한국인의 심실중격결손증 제 1형

이영균,양기민,Lee, Yung-Kyoon,Yang, Gi-Min 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

During the period from August 1959 to end of July 1980, 69 cases of Type I VSD were noted among 235 cases of ventricular septal defect who were operated utilizing cardiopulmonary bypass in the Department of Cardio-thoracic Surgery, College of Medicine, Seoul National University(29.4%). During the same period 1162 open heart surgery cases were experienced among whom 778 cases were congenital anomalies. There were no significent differences between Type I '||'&'||' other tvpo:s of VSD in sex and age distribution. In Type I VSD frequency of aortic regurgitation association was much higher than rest of the types. (8.7% to 2.6%). Necessity of patch closure in Type I was not different from other types. The high incidence of Type I VSD is quite similar to Japanese references which show quite higher ratio compared with from Euroamerican caucasian patients materials. All cases were operated on with bubble type oxygenator mainly Shiley**" oxygenator utilizing hypothermic hemodilution perfusion technique.echnique.

지상작전수립을 위한 Fuzzy-AHP 기반의 의사결정 모델 연구

이영균,김기앙,나홍범,박진우,Lee, Young-Kyun,Kim, Ki-Ang,Na, Hong-Bum,Park, Jin-Woo 한국시뮬레이션학회 2008 한국시뮬레이션학회 논문지 Vol.17 No.4

육군은 군단급 이하 제대에 육군전술지휘정보체계 ATCIS(Army Tactical Control Information System, 이하 ATCIS)를 구축하여 전장을 가시화하고 반응 시간의 단축을 이루고 있다. 이러한 ATCIS 및 정보 감시장비의 도입으로 전장(Battlefield)의 불확실성과 가변성이 점점 줄어들고 있음에도, 지상작전을 위한 의사결정의 방법은 지휘관 및 주무 참모의 전술적 관점이나 과거 자료 및 경험에 기초한 정성적인 방법이 널리 적용되고 있다. 또한, 방책(Course of Action)을 선정하고 분석하기 위한 워게임(War game)과정에서도 가용 시간 및 능력의 제한 등으로 피 아의 강약점 분석에 의존하고 있는 실정이다. 이에 새로운 장비도입에 따른 유 무형 전력의 균형적인 발전의 측면에서 보다 과학적이고 정량적인 의사결정방법의 필요성이 제기되고 있으며, 야전부대에서 보다 빠르고 쉽게 적용할 수 있는 방법이 요구되고 있다.본 연구에서는 지상작전을 위한 의사결정과정인 부대지휘절차간 전장정보분석(Intelligence Preparation of the Battlefield; IPB)을 위한 지휘관 및 참모들의 상황평가에서 전장의 불확실성으로 인해 발생하는 모호한 평가 및 분석을 정량적으로 반영하고 보다 실증적인 의사결정을 위해 Fuzzy AHP 기법을 적용한 지상작전 의사결정방법을 제안하고자 한다. The ROK army has equipped ATCIS (Army Tactical Control Information System) for the Corps echelon to visualize the battlefield and reduce the reaction time. Due to the information&surveillance equipment, uncertainty and variance of the battlefield have been decreased. However decision making for the ground operations has not changed as it depends on knowledge of the commander and staffs. The War game process to select and assess the best CoA (Course of Action) also depends on the pros and cons due to the limitation of time and capability. For the balanced development between intangible and tangible military strength, a new decision making process which is quantitative and useful for the military is needed. In this study, we suggest a Fuzzy-AHP based decision making model to improve troop leading procedure which is useful to evaluate and reflect intangible characteristics of the battlefield.

도로운영 효율화와 ITS

이영균,Lee, Yeong-Gyun 한국도로교통협회 1999 도로교통 Vol.77 No.-

단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과

이영균,한영민,김종태,정동섭,박영섭,박춘근,강준기,Lee, Young-Kyun,Han, Young-Min,Kim, Jong-Tae,Chung, Dong-Sup,Park, Young-Sup,Park, Chun-Kun,Kang, Joon-Ki 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

승모판막 대치이식술 238예 보고

이영균,양기민,Lee, Yung-Kyoon,Yang, Gi-Min 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

Since 1968 up to the end of October 1980, 448 valves were replaced in 354 patients in Seoul National University Hospital. There were 238 mitral, 38 aortic, 7 tricuspid, 45 aortic with mitral, 23 tricuspid with mitral, and 3 triple valve replacement aortic mitral and tricuspid cases. Annual increase of mitral valve replacement cases and decrease of operative maortality were remarkable. Recently operative mortality of mitral valve replacement is about 5%. Sex ratio of mitral valve replacement is almost equal and there were 12 cases of pediatric patients (5%) among 238 cases, and patients under the age of 20 years were 34 (14.3%). Mitral valve replacement was done for 199 single mitral, 38 double valve and one triple valve lesions. Among 238 mitral valve replacement paients left atrial thrombus in 23(9.7%), atrial fibrillation in 132 (55.5%), and reoperation after blind mitral commissurotomy in 12(5%) cases were noted. In recent cases bioprosthetic valves, mainly lonescu-shiley valve were utilized to overcome the difficulties of postoperative late complications in anticoagnuation, especially for the rural patients and pediatric cases, in addition to the hemodynamic advantages of lonesocu valve. Among 354 patients 16 cases were congenital heart anomaly related, 5 ventricular septal defect related aortic and 4 Ebstein related tribuspid valve replacement cases. There were 2 congenital anomaly related mitral valve replacements, one for congenital mitral insufficiency of 7 years old boy and one for corrected transposition of the great vessels associated with mitral insufficiency. Among total 354 valve replacements 49 operative deaths (13.3%) were noted and in 238 mitral valve replacement 24 operative deaths occurred (10.1%). In 39 patients among 354 total valve replacements late complications were found. In 238 mitral valve replacement cases late complications were noted in 26 patients, among whom 16 cases expired. Main late complications were thrombe-embolism, subacute becteerial endocarditis, arrythmia cerebral hemorrhage due to unsatisfactory anticoagulation, and congestive heart failure in the incipient period of valve replacement were also noted. In mitral valve replacement cases long-term survival rate was 83.2% who showed marked clinical improvement. Ther were no evidences of calcification during the 2 years follow-up period for the lonescu-valve replacement cases among 19 pediatric patients. In conclusion 238 cases of mitral valve replacement were done with 24 operative deaths and 26 late complication cases among whom 16 expired. The long term survival was 83.2% of the cases. In pediatric cases in place of coumadin anticoagulation Persantin **** 75 and aspirin were administered after valve replacement. In adult cases who have difficulaties with coumadin anticoagulation and for those even with bioprosthetic heart valve replacement who needs long-term or permanent anticoagulation persantin 75 and aspirin combination regimen were administered with antisfactory results.

연골모세포종의 치료 결과

이영균,한일규,오주한,이상훈,김한수,Lee, Young-Kyun,Han, Il-kyu,Oh, Joo-Han,Lee, Sang-Hoon,Kim, Han-Soo 대한근골격종양학회 2007 대한골관절종양학회지 Vol.13 No.2

목적: 연골모세포종은 원발성 골종양의 드문 양성 종양으로 국소 재발이나 원격 전이를 일으키는 것으로 알려져 있다. 본 연구에서는 연골모세포종 30례의 치료 결과를 분석하고 예후에 미치는 인자들을 분석하고자 하였다. 대상 및 방법: 1981년부터 2005년까지 연골모세포종으로 치료 받은 30례의 환자를 후향적으로 분석하였다. 최종적으로 30명이 분석에 포함되었으며 남자가 16명, 여자가 14명이었고 술 후 평균 추시관찰 기간은 평균 7.2년이었다.(범위, 1.6~21.2년) 발생 부위로는 상완골 근위부(6례), 경골 근위부(6례), 대퇴골 원위부(6례)와 대퇴골 근위부(4례)에서 주로 발생하였다. 발생 연령은 평균 20세였으며, 20명(67%)에서는 성장판이 닫힌 이후에 발생하였다. 대부분의 예에서 적극적 소파술(과 골 이식 또는 골 시멘트 주입술) 또는 광범위 en bloc 절제술을 시행하였다. 연골모세포종의 국소 재발율과 재발에 관련이 있는 것으로 알려진 임상적, 병리학적 인자들과 국소 재발과의 관계를 분석하였다. 결과: 국소 재발은 4례(13%)에서 발생하였고 발생 시기는 각각 술 후 4개월, 6개월, 7개월과 16개월이었다. 재발한 4례에서 1회(2례) 또는 2회(2례)의 소파술을 재시행 후 국소 재발은 발생하지 않았고 최종 추시시 모두 무병생존 상태였다. 종양이 불완전하게 제거된 2례에서 모두 재발하였고, 재발한 다른 두 례는 소파술과 골 이식(1례) 또는 골 시멘트 주입술(1례)을 시행한 환자였다. 성장판의 개폐 여부(open physis), 동맥류성 골낭종의 동반 여부와 종양의 발생 부위 등은 국소 재발과 관계가 없는 것으로 관찰되었다. 결론: 연골모세포종의 국소재발을 막기 위해 종양의 완전한 제거를 위한 적극적인 소파술 또는 광범위 절제술이 필요할 것으로 생각된다. 기존에 알려져 있는 성장판의 개폐 여부, 동맥류성 골낭종의 동반 여부와 종양의 발생 부위 등은 재발과 관련 없는 것으로 보인다. Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

원발성 뇌하수체 아스페르길루스증 - 증례보고 -

이영균,김종태,유관욱,안창호,정동섭,박영섭,강준기,Lee, Young Kyun,Kim, Jong Tae,Yoo, Kwan Uk,Ahn, Chang Ho,Chung, Dong Sup,Park, Young Sup,Kang, Joon Ki 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Aspergillosis is an uncommon form of fungal infection of the central nervous system in immunocompetent patient, especially those involving the pituitary gland. Several cases of pituitary aspergillosis have been reported, but most of them are directly invaded from aspergillosis of sphenoid sinus. In the present case, a woman with primary pituitary aspergillosis had neither evidence of infection of the sphenoid sinus nor immunodeficiency. The patient underwent a transsphenoidal surgery for a presumed pituitary tumor. Histopathology demonstrated typical findings of aspergillosis. Postoperatively, amphotericin-B was administered and Gallium-67 scan was performed. We describe a case of primary pituitary aspergillosis mimicking pituitary tumor.

IonescuShiley 판막 사용 심장판막이식술[265례 보고]

이영균,김삼현,Lee, Yung-Kyoon,Kim, Sam-Hyun 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.4

In this department 504 cases of valve replacement were done since 1968 to the end of October 1981. Since October 31, 1978 to the end of October 1981 ,333 Ionescu-Shiley bovine pericardial xenograft bioprosthetic cardiac valves were replaced in 265 patients. There were 149 males and 116 female. Ages ranged from 2 to 63 years with 25 cases under 15 years of age. Among 265 cases of Ionescu valve replacement there were 157 MVR, 36 VAR, 6 TVR, 45 MVR+ AVR, 16 MVR+TVR and 5 MVR+AVR+TVR cases with mortality of 5.7%, 8.3%, 16.7%, 8.9%, 18.8% and 20% for each group respectively. Over all mortality rate in 265 Ionescu valve replacement cases was 7.9% with 21 total deaths. Main causes of operative deaths were due to LCOS in 7, bleeding in 5, arrhythmia in 3, air embolism in 2,and heart block in 2 cases. There were 12 late complications with 6 deaths. Over all long-term survival rate was 89.8%. MVR showed the highest long-term survival rate with 92.4%, and MVR+AVR+TVR the lower with 80% lower with 80%.Average follow-up period was 14 month duration. Twenty five congenital anomaly cases were operated with Ionescu-valve replacement that consisted of 7 VSD+AI, and 5 Ebstein anomaly cases with over all operative mortality of 16% and late mortality of 14.3% among 21 operative survivors. There were 25 Ionescu valve replacement cases in pediatric patients under the age of 15 years, with 4 operative deaths. Fourteen MVR, 7 AVR, and 3 TVR cases were found. Even though long-term follow-up study was short in postoperative period with total of 33~.0 months among 244 operative survivors ranging one to 36 months, the late survivors showed beneficial long-term results two thromboembolic episodes in 244 patients were found. More cases and longer term follow-up study are warranted for valve replacement in pediatric and TVR cases with Ionescu-valves which have advantageous hemodynamic structures compared with other bio-prosthetic heart valves.

심장질환의 외과적 요법에 관한 연구: II.후천성 심장질환, 1. 판막대치 이식수술

이영균,서경필,Lee, Yung-Kyoon,Seo, Gyeong-Pil 대한흉부심장혈관외과학회 1977 Journal of Chest Surgery (J Chest Surg) Vol.10 No.2

From 1958 to October 1977, 294 cases of acquired heart disease were operated. There were 68 cases of pericardium, 3 trauma, 2 foreign body, one cardiac thrombus, 3 atrial myxoma, 2 left atrial and 1 right atrial, 2 Budd-Chiari syndrome, and 214 valvular heart disease. Out of 214 cases of valve operation 73 valves were replaced in 64 patients. Male to female ratio was 1.46: 1. The youngest age was 14 years in male and 18 in female. The oldest was 54 years in male and 52 in female. Fifty-five cases of single valve were replaced, consisting of 47 mitral and 8 aortic valves. There were 9 double valve replacement cases which consist of 7 mitral and aortic and 2 mitral .and tricuspid valves. Six varieties of prosthetic valves, 3 ball and 3 disc types and 3 kinds of xenograft tissue valves were utilized. Beall, BjSrk-Shiley and Starr-Edwards prosthetic valves and Hancock valves were used mainly. For single valve 34. 5% and for double valve replacement 44% mortality were noted. There were 23 operative deaths out of 64 patients, over all mortality rate of 36.9%. Mortality for mitral valve replacement was 29.5%. But in recent 12 consecutive cases one death occurred, showing 8.3% mortality. In earlier days thrombocyte anti-adhesive drug dipyramidole-persantin-aspirin and/or SP 54 were adminstered. But in recent cases after heparinization, coumadin and Persantin were prescribed routinely.

성인 심장기형 266예 수술 예

이영균,양기민,Lee, Yung-Kyoon,Yang, Gi-Min 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.4

During the period from 1958 to July 31, 1980, there were 1764 Cardiovascular Surgical cases consisting of 1166 congenital and 598 acquired lesions in the Department of Cardiothoracic Surgery, Seoul National University Hospital. For 1764 cases 1162 open heart surgery and 602 conventional operations were performed. Among 1166, congenital lesions 266 adult cases were found. Adult cases occupy 15.1% of the total cases consisting of 24.5% of acyanotic and 19.9% of cyanotic group. Over all operative mortality of adult cases was 6.8% compared with 12.4% of total cases. Left over congenital cardiovascular anomalies in Korea can be safely operated at the present time. The oldest operated patient among adult congenital cardiovascular anomalies was 57 years old female atrial septal defect case. For 1162 cases open heart surgery bubble oxygenators were utilized except 2 membrane oxygenators. Various kinds of bubble oxygenators have been used but recently Shiley**** oxygenators are being used exclusively with satisfactory results.