Post-Coronary Artery Bypass Grafting Myocardial Ischemia Caused by an Overgrown Left Internal Thoracic Artery Side Branch

김응래,오세진,강현재,김기봉 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.5

We present a patient who developed recurrent angina after coronary artery bypass grafting (CABG). Myocardial single- photon emission computed tomography (SPECT) demonstrated deterioration in the myocardial perfusion, and coronary angiography revealed an overgrown side branch of the grafted left internal thoracic artery (ITA); otherwise, there were no significant changes compared with previous imaging studies obtained after the CABG. After percutaneous embolization of the grafted left ITA side branch, the angina was resolved and myocardial SPECT showed improved perfusion.

Robot-Assisted Cardiac Surgery Using the Da Vinci Surgical System: A Single Center Experience

김응래,임청,김동진,김준성,박계현 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.2

Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci SurgicalSystem. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasiverobot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasivedirect coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass timeand average aorta cross-clamping time were 194.8±48.6 minutes and 126.1±22.6 minutes in mitral valve repair operationsand 132.0±32.0 minutes and 76.1±23.1 minutes in myxoma removal operations, respectively. During atrialseptal defect closure operations, the average cardiopulmonary bypass time was 128.3±43.1 minutes. The medianlength of stay was between five and seven days. The only complication was that one patient needed reoperationto address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effectivefor mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operativetime depends heavily on the experience of the entire robotic surgical team.

A Recurrent Cellular Schwannoma

김응래,최은오,이경분,강창현,김영태,박인규 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.5

Cellular schwannoma is an uncommon variant of schwannomas that can occur in a peripheral nerve. Although cellular schwannomas typically do not differ in prognosis from regular schwannomas, they are known to cause local recurrence when not completely resected. Here, we report the case of a patient with cellular schwannoma of the posterior mediastinum, which recurred after 13 years.

Surgical Management of Mitral Regurgitation in Patients with Marfan Syndrome during Infancy and Early Childhood

김응래,김웅한,최은석,조성규,장우성,김용진 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.1

Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients withMarfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy forthese patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgeryfor mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47months (range, 3 to 140 months) and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years). Mitralvalve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanicalprosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two monthsafter repair. The four patients who underwent mitral valve replacement did not experience any complications relatedto the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfansyndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasibletreatment option for these patients.

논문 : 이익계획과 손익분기점

김응래 관동대학교 1966 關大商學報 Vol.2 No.-

산양산삼(山養山蔘)열수추출물이 db/db 마우스 당뇨모델에서 혈중 지질대사와 혈당에 미치는 영향

김응래 ( Eung Lae Kim ),김창식 ( Chang Sik Kim ),이희영 ( Hee Young Lee ),이혜림 ( Hye Rim Lee ),김응렬 ( Eung Yeol Kim ),윤미정 ( Mi Chung Yoon ),신순식 ( Soon Shik Shin ) 대한본초학회 2012 大韓本草學會誌 Vol.27 No.2

Objectives:We investigated the effects of mountain cultivated ginseng water boiled extract(MCG) on blood glucose and insulin levels, and examined whether lipid metabolism are improved by it in male db/db mice(a murine model of type 2 diabetes mellitus). Methods:9 weeks old, male db/db mice were divided into 5 groups: C57BL/6J normal, control, MCG-250㎎/㎏ (MCG-1), MCG-500㎎/㎏(MCG-2) and MCG-1000㎎/㎏(MCG-3). After mice were treated with MCG for 8 weeks, we measured body weight, food intake, fat weight, visceral organ weight and blood glucose, insulin and lipid levels. Results:1. We found no difference in body weight, food intake, fat weight and visceral organ weight among the animal groups. 2. Compared with controls, MCG-treated mice had lower blood glucose level and higher blood insulin levels, the magnitude of which was prominent in MCG-2. 3. Compared with controls, MCG-treated mice had lower LDL-cholesterol and higher HDL-cholesterol levels. 4. Compared with controls, MCG-treated mice had blood triglyceride and free fatty acid levels, the magnitude of which was prominent in MCG-2. 5. Blood AST and ALT concentrations were not changed by MCG, indicating MCG do not show any toxic effects. Conclusions:These results demonstrate that MCG effectively increases blood insulin level and decreases blood glucose level, blood lipid levels, and prevents and improves diabetic dyslipidemia and cardiovascular disease.

Successful Repair of Critical Tricuspid Regurgitation Secondary to a Ruptured Papillary Muscle in a Neonate

민준철,김응래,양찬규,장우성,조성규,김웅한 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.4

Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report a neonate with profound cyanosis and severe tricuspid regurgitation caused by a rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. The repair of the tricuspid valve was performed after initial stabilization by using extracorporeal membrane oxygenation.

韓國의 外換市場介入에 관한 硏究

金炳民,金應來 대전대학교 사회과학연구소 1994 社會科學論文集 Vol.13 No.2

本 硏究에서는 주로 환율의 안정화를 도모하기 위한 수단으로서 外換市場介入에 관한 일반이론과 우리나라의 외환시장개입규모 및 행태에 관한 연구를 행했다. 그러나 분석내용이 외환당국이 外換市場介入規模를 발표하지 않는 상태에서 대리변수를 통하여 外換市場介入規模를 추정했으므로 외환시장개입규모는 외환당국의 공식발표가 있어야만 정확한 추정이 이루어 질 수 있을 것이다. 또한 월별 또는 일별 시계열 자료를 사용하여 분석해야 더욱 정확한 외환시장개입규모를 추정할 수 있으나 분기별 자료를 사용했다는 점을 감안해야 다. 한편,외환당국이 외환시장에 대한 介入行態가 환율의 과도한 상숭 또는 하락을 저지하기 위한 바람에 기대는 介入政策(learning against the wind) 으로 실중분석결과 밝혀졌으므로 고명가된 환율이 절상되고 있는 상황에서는 바람에 기대는 개입방식이 환율의 고평가를 시정하는 목표와 換率安定이라는 目標를 동시에 달성할 수 있는 정책이라 할 수 있다. 그러나 전반적인 환율 움직임의 추세가 명가절상추세에 있을 때에는 바람에 기대는 정책만 가지고는 환율의 추세를 변경시켜 환율의 고평가 상황을 시정하기 어렵다는 것이다. 그 이유는 외환시장개업이 장기적인 환율의 추세에 영향을 미치기 위해서는 財政또는 金없政策이 뒷바침 되거나 경제상황에 상충되지 않는 경우에 한해서 채택해야 되기 때문이다. 끝으로 외환당국이 外換市場에 介入할 경우 그것이 최적개업수준인가 하는 판단기준이 불분명하므로 현실적으로 이용이 쉽고 편리한 最遭介入指數의 개발을 위한 연구가 수반되어야 할 것으로 판단된다. 왜냐하면 이러한 문제들을 향후 국내금융시장의 기반강화가 구축되고 외환시장 또한 제기능을 원활히 수행할 수 있을 뿐만 아니라 金融國際化가 성숙단계에 이른 후에 현실적으로 대두될 정책문제이기 때문이다.

Thoracoscopic Patch Insulation for Phrenic Nerve Stimulation after Permanent Pacemaker Implantation

강윤진,김응래,곽재건,김웅한 대한흉부외과학회 2018 Journal of Chest Surgery (J Chest Surg) Vol.51 No.5

One of the complications of permanent pacemaker implantation is unintended phrenic nerve stimulation. A 15-year-old boy with a permanent pacemaker presented with chest discomfort due to synchronous chest wall contraction with pacing beats. Even after reprogramming of the pacemaker, diaphragmatic stimulation persisted. Therefore, we performed thoracoscopic phrenic nerve insulation using a Gore-Tex patch to insulate the phrenic nerve from the wire. A minimally invasive approach using a thoracoscope is a feasible option for retractable phrenic nerve stimulation after pacemaker implantation.

Development of a Pulmonary Arteriovenous Fistula after a Modified Glenn Shunt in Tetralogy of Fallot and Its Resolution after Shunt Takedown in a 57-Year-Old Patient

김상윤,김응래,방지현,김웅한 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.3

Pulmonary arteriovenous fistula (PAVF) is a complication of the Glenn shunt. A 57-year-old tetralogy of Fallot (TOF) patient, who had undergone a Glenn shunt and TOF total correction, complained of dyspnea and cyanosis. P AVFs w ere present i n the rig ht l ung, and rig ht l ung perfusion was nearly a bsent. A fter c oil embolization, t akedown of the G lenn s hunt, a nd r econstruction of t he rig ht pulmonary a rtery, the p atient’s s ymptoms were relieved. Extrapulmonary radioisotope uptake caused by the PAVFs shown in lung perfusion scans decreased, and right lung perfusion increased gradually. Although the development and resolution of PAVFs after a Glenn shunt have been reported in the pediatric population, this may be the first report on this change in old age.