Augmentin의 세균학적 감수성에 대한 연구

염욱,성상현,이명희 최신의학사 1990 最新醫學 Vol.33 No.3

혼합형 동종이인자형 키메라쥐에서 특정공여군의 동종 폐이식펀에대한 관용

염욱,Youm, Wook 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.7

폐이식후의 수용자들의 낮은 생존율은 주로 거부반응 또는 면역억제제 사용에 따른 합병증과 관련이 있다. 따라서 이식편에대한 수용자의 관용을 유도해낼 수 있는 더욱 좋은 방법이 절실히 요구된다. 저자 는 동종의 골수간세포가 주입되어진 혼합동종이 인자형 키메라 쥐에서 특정 동종 공여군의 공여 폐이식 편에대한 관용의 초래여부를 연구하였다. Fisher(F344)와 Wistar Forth(WF)종주의 쥐에서 치사량의 (1100c0y) 방사선조사후 T-임파구를 제거한 동일종주와 동종이인자형 골수의 혼합물로 재구성하였다 (F)44+WFIWF, AC1+F3441F3f4).28일후 말초혈액에서 임파구형의 검사로 혼합형 키메리즘이 확 인된 쥐에서 특정 공여군 또는 제3군의 동종 공여폐로 좌측의 동소 폐이식을시행하였다. 이식후 어떠 한 면역억제제도 투여하지 않았다. 이식편의 거부는 흉부 X선검사로 관찰하였고 조직학적으로 확인하 였다. 혼합형 키메라쥐들은 특정 공여군의 폐들을 받아들였으나 종주들 끼리의 특정효과에의한 것은 아 니었고, 이들에서 150일이상 거부반응을 관찰할 수 없었다. 이식편에대한 관용은 키메리즘의 백분율과 는 관계없이 일어났으며 제3군의 공여폐에대해서 \ulcorner정상대조군에서와 마찬가지로 10일내에 이식편에 대한거부반응이 완료되었다. 이 결과들은흔합형 키메라에서 정상적인 면역기전을 유지하면서도,특정 공여군의 폐이식후 안정적이고_1. 지속적 인, 이식 편에대한 관용이 일어난다는 것을 보여준다. Poor long term patient survival (60% at 2 years) in lung allograft recipients are mainly due to rejection and complications associated with the use of nonspecific immunosuppressants. Better means to achieve waft acceptance is desperately needed. 1 have investigated whether mixed allogeneic chimerism in the form of bone marrow stem cell engraftment would induce donor-specific tolerance for lung allografts. Fisher (F344) and Wistar Forth (WF)rats were lethally irradiated (1100c0y) and reconstituted with a mixture of T-cell depleted syngeneic and allogeneic bone marrow (F344+WFIWF, ACI +F344- F344). After Mixed chimerism was documented by peripheral blood Ipnphocyte typing at 28 days, orthotopic left single lung transplantation was performed, using donor-s ecific or third party allografts. No immunosuppressants were administered. Graft rejection was monitored by chest rentgenography, and con- firmed by histology Mixed chimeric rats accepted lung allografts permanently, and it was not strain specific effect. Tolerance was all or none phenomenon which had nothing to do with the percentage of chimerlsm. Mixed chimeras rejected third party allografts in less than 10 days, a time course similar to that of unmanipulated controls. No acute or chronic rejection was observed in donor specific grafts more than 150 days posttransplant. These data suggest that mixed chimerism in the form of bone marrow stem cell engraftment results in stable, systemic donor-specific transplantation tolerance for lung allografts.

심실중격결손을 동반한 완전대혈관전위증 [S.D.D]에서의 Mustard 씨 수술[치험 1예]

염욱,임승평,김종환,Youm, Wook,Lim, Seung-Pyung,Kim, Chong-Whan 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.2

Mustard succeeded in the physiological correction of the circulation for transposition of the great arteries by redistribution of the pulmonary and systemic venous blood flow using pericardial baffle in the atrium. This procedure has become one of the most confirmative corrective operations for transposition. A six years old girl was performed mustard operation for complete transposition of the great arteries combined with hemodynamically insignificant ventricular septal defect in December 1979. The postoperative patient`s condition has been satisfactory and she is now enjoying a productive life.

개심술 168례에 관한 임상적 고찰

염욱,성상현,Youm, Wook,Sung, Sang-Hyun 대한흉부심장혈관외과학회 1988 Journal of Chest Surgery (J Chest Surg) Vol.21 No.1

168 cases of open heart surgery had been performed in Korea Veterans Hospital from Aug. 1984 to Nov. 1987. There were 150 cases of congenital heart disease and 18 cases of acquired heart disease. In congenital heart cases, 123 cases [82%] were acyanotic and 27 cases [18%] were cyanotic. Common congenital defects were VSD, TOF, ASD, PS in order of frequency. There were 11 cases of operative mortality; 5 cases [4%] in acyanotic group, 6 cases [22\ulcorner6] in cyanotic group. There was no mortality in valvular heart disease group. Overall mortality rate was 6.5%.

토끼 단일 심방근 세포에서 Na-Ca 교환전류의 특성에 관한 연구

염욱,호원경,서경필,Youm, Wook,Ho, Won-Kyung,Suh, Kyung-Phill 대한흉부심장혈관외과학회 1989 Journal of Chest Surgery (J Chest Surg) Vol.22 No.4

In single atrial cells isolated from the rabbit the properties of inward current of Na-Ca exchange were investigated using the whole cell voltage clamp technique. The current was recorded during repolarization following brief 2 ms depolarizing pulse to +40 mV from a holding potential of * 70 mV. Followings are the results obtained: 1. When stimulated every 30 seconds, the inward currents were activated and reached peak values 6-12 ms after the beginning of depolarizing pulse. The mean current amplitude was 342 pA/cell. 2. The current decayed spontaneously from the peak activation and the time course of the relaxation showed two different phases fast and slow phase. The time constants were 10-18 ms and 60-140 ms, respectively. 3. The recovery of inward current was tested by paired pulse of various intervals. The peak current recovered exponentially with time constant of 140 ms and 1 p M isoprenaline accelerated the recovery process. 4. Relaxation time course was also affected by pulse interval and time constant of the fast phase was reduced almost linearly according to the decrease of pulse interval between 30 sec and 1 sec. 5. The peak activation was increased in magnitude by long prepulse stimulation, 5 p M Bay K, 1 p M isoprenaline or internal and external application of c-AMP. 6. The relaxation time constant of the fast phase was prolonged by 5 p M Bay K or c-AMP, and shortened by isoprenaline. However the time course of the slow relaxation phase was not so much changed. From the above results, it could be concluded that increase of the calcium current by Bay K or c-AMP results in the potentiation and prolongation of intracellular calcium transient, and the facilitation of Ca uptake by SR might be a mechanism of shortening the time constant of current relaxation by short interval stimulation or isoprenaline.

심장 점액종

염욱,이영균,Youm, Wook,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.1

Cardiac Myxoma is a most frequent benign tumor in primary cardiac tumors. About 75% occur in the left atrium & 20% in the right atrium, ventricular Myxoma is a very rare one among the cardiac myxoma. They may cause severe and progressive disease resembling valvular heart disease. With the advent of various diagnostic modalities, especially real time bidimensional echocardiography enabled us more accurate diagnosis of cardiac myxoma noninvasively and preoperatively. From April 1977 to Sept. 1981, 16 cases of cardiac myxomas were operated in Seoul National University Hospital using cardiopulmonary bypass. There were 13 cases of left atrial myxomas and each of a case was right atrial and right ventricular and left ventricular one. In all cases tumors were resected successfully & were discharged in healthy state. Follow up results of each patient was excellent.

원발성 폐암의 외과치료

염욱,성상현,박성혁,Youm, Wook,Sung, Sang-Hyun,Park, Sung-Hyuk 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.5

Primary lung cancer has increased markedly in its incidence and prevalence rate recently in Korea. In frequency, it occupies the second rank cancer preceded by stomach cancer in korean male. From February 1986 to December 1992, we have operated on 55 cases of primary lung cancer in Korea Veterans Hospital and followed them. The results are as follows; 1. The peak incidence of age of primary lung cancer was 6th decade and 5th decade and those were 87.3% of study group, mainly in male. 2. Symptoms were cough [63.6%], dyspnea [41.8%], chest pain and discomfort [38.2%], blood tinged sputum and hemoptysis [21.8%]. Symptoms were frequently encountered before hospitalization and asymptomatic cases were 9.1% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy [52.7%], percutaneous needle aspiration[PCNA][21.8%], sputum cytolgy [12.7%], open biopsy [12.7%]. 4. Histopathologically, squamous cell carcinoma [76.4%] was the most frequent cancer and adenocarcinoma [10.9%], giant cell cancer [7.3%], and the others in order. 5. Methods of operation were pneumonectomy [32.7%], bilobectomy [18.2%], lobectomy [27.3%], lobectomy and segmenectomy [1.8%], exploration [20%], and overall resectability was 80%. 6. Operative mortality was 5.5% [3 cases] and there were 5 cases of complication. 7. Postoperative long-term follow up reveals that the cumulative survival rates in 6 months, 12 months, 26 months, 34 months, 43 months, 64 months were 89.5%, 71.7%, 66.7%, 57.2%, 50.8%, 42.3% respecively.

동맥관 개존증을 동반한 주폐동맥의 동맥류 치험 1예

염욱,조대윤,노준량,Youm, Wook,Cho, Dae-Yun,Rho, Joon-Ryang 대한흉부심장혈관외과학회 1982 Journal of Chest Surgery (J Chest Surg) Vol.15 No.4

Pulmonary artery aneurysm usually carries an ominous prognosis due to the associated pulmonary hypertension. In July 1981, a patient with a huge aneurysm of main pulmonary artery secondary to pulmonary hypertension and bacterial endocarditis due to a patent ductus arteriosus was treated by resection of the aneurysm and Dacron patch graft replacement and closure of the patent ductus arteriosus. The immediate postoperative result was excellent. We now report the surgical treatment, clinical course, and one and half years follow up of the patient.

삼첨판막 이식: 57례 보고

염욱,이영균,Youm, Wook,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1983 Journal of Chest Surgery (J Chest Surg) Vol.16 No.1

Fifty-Seven Cases of tricuspid valve replacement were done from April 1976 to January 1983. Fourteen congenital and 43 acquired cases were found. In 13 cases tricuspid valve alone was replaced with 2 operative deaths and one late deaths. In 35 cases TVR and MVR were done with 6 operative deaths and 6 late deaths. In 9 cases TVR, MVR, and AVR were done with one operative deaths. Over all operative mortality was 15.8% and late mortality 12.3% among the 48 survivors. Over all Survival rate was 71.9% during follow-up period ranging from 8 months to 6 years and 9 months. In every case TVR was done with bioprosthetic xenograft valves.

체외순환을 사용한 관상동맥우회술 후 발생한 헤파린 유발 혈소판감소 및 혈전증

염욱 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Acute graft occlusion early postoperatively after coronary artery bypass grafting is a rare but formidable complication. Emergency reoperation and reanastomosing of concerned graft is usual, but myocardial damage restrict the survival rate, and mortality rate is very high. Various causes can induce graft occlusion. Occasionally unfractionated heparin infused during cardiopulmonary bypass develop anti heparin-platelet factor4 antibodies those activate platelet and coagulation very stronly, thereby cause thromboembolic phenomena including graft occlusion. This prothromboembolic disorder is called heparin-induced thrombocytopenia(HIT). When extracorporeal circulation is necessary for acute or subacute HIT patient, thrombin inhibitors other than heparin should be considered and there are many options