절개에 의한 폐엽의 기관지-혈관 격리술

박형주,이철세,고정관 순천향대학교 1994 논문집 Vol.17 No.4

Major hemoptysis is not only a clinical challenge but also the most critical situation when it is aspirated into the tracheobronchial tree especially in the chronic debilitated patients. Recently, bronchial artery embolization(BAE) is the most effective measure for the primary conservative management and salvages a lot of lives in the emergency situations. However, as the recurrence rate of hemoptysis after embolization is significant and there are very poor cases that cannot be controlled by every medical efforts, emergency surgical resection is the only way of lifesaving. In these high risk group of patients, standard lobectomy resulted in high mortality and morbidity. Since October, 1993, we introduced a new surgical approach of "Broncho-vascular Isolation Lobectomy" for the lifesaving of medically failed life-threatening hemoptysis. Now we report 3 cases treated by this approach and would like to suggest future implications in the treatment of major hemoptysis.

Disorders of Liver : The Efficacy Of Hepatic Resection After Preoperative Chemoembolization And Radiation Therapy In Hepatocellular Carcinoma More Than 5 cm In Size

( Sae Byeol Chol ),( Kyung Sik Kim ),( Dong Sub Yoon ),( Kwang Hyub Han ),( Woo Jung Lee ),( Byong Ro Kim ),( Jin Sil Seong ),( Jong Tae Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: In cases of advanced hepatocellular carcinoma (HCC), palliative treatment such as transarterial chemoembolization or chemoinfusion (TACE/TACI) and radiation therapy are performed preoperatively. The aim of this study was to evaluate the outcome of these preoperative treatment prior to hepatic resection. Methods: Between January 1994 and May 2007, 16 patients with advanced stage HCC greater than 5 cm in size are treated with TACE/TACI and radiation therapy prior to hepatic resection. The clinicopathologic factors were reviewed retrospectively. Results: Of the sixteen patients, there were fourteen men and two women, and the mean age was 51 years (range 22-70 years). Preoperative TACE/TACI was performed three times in average, and the median radiation dosage was 45 Gy (range 30-68 Gy). Major hepatic resection was performed. The median diameter of tumor on specimen was 9.0 cm. The degree of tumor necrosis was more than 90% in fourteen patients. Median survival time was 13.3 months. Eleven patients were dead due to tumor recurrence (n=8) and hepatic failure (n=2). Five patients had survived more than 2 years and there were two patients who had survived more than 5 years. Conclusions: Although the prognosis of HCC patients who were underwent preoperative combined TACE/TACI and radiation therapy is not satisfactory, some showed long term survival more than 5 years. Further research will be required to examine the survival and disease control impact in a prospective randomized study.

Hip Exoskeleton 구동력 보조 구간 설정을 위한 골반의 움직임에 따른 보행 주기에 관한 연구

강세훈(Sae-Hun Kang),염승호(Seung-Ho Yum),이원영(Won-Young Lee),이철우(Chol-U Lee),이응혁(Eung Hyuk Lee) 대한전자공학회 2020 대한전자공학회 학술대회 Vol.2020 No.8

The lower exoskeleton uses the FSR sensor to determine when to support the driving force, and determines the control timing. However, the FSR sensor increases the weight and volume of the instrument. In this paper proposes an algorithm that determines the gait cycle through the pelvic angle for smooth control of the hip exoskeleton without the FSR sensor. In order to verify the proposed algorithm, a level walking test was conducted, and through the experiment, it was shown that the ground contact required section can be set without detecting an FSR sensor.

지연성 외상성 횡격막탈장

이철세 최신의학사 1995 最新醫學 Vol.38 No.1

瓜蔞仁(Trichosanthes semen)과 白芥子(Sinapsis semen) 抽出物에 依한 數種 癌細胞의 增殖抑制 效果瓜蔞仁(Trichosanthes semen)과 白芥子(Sinapsis semen) 抽出物에 依한 數種 癌細胞의 增殖抑制 效果

李哲世,朱軫淳,黃祐翊 고려대학교 의과대학 1983 고려대 의대 잡지 Vol.20 No.1

This study was devised to observe the effects of water extracts of the Trichosanthes semen and Sinapsis semen against the growth of some cancer cells in vitro and in vivo. There species of cancer cells, murine lymphoid leukemic cells, L1210, murine lymphocytic cells, P388, and murine ascitic Sarcoma 180 cells, were used for the experiment. The effects of incubation time and concentration of the extracts in the culture medium against the growth of L1210 and P388 cells in vitro were determined. And survival time and results obtained are summarized as follows; 1. The doubling times of the L1210, P388 and Sarcoma 180 cells in culture medium without adding any extracts were 11, 11, and 26 hours, respectively. 2. The growth rates of the L1210 and P388 cells in the culture medium contained the extract of Trichosanthes semen(0.1 ml/5 ml) were 27.3% and 43.6%, respectively, and ED50 values of the both cells were belong to below 0.1 ml of the extract. 3. The growth rates of the L1210 and P388 cells in Sinapsis semen extract were 63.2% to 32.1% and 68.8% to 46.6%, respectively, and ED50 values of the both cells were in the range of 0.1ml to 0.2ml of the extract. 4. The inhibitoy effects of Trichosanthes semen and Sinapsis semen extracts on the growth rate of L1210 and P388 cells in vitro were increased, compared with the control group, by the extention of the incubation time and the increase of concentration of each extract in the culture medium. 5. The numbers of Sarcoma 180 cell ascite of Swiss mice were slightly decreased, compared with control group, by the administration of the both extracts. 6. The survival times of the Swiss mice inoculated with Sarcoma 180 cells were not affected by the administration of the both extracts. According to the above results, it could be said that the water extracts of the Trichosanthes semen and Sinapsis semen were indicated the inhibitory effects on the growth of the L1210 and p388 cells in vitro and in vivo, but the survival time of Swiss mice inoculated with Sarcoma 180 cells could not extended by administration of the both extracts.

흰쥐 횡경막신경근 표본에서 Hexamethonium 과 Lidocaine α-Bungarotoxin 또는 Decamethonium 과의 상호작용에 관한 연구

이정석,김성열,전대근,최세진 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.40 No.5

Background: Interactions of neuromuscular blocking agents are antagonistic in a combination of depolarizing and nondepolarizing agents, additive in a combination of relative two compounds or synergistic in a combination of different two nondepolarizing agents. However, the interactions of neuromuscular blocking agents with a different site of action from each other have not been studied clearly. This study was designed to examine the interaction between hexamethonium and lidocaine, a-bungarotoxin or decamethonium with markedly different pre and postsynaptic sites of action. Methods: Square wave, 0.1 Hz supramaximal stimuli or 2 Hz, 0.2 ms train of four (TOF) stimuli, was applied to the rat phtrnic nerve-hemidiaphragm preparation, and the twitch height response was recorded mechanomyographically. The cumulative concentration effect and TOF ratio at each point of twitch depression after hexamethonium, lidocaine, a-bungarotoxin or decamethonium given were measured. The EC_50 and EC_95 of hexamethonium, lidocaine, a-bungarotoxin and decamethonium were calculated using an inhibitory sigmoid E_max model. In the experiment of each combination of two drugs, three points of the isobole for hexamethonium-lidocaine, hexamethonium-a-bungarotoxin and hexamethonium-decamethonium were established using ratios of 1:3, 1:1 and 3:1 of their EC_50. Points on the line of theoretical additivity and 95% confidence intervals were calculated according to Tallarida et al. TOF ratios were observed at 75, 50 and 25% of the control twitch height value during each combination ratio of their EC_50. Results: Significant deviations of points on the isobole from the line of additivity to the left were found at all EC_50 ratios of hexamethonium-lidocaine (P<0.05 respectively), that to the right was found at all EC_50 ratios of a hexamethonium-a-bungarotoxin and hexamethonium-decamethonium (P<0.05 respectively). The magnitude of TOF fade depended upon the mixed ratios for their EC_50. Conclusions: The interaction was found to be synersistic in the combination of hexamethonium-lidocaine, and antagonistic in the combination of hexamethonium-a-bungarotoxin and hexamethonium-decamethonium.

흉부 둔상에 의한 하행대동맥 파열

이철세 최신의학사 1995 最新醫學 Vol.38 No.1