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오상준,김근호,O, Sang-Jun,Kim, Geun-Ho 대한흉부심장혈관외과학회 1984 Journal of Chest Surgery (J Chest Surg) Vol.17 No.3
During the period of August 1983 to February 1984 study has been done on the value of serum lactate at regular intervals before, during and after operation on 30 patients who went through open heart surgery with extracorporeal circulation for congenital or acquired heart diseases at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University- The results were as follows: 1.The mean value of serum lactate before the operation was observed to be 28.5 \ulcorner.41 mg/dl. 2.At 10 minutes after the beginning of extracorporeal circulation the mean value of serum lactate showed a rapid increase to 73.24\ulcorner3.61 mg/dl, an increase of 44.74 mg/dl [156.9%] from the pre-operation value. 3.At 40 minutes after the beginning of extracorporeal circulation the mean value of serum lactate was observed to be 78.98\ulcorner1.67 mg/dl which was the highest level. It was an increase of 50.48 mg/dl [177.12%] from the preoperation value. 4.At 70 minutes after the beginning of extracorporeal circulation the mean value of serum lactate was observed to be 64.39\ulcorner9.29 mg/dl, an increase of 35.89 mg/dl [125.9%] from the preoperation value, and at over 100 minutes it was observed to be 68.00\ulcorner5.79 mg/dl, an increase of 39.5 mg/dl [138.5%] from the preoperation value. 5.The mean value of serum lactate immediately after the operation was 61.36\ulcorner6.94 mg/dl, an increase of 32.86 mg/dl [115.2%] from the preoperation value. 7.On the 7th post-operative day the value of serum lactate returned the preoperation value.
오상준,유완준 대한흉부심장혈관외과학회 1996 Journal of Chest Surgery (J Chest Surg) Vol.29 No.9
발살바동 동맥류는 매우 드문 질환으로 1987년부터 1994년까지 인제대학교 의과대학 서울백병원 흉부외과학교실에서는 총 12례를 경험하였으며 이는 이 기간중의 심폐체외순환을 이용한 심장수술중 0.7%였다. 남자가 8례, 여자가 4례였고, 연령분포는 8세에서 38세까지로 평균 19.2세 였다. 파열이 있었던 경우는 8례였다. 발살바동 동맥류의 기원은 우측 발살바동에서 10례(83.3%), noncoronary 발살바동에서 2례 (16.6%)였다. 파열된 경우에는 우측 발살바동에서 6례, noncoronary발살바동에서 2례였으며, 우측 발살바동에서 기원한 6례중 5례가 우심실로, 1례가 우심방 및 우심실로 파열됐고, noncoronary 발살바동에서 기원한 2례중 1례가 우심방으로, 1례가 우심실로 파열됐었다. 동반된 심질환은 심실중격결손이 10례(83.3%)였고 이중 9례는 우측 발살바동에서 동반되었으며, 대동맥 판폐쇄부전이 동반된 예는 3례로서 모두 심실중격결손도 같이 동반하고 있었다. 그외 승모판폐쇄부전이 1례, 우심실양분증이 1례였다. 조기사망은 없었고, 만기사망은 술후 15개월에서 1례있었는데 심내막염으로 인하여 사망하였다. 술후 평균 29개월(4~60개월)간의 추적기간 \ulcorner만기사망 1례를 제외한 11례에서 WYHA기능적 분류로 classs I의 상태이다. 수술의 위험도나 사망률이 낮으므로 합병증의 위험이 있으면 파열이 없더라도 수술하여야 하며, 파열이 있는 경우는 진단이 되면 바로 수술을 해야할 것으로 사료된다. 대부분의 경우 대동맥판막 및 동맥류의 정확한 판단 및 교정을 위해 대동맥절개가 필요하다. 한편 동반된 심질환도 동시에 교정해주며 특히 대동맥판막에 대해서는 철저히 교정 해주어야 한다고 생각한다. Aneurysm of the sinus of Valsalva is fairly rare. Between 1987 and 1994, we operated on a total of 12 cases of aneurysm of the sinus of Valsalva at the Inje University Seoul Paik Hospital. This represents 0.7% of all cardiac operation under cardiopulmonary bypass. There were eight male and four female patients aged from 8 to 38 years(mean, 19.2 years). 8 of 12 patients had ruptured aneurysms. The origin of aneurysm of the sinus of Valsalva was the right coronary sinus in 10(83. 3%), and the noncoronary sinus in 2(16.6%). In ruptured aneurysm, the origin was the right oronary sinus in 6, and the noncoronary sinus in 2. The aneurysms originating from the right coronary sinus ruptured into the right ventricle in 5, and into both the right atrium and right ventricle in 1. The aneurysms originating from the noncoronary sinus ruptured into the right ventricle in 1, and into the right atrium in 1. Associated congenital cardiac defects included ventricular septal defect in 10(83.3%) patients 39 cases of these were associated with the aneurysms of the right coronary sinus), aortic regurgi- tation in 3 (all of these had an additional ventricular septal defect), mitral regurgitation in 1, and double chambered right ventricle in 1. No hospital deaths occurred, although one late death occurred as a result of endocarditis 15 months after the first operation. The mean follow-up period was 29 months, range from 4 to 60 months. Eleven patients except one late death were in New York Heart Association class 1. Due to the low mortality risk o( an operation for aneur sm of the sinus of Valsalva, a ruptured aneurysm of the sinus of Valsalva should be corrected surgically when the diagnosis is mane, and unruptured aneurysm of the sinus of Valsava with complication should also be operated. In most cases the aorta was opened to examine the morphology of the aneurysm and the aortic cusps, and an associated aortic valve defect should be corrected simultaneously.
오상준,김홍용,우건화 대한외상학회 2000 大韓外傷學會誌 Vol.13 No.1
Background: Sternal fracture, once thought of as an uncommon phenomenon, has occurred with increasing frequency, paralleling the incidence of motor vehicle accidents. The tremendous force necessary to cause sternal fracture and this bone's prominent position overlying major intrathoracic and mediastinal structures, have important implications in the assessment and the treatment of patients. Methods: Data on blunt trauma victims admitted to our hospital were retrospectively analyzed to determine the significance of sternal fractures and possible associated injuries. One hundred four patients with sternal fractures due to blunt trauma were admitted from January 1990 to December 1999. Result: The frequency was about 4.2% of nonpenetrating chest traumas. The ratio of males to females was 2.1: 1. The most common cause of sternal fractures was TA (80 cases). The most common fracture site was the sternal body (83 cases). Abnormal ECG findings were sinus bradycardia (8 cases), sinus tachycardia (6 cases), complete or incomplete RBBB (3 cases), specific S-T change (3 cases), 1st degree A-V block (1 case), LVH (1 case), PVC (1 case), atrial fibrillation (1 case), and Low voltage (1 case). CK-MB was increased in about 14.4% of the sternal fractures. Patients were treated with conservative treatment (100 cases) and open reductions & steel-wire fixations (4 cases). The complications after treatment were atelectasis (4 cases), empyema (2 cases), ARDS (1 case). One patient died at the emergency center. The causes of death were lung contusion and ARDS. Conclusion: Although sternal fractures do not occur frequently, and are mostly treated with conservative treatment, they should be carefully observed because of critical associated injuries.
오상준,김창호,O, Sang-Jun,Kim, Chang-Ho 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.5
Since Carrel in 1907 reported transfer of a free jejunal segment in dog, reconstruction of the cervical esophagus and hypopharynx has been accomplished successfully with free jejunal transplantation using microvascular technique. Free jejunal graft is useful in cases of failed colonic interpositions. Three patients with benign esophageal stricture had undergone reconstruction with right colon interposition. Because of necrosis and stricture of the interposed colon, in each case the defect was reconstructed with a free jejunal graft by using microvascular technique. The postoperative course in two patients was uncomplicated, and they were able to eat general diet. Graft necrosis occurred in one patient, but she is waiting for a reoperation.
오상준,서상욱,Oh Sang-Jun,Suh Sang-Wook 한국건설관리학회 2001 건설관리 : 한국건설관리학회 학회지 Vol.2 No.4
건설산업은 타산업에 비해 불확실성이 크게 존재하고, 작업간에 상호 의존성이 강한 산업으로, 불확실성에 의해 발생되는 변이는 건설산업의 생산성 감소를 가져온다. 불확실성에 의한 변이의 대처방안으로 변이관리 및 연구의 필요성이 절실히 요구되고 있으나, 아직까지 국내에선 연구가 미흡한 실정이다. 본 연구의 목적은 건설산업에서 변이의 원인 빛 유형을 분석하고 그에 대한 대안으로 변이관리 기구 및 기법을 정립에 있다. 변이관리를 위한 방법으로, 우선 국내 건설현장에서의 변이관리 실태를 조사하였으며, 이를 토대로 변이관리 모델을 제안하였다. 변이관리 모델은 변이관리 기구를 통한 첫 번째 접근과 변이관리 기법을 통한 두 번째 접근 방식으로 제안하였고, 변이발생 시기에 따른 접근으로 변이의 발생 전과 발생 시, 발생 후로 변이관리의 상태를 분류하였다. 또한 변이관리에 적용되는 변이관리 기법으로 쉴딩(shielding)과 디커플링(decoupling) 두 가지를 사용하였다. 변이관리 기구 빛 기법의 적용은 국내 건설산업에서 생산성과 신뢰도(reliability)향상을 증대시키는 중요한 요소이며, 변이관리 모델을 이용한 변이관리는 국내 건설산업의 새로운 방향을 제안한다. The purpose of this study is to present a way of Variation Control in building construction process. The study suggest a way of the application method of shielding, decoupling concept and also Poka-yoke device to control variation that occurs from uncertainty in construction industry with lots of waste factors. The main contents of the study are as follows; (1) It's suggested strategy to apply shielding, decoupling as variation control technique. (2) Current Poka-yoke devices are investigated and analyzed. As a future research, it is required to study continuously on the more effective application method of Poka-yoke device and on existing examples in domestic construction sites for the process improvement.
원발성 폐암에서 종격동 림프절 평가에 대한 종격동경 검사의 가치
오상준,김창호,O, Sang-Jun,Kim, Chang-Ho 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.8
For the period from June 1988 to July 1991 we studied 29 patients who were judged to have operable disease before mediastinoscopy on clinical criteria[absence of distant metastases, phrenic or laryngeal nerve paralysis, positive scalene node biopsy, and malignant pleural effusion]. All patients had computed tomography and mediastinoscopy prior to operation. In the present study, the sensitivity, specificity, and accuracy of CT were 92%, 56%, and 72%, respectively. And the sensitivity, specificity, and accuracy of mediastinoscopy were 92%, 100%, and 97%, respectively. We concluded that because of the low accuracy of CT, CT cannot replace mediastinoscopy, and routine mediastinoscopy should be performed in preoperative staging of bronchogenic carcinoma.
오상준 대한흉부심장혈관외과학회 1985 Journal of Chest Surgery (J Chest Surg) Vol.18 No.4
Since the first report on a successful method of correcting tricuspid atresia by Fontan and Baudet in 1971, several alternative surgical techniques have been described. Bjrk`s modification was performed three patients, 3, 8, and 9 years of age, in our Hanyang University Hospital. The diagnoses were tricuspid atresia type lb, tricuspid atresia type lib and d-TGA with huge VSD and valvular PS. None had previous palliative procedures. The patients were operated on with good results. The CVP after operation was 10-14 mmHg and early extubation was done. Postoperatively, none had peripheral edema or ascites. Postoperatively, all three were acyanotic and had improved physical capacity compared with their preoperative status.