Mitral Ring을 이용한 Mitral Annuloplasty후 Ring종류에 따른 단기간의 심장의 변화

손봉준,김기식,조봉기,김기영,허승호,김윤년,김권배 한국심초음파학회 2002 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.10 No.1

자연대류를 고려한 전류도입선의 최적설계

손봉준(B.J.Son),설승윤(S.Y.Seol) 대한기계학회 2003 대한기계학회 춘추학술대회 Vol.2003 No.11

In this paper, the current lead for superconducting device is studied by numerical method. The current lead is<br/> cooled by surrounded N2 gas by natural convection. The heat conduction equation for current lead and<br/> boundary layer equation for N2 gas must be solved simultaneously. The boundary layer equation for N2 gas is<br/> highly nonlinear for varied temperature of current lead. So the linearization method is adopted for simplicity.<br/> Numerical results using natural convection cooling are compared with the conventional cooling methods such<br/> as conduction cooling and vapor cooling methods. The main difference of natural convection cooing is the<br/> non-zero temperature gradient at the top of current lead for the minimum heat dissipation into superconducting<br/> devices. For the optimized conduction-cooling and vapor-cooling current leads, the temperature gradient at the<br/> top of current lead is zero. Also, the heat flow at the cold end is much smaller than conduction cooling case.

증례 : 악성 식도협착에 있어 티타늄 제재의 금속제 확장형 인공식도삽관술 최근 경험 5예

손봉준 ( Bong Jun Son ),유종현 ( Jong Hyeon Yoo ),황기은 ( Ki Eun Hwang ),장남수 ( Nam Soo Chang ),김기택 ( Ki Taek Kim ),전우규 ( Woo Kyu Jeon ),정을순 ( Eul Soon Chung ),이상종 ( Sang Jong Lee ) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.6

Endoscopic esophageal endoprosthesis is a safe and effective procedure for the palliative treatment of obstructive esophagogastric malignancy. However, the placement of conventional plastic esophageal endoprosthesis is difficult in some cases and this procedure is associated with significant complications such as perforation, hemorrhage & dysfunction of the prosthesis in the long term. The self-expanding metallic stents offer an attractive alternative to conventional esophageal stents. Ultraflex(TM) esophageal prosthesis is knitted from a single strand of Elastalloy(TM) wire, and undulates to conform with normal esophageal peristalsis, maintaining patency and promoting patients` comfort. Recently developed EsophaCoil(TM) esophageal prosthesis is unique in that it is a simple coil with close loops made from a single flat wire of nickel titanium alloy. Because the radical force of this material is much stronger than stainless steel, expansion time is therefore faster and the stent is able to dilate even extremely resistant strictures. We report our recent experience in five patients with malignant esophageal obstruction palliated with the new self-expandable titanium stent(Ultraflex(TM) and EsophaCoil(TM)).(Korean J Gastroenterol 1997;29:826-835)

장간막 섬유종증 1 예

전우규,이상종,정을순,김명숙,배원길,편유장,손봉준,김경수,유영석 대한내과학회 1997 대한내과학회지 Vol.52 No.5

The fibromatosis is a broad group of benign fibrous tissue proliferations of similar microscopic appearance that are intermediate in their biological behavior between benign fibrous lesions and fibrosarcoma. Although various series have been reported of abdominal wall and extra-abdominal desmoid tumors, intra-abdominal desoids are extremely rare. We experienced a case with mesenteric fibroma-tosis occuring in a 30 year-old male. He was admitted to the Kangbuk Samsung hospital complaining of right lower quadrant abdominal mass and abdominal bloating sense. Utrasonography and computed tomography of the abdomen showed a solid mass in the left abdomen surrounded by loops of small bowel. At explorative laparotomy, there was a hard, well circumscribed round mass (25×15×12 cm) in the mesentery of the terminal ilem. After the tumor was dissected from the retro- peritoneum and surrounding tissues, segmental re- section of ileum with end-to-end anastomosis was performed. On the histopathologic examination, it was confirmed as mesenteric fibromatosis. A brief review of the literature on mesentery fibromatosis was done.

헤파린 부착 JO 스텐트와 미부착 JO 스텐트 삽입술 후의 장기 추적 성적 비교

남창욱,김권배,김기영,김성열,권택근,이영수,조봉기,손봉준,한성욱,김기식,김윤년 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.2

The risk of acute or subacute closure after angioplasty has been minimized by using stent deployment. However, restenosis rating 20% ∼30% after stenting is still most important limiting factor for stenting. We investigated a long-term effect of implantation of a heparin-coated JO stent compared with the use of un-coated JO steno. Thirty eight patients were assigned heparin-coated JO stent{21 patients, JO(H)} or uncoated JO stent(17 patients, JO). All clinical and angiographic parameters were retrogradely reviewed. They were followed up monthly and performed follow-up coronary angiography 7 months later. The clinical and angiographic parameters were statistically not different between two groups, except hypertension {JO:18%, JO(H):52%, p<0.05}. The reference diameter was 3.12±0.53mm in 10 and 2.85 ±0.43mm in JO(H) (p=0.071). The minimum luminal diameter after stenting was not significantly different{2.91±0.52mm in JO, 2.78±0.42mm in JO(H), p=0.381}. The restenosis rate of JO was 32% and JO(H), 35%(p=0.545). Over seven months follow up, it seems that a strategy of elective stenting with heparin-coated JO stent was not more effective than uncoated JO stent.

좌심실 이완기능 장애와 좌심방 용적의 연관성

이영수,김기식,박형섭,윤혁준,권택근,손봉준,조봉기,한성욱,허승호,김윤년,김권배 한국심초음파학회 2002 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.10 No.1

식도 평활근종 2예

박성민,김범수,이만호,전우규,이상종,김명숙,손봉준,임병훈,장운하 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.4

Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely as compared with the incidence of carcinoma in this area. Most of leiomyomas may manifest itself with unusual and inconsistent symptoms, and found incidentally during endoscopic or radiographic examination. Those who menifested symptoms are included as dysphagia and vague pain mostly. We experienced recently two cases with esophageal leiomyoma who underwent successful surgical resection and endoscopic enucleation, respectively.

인슐린비의존성 당뇨병환자의 말초동맥에 대한 도플러 유량속도 파형분석

김범수,이만호,이상종,김병익,정을순,전윤창,권중혁,손봉준 대한당뇨병학회 1995 Diabetes and Metabolism Journal Vol.19 No.2

수술후 스트렙토조토신으로 치료한 악성 인슐린종 1 예

김명숙,이만호,임병훈,이상종,김병익,전윤창,손봉준,배원길 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.2

Insulinoma is clinically characterized by fasting hypoglycemia, various neuropsychiatric symptoms, and these caused by secondary to hypoglycemia. Of patients with insulinoma, 80 percent have single benign tumors, 11 percent have multiple benign tumors, 6 percent have single malignant tumors, and the remainder have multiple malignant tumors or islet hyperplasia according to Service's statement. A 42 year-old male chemical engineer who had insulinoma associated with regional lymph node metastasis has been successfully performed with curative resection and consecutive postoperative therapy with streptozotocin. He entered to this hospital because of frequent occasion of bizarre behavior and language, transient unconsiousness and syncopal episode, and sweating associated with hypoglycemia especially in night four months prior to addmission in November 1992. Those symptoms and hypoglycemia were controlled by intravenous glucose injection and/or oral feeding of glucose riched stuffs. No physical abnormalities were found except neuropsychiatric symptoms. On admission the fasting blood glucose level was 10 mg/dl, plasma immunoreactive plasma insulin level was 125.23 uU/ml, and plasma C-peptide level was 10.24 ng/ml, respectively. Abdominal CT was suggestive of retroperitoneal tumor just behind the pancreas. Selective celiac axis angiography demonstrated hypervascular mass supplied by dorsal pancreatic artery which was compatible with insulinoma. Surgical intervention including distal pancreatectomy, as well as splenectomy and parital omental resection were performed successfully. Consecutive postoperative treatment of streptozotocin was done without any side effects. His condition is very good and enjoyed his life with full activity to date(J Kor Soc Endocrinol 9:150-155, 1994).

승모판 폐쇄부전을 동반한 승모판 탈출증에서 승모판 수선술 후 심장 기능 및 형태의 변화

김성열,김기식,권택근,이영수,조봉기,손봉준,강미숙,남명희,김윤년,김권배 한국심초음파학회 2000 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.8 No.2

Background and Objectives:Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven’t been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. Methods and Results:Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female15) were included in this study. The average age of them was 44.30±14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25±1.06 cm vs. 5.14± 0.62 cm, LV mass 272.46±107.36 gm vs. 197.30±75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. Conclusion:Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others. 연구목적: 승모판 폐쇄부전을 동반한 승모판 탈출증 환자에서 승모판 수선술 후 잔여 역류의 양상 및 심장 기능과 형태의 변화를 관찰하는 것은 승모판 수선술의 발전 및 술후 예후 평가에 도움이 될 것으로 보인다. 이에 본 연구는 이들에서 승모판 수선술 후 심장 기능 및 형태의 변화, 잔여 역류가 심장 기능 및 형태에 미치는 영향에 대해 알아보고자 하였다. 방 법: 1996년 2월부터 2000년 2월까지 계명대학교 동산의료원에서 심한 승모판 폐쇄부전을 동반한 승모판 탈출증을 진단 받고, 승모판 수선술을 시행한 환자들 중, 심초음파 추적검사를 시행한 30명(남자 15명, 여자 15명)을 대상으로 이들의 심초음파 결과, 병력기록지, 수술 기록지 및 외래추적관찰을 후향적으로 분석하였다. 결 과: 심초음파 소견상 흉골연장축 단면도에서 측정한 이완기말 좌심실 내경은 술 후 유의한 감소를 보였고(술전 6.25±1.06 cm, 술 후 5.14±0.62 cm), 심장의 다른 부분(수축기말 좌심실 내경, 좌심방 내경, 승모판륜 직경)의 크기도 유의하게 감소하였다. 술 후 잔여 역류는 22명(73.3%)에서 있었고, 이중 미세 역류를 제외하면, 승모판 전엽을 침범한 경우에서 가장 많았다승모판 전 엽 침범 5명(16.7%), 후엽 침범 2명(6.7%), 양쪽 엽침범 3명(10%). 미세 역류를 제외한 술 후 잔여 역류의 방향 중 eccentric flow는 승모판 전엽 침범시 2명, 양쪽 엽을 침범시 2명, 후엽 침범시 없었다. 술 후 잔여 역류가 없거나 미세한 경우와 경도 이상의 잔여 역류가 보이는 경우를 나누어, 술 전후 심초음파도를 비교했을 때 심장 기능 및 형태에서 유의한 차이가 없었다. 결 론: 승모판 수선술은 승모판 폐쇄부전증을 동반한 승모판 탈출증 환자에서 심장 크기 및 질량을 유의하게 감소시켰다. 술 후 잔여 역류는 승모판 탈출증이 승모판 전엽을 침범한 경우에서 더 많았고, 평균 9.5개월 간의 추적기간 동안에는 심장 형태 및 기능에 유의한 변화를 일으키지 않았다.