최근 10년간 원광의대병원에서 시행한 소아 심장혈관 수술의 임상적 고찰

윤향석,정수미,최두영,오광수,오연균,김종덕,양현웅,이삼윤,김형곤,최종범,최순호,노병석 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

We reviewed 10 years experiences of the clinical aspects and early postoperative results in 544 pediatric patients(age less than 16 years old). Among them. 529 cases had the congenital heart diseases, and 15 had the acquired diseases. Open heart surgery was performed in 413 patients. 115 cases were treated with non-open heart surgery. 16 with interventional catheterization. Annual increase of the cardiac patients was not significant in recent 10 years, except slight increase in 1994. The mean age of the study patients had been evidently changed to younger year by year. Total mortality rate of the open heart surgery was 6.4%. The cyanotic congenital heart diseases were high in early postoperative mortality by 25.7%, whereas 4% in acyanotic group. The age group less than one month was most highest in surgical mortality(66.7%). There were no deaths in patients with patent ductus arteriosus(103 cases), atrial septal defect(83 cases) or pulmonary stenosis(17 cases). Among 220 patients with ventricular septal defects(VSD). 10(4.5%) were died early postoperatively. In cyanotic group, the patients with pulmonary atresia with ventricular septal defects(PAVSD), transposition of the great arteries(TGA), interrupted aortic arch(IAA), complex cardiac anomalies with isomerism seemed to be most susceptible to an early death.

하악 제3대구치와 하악관과의 위치관계에 대한 파노라마 방사선사진과 cone beam형 전산화단층영상의 비교

최형수,김규태,최용석,황의환 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.3

Purpose : To assess the diagnostic accuracy and value in an imaging technique field through the comparison of cone beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Materials and Methods : Participants consisted of 100 patients offered the images through cone beam computed tomography and panoramic radiography. PSR-9000 Dental CT system (Asahi Roentgen Ind. Co., Ltd, Japan) was used as the unit of cone beam computed tomography. CE-II (Asahi Roentgen Ind. Co., Ltd, Japan) and Pro Max (Planmeca Oy, Finland) were used as the unit of panoramic radiography. The images obtained through panoramic radiography were classified into 3 types according to the distance between mandibular canal and root of mandibular third molar. And they were classified into 4 types according to the proximity of radiographic feature. The images obtained through cone beam computed tomography based on the classification above were classified into 4 types according to the location between the mandibular canal and the root and were analyzed. And they were classified into buccal, inferior, lingual, and between roots, according to the location between mandibular canal and root. The data were statistically analyzed and estimated by χ²-test. Results : 1. There was no statistical significance according to 3 types (type l, type ll, type lll) through CBCT. 2. The results of 4 types (type A, type B, type C, type D) through CBCT were as high prevalence of CBCT 1 in type A, CBCT 2 in type B, CBCT 3 in type C, and CBCT1 in type D and those of which showed statistical significance (P value=0.03). 3. The results according to location between mandibular canal and root through CBCT recorded each 49, 25, 17, 9 as buccal, inferior, lingual, between roots. Conclusion : When estimating the mandibular canal and the roots through the panoramic radiography, it could be difficult to drive the views of which this estimation was considerable. Thus it is required to have an accurate diagnostic approaching through CBCT that could estimate the location between mandibular canal and roots.

개심술(開心術)의 임상적 고찰 : 치험 200예 200 Cases

최형호,서홍주,임영혁,김정중,배대양,이석기,임진수 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Background and Objectives: Two hundred cases of the open heart surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 2001. Material and Methods: The number of congenital heart disease was 132 cases. 68 cases were acquired heart disease. 'The age of the congenital heart disease was from 22 days to 45 years. In the acquired heart disease, the age was from 14 to 72 years. Result: Congenital heart disease consisted of 113 congenital acyanotic heart disease, 19 congenital cyanotic heart disease. Corrective operation was done for congenital heart disease with 4. 5 % operative mortality. Of 68 cases acquired heart disease, 44 patients were valvular heart disease, 3 cardiac tumors, 9 ischemic heart diseases, 12 aortic dissections and etc. The operative mortality was 13%. Conclusion: The postoperative complications were appeared in 68 cases and the complications were wound infection, occipital alopecia, low cardiac output syndrome, arrhythmia, septicemia etc. The mortality after open heart surgery was 15 cases and the causes of death were low cardiac output syndrome, septicemia, respiratory failure and left ventricle rupture.

폐모세포종 : 1례보고 A Case Report

최영호,서홍주,임영혁,김정중,박성강,이석기,임진수,김은규 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pulmonary blastoma is a very rare primary neoplasm of the lung. We experienced a case of pulmonary blastoma in a 40 years old man. The mediobasal segmentectomy of the right lower lobe was performed. The patient was discharge on the postoperative days 6. There is no evidence of recurrence or metastasis on followup study during 7 months period after operation.

4세대 이동 멀티미디어 시스템의 연구동향 분석

최명수,박형준,박남철,김경호,이성로 목포대학교 정보산업연구소 2000 情報産業硏究誌 Vol.8 No.-

In this paper, we first define 4th-generation multimedia systems that play an important role in 21C information society. Nest, we investigate and analyze the international trend of the related research and then predict the evolutionary model for 155Mbps wireless mobile multimedia systems.

충남대학교병원 마취발전의 경향에 관한 분석 : 1967년부터 - 1996년까지 from 1967 to 1996

최세진,김상수,정규돈,윤석화,신용섭,손수창,이원형,김혜자,이정은 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

To evaluate the specificity and historical trends of the anesthesia in Chungnam National University Hospital, anesthetic experiences of 83,572 in total performed at Chungnam National University Hospital from January 1967 to December 1996 were analyzed statistically and clinically according to age, sex, surgical department, physical status, elective and emergency surgery, premedicants, IV anesthetics, anesthetic methods, inhalational anesthetics, muscle relaxants. The results were as follows : 1. The number of cases has been steadily increased year by year. 2. The ratio of male to female was 52.8% : 47.2%. 3. According to the age, There were 44,905 cases (54%) in the group of 13-45 years. 4. According to the ASA classification of physical status, most of the cases were belonged to the class 1 & 2 (72.5%). 5. The ratio of elective to emergency was 79.4% to 20.6%. 6. Recently, glycopyrrolate has been used increasingly. 7. Thiopental sodium has been mainly used for intravenous induction agent. 8. General anesthesia has been used mainly. 9. Enflurane is the most common inhalational anesthetic agent. but Isoflurane has been used increasingly. 10. Most of muscle relaxants are Pancuronium & Vecuronium(84.5%).

Hypophosphatasia 환아의 치료 증례

최병제,최형준,이제호,김기덕,박수정 大韓小兒齒科學會 1998 大韓小兒齒科學會誌 Vol.25 No.3

1. Hypophosphatasia 는 골조직 및 치아조직의 비정상적인 석회화를 나타내는 대사장애로, 특징적구강내 소견 인 우치의 조기탈락 양상으로 치과에서 조기진단이 가능하다. 2. 본 증례에서 상악궁 확장을 동반한 의치 제작으로 심미적, 기능적으로 양호한 결과를 얻었으며, 영구치열기 까지 장기적 관찰 및 치료가 필요할 것으로 사료된다. hypophosphatasia is a rare metabolic disorder which manifests characteristics such as abnormal mineralization of bone and dental tissues, diminished serum and tissue alkline phosphatase, and increased urinary secretion of PEA. It ingerited as an autosomal recessive or dominant trait and occurs in all races. In general, hypophosphatasia can be classified in 4 subtypes which are the perinatal, infantile, childhood, adult type depending upon the age at presentation and severity. In young children with Hypophosphatasia the long bones show irregular defects, and the skull showes poor calcification. In older children with premature closure of the skull sutures there may ve multiple lucent area called gyral or convolutional markings, described as resimbling beaten copper, presumably resulting from increased intracranial pressure,Examination of the jaws reveals a generalized lucency of the maxilla and mandible, the cortical bone and lamina dura are thin, and the alveolar bone may be deficient. Clinical features of Hypophosphatasia imclude premature loss of deciduous teeth, especially incisors, hypoplasia of aplasia of root cementum, enamel hypoplasia, irregular calcification of dentin, large pulp chamber, and resorption of marginal alveolar bone and roots. Our report involves a patient with a chief complaint of early loss of both Mx. and Mn. deciduous ncisors. after conducting a through clinical and radiographic examination this patient was referred to pediatrics under the suspicion of hypophosphatasia, the diagnosis proved to be correct and successful results were accomplished through a denture made to improve esthetics and function.

대동맥-장골동맥 폐색증에 대한 경피경관 혈관성형술 및 스텐트삽입술의 누적개존율

최동현,이상목,고석환,홍성화,오수명,윤충,박호철,오주형 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1

심부 매복 정중 과잉치 수술 시 마취방법 선택

민수영,송제선,이제호,최형준,손흥규,김성오 大韓小兒齒科學會 2012 大韓小兒齒科學會誌 Vol.39 No.1

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it’s need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc. 정중 과잉치(mesiodens)는 대개 상악 절치부에서 발견되며, 주로 구개측에 위치하는 경향이 있다. 정중 과잉치의 자연맹 출 가능성이 관찰되면, 주기적으로 검사하여 구강내로 충분히 맹출한 후에 단순발치를 시행한다. 주기적 검사에서 자연맹출 소견이 보이지 않거나, 형태이상 혹은 맹출방향의 이상으로 구강 내로 자연맹출 할 가능성이 없으면, 수술적 제거방법을 고려 해야 할 것이다. 특히, 인접한 중절치나 측절치의 맹출을 방해하고 있는 상황이 관찰된다면, 빠른 시일 내에 과잉치 제거를 위 한 수술적 방법을 시도하는 것이 타당하다. 한편, 외과적 수술의 시기를 늦추는 것을 고려해야 하는 경우도 있다. 정중과잉치가 인접하여 발육중인 정상 치아의 맹출을 방해하지 않는 경우이다. 이때, 삼차원 CT사진을 촬영하여보면, 과잉치 주변으로 영구절치의 치배가 근접하여 성곽처럼 둘러 싸고 있는 것을 볼 수 있다. 미성숙한 치배가 둘러 싸고 있는 상황에서, 무리하게 과잉치를 제거하려고 시도할 경우 인접 치배 를 손상시킬 가능성을 배제하기 어렵다. 이 점을 고려 한다면, 가급적 인접한 치아의 치근이 보다 발육한 후에 수술을 시도하 는 것이 바람직할 것이다. 초등학교 2학년 이상의 어린이들은 외래에서 국소마취하 제거하는 수술방법에 대개 잘 적응하며 고학년이 될수록 보다 수월해진다. 수술시기를 너무 늦추거나, 과잉치가 너무 늦게 발견된 경우 구개측 심부로 깊이 이동한 것을 볼 수 있다. 때로는 과잉치의 위치가 처음부터 심부에 매복되어 있을 수 있다. 이와 같은 경우, 전신마취방법을 생각해 볼 수 있을 것이다. 본 증례는 상악 정중부의 깊은 부위에 역위 매복된 과잉치를 외래에서 국소마취하에 치료를 시도할 때 관찰되는 문제점을 고찰하였고, 전신마취방법을 결정하기 위한 기준을 제시하였다. 심부 매복된 치아의 외과적 발거시 어린이의 행동조절이 가장 큰 문제였으며, 방사선 소견상 과잉치 치관의 위치가 절치의 치근단보다 상방에 위치할 경우 전신마취로 전환 하는 것이 바람직 할 것으로 사료된다.

위성 ATM망에 적합한 응용서비스 모형 개발

최명수,박남철,박형준,김경호,이성로 목포대학교 정보산업연구소 2000 情報産業硏究誌 Vol.8 No.-

The use of the Internet is much increased and the multimedia data such as voice and image should be processed in the Internet. The required characteristics of the communication networks for the 21-st century Internet are the fusion between communications and broadcasting, high speed, large capacity, high intelligence, and personalization. In realizing the characteristics mentioned above, the ATM is the only technique that can practically guarantee QoS and is the core technique in super high-speed service networks. In this paper, we will investigate the international study of the high-speed the satellite communication and then research plans for developing and providing optimum application services.