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- 저자 : 남충희(Choong Hee Nam) (검색결과 6 건)
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백승환,양석린,김선한,남충희,이길노,Baeck, Seung-Hwan,Yang, Suk-Rhin,Kim, Sun-Han,Nam, Choong-Hee,Lee, Khil-Rho 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.5
The development of severe pericardial adhesion after cardiovascular surgical procedures often increases the risk of injuring the heart, great vessels, or extracardiac grafts during resternotomy. Several pericardial substitutes have been tested in an attempt to facilitate reoperation with inconclusive results. This study was designed to evaluate the applicability of two different materials as pericardial substitutes to minimize the pericardial adhesion and epicardial reaction. A procedure for induction of pericardial adhesion was carried out in 30 rabbits. Rabbits were divided into three groups of ten rabbits each: Group 1[control, simple pericardial closure]: Group 2[bovine pericardium as pericardial substitute]: Group 3[e-polytetrafluoroethylene surgical membrane, e-PTFE as a pericardial substitute]. Bovine pericardium or e-PTFE surgical membrane was interposed between the sternum and the heart. Rabbits were sacrificed at 4 weeks after operation. The development of adhesions and epicardial reactions were graded as: none [I]; minimal[II]; moderate[Ill]; and severe[1V]. Histologic studies of the substitute, the pericardium, and the epicardium were performed. The results were as follows; l. In group 1[control group], the degree of pericardial adhesions were grade I in none, grade II in 1, grade III in 3, and grade 1V in 6 animals. Epicardial reactions were grade I in none, grade II in 3, grade K in 4, grade 1V in 3 animals respectively. 2. In group 2[bovine pericardium], the degree of pericardial adhesions were grade I in 1, grade II in 5, grade III in 3, and grade 1V in 1 animal. Epicardial reactions were grade I in 1, grade II in 2, grade III in 4, and grade 1V in 3 animals respectively. 3. In group 3[e-PTFE], the degree of pericardial adhesions were grade I in 7 animals, grade II in 2, grade III in 1, and grade g in none. Epicardial reactions were grade I in 4, grade II in 3, grade III in 2, and grade IV in 1 animal respectively. Pericardial adhesions more than grade II were 90.9% in group 1, 40 % in group 2, and 10% in group 3. Pericardial adhesions were significantly reduced in group 3 compared to group 1 or 2. Epicardial reactions more than grade II were 70 % in group 1, 70 % in group 2 and 30 % in group 3. We concluded that this 0.1mm thick polytetrafluoroethylene surgical membrane is a suitable pericardial substitute to minimize the development of pericardial adhesion or epicardial reaction following cardiovascular surgery.
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心臟 再灌流損傷에 대한 Deferoxamine의 心筋保護 硏究
남충희,이길로 순천향대학교 1994 논문집 Vol.17 No.2
When ischemically stored heart transplants are reperfused (reoxygenated), iron catalysis is involved in the generation of the highly cytotoxic hydroxyl radical and in the chain reactions of subsequent lipid peroxidation that lead to irreversible membrane damage. In 30 isolated working rabbit hearts, I assessed the effects of the iron chelator deferoxamine which might have protective effect on myocardium by blocking of iron catalysis. The experimental procedures are as followings; After non-working retrograde perfusion (15 min.), the perfusion sytem was converted to working mode(15 min.) and heart rate, peak aortic pressure, aortic flow, and coronary flow were obtained at the end. The hearts were arrested with St. Thomas' cardoplegic solution II(4˚C, 3 min.) and stored in the same solution for 2 hrs(the last myocardial temperature; 2˚C). At the end of cold storage, the hearts were perfused with the same solution(4˚C ~ 18˚C) which intended to simulate the implantation procedure of heart. After reperfusion cardioplegia with the same solution(28˚C, 3 min., CPK leakage checked) and non-working retrograde reperfusion(15 min., CPK leakage for initial 3 min.), working perfusion(15 min.) was done and post-ischemic cardiodynamics were measured at the end. After all procedures, biopsy for electron microscopy was done from LV septum(2 randomly selected for each group) and wet and dry weights of the hearts were measured for tissue water and water content. Control group(15) was done as the above procedures, but in the experimental group(15), deferoxamine was mixed into reperfusion cardioplegia(0.04 mMol/L) and reperfusion Krebs-Henseleit solution(0.01 mMol/L). No significant difference between the 2 groups was found on heart rate, peak aortic pressure, and coronary flow but the percent recovery of aortic flow(control; 52.64 ± 1.89 % vs experimental; 62.66 ± 3.24 %, p=0.0124), cardiac output(control; 54.35 ± 1.97 % vs experimental; 65.15 ±3.30 %, p=0.0089), and stroke volume(control; 61.82 ± 2.32 % vs experimental; 69.41 ± 2.89 %, p=0.05) were significantly better in the experimental group. No significant difference between the 2 groups was found in the tissue water(control; 5.36 ± 0.14 vs experimental; 5.15 ± 0.30gm/dry gm of heart) and water content(control; 84.18 ±0.35 % vs experimental; 83.23 ±0.76 %). The leakage of CPK was significantly lowered in the experimental group on the reperfusion cardioplegia(control; 97.48 ± 12.67 vs experimental; 28.45 ± 4.59IU/L/dry gm of heart, p<0.0001) and inital reperfusion(control;44.31 ±6.92 vs experimental; 17.19 ±3.74 IU/L/dry gm of heart, p=0.0018). The myocardium of the experimental group was preserved better than the control group in the electron microgram finding. Conclusively, this study revealed that deferoxamine added to the reperfusion cardioplegia and reperfusion buffer reduce significantly the reperfusion injury presumably by chelation of iron catalysis after cold storage and global ischemia in the isolated working rabbit hearts.
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신원한,남충희 대한신경외과학회 1995 Journal of Korean neurosurgical society Vol.24 No.6
Thoracic disc herniation is an uncommon disease and its diagnosis and treatment still remain difficult. We present a case of thoracic disc herniation at T7-8 vertebral level presenting with signs of spinal cord compression. The lesion was diagnosed by magnetic resonance image(MRI) and iopamidol-enhanced computed tomography(CT). The patient was operated by transthoracic transpleural approach using the surgical microscope, the operative result was excellent. A brief review of the literature is given.
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