고폐동맥압을 동반한 선천성 심기형 환자에서 술후 폐동맥압과 혼합정맥혈 산소분압의 변화에 관한 분석

김기봉,김용진,Kim, Gi-Bong,Kim, Yong-Jin 대한흉부심장혈관외과학회 1989 The Korean Journal of Thoracic and Cardiovascular Vol.22 No.6

It has been suggested that mixed venous $O_{2}$ tension is a predicor of cardiac output especially in a critically ill patient after an open heart surgery. From April 1988 through September 1989, we monitored mixed venous $O_{2}$ tension and pulmonary arterial pressure in 48 patients with acyanotic congenital heart disease at postoperative 1 hour, 6 hour, 12 hour, 24 hour, and 48 hour respectively. They were divided into Group I, with severe pulmoary hypertension, and Group II, without severe pulmonary hypertension. In Group I, mixed venous $O_{2}$ tension and cardiac index showed significant increase with time (p<0.05), but the ratio of pulmonary-aortic systolic pressure didn't show significant change. The increase was significant only 24 hour after operation, and so this low cardiac performance in early postoperative period should be considered when postoperative management is being planned in the risky patient. In Group II, all of the three variables didn't show any significant change with time. The correlation coefficient between mixed venous $O_{2}$ tension and cardiac index was significantly different from zero in both Group I (p<0.001) and group II (p<0.05) at each imeperiod, but the ratio of pulmonary-aortic systolic pressure didn't correlated well with the other 2 variables. Our study showed that serial determination of mixed venous $O_{2}$ tension in acyanotic congenital heart disease could be used as a guide in estimating the cardiac index postoperatively.

Fe-Cr-Mo 합금 분말의 성형 및 소결특성에 미치는 입도분포 영향

김기봉,양상선,김용진,박용호,Kim, Ki-Bong,Yang, Sangsun,Kim, Yong-Jin,Park, Yong-Ho 한국분말야금학회 2013 한국분말재료학회지 (KPMI) Vol.20 No.1

The effect of particle size distribution on green and sintered properties of Fe-Cr-Mo prealloy powder was investigated in this study. For the study, prealloyed Fe-Cr-Mo powders with different particle sizes were mixed as various ratios and cold compacted at various pressure and sintered at $1250^{\circ}C$ for 30 min, $90%N_2+10%H_2$ atmosphere in the continuous sintering furnace. The results shows that the powders with large particle size distribution have high compressibility and low ejection force. However the green strength are much less than those with small particle size distribution. Tensile prperties of the sintered specimes with large particles size also have high strength and elongation.

소아(小兒) stress에 관한 문헌적(文獻的) 고찰(考察)

김기봉,김장현,Kim, Ki-Bong,Kim, Jang-Hyun 대한한방소아과학회 2002 대한한방소아과학회지 Vol.16 No.1

With the progress of civilization, the disorders due to the stress, which derived from the social-structural complexity and diversity, are on an increasing trend in our times. Accordingly, the accurate diagnosis and appropriate treatment for them are required. Especially in the current years, children's disorders delivered by the emotional problems keep increasing. In this research, the researcher tried to figure out the cause of the children's stress and its treatment, studied the theories of the stress in the modem medicine and the sever emotions in oriental medicine, and came to the conclusion as follows: 1. The stress can be defined as the combination of the reaction to noxious stimuli and its defense mechanism of the body, In oriental medicine, it is considered as pathological notions which includes seven emotions as the internal factor, six evils as the external factor and other foods, expectoration, ecchymoma as the non-internal/external factors. 2. Children usually get stressed by various reasons in a growth process such as schooling, relationship with friends, the opposite sex of family, or change of surroundings, and these can cause the various disorders. 3. In the study of the children's stress symptoms, it is found that the silent reaction is uncommon. It usually appeared in both reactions: firs, physical reactions such as stomachache, vomiting, headache, neural frequent urination, bronchial asthma or excessive respiration and/or, second, behavioral reactions such as a decline of performance, alimentary disorder, e.g. anorexia nervosa or bulimia, sleep disorder, e.g. nightmare or panic in sleep, anthrophobia, refusal to a school attendance or hyperactiveness. Besides, the peculiar mental disorder such as paroxysm of anger, tic, autism, nocturnal enuresis, lack of attentiveness, impediment in linguistic development, learning difficulty, intellectual decline, etc. can be appeared, and the heavy stress during the babyhood can cause the regression of behavior or the immaturity of formation of character. 4. The appropriate treatments for the children's stress are Osteopathy, Manpulation, Aroma Therapy, Alexander Technique, Autonomic Never Control Treatment, Biofeedback, Chiropractic, Dance Therapy, Feldenkrasis Technique, Gravity Therapy, Homepathy, Aquatherapy, Hypnotherapy, Naturopathy and Meditation.

관상동맥우회술 후 1년 개존성에 관한 연구

김기봉,김현조,성기익,Kim, Gi-Bong,Kim, Hyeon-Jo,Seong, Gi-Ik 대한흉부심장혈관외과학회 1997 Journal of Chest Surgery (J Chest Surg) Vol.30 No.12

1994년 7월부터 1995년 8월까지 서울대학교병원 흉부외과에서 시행한 관상동맥 우회술 78례 중 49례 (62,8%)에서 수술 1년 후 관상동맥 조영술을 시행하여 이식 혈관의 개존성을 조사하였으며, 수술 전,후 및 수술과 관련된 여러 위험 요소들이 개존성에 미치는 영향에 대하여 분석하였다. 관상동맥 우회술 후 평균 13.4$\pm$2.1개월 째에 관상동맥 조영술을 시행하였다. 내유동맥으로 문함을 시행한 60개소 중 3개소에서 string sign을 보였으나, 폐쇄 없이 전례에서 개존성이 유지되었으며, 요골동맥으로 문합을 시행한 4개소는 모두 개존성이 유지되었다. 복제정맥으로 문합을 시행한 81개소 중 69개소(85.2%)에서 개존성이 유지되었으며, 12개 소(14.8%)에서 폐쇄되었다. 개존성에 미치는 위험요소로 수술 전,수술 중 그리고 합병증 등의 수술 후 요소로 나누어 일원적 및 다원적으로 분석하였으며, 내유동맥의 협착 과 복재정맥의 개존성, 폐쇄에 미치는 요소들을 분석하였다. 내유동맥은 환자의 연령(60세 이상),수술 후 대동맥 내 풍선펌프의 삽입,수술 후 출혈, 및 급성신부전 등 합병증이 이식 혈관의 협착과 관련된 위험 인자였으며, 복제정맥은 우회술을 시\ulcorner 받은 관상동맥의 직경이 1.5mm 이하인 경우가 이식 혈관의 폐쇄 위험성과 관련된 위험 인자로 분석되었다(p<0.05). 관상동맥 우회술 1년 후 이식 혈관의 개존성은 내유동맥이 복재정맥보다 우수함을 보였으며 환자 연령 수술 후 대동맥 내 풍선펌프의 삽입여부, 출혈, 급성 신부전 등의 합병증 및 문합된 관상 동맥의 직경 등이 개존에 관련된 요소로 분석되었다. 이러한 결과를 토대로 수술 후 이식혈관의 폐쇄 여부에 대한 11측과 수술 방법이나 수술 후 환자의 추적 관찰에 도움을 줄 수 있으리라 생각된다. Between July 1994 and August 1995, 78 patients underwent coronary artery bypass graft at Seoul National University Hospital. Coronary angiogram was performed one year after coronary artery bypass graft in 49 patients(62.8%) for evaluation of the graft patency and analysis of the risk factors for graft occlusion. The patency rates of both the internal mammary artery and the radial artery grafts were 100% , although three internal mammary artery grafts(5.0%) were narrowed(string sign). And that of the saphenous vein grafts were 85.2%. Multivariate analysis for the preoperative, operative, and postoperative factors was done between the widely patent and the narrowed internal mammary artery graft groups, and between the patent and the occluded saphenous vein graft groups by the general linear models procedure. Patient's age($\geq$60 years), postoperative intraaortic balloon pump insertion, bleeding, and acute renal failure were found to be the significant risk factors for internal mammary artery graft narrowing, and coronary artery size(< 1.5 mm) was the significant risk factor for the saphenous vein graft occlusion (p<0.05) . This study confirms that the arterial graft is superior to the vein graft at one-year patency rate, and suggests the risk factors for graft occlusion during the first postoperative year. Knowledge of this study may provide a basis for estimating the risk factors for graft occlusion, and thereby modifying surgical strategy and postoperative surveillance.

소아(小兒) 임상상(臨床上) 한약제형(韓藥劑形)에 관(關)한 연구(硏究)

김기봉,김장현,Kim Ki-Bong,Kim Jang-Hyun 대한한방소아과학회 1999 대한한방소아과학회지 Vol.13 No.2

In children, flesh and muscle are tender, mental function is feeble, digestion and absorption are weak. Also food, drink and medicine which burden the stomach and bowels must be avoided. Oriental medicines are divided in object of medical treatment into three types, liquid medicine, medicinal powder and pill. In spite of this types, time and effort are spended greatly on children's eating medicine. In this paper, studying general characteristic of oriental medicinal types and effective types of oriental medicine, I can obstain such conclusions. 1. The oriental iense pillow remedy sets at easy, promotes degistion, treats disease of theesporatory organs. 2. The distillation remedy is suited to a chronic disease of children the degistion are ak in. 3. The mother remedy, because medicine is supplied through mother's body, is effective to infant. 4. The external use remedy is suited to skin disease, eye disease and nose disease, and has similar effect to taking liquid medicine. 5. The confectionery remedy is the method which children like greatly, but is the effective method to many children because of technical manufacture.

구리를 함유하지 않은 친환경 자동차 브레이크 패드의 마모 특성에 관한 연구

김기봉,양상선,이성주,황석훈,김신욱,김용진,Kim, Ki-Bong,Yang, Sangsun,Lee, Seong-Ju,Hwang, Suk-Hun,Kim, Sin-Wook,Kim, Yong-Jin 한국분말야금학회 2018 한국분말재료학회지 (KPMI) Vol.25 No.1

The friction characteristics of Al-Fe alloy powders are investigated in order to develop an eco-friendly friction material to replace Cu fiber, a constituent of brake-pad friction materials. Irregularly shaped Al-Fe alloy powders, prepared by gas atomization, are more uniformly dispersed than conventional Cu fiber on the brake pad matrix. The wear rate of the friction material using Al-8Fe alloy powder is lower than that of the Cu fiber material. The change in friction coefficient according to the friction lap times is 7.2% for the Cu fiber, but within 3.8% for the Al-Fe alloy material, which also shows excellent judder characteristics. The Al-Fe alloy powders are uniformly distributed in the brake pad matrix and oxide films of Al and Fe are homogeneously formed at the friction interface between the disc and pad, thus exhibiting excellent friction and lubrication characteristics. The brake pad containing Al-Fe powders avoids contamination by Cu dust, which is generated during braking, by replacing the Cu fiber while maintaining the friction and lubrication performance.

소아(小兒) 기억(記憶)에 관한 한의학적(韓醫學的) 고찰(考察)

김기봉,김장현,Kim Ki-Bong,Kim Jang-Hyun 대한한방소아과학회 2000 대한한방소아과학회지 Vol.14 No.1

In children, the poor intelligence and failing of study from it raise problems in mentality, character and society. The poor intelligence and failing of study are closely connected with brain, Xin(心), Shen(神), Jing(精), Qi(氣). In this paper, studying causes of the poor intelligence and failing of study, through documents, I can obstain such conclusions. 1. Xin(心) takes charge of brain and manages life, mind and mentality. 2. Shen(神) controls mind and Jing(精) is the origin of life. So Shen and Jing must be built up for increase of memory and study. 3. For increase of intelligence and study, Qi(氣) must go round smoothly. 4. Causes of the poor intelligence and failing of study are the lack of blood, damage of Shen(腎), huo(火), phlegm etc.

심막 낭종의 외과적 수술3례 보고

김기봉,김주현,Kim, Gi-Bong,Kim, Ju-Hyeon 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.1

Pericardial cysts are infrequent benign intrathoracic lesions. They rarely cause symptoms, and they are usually discovered on routine X-ray by chance. Over 70% of the cases occur at the right anterior cardiophrenic angle. Surgery is generally not indicated if the diagnosis of pericardial cyst can be made with certainty, and then an operation is performed to rule out other lesions. The authors present 3 cases of pericardial cyst confirmed by surgery. In two Gases Of the three, the pericardial cysts were located at the right anterior cardiophrenic angle, and in one case, at the left superior area of the posterior mediastinum. We managed them successfully by surgery, and they were discharged uneventfully.

아토피피부염에서 갈근황금황련탕 추출물의 ECS 조절을 통한 염증 완화 효과

김기봉,안상현,Kim, Ki Bong,Ahn, Sang Hyun 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.4

Objective The purpose of this study was to confirm the effects of Galgeunhwanggeumhwangryeon-tang in reducing inflammation through the endocannabinoid system (ECS) control in atopic dermatitis. Methods 8-week-old Balb/C mice were divided into 4 groups: contorl group (Ctrl), lipid barrier elimination group (ADE), palmitoylethanolamide treated group after lipid barrier elimination (PEA), and Galgeunhwanggeumhwangryeon-tang applied group after lipid barrier elimination (GGRT). After inducing atopic dermatitis, cannabinoid receptor (CB) 1, CB2, CD68, phosphorylated inhibitor kappa B (p-IκB), inducible nitric oxide synthase (iNOS), substance P and serotonin were observed to confirm the regulation of the ECS, macrophage activity and mast cell activity. Results CB1 and CB2 showed higher positive reactions in the GGRT than in the LBE and PEA. CD68, p-IκB and iNOS showed higher positive reaction in the LBE, PEA and GGRT than in the Ctrl, but the increase in the positive reaction was lower in the GGRT compared to the LBE and PEA. Substance P and serotonin showed higher positive reaction in the LBE, PEA and GGRT than in the Ctrl, but the increase in the positive reaction was lower in the GGRT compared to the LBE and PEA. Conclusions The effects of Galgeunhwanggeumhwangryeon-tang were confirmed though the regulation of the ECS, macrophage activity and mast cell activity.

Cox-Maze III 술식의 변형

김기봉,허재학,장지민,이정상,안혁,손대원,Kim, Ki-Bong,Huh, Jae-Hak,Chang, Ji-Min,Lee, Jeong-Sang,Ahn, Hyuk,Sohn, Dae-Won 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.11

배경: Cox-Maze III (CM-III) 술식은 복잡한 심방 절개로 인한 긴 수술시간 때문에 다른 개심 수술과 병행하여 시행하기 어려운 단점이 있다. 대상 및 방법: 저자들은 CM-III 술직을 다음과 같이 변형하여 시행하고 그 임상성적을 분석하였다. \circled1 좌심방이를 절제하는 대신 좌심방이를 외부에서 결찰하고, \circled2 폐정맥 분리 절개선과 좌심방이 사이에 냉동절제술을 시행하며, \circled3 우심방이를 절제하는 대신에 우심방 외측 절개선을 우심방이까지 연장하고, \circled4 후종 우심방 절개 하부에서 우심방 외측을 지나 삼첨판막륜으로 향하는 T-자 절개선을 생략하였다. 저자들이 시행한 변형 술식의 용이성과 효율성을 평가하기 위하여, 우리나라에서도 빈도가 높은 류마치스성 승모판막 질환에서, 전통적인 Cox-III 술식(그룹 I)의 임상결과와, 변형된 CM-III 술식(그룹 II)의 임상결과를 비교하였다. 결과: 그룹 I(n=18)에서 동반된 수술은 승모판막 치환술 10례, 승모판막 성형술3례, 승모판막 치환술과 삼첨판막륜 성형술3례, 승모판막 재치환술 2례 등이었다. 그룹II(n=23)에서 동반된 수술은 승모판막 치환술 7례, 승모판막 성형술 5례, 승모판막 치환술과 삼첨판막륜 성형술 1례, 승모판막 재치환술 10례 등이었다. 그룹 I과 그룹 II에서 평균 대동맥 차단 시간(ACC)은 각각 135$\pm$29분과 104$\pm$18 분, 심패바이패스(CPB) 시간은 각각 240$\pm$33분과 185$\pm$42분이었다. 그룹 I과 그룹 II의 평균 추적 관찰 기간은 각각 47$\pm$14 개월과 29$\pm$4 개월이었다. 그룹 I에서는 16례(88.9%)에서 정상 동율동으로 회복되었고 1례에서 심방세동이 남아 있었으며, 다른 1례는 서맥증후군(sick sinus syndrome)으로 인공 심박조율기를 삽입하였다. 그룹 II에서는 21례(91.3%)에서 정상 동율동으로 회복되었고 2례는 심방세동이 지속되었다. 그룹 I에서 정상동율동으로 회복된 16례는 100%(16/16)에서 우심방의 수축을 심장 초음파검사에서 확인할 수 있었으며, 좌심방의 수축은 75%(12/16)에서 확인할 수 있었다. 그룹 II에서는 정상 동율동으로 회복된 21례 중 100%(21/21)에서 우심방의 수축을 확인할 수 있었으며, 좌심방의 수축은 76.2%(16/21)에서 확인할 수 있었다. 결론: 변형 CM-III 술식은 전통 CM-III 술식에 비하여 ACC time(p<0.005)과 CPB time(p<0.001)을 의미있게 줄이면서도 필적할 만 한 정상 동율동 전환율과 심방 수축력의 회복을 보여주었다.